Digital Commons Network^™

Reducing Maternal Morbidity From Peripartum Hemorrhage In Cesarean Delivery, Jennie Lee

Dissertations

Background/Purpose: Maternal hemorrhage is the second highest cause of direct maternal death and the leading cause of morbidity and mortality in the United States. This public health crisis is highlighted by the economic burden of over $30.8 million annually in the United States. The greatest tragedy in the review of maternal mortality is that 84% of pregnancy-related deaths were determined preventable. Identifying trends of factors that predispose women to hemorrhage can mitigate rates of severe maternal morbidity and mortality. This study describes relationships among demographic factors (maternal age, race, and ethnicity), clinical and physiologic factors, which include coexisting medical conditions …

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Improving Obesity And Related Chronic Disease Outcomes: Developing Nurse Practitioner Competence In Motivational Interviewing, Jodi Wilson

Doctor of Nursing Practice Final Manuscripts

Background: Despite America’s persistent focus on health, over 40% of the US population is obese. A significant obstacle to mitigating disease in those with obesity is inspiring lasting behavioral change. Motivational Interviewing (MI) is highly effective yet under-utilized for catalyzing personal change inertia. Recent meta-analyses demonstrated statistically significant improvement in BMI, A1C, and blood pressure. Objectives: This evidenced-based project (EBP) aimed to develop nurse practitioner (NP) skills in deploying fidelity-based MI, resulting in increased adherence to lifestyle interventions. Implementation: This EBP project implemented MI into routine primary care through a self-paced healthcare provider MI certification and a 45-minute skill …

Reducing Inpatient Falls Utilizing Multimodal Standardized Patient Education: An Evidence-Based Practice Project, Sheryl Almandrez

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: This project aims to utilize multimodal standardized patient education as an evidence-based practice intervention to reduce inpatient falls.

Background: In 2022, Kaiser Foundation Hospital (KFH) San Diego had 116 falls. Inpatient falls with injury account for the second-highest Joint Commission (TJC) sentinel event and California Department of Public Health (CDPH) adverse events. These injuries include lacerations, subdural hematoma, subdural hemorrhage, hip fractures, and wrist fractures. The Centers for Medicare and Medicaid Services (CMS) have also stopped reimbursing hospitals for the care provided after patients have sustained a fall with injury.

The project was implemented at KFH-San Diego …

Implementing An Abnormal Involuntary Movement Scale At An Outpatient Mental Health Clinic, Amanda Ghamsari

Doctor of Nursing Practice Final Manuscripts

Background: Movement disorders caused from psychotropic medications affect an estimated 500,000 people in the United States. These disorders bring an added cost for treatment to the patient, cause emotional distress, and may hinder daily life. Overall health and additional medication costs were increased for these patients by $25,879 per patient per year compared to patients without a movement disorder.

Purpose of Project: To address the issue, the team of mental health providers at an outpatient clinic assess their mental health patients at start of care and at follow up visits utilizing the Abnormal Involuntary Movement Scale. With the goal of …

Improving Hypertension Outcomes In A Rural Community With The Use Of Remote Patient Monitoring, Jessica Ruiz Cuen

Doctor of Nursing Practice Final Manuscripts

Hypertension (HTN) remains one of the leading causes of premature death. Uncontrolled HTN is known as the “silent killer,” affecting 1.28 billion adults worldwide. Management of this chronic disease requires early detection, intervention, and, most importantly, patient involvement. Recent advancements in Telehealth medicine have identified Remote Patient Monitoring (RPM) as an essential avenue in managing HTN. This project aimed to improve patient outcomes by reducing blood pressure readings and emergency room visits. This evidence-based project used the Iowa Model and examined the effects of daily remote blood pressure measurements using the transmission of biometric data using a Bluetooth-operated device linked …

Implementation Of Controlled Substance Agreements In An Adult Outpatient Psychiatric Clinic, Bryana Weimer

