Digital Commons Network^™

Uncontrolled Asthma In Pediatrics, Lydia M. Chapa-Wilson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Asthma tends to be underdiagnosed and undertreated. Several studies concluded that asthma was poorly managed among pediatric care providers. To address the patient/problem, intervention, comparison, outcome, and setting (PICOTS) question: Among the pediatric providers at a primary care clinic in an urban Texas city, what was the effect of administering asthma control tests (ACT/C-ACT) on modifying the care plan of pediatric patients diagnosed with uncontrolled asthma? The purpose of this evidence-based practice (EBP) project was to evaluate the association between the test scores and the provider’s decision whether to change the patient’s care plan, and ultimately to bring the clinic …

Improving Health Literacy Through Knowledge And Technology, Maricela Hernandez

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Health literacy is key in promoting positive health outcomes, particularly in older adults who often face difficulties understanding and managing complex medical conditions. Limited health literacy contributes to poor management of chronic conditions and health disparities, especially in disadvantaged populations.

Objectives: This project aimed to improve health literacy in older adults through a health literacy bundle.

Design: A pre/post single group design was used to evaluate the impact of the health literacy bundle on participants’ health literacy levels. The intervention was conducted over eight weeks.

Setting: The project was implemented in a small rural town in South Texas with …

Individualizing Patient Education To Reduce Heart Failure Readmissions, Melissa M. Andersen

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Heart failure (HF) is a chronic condition with high readmission rates, often due to inadequate patient knowledge about home care and symptom management. Individualized patient education combined with standardized approaches could improve patient outcomes.

Objective: This project’s goal was to determine if using individual patient knowledge to create a personalized education along with standard HF education would improve patient HF knowledge, improve home management and decrease HF readmission rates.

Methods: This pilot quality improvement (QI) project was conducted in an acute care hospital using a convenience sample of 29 patients admitted due to a HF exacerbation using pre-posttest design. …

Development Of An Order Set To Improve Consistency Of Blood Glucose Monitoring For Hospitalized Patients On Enteral Feeding, Kristen Calebaugh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Development of an Order set to Improve Consistency of Blood Glucose Monitoring for Adult Hospitalized Patients on Enteral Feeding

Kristen Calebaugh, BSN, RN

Background

Hospitalized patients often require artificial nutrition through either enteral feeding, placing the patient at risk for glucose alterations related to physiological responses of nutritional metabolism. Historically, there has been no standard of care or consistency aligning tube feedings times with point of care blood glucose testing. Without a standardized order set to guide blood glucose monitoring orders, patients on artificial nutrition may experience undetected hypo or hyperglycemia or inadequate glycemic control, which can cause adverse …

A Multidisciplinary Approach To Identify Postoperative Delirium In Geriatric Patients Using A Brain Health Screening Tool, Ashlyn Mccartney

Graduate Theses, Dissertations, and Problem Reports (ETD)

Postoperative delirium (POD) is a common occurrence, effecting nearly 61% of the surgical population recovering from anesthesia. POD increases risk of morbidity and mortality leading to prolonged hospital length of stay by 0.8 to 7.3 days and increased costs by $1,551 to $23,698 (Masharaf et al., 2022; Sethi, 2021). An academic medical center in northern West Virginia (WV) lacks a structured practice/protocol to identify high risk patients and assess POD. An evidence-based solution was developed based on the PICO question: Does a multidisciplinary approach to perianesthetic care utilizing a brain health screening tool, compared to lack of a screening tool, …

Project Quiet: A Quality Improvement Initiative To Reduce Noise Pollution During Anesthesia Induction And Emergence, James Christopher Woods

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: Excessive intraoperative noise puts anesthesia providers at risk for errors that could negatively impact patient morbidity and mortality. Distractions from excessive noise experienced during the “critical phases” of anesthesia present a risk to patient safety and need to be reduced or eliminated. Anecdotally, reports from anesthesia staff at a large academic medical center confirmed that noise pollution during induction and emergence significantly impacted the performance of critical anesthesia tasks. Objective: The goal of this quality improvement (QI) project was to implement a series of interventions designed to reduce noise pollution during induction and emergence, and to reduce …

Do Pediatric Patients That Receive Dexmedetomidine As Premedication Experience Less Emergence Delirium Than Pediatric Patients That Receive Midazolam As Premedication?, Shelby Mccloud

Theses, Dissertations and Capstones

Title: Do pediatric patients that receive dexmedetomidine as premedication experience less emergence delirium than pediatric patients that receive midazolam as premedication?

