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Prediabetes In Rural Primary Care: Screening, Diagnosis And Treatment, Rebecca M. Bodle-Shingu

Doctor of Nursing Practice

Background

Prediabetes affects one in three US adults. Over 80% of individuals with prediabetes are unaware of having the condition. Evidence-based clinical practice guidelines (CPG) recommend screening adults 35 to 70 years old with a BMI of 25 or higher. Prediabetes treatment consists of lifestyle modification, referrals to nutrition counseling, and metformin for individuals who cannot make lifestyle changes. Diagnosis and treatment of prediabetes reduces the risks or delays the progression to type 2 diabetes.

Purpose

The purpose of this DNP quality improvement project was to impact primary care providers beliefs, knowledge, and practices in identifying, diagnosing, and treating …

Improving Glycemic Management Of The Inpatient Adult With Diabetes Mellitus Through The Development Of A Bedside Decision Support Tool For The Medical-Surgical Floor Nurse, Robin Deville Guidry

Doctor of Nursing Practice Final Project Abstract

Background: Uncontrolled blood sugar can lead to adverse events in the adult perioperative inpatient population. Hyperglycemia can lead to diabetic ketoacidosis (DKA), infection, delayed wound healing, increased hospital lengths of stay (LOS), and even mortality. Uncontrolled hypoglycemia can result in confusion, seizures, and even coma.

Purpose: This single-PDSA-cycle quality improvement project aimed to prevent and/or minimize the duration of uncontrolled blood sugar in the peri-operative adult inpatient. The primary objective was to reduce the incidence of hyperglycemia defined as >180 mg/dL by at least 10% from baseline with a goal rate of less than 25%, while also reducing the incidence …

Improving Nurse Confidence Around Communication With Physician Partners Through The Caritas Processes, Deborah M. Yracheta

Doctoral Projects

Nurses are the eyes and ears at the bedside during a patient’s hospital stay. They are responsible for communicating significant changes in a patient’s health status, mainly to their physician partners. Unfortunately, good communication between nurses and doctors is a shortcoming of the nursing profession. Seven thousand reviewed malpractice lawsuits were directly related to poor provider communication, resulting in $1.7 billion in malpractice cases and 2,000 preventable deaths. These communication errors also lead to prolonged hospital delays in care, underscoring the need for improved communication. These poor outcomes compromise patients’ lives, safety, and well-being and decrease patient satisfaction scores, ultimately …

Sexual And/Or Gender Minority (Sgm) Stigma Within Nursing Schools: The Relationship Between Stigmatic School Attributes, Minority Stressors, And Sgm Nursing Student Mental Health, Michelle Gee

Dissertations

Nursing education is heteronormative and cis-normative, which has been correlated to stigma and ignorance exhibited by nurses towards sexual and/or gender minorities (SGM). Minority Stress Theory (MST) states that circumstances in the environment that promote stigma related to minority identities lead to unique minority stressors, such as discrimination. These minority stressors subsequently affect mental health. While it is known that SGM patients experience mental health issues that relate to stigma and discrimination in healthcare settings, nothing is known about SGM nursing students dealing with stigma and discrimination within nursing education. The aim of this descriptive correlational study was to inform …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

The Lived Experience Of New Graduate Nurses Implementing Evidence-Based Practice In A Clinical Setting, Kimberly A. Mcfarland

Electronic Theses and Dissertations

The purpose of this qualitative interpretive phenomenological analysis study was to explore the perceptions and lived experiences of new graduate nurses (NGNs) as they implemented evidence-based practice (EBP) in clinical settings. This study addressed the problem that NGNs often lack the skills and confidence to effectively apply EBP, despite its critical role in improving patient outcomes. The research aimed to provide insight into the challenges, support systems, and strategies that influence EBP integration during the transition from student to practicing nurse. The study utilized the interpretive phenomenological analysis methodology to analyze data collected through semistructured interviews conducted via the Teams …

Impact Of Education For Bedside Nurses In A Community Hospital To Increase Intent Or Utilization Of A Career Ladder Advancement Tool, Carrie E. White

Doctoral Dissertations and Projects

This scholarly project is centered on lack of engagement in a new career ladder program. This project includes the creation of career ladder education with an intent to help with understanding, support, and engagement of the nursing caregivers. Education was created to propel the work of the career ladder within a small rural hospital. The program is 12 weeks long and covers eligibility criteria, activity details, technology education, and one-on-one support for understanding of the career ladder program. The hopes for the educational program were to increase nursing satisfaction, with the intent to stay with the organization, and foster participation …