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project was to evaluate the clinical applicability of Controlled Substance Agreements (CSAs) in the adult outpatient psychiatric clinical setting. The first goal was to determine the frequency of Controlled Substance Agreement (CSA) utilization. The second goal was to identify potential outcomes associated with the implementation of CSAs, such as improved monitoring practices. Finally, this project aimed to evaluate provider perception of the efficacy of CSAs.
Background: The misuse and diversion of prescribed controlled substances contribute significantly to addiction and fatalities nationwide. Prescription psychotropics are the second most …

Impact Of Mindfulness Education And Resources On Stress In Parents Of Children With Autism Spectrum Disorder, Jacqueline James

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to reduce stress levels of parents of children with autism spectrum disorder (ASD) by teaching them mindfulness practices and education on free and accessible methods to integrate mindfulness into their daily lives, as well as the benefits of mindfulness in reducing stress and improving psychological well-being.

Parents of children with ASD experience high levels of stress and numerous research studies support the use of mindfulness techniques to reduce stress levels in adults. The participants in this project included mothers who have at least one child with ASD who attend the Thompson Autism and Neurodevelopmental …

Keep Our Children Smiling: Fluoride Varnish Education In The Pediatric Primary Care Setting, Isabella Mortola

Doctor of Nursing Practice Final Manuscripts

Background: Dental caries is the most common chronic childhood disease. In early childhood, it is associated with many negative factors such as pain, loss of teeth, and impaired growth. Fluoride varnish (FV) is a protective resin coating treatment that is reimbursable by most insurances and is recommended by the American Academy of Pediatrics (AAP), United States Preventative Services Task Force (USPSTF), and the American Dental Association (ADA) due to its high efficacy in preventing dental caries. FV is a low-cost treatment that can be easily applied in 1-2 minutes during a well-child visit in the primary care setting, where children …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

Assessing The Influence Of Education And The Diet Readiness Test On Self-Efficacy, Motivation And Resilience In Overweight Women, Ijeoma Iwu

Doctor of Nursing Practice Final Manuscripts

Purpose

The purpose of this evidence-based project is to assess motivation for weight loss and resilience to make lasting changes with weight management. The Diet Readiness Test (DRT) Questionnaire is a behaviorally based assessment tool used to evaluate psychological status prior to or during a weight-loss management program based on patients’ attitudes toward diet and exercise. The goal of using this survey was to identify predictive factors of successful weight changes for practitioners to implement into their approach to tackling obesity.

Background

One of the rising crises both in the United States and globally has been the topic of obesity. …

Lived Experiences Of Quality Of Life Among Makonde Immigrants In Kenya During And After The Covid-19 Pandemic, Shem Migosi Kenyanya

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic affected Makonde immigrants’ health and quality of life around the world more than any other previous event. This descriptive qualitative study aimed to contribute knowledge and understanding of the lived experiences of Makonde immigrants and their health and quality of life during and after the COVID-19 pandemic. Shye’s systematic quality of life model served as the theoretical basis for the study, along with Wilson and Cleary’s conceptual model of health quality of life. Semi-structured interviews were conducted with ten participants recruited through social media and flyers posted in Kilifi and Kwale counties. Subjects were interviewed face-to-face and …

Clinical Nurse Manager Fatigue And Its Personal And Professional Impacts, Carlene Galanopulo

Walden Dissertations and Doctoral Studies

Workplace fatigue has been empirically linked with errors, injuries, and chronic health issues that negatively impact the healthcare worker, patients, and staff with whom that person comes in contact, as well as the organization for which that person works. The experience of fatigue in clinical nurse managers (CNMs) has been understudied. The purpose of this study was to understand the individual experience of fatigue and its professional and personal impacts as more fully described by CNMs. The research question that guided this study involved the professional and personal impact of fatigue as described by CNMs. The occupational fatigue in nursing …