Problem Statement: Midazolam remains the current choice within the practice for premedication in the prevention of emergence delirium, however as research continues there could possibly be a gap between the research and current practice. Throughout the practice of pediatric anesthesia most providers choose to premedicate with midazolam while there may be a more beneficial option of dexmedetomidine.

Results: The study found a significant variance in the incidence of emergence delirium among pediatric patients, ranging from 18.1% to 89%, depending …

Molecular Study Of The Agr Gene In Multidrug-Resistant (Mdr) And Extensively Drug-Resistant (Xdr) In The S. Aureus, Mays Ali Salim, Estabraq Ali Maklef, Montaha Abdul-Karim Al-Saffar

Al-Esraa University College Journal for Medical Sciences

Staphylococcus aureus a gram-positive coccus and one of the most important opportunistic bacteria that can lead to nosocomial infections. The purpose of this study is to explore the distribution and prevalence of the Agr gene in multidrug-resistance (MDR) and extensively drug-resistant (XDR) S. aureus. 62 isolates performed antibiotic sensitivity test. The isolates showed 66.12% resistance to clindamycin with MIC at range≥4, erythromycin 77.41% with MIC at range≥8, ciprofloxacin 19.35% with MIC at range≥4, oxacillin 75.80% with MIC at range≥4, cefoxitin 45.16% with MIC at range≥8, gentamycin 29.03% with MIC at range≥16, nitrofurantoin 14.51% and MIC at range≥128, and tetracycline …

Distribution Of Epidemiological Characteristics Of Low Back Pain Patients Attending To Baghdad Teaching Hospital, Khadija Kamil Salman, Ali Hussein. Al-Hafid, Shatha Ahmed Mohammed Ali

Al-Esraa University College Journal for Medical Sciences

Background: Low back pain (LBP) is a very common health problem worldwide especially in the low and middle-income countries. The LBP may be acute or chronic in nature caused by several medical conditions. The majority of acute low back pain is mechanical in nature due to sprains and strains. Chronic LBP, on the other hand, is most commonly attributed to sciatica, which a radiculopathy condition caused by compression, inflammation and/or injury to the spinal nerve roots. Aims of study: To study epidemiological features of low back pain. Patients and Methods: A cross-sectional study of 440 individuals diagnosed with …

Comparison Between Crp Level And Some Biochemical Parameters In Hashimoto And Hypothyroidism Iraqi Patients, Shahad Muthanna Abdulsattar, Ahmed Salem Mohammed, Susan Ahmed Zwyea

Al-Esraa University College Journal for Medical Sciences

Background: Hypothyroidism is a common medical condition that occurs due to a lack of the hormone thyroxine. Hashimoto's thyroiditis (HT) is the most prevalent thyroid disorder, also known as autoimmune thyroid disease (AITD). Approximately 20-30% of people develop hypothyroidism due to ongoing inflammation of the thyroid tissue it triggers. Aims: To investigate the difference between inflammatory and biochemical test in Hashimoto autoimmune thyroiditis (AITD) and hypothyroidism patients (non-autoimmune) Methods: The study was done on 50 Hashimotos patients, 50 Hypothyroidism patients from the Endocrinology Unit at Baghdad Teaching Hospital and Educational Laboratories / Baghdad City, Iraq, and 50 control healthy …

Improvement Of Hypertension Self-Care Management In African American Older Adults With Uncontrolled Hypertension Through Shared Decision-Making, Sigga Jobe

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension affects nearly half of the population in the U.S., with the prevalence disproportionately higher in African Americans (Centers for Disease Control and Prevention [CDC], 2023). Complications of uncontrolled hypertension, such as cardiovascular disorders and stroke, increase with age, prompting the importance of controlling high blood pressure in older adults. African American older adults are at higher risk of developing uncontrolled hypertension and related complications due to the lack of healthcare access, financial constraints leading to the inability to access healthier food choices, exercise capabilities, weight control, adherence to recommended medications, and knowledge deficit.

Methods: This project focused on …

Development Of A Positive Urinalysis Criteria Using A Machine Learning Approach, Kari Flicker, Jessica Parrott, Tammy Speerhas, Turaj Vazifedan, Theresa Guins, Jeffrey Bobrowtiz, Anne Mcevoy, Jade Eves, Debra Conrad, Benjamin Klick

Ellmer School of Nursing Faculty Publications

Background: Urinary tract infections (UTIs) are a commonly encountered diagnosis at pediatric urgent care (UC) centers. The urinalysis (UA) is usually the initial study in UC settings used to guide decisions regarding initiating empiric antibiotics and/or pursuing urine culture. However, studies in pediatric UC settings examining the ideal threshold for a positive result are lacking.