What Do Safety And Risk Mean To Women Who Choose To Birth At Home? A Systematic Review, Candice Chauncy, Kate Dawson, Sara Bayes

Research outputs 2022 to 2026

Introduction: Despite clear evidence to support the safety and efficacy of homebirth, the concept challenges the almost universal belief that hospital is the safest place to give birth. Homebirth remains largely unsupported around the world due to prevailing beliefs and constructs surrounding risk and safety. Despite barriers to access, women continue to choose home as a place to birth. Methods: A systematic review of qualitative research was conducted to explore and understand women's views on what constitutes risk and safety in labour and birth for those who choose to birth at home. All studies were evaluated for quality and relevance. …

Twenty-One Year Trends In Pressure Injury In A Western Australian Hospital, Linda L. Coventry, Istvan Kabdebo, Nicole Walsh, Joelle Winderbaum, Mark Jenkins, Prachi Kaistha, Diane E. Twigg, Shirley Jansen, Dimitri Beeckman

Research outputs 2022 to 2026

No abstract provided.

Factors That Influence International Nursing Students’ Experiences And Perceptions Of Their Learning Environments: A Scoping Review, Fatch Welcome Kalembo, Sally Wilson, Terena Solomons, Irene Ngune, Eric Lim, Anna Bosco, Paul Kebble, John Taplin, Janie Brown

Research outputs 2022 to 2026

Objective: The objective of this review was to explore factors that influence international undergraduate nursing students’ experiences and perceptions of their learning environment. Introduction: In the past 2 decades, international student enrollment in tertiary education increased globally, with English-speaking countries such as Australia, Canada, the United Kingdom, and the United States attracting a significant majority of these students. Many of these international students are attracted to studies in health professions and related sciences, particularly nursing. Despite their economic and cultural contributions to the host country, international nursing students face numerous challenges that affect their learning experiences. Inclusion criteria: Peer-reviewed studies …

Implementation Of Houdini Guidelines Nurse-Driven Protocol To Lower Catheter-Associated Urinary Tract Infections And Foley Utilization Days, Tammie N. Collins

Electronic Theses and Dissertations

Catheter-associated urinary tract infections are a common issue in healthcare settings. These issues contribute to hospital-acquired infections and can lead to complications and increased healthcare costs. The quality project evaluated the impact of the HOUDINI guidelines nursedriven protocol to reduce infection rates and Foley utilization days. A structured guideline for Foley catheter safe removal was implemented using a quantitative method. Catheter-associated urinary tract infection rates and Foley utilization days pre- and postintervention were tracked. Data were collected using the electronic health records, infection control data sheets, and the HOUDINI checklists. A baseline assessment of catheter-associated urinary tract infections rates was …

An Exploration Of Bedside Critical Care Nurses’ Attitudes Towards The Teleicu, Theresa Marie Drucker

Theses & Dissertations

Background

Acute care facilities are seeing an increased demand for critical care resources, given the increasing aging population with more complex health problems, retiring healthcare professionals, and subsequent decreasing supply of new expertise (Shahpori et al., 2011). Telehealth in the ICU is a valuable resource that some hospitals have employed to bridge this gap. The use of the teleICU has been associated with improved outcomes for patients (Williams et al., 2019), and reduction in failure to rescue (FTR) events. Despite the increasing availability of teleICU programs and the associated potential benefits, there continue to be inconsistencies in terms of usage …

The Lived Experience Of Women Who Have Experienced Intimate Partner Violence In Trinidad And Tobago, Lyris Antoinette Greenidge

Theses & Dissertations

Background: Intimate partner violence (IPV) is an increasing public health issue worldwide and is predominantly committed by males against females. One in every three women worldwide has experienced IPV (World Health Organization [WHO], 2024). The Pan American Health Organization studied IPV in 12 Latin American and Caribbean countries (Bott et al., 2019), and the Republic of Trinidad and Tobago was included. At the inception of this study in 2018, the prevalence and effect of IPV, though captured in the media by Fraser (2014) and others, were recognized as a widespread monumental problem in Trinidad and Tobago. However, it appeared to …

Building Health Policy Advocacy Expertise In Pediatric Nurse Practitioners Through Civic-Based Experiential Learning, Christine A. Schindler, Jill C. Kuester, Jennifer K. Pfister, Katie L. Mcdermott

College of Nursing Faculty Research and Publications

Background:

Many nurses work largely as policy implementers rather than policy developers. The literature posits several multifaceted reasons for this lack of policy acumen including interprofessional power dynamics, marginalization of nurses in policy making, and lack of formal training in public policy advocacy.