Challenges And Opportunities In The Uptake Of Simulation In Healthcare Education In The Developing World: A Scoping Review, Faisal Wasim Ismail, Khairulnissa Ajani, Syed Mujtaba Baqir, Ahmed Nadeem, Rayyan Qureshi, Pammla Petrucka

Centre for Innovation in Medical Education

Background: Simulation is increasingly being adopted by healthcare educators throughout the developed world as it offers a safe environment to practice skills. While there is literature on learning via simulation in healthcare in the developed world, more studies are required to investigate the factors influencing this approach in the developing world.
Objective: This scoping review highlights the key factors that act as deterrents as well as encouragement to the uptake of simulation as a teaching methodology in healthcare education in developing countries.
Design: The MEDLINE (via OVID, using keywords and MeSH in OVID), and PubMed (via NCBI using MeSH), and …

Short- And Long-Term Predicted And Witnessed Consequences Of Digital Surveillance During The Covid-19 Pandemic: Scoping Review, Leigha Comer, Lorie Donelle Phd, Rn, Fcan, Bradley Hiebert, Maxwell J. Smith, Anita Kothari, Saverio Stranges, Jason Gilliland, Jed Long, Jacquelyn Burkell, Jacob J. Shelley, Jodi Hall, James Shelley, Tommy Cooke, Marionette Ngole Dione, Danica Facca

Publications

BACKGROUND: The COVID-19 pandemic has prompted the deployment of digital technologies for public health surveillance globally. The rapid development and use of these technologies have curtailed opportunities to fully consider their potential impacts (eg, for human rights, civil liberties, privacy, and marginalization of vulnerable groups). OBJECTIVE: We conducted a scoping review of peer-reviewed and gray literature to identify the types and applications of digital technologies used for surveillance during the COVID-19 pandemic and the predicted and witnessed consequences of digital surveillance. METHODS: Our methodology was informed by the 5-stage methodological framework to guide scoping reviews: identifying the research question; identifying …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Addressing Farm Safety: Farm Safety Dinner Theaters In The Shenandoah Valley, Tammy Kiser, Michelle Seekford, Jeremy Daubert

Virginia Journal of Public Health

Statistics demonstrate that farm safety and wellness issues affect all ages in the agricultural community. However, an increased proportion of youth and older farm workers comprise the highest rates of farm-related morbidity and mortality. Engaging farmers in increasing safe practices in the agricultural community is an important, ongoing challenge.

Methodology

Farm Safety Dinner Theaters, an initiative created through community-based participatory research (CBPR) at the University of Kentucky, provide a relaxed environment where farmers and their families can identify safety and wellness issues, watch as the actors process these issues, and enjoy a meal. Seeing the situations played out in theater …

Enhancing Community Engagement: Perspectives From Researchers, Community Members, And Service Providers, Anne-Marie O'Brien, Elyssa Wood

Virginia Journal of Public Health

Purpose: Compare and contrast perspectives from Research Team Members (RT), Community Members (CM) and Service Providers/Others (SP/O) about barriers and facilitators to community engagement and participation in health research.

Methods: A cross-sectional, descriptive survey study with a convenience sample of adults who lived and/or worked in the Commonwealth of Virginia was conducted between May and July 2022. Descriptive statistics and chi-square analyses were conducted to identify similarities and differences across the three stakeholder groups.

Results: A total of 303 participants were involved in this study. In general RTs, CMs and SP/Os were similar in their responses to perceived barriers and …

Evaluating The Implementation Of Biplane Ultrasound Probes For Guided Peripheral Intravenous Access In The Emergency Department, Ian Troupe

Doctor of Nursing Practice Final Manuscripts

Background: Single plane ultrasound (US) probes are currently standardized for initiating US guided peripheral intravenous (USGPIV) access for difficult intravenous access (DIVA) patients in the emergency department (ED). Emerging literature reveals the increased efficacy of biplane US probes for USGPIV access with an improved success rate of up to 36.6%.