Methods: UA result data were extracted from the records of 6,327 pediatric patients, which were collected as part of a previous QI project. Logistic regression was used to determine the predictors of positive urine cultures. Decision trees for a positive UA result for both clean …

Enhancing Interprofessional Communication: Strategies For Nurses And Residents At Hca Florida Osceola Hospital, Juan Thomas Del Calvo, Mehuliben Upadhyaya, Sathvik Saineni, Minh Anh Le, Awss Shalhoub, Nima Hosseinian, Ashwini Komarla, Olga Karasik

North Florida Division GME Research Day 2024

No abstract provided.

Memory Cart: Memory-Making Interventions For Nurses To Enhance The Meaningfulness Of End-Of-Life Care In The Icu, Grace Zimmerman

Articles, Abstracts, and Reports

No abstract provided.

Ironing Out The Details: Early Detection And Treatment Of Iron Deficiency In A Level 4 Nicu, Rachel Mills

2024

No abstract provided.

Increasing Colorectal Cancer (Crc) Screening In Hispanic Adults Using An Evidence-Based Social Determinants Of Health-Oriented Guide For Patient Navigation, Joyce A. Acquah Dnp, Aprn, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. It affects over 140,000 individuals and results in over 50,000 deaths per year. It is estimated that increasing screening to 80% could potentially prevent approximately 300,000 new cases and over 200,000 deaths by 2030. Screening disparity among the Hispanic population is influenced by socio-economic and socio-cultural factors. The aim of this project was to develop a balanced scorecard (BSC), using publicly available data and research files from three databases (Behavioral Risk Factor Surveillance System [BRFSS], Texas Health Care Information Collection [THCIC], and Healthy North Texas …

Guideline For Sbhc Provider Education To Start The Hpv Vaccine At Nine Years Old, Jasmine K. Serrano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

It is estimated that 80% of people worldwide, regardless of gender, will contract human papillomavirus (HPV) at some point in their lives. The HPV vaccine series prevents high-risk strains that are known to cause cancer and genital warts (Osaghae et al., 2022). School-based health clinics (SBHC) can increase access to and completion of the HPV vaccine series, which remains low throughout the United States (Javaid et al., 2017; Rane et al., 2021; Shah et al., 2020). This guideline was created to increase SBH provider education to start the HPV vaccine at nine years old. The project lead conducted a systematic …

Guideline For Breastfeeding Difficulty, Collin Naugher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

The American Academy of Pediatrics recommends exclusive breastfeeding for all infants until six months of age. In the United States, the exclusive breastfeeding rate is 52%, with a goal of 73% by Healthy People 2030 at six weeks of age. Breastfeeding difficulty will occur 70% of the time in mother-baby dyads, requiring some intervention by the primary care provider during the breastfeeding course. This study aims to build a clinical practice guideline that can guide interventions to improve successful breastfeeding rates in a birthing center.

Methods

The literature search was performed and condensed to an evidence table where studies …

Evaluation Of A Simulation-Based, E-Learning Intervention To Develop Prelicensure Nursing Students' Clinical Competency To Recognize Tracheostomy Airway Complications, Ruth Bargainer Tobin

Nursing Dissertations - Archive

Tracheostomy airway patient safety errors are a global, yet preventable problem. Unrecognized tracheostomy airway complications lead to patient deterioration, resulting in hypoxic brain damage and death or permanent disability. The majority of preventable tracheostomy events occur after patient discharge from the intensive care setting. These catastrophic events are attributed to deficiencies in competent and safe nursing care. Prelicensure nursing students have few clinical opportunities to learn tracheostomy management and may enter nursing practice lacking the clinical competency (CC) to recognize a tracheostomy airway problem. Simulation is a modality for learning high-risk skills such as tracheostomy care (TC) in a setting …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Whs Guidelines For The Treatment Of Pressure Ulcers: 2023 Update, Lisa J. Gould, Jenny Alderden, Rummana Aslam, Adrian Barbul, Kath M. Bogie, Mohamed El Masry, Letitia Y. Graves, E. Foy White-Chu, Amany Ahmed, Kerriann Boanca, Jessica Brash, Katie R. Brooks, Wendy Cockron, Susan M. Kennerly, Aaron K. Livingston, Jeni Page, Catherine Stephens, Velena West, Tracey L. Yap