Purpose:

To evaluate the impact of a targeted teaching strategy on increasing political astuteness, perceived skill, and comfort in health policy advocacy among a cohort of acute care pediatric nurse practitioner students.

Methods:

Curriculum assessment data were collected using the Political Astuteness Inventory, pre- and postclass discussions, and written reflections.Results: This curriculum evaluation suggests that specific policy …

The Impact Of Covid-19 During The First Two Years: Giving Voice To Pediatric Nurses, Karen S. Gralton, Kathryn J. Malin, Eileen Sherburne, Danielle Smith, Stacy Wenner, Julie Averbeck, Amy Newman, Anita Norton, Genesee Hornung, Karen Kavanaugh

College of Nursing Faculty Research and Publications

Purpose

The purpose of this study was to describe the experiences of pediatric nurses providing direct care in a variety of settings during the first two years of the COVID-19 pandemic.

Design and methods

This was a qualitative descriptive study. Donabedian's Quality Framework for the Evaluation of Healthcare was used to guide the design. Purposive sampling was used to recruit 24 direct care nurses from inpatient and outpatient settings within one healthcare system. Semi-structured, audio-recorded interviews were conducted in-person or via a virtual platform from November 2021 through March 2022.

Results

Four major themes were determined across all settings and …

Polypharmacy And Pharmacogenomics In High-Acuity Behavioral Health Care For Autism Spectrum Disorder: A Retrospective Study, Sheldon R. Garrison, Sophie A. Schweinert, Matthew W. Boyer, Maharaj Singh, Sreya Vadapalli, Jeffery M. Engelmann, Rachel A. Schwartz, Madeline M. Hartig

College of Nursing Faculty Research and Publications

Background

This study evaluated pharmacogenomic (PGx) testing in children and adolescents with autism spectrum disorder (ASD). ASD frequently presents with co-occurring depression and anxiety. This complex phenotype often results in psychotropic medication polypharmacy. Incorporating PGx testing into the medical work-up may reduce polypharmacy and improve quality of life with symptom reduction.

Methods

A retrospective electronic health record (EHR) review between January 2017 and May 2023. Individuals either received PGx testing or treatment as usual (TAU). The co-primary outcomes were instance of polypharmacy and the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Secondary outcomes included length of stay, average …

Open-Label Randomized Controlled Trial And Feasibility Study Of An Oral Probiotic Intervention To Reduce Group B Streptococcus Colonization In Pregnant People By The Time Of Birth, Katrina Nardini, Lisa Hanson, Noelle Borders, Maharaj Singh, Anna Shields, Victoria Y. Trujillo, Robyn Lawton, Emily Malloy

College of Nursing Faculty Research and Publications

Introduction

The purpose of this midwife-led study was to determine the feasibility of a randomized controlled trial (RCT) of probiotics to reduce group B Streptococcus (GBS) colonization by the time of birth in healthy, GBS-positive, pregnant adults.

Methods

An open-label randomized clinical trial comparing Florajen Digestion, a commercially available combination oral probiotic, with usual care (ClinicalTrials.gov NCT04721912) was conducted in a midwifery practice serving a racially and ethnically diverse population. Eligible patients who tested positive for GBS at routine third-trimester screening were offered informed consent and participation. The primary outcome was feasibility for a larger RCT, including feasibility of probiotic …

Participant Personal Characteristics And Adherence To Oral Capsules: A Secondary Analysis Of A Randomized Placebo-Controlled Trial Of Antenatal Probiotics, Lisa Hanson, Kathlyn Albert, Emily Malloy, Maharaj Singh, Mikala Kallay, Ava Brandt, Courtney Morris, Diana Kleber, Marie Forgie

College of Nursing Faculty Research and Publications

Background

Adherence to study interventions is critical to the conduct of randomized controlled trials (RCTs). The relationships between participant characteristics and intervention adherence are understudied in pregnant populations. The purpose of this study was to conduct a secondary analysis of adherence to study capsules in a double-masked, placebo-controlled RCT of a probiotic intervention to reduce antenatal Group B Streptococcus colonization, in relationship to participant characteristics.