Purpose of Project: Implement best practice recommendations by integrating one biplane US probe for USGPIV access at a Level 1 Trauma Center ED in Southern California after training ten registered nurses (RN) on its use. The project aimed to improve patient outcomes, department flow, RN education, and utilization …

Implementation Of Post-Operative Discharge Instructions To Outpatients In A Pre-Procedural Endoscopy Suite Prior To Sedation, Kalaya Valdez

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project is to improve overall patient satisfaction scores, patient safety and education retention postoperatively. The aim is to provide patients with the opportunity to review their discharge instructions and seek clarification prior to their procedure.

Background: Roughly 75 million endoscopies are conducted annually in the United States. The majority, 68%, are gastrointestinal endoscopies. Routine endoscopy procedures such as a colonoscopy or esophagogastroduodenoscopy utilize moderate sedation which is often a combination of midazolam and fentanyl. This combination reduces anxiety and discomfort during the procedure. The amnesic effects …

Improved Pediatric Icu Mortality Prediction For Respiratory Diseases: Machine Learning And Data Subdivision Insights, Johayra Prithula, Muhammad E H Chowdhury, Muhammad Salman Khan, Khalid Al-Ansari, Susu M Zughaier, Khandaker Reajul Islam, Abdulrahman Alqahtani

Faculty, Staff and Student Publications

The growing concern of pediatric mortality demands heightened preparedness in clinical settings, especially within intensive care units (ICUs). As respiratory-related admissions account for a substantial portion of pediatric illnesses, there is a pressing need to predict ICU mortality in these cases. This study based on data from 1188 patients, addresses this imperative using machine learning techniques and investigating different class balancing methods for pediatric ICU mortality prediction. This study employs the publicly accessible "Paediatric Intensive Care database" to train, validate, and test a machine learning model for predicting pediatric patient mortality. Features were ranked using three machine learning feature selection …

Improving The Utilization Of Lunch Breaks For Nursing Staff, Norma Dawson, Kelsey Robinson, Bridget Miller, Deborah Monck, Beth Kessler

Operations Transformation

The Med-Surg Unit at LincolnHealth has a high number of nursing staff missing lunch breaks, despite encouragement and existing efforts to promote taking breaks. In addition, there are many instances where staff are not accounting for the breaks they have taken on their time sheets.

Adapting To Change: Adn Faculty Perspectives About The Future Of Adn Education: A Qualitative Case Study, Linda D. John

Doctoral Dissertations and Projects

The purpose of this qualitative, single case study was to offer more insight into how the adoption of the BSN as the entry-level for nursing practice affects the future ADN education and what the change means for ADN faculty at multiple programs throughout regions of the United States. Eleven ADN faculty were sampled to acquire their perspective about this phenomenon. Semi-structured, open-ended interviews enabled data collection. Rogers’ diffusion of innovation theory (DIT) facilitated an understanding about how ADN faculty are responding and adapting to the anticipated educational change. The central research question asked, “What is the perspective of ADN faculty …

The Impact Of Reporting Patient Safety Events: An Integrative Review, Catherine M. Amitrano

Doctoral Dissertations and Projects

Since the 1999 Institute of Medicine landmark report, To Err is Human, leading organizations such as the Agency for Healthcare Research and Quality have been working with healthcare leaders to reduce patient harm. A problem in healthcare is errors continue to occur at alarming rates. The COVID-19 pandemic impacted patient safety efforts and organizations are trying to get to pre-pandemic patient safety progress. The purpose of this integrative review was to review and evaluate individual research studies on patient safety event reporting and summarize what is known about the topic in terms of how patient safety event reporting impacts patient …

Improving The Socio-Emotional Competence Of Academic Nurse Educators: An Experimental Study, Helen Freeman