Nursing Faculty Publications and Presentations

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million. However, this estimate is derived from acute care facilities and does not include people who are living at home or in nursing facilities. Despite the implementation of hospital and facility-based preventive measures, the incidence of pressure ulcers has not decreased in decades. In addition to the burden of pain, infection and death, it is estimated …

Information Impact On Home-Based Palliative Care Admissions, Donna Rugh

West Chester University Doctoral Projects

Patients appropriate for Home-Based Palliative Care services are fragile with increased risk for mortality and hospital readmissions. Utilization of Home-Based Palliative Care skilled nursing services have been proven to decrease these risks and improve quality of life. Information deficits negatively impact nurse clinical decision making during the admission process, potentially misguiding the nurse resulting in a non-admission to service. This project focused on the impact of both nurse education and clinical information sharing at admission. Pre and post data was compared to examine the impact of these interventions on non-admissions rates for the reasons of “no skilled need” or “not …

Enhancing Commercial Driver Safety Screening For Obstructive Sleep Apnea Through Educational Intervention, Wendy Mortimer

West Chester University Doctoral Projects

This quality improvement project aimed to identify if an educational intervention will increase obstructive sleep apnea (OSA) screening in commercial medical drivers over six weeks. Eight healthcare providers certified as commercial medical examiners from a national occupational company in central Pennsylvania engaged in an optional educational poster for two weeks. A pre-and post-educational retrospective chart review was performed on 80 charts, 40 from pre-educational and 40 from post-educational. Each chart was reviewed to determine if the commercial driver was at risk for OSA and, if so, if the commercial medical examiner performed an obstructive sleep apnea screening. The educational intervention …

Dying Is The Easiest Part: Implications Of Palliative Care In America, Sophia Jordan

Undergraduate Honors Theses

The purpose of this paper is to uncover why Americans fear death. What are the foundational principles that cause most individuals of the American society to prolong the dying process? The topics discussed will include physician bias, disease mongering by pharmaceutical companies, consequences of aggressive treatment, the barriers to palliative care and the specific effects of pediatric palliative care. There is a small amount of research on this specific topic, therefore, this paper also seeks to bring awareness to the benefits of palliative care. It is the overall aim of this paper for society to shift their beliefs towards the …

Effectiveness Of Harm Reduction And Narcan Education For Young Adults, Jason Bolfango

Nursing | Student Research Posters

Education on the Harm Reduction Model is an upstream preventative approach to addressing the opioid crisis and a strategic method to promote safety among young adults.

Lived Experiences Of People With Substance Use Disorder As Healthcare Education To Develop Empathy For This Population, Whitney Bynum

Nursing | Senior Theses

The negative attitudes and feelings of healthcare workers towards patients with substance use disorder are well documented. These include, but are not limited to, believing a person with this disease is “drug seeking”, “violent”, and “unmotivated”. While this population has challenging issues to address, these beliefs can decrease the quality of care provided and results in less people seeking out needed treatment. Reducing stigmas through alternative education methods, like learning the life story of a patient, can help health care workers develop feelings of empathy and compassion. Subsequently, this education can result in better care and outcomes for these patients. …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Exploring The Impact Of Swimming On Asthma Management In Asian Americans, Trishtine Tran

Nursing | Senior Theses

Asthma is a respiratory disease that leads to narrowing of the airways in the lungs due to inflammation and mucus. Common symptoms include cough, wheezing, asthma attacks, excess mucus production, and decreased exercise tolerance. Pharmacological treatment methods for asthma include bronchodilators, corticosteroids, and allergy medications. Nonpharmaceutical treatments include monitoring of exposure to allergens and breathing exercises, however swimming is not as commonly suggested. The purpose of this study is to investigate whether implementation of a swimming education class will influence the effectiveness of swimming on asthma management in Asian Americans. This study aims to examine quality of life, changes in …

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Increasing Awareness Of Implicit Bias And Systemic Racism Among Clinical Staff Caring For Non-Hispanic Black Maternal Patients, Melissa Courtney

DNP Projects

Background: Kentucky is ranked 17^th in the nation for the highest maternal mortality rate in the U.S. with a rate of 22.9 per 100,000, and 78 percent of those maternal deaths were considered preventable. The Non-Hispanic Black maternal death rate in the U.S. and Kentucky is 2.9 times higher than that of the Non-Hispanic White maternal counterparts (Kentucky Department of Public Health Division of Maternal and Child Health (KDPHDMCH), 2022). The fundamental cause of maternal health inequities is structural racism, which leads to poor treatment and experiences in the healthcare system (Chinn et al., 2020). Structural racism and implicit …