Methods

We analyzed the relationship between capsule adherence rates and demographic characteristics among 81 RCT participants. Categorical variables were reported using counts and percentages, and continuous variables were expressed as means along with their standard …

Transformative Learning In Homebirth Settings: A Reflexive Thematic Analysis Of Midwifery Students' Experiences, Kate Buchanan, Sara Morris, Sara Bayes, Clare Davison

Research outputs 2022 to 2026

Background: The homebirth setting provides opportunities for midwifery students to witness autonomous midwifery practice, but these experiences are limited. Factors that limit practicum placement in the home birth setting are either logistical, with less than one percent of women having a homebirth in Australia or related to university governance, whereby approval is not granted for midwifery students attending homebirth. Objectives: To explore midwifery students' experiences in the homebirth setting and to determine how this has influenced understandings of the role and scope of practice the midwife. Methods: Qualitative methods were chosen to inform this study. Setting: A University that offers …

Indirect Evidence Of Sex-Selective Abortion Practices To The Imbalanced Sex Ratio At Birth In Australian Migrant Populations, Amanuel Tesfay Gebremedhin, Gizachew A. Tessema, Ravisha Srinivasjois, Judith A. Daire, Kevin A. Chai, Bereket Duko, Kalayu Brhane Mruts, Gavin Pereira

Research outputs 2022 to 2026

A skewed sex ratio at birth (SRB), commonly observed in countries with high son preference can be attributed to prenatal sex-selective abortion. However, the possibility of sex selection among migrants in high-income countries has received little attention. Our study aims to identify the indirect evidence of sex-selective abortion practices to the SRB imbalance in a large Australian cohort. Our study aims to identify the indirect evidence of sex-selective abortion practices to the SRB imbalance in a large Australian cohort. In this population-based study, perinatal data were obtained from all registered births in Western Australia (WA) and New South Wales (NSW) …

Relationship Between Mental Health Education And Nurse Preparedness, Deborah C. O'Dell

Doctoral Dissertations and Projects

This quantitative study was to see if there was a relationship between the type of Mental Health education undergraduate nurses received or the number of Mental Health clinical days they experienced and how prepared they were to care for Mental Health Consumers (MHCs) when they first were employed. This information had never before been studied, so had the potential to change nursing curriculum and provide better care for MHCs. An anonymous survey using the Behavioral Health Care Competency’s questions was used and an invitation to participate was placed on various nursing discussion forums and social media sites. Participants (n = …

Nursing Faculty Experiences Of Teaching Dementia Care: A Transcendental Phenomenological Study, Jeannie Simpson

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the experiences of nursing faculty teaching dementia care to nursing students in Texas. The theory guiding this study was Kolb’s experiential learning theory as it offers a structured framework for examining how experiences lead to learning. This theory also introduced the concept of the Experiential Educator profile, specifically delineating the role of educators in facilitating knowledge acquisition (Kolb, 2014). This study bridged the gap in existing literature regarding the experiences of nursing faculty in teaching dementia care to nursing students and provided a comprehensive look at dementia education in nursing schools. …

A Quantitative Study Teaching De-Escalation With Virtual Reality Simulation To Associate Nursing Students Measuring Effectiveness, Learning, And Confidence, Michele Rene Marbet

Doctoral Dissertations and Projects

Workplace violence against nurses is a critical global public health issue, as one in four nurses reportedly experience physical assault by patients. This quantitative quasi-experimental, pretest-posttest study aimed to assess the effectiveness of virtual reality simulation as a teaching strategy for de-escalation education in associate nursing students’ (N = 29) perception in learning and confidence. The study utilized the Simulation Effectiveness Tool-Modified (SET-M) instrument to measure outcomes guided by Kolb's experiential learning theory and the NLN Jeffries simulation theory. The learning variable demonstrated significant improvement as confirmed by paired t-test analysis (p < .01). For the effectiveness and confidence variables, which violated assumptions of normality, a comprehensive statistical approach was implemented. Analysis included parametric testing via paired t-tests, supplemented by nonparametric methods (Wilcoxon Signed-ranks test and Sign test) to ensure statistical rigor. The cumulative results across all three statistical tests consistently demonstrated significant improvements (p < .001). Effect size calculations revealed medium to large significance for all variables measured by Cohen’s d. The conclusive findings of this research included a rejection of all three null hypotheses, which suggests that virtual reality simulation is an effective teaching strategy for developing de-escalation skills, enhancing both learning and confidence among associate nursing students. Future studies are needed to further validate and expand upon the findings of the current research, potentially leading to more widespread adoption of virtual reality simulation in nursing education for teaching de-escalation.