Doctoral Dissertations and Projects

An academic nurse educator with a high level of socio-emotional competence (SEC) can create an inviting learning environment that promotes the highest level of achievement from students. The purpose of this two-group pretest-posttest experimental study was to determine the extent of effectiveness of socio-emotional intelligence education and a reflection-guided professional development plan in improving the socio-emotional competence of academic nurse educators. The Bar-On emotional social intelligence (ESI) conceptual model and the Purkey invitational theory were frameworks used to guide the study. The Emotional Quotient Inventory (EQ-i 2.0) was used as the data collection instrument to measure the pretest and posttest …

The Experience Of Nursing Faculty In Uganda Integrating Technology In The Classroom: A Phenomenology Study, Catherine Nankanja

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the lived experiences of nursing faculty in integrating digital technology in the classroom in Uganda. Technology penetration in Uganda, a developing country, is still minimal and as a result little is known about impact of digital technology integration in the nursing education. This study was guided by this central research question: What is the experience of nursing faculty in Uganda in integrating digital technology in the classroom? There were four other sub-questions. The study was founded on the connectivism learning theory, which emphasizes leveraging digital technology in education. However, to …

Faith-Based Intervention To Prevent Adolescent Self-Injury: An Integrative Review, Adekemi O. Akinyemi

Doctoral Dissertations and Projects

This integrative review explores the efficacy of incorporating faith-based (Christian/spiritual) interventions within the framework of Dialectical Behavior Therapy (DBT) to prevent non-suicidal self-injury (NSSI) among adolescents aged 11-19. As the prevalence of NSSI among this demographic group continues to rise, understanding the potential benefits and challenges of integrating faith-based components into evidence-based therapeutic approaches is crucial. The review synthesizes existing literature, drawing on empirical studies, theoretical frameworks, and clinical evidence to assess the impact of faith-based integration in DBT. Through a comprehensive analysis of diverse sources (e.g. CINAHL, PubMed, PsycINFO, NIH) this review was able to shed light on the …

Do More Than Train New Nurses...Retain Them! A Qualitative Research Study, Kerrin L. Hampton

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study is to understand the orientation experiences of new graduate nurses and identify retention practices that are relevant and beneficial to the population of interest. Study participants were new graduate nurses employed at a five-hospital healthcare system. Using social constructivism as the theoretical framework, the study sought to answer the research question of what are the lived experiences of new graduate nurses during orientation? Ten new graduate nurses participated in individual interviews to discuss their personal orientation experiences. The interviews informed the researcher regarding the meaning and value new graduates place on their orientation …

Facilitator Ethnicity And Clinical Judgement Among Senior Minority Students Using Unfolding Case Studies, Rachael King

Doctoral Dissertations and Projects

Unfolding case studies are a technique used in advancing critical thinking in order for nursing students to enhance their clinical judgement. The format at which they are delivered can influence the degree of learning, understanding, applying, analyzing, and evaluating for students, especially senior minority nursing students. This quasi-experimental posttest survey between-groups study involved implementing unfolding case studies with a randomly selected minority or non-minority facilitator video recording for senior minority nursing students. After completing the case study, all participants were given a posttest survey, the Clinical Decision Making in Nursing Scale (Jenkins, 1983). The survey evaluates students’ self-perceived clinical judgement. …

Using Gerontechnology For Care Transition Conversations In Senior Living, Roschelle L. Fritz, Catherine Van Son, Chris Veloicaza, Stephanie Soriano, Gabrielle Barling

ICHRIE Research Reports

Every day across the United States, thousands of senior living organizations assist with housing transition decisions for older adults experiencing health-related changes. These decisions impact resources for older adults and senior housing corporations, yet these decisions are based primarily on subjective observational data regarding older adults’ changes in function or cognition. Smart homes offering continuous, unobtrusive health monitoring with artificial intelligence capabilities are emerging as solutions offering health maintenance support and objective functional and health information. Such systems are well-positioned to support hospitality staff conversing with residents about transitioning from independent to assisted living. Our interdisciplinary nursing research and hospitality …