Contrasting Patients' And Healthcare Professionals' Experience In Hematological Cancer Care Pathway: A Narrative Study, Karine Bilodeau, Cynthia Henriksen, Camilia Aloisio Alves, Charlotte Gélinas-Gagné, Lynda Piché, Jacinthe Pepin, Virginia Lee, Marie-France Vachon, Nathalie Folch, Marie-Pascale Pomey, Nicolas Fernandez

Patient Experience Journal

Hematological cancers represent 10% of cancers diagnosed in Canada. Treatments involve complex care pathways and various modalities as well as the management and monitoring of multiple side effects. There is limited understanding of these pathways from the perspectives of the people living with cancer (PLC) and the healthcare professional (HCP). The aim of this article is to contrast the experiences of PLCs and HCPs in the context of hematological cancer care pathway. Narrative study approach was chosen for this exploratory study. Twenty-one narratives were co-created with PLCs (n = 12) and HCPs (n = 9). A structural and comparative analysis …

Experiences Of Women In The Labour Room: The Untold Story, Emmanuel Dziwornu, Belinda Kpodo, Ophelia Anarfi, Enyonam Afi Adzato, Anita Fafa Dartey

Patient Experience Journal

Background: Childbirth experiences are some of the most sensitive indicators of the utilisation of health facilities. Women who go through the child-birthing process are reported to be faced with a range of experiences. Aim: This study described women's experiences in the labour room. Methods: The study employed a qualitative research approach with a descriptive design. Purposive sampling was used in this study and data saturation was reached after the 18^th participant. In-depth interviews were used to obtain information from recently delivered women. Interviews were audio recorded and transcribed verbatim. Thematic content analysis (TCA) was done and the results were …

Social Determinants Of Health Screening In The Pediatric Population: Evaluating The Effectiveness Of Staff Education, Brenda Awuah, Kansas S. Logan, Sally Humphrey Dnp, Aprn, Cpnp-Pc, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Social Determinants of Health (SDOH) are conditions that influence health outcomes. SDOHs are screened and addressed in many clinics and hospitals to reduce patients' social needs. Research indicates how unaddressed SDOH can negatively impact chronic illness, along with the daily life of pediatric patients. SDOH's role in pediatric patients includes food security, housing stability, access to healthcare, caregiver education, and parental mental health. Previous research has addressed these factors; however, the lack of staff education prevents effective compliance and follow-up on SDOH screening. Challenges remain in implementing and integrating SDOH into routine well-child visits. This scoping review will evaluate and …

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …

Staff Education On The Use Of The Teach-Back Method To Decrease Nonadherence To Psychotropic Medications Among Inmates, Moradeke Okunoye

Walden Dissertations and Doctoral Studies

This staff education project focused on improving nurses’ and mental health clinicians’ knowledge about the teach-back method (TBM) to improve psychotropic medication adherence. The practice problem was psychotropic nonadherence among inmates in a county jail in the Southeast region of the United States. The practice project question for this project was the following: For nursing staff and mental health clinicians in the jail, will training on the use of the TBM increase knowledge toward the goal of decreasing nonadherence to psychotropic medications among inmates? Psychotropic nonadherence is a significant issue in the jail that can lead to serious consequences including …

Impact Of Medication Opioid Use Disorder (Moud) Programs In Emergency Departments, Mechelle A. Zima

Nursing Capstones

The purpose of this paper is to provide a discussion of how a medication opioid use disorder (MOUD) programs integrated into the emergency department (ED) can improve patient’s outcomes compared to standard ED discharges. This study utilized a systematic literature review using PubMed, CINAHL and Google Scholar. The initial literature search identified 594 articles. After applying the predefined inclusion and exclusion criteria, 18 articles were selected. Inclusion criteria included peer reviewed articles that focused on opioid use disorder (OUD) patients treated in the ED with OUD medications while exclusion criteria involved articles with OUD patients treated in ED without OUD …

Staff Education On Evidenced-Based Approaches To Lifestyle Modification Teaching For Diabetic Patients, Chinenye Acho

Walden Dissertations and Doctoral Studies

A notable gap existed in the healthcare staff's knowledge of evidence-based lifestyle modifications for patients with diabetes within outpatient internal medicine (OP IM) settings. The increasing prevalence of Type 2 diabetes emphasizes the urgent necessity for a structured educational framework to enhance staff understanding. In this project, I evaluated the efficacy of organized staff education in enhancing healthcare providers' confidence related to diabetes management. I conducted a thorough literature analysis and identified 18 peer-reviewed studies classified according to the Johns Hopkins Evidence-Based Practice Model. The findings reveal that Diabetes Self-Management Education and Support (DSMES) programs are associated with significant reductions …