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I Was Determined To Breastfeed, And I Always Found A Solution: Successful Experiences Of Exclusive Breastfeeding Among Chinese Mothers In Ireland, John Kearney, Qianling Zhou, Haoyue Chen, Katherine Younger, Tanya M. Cassidy

Articles

Background: The prevalence of exclusive breastfeeding for at least 4 months was previously found to be very low among Chinese immigrants in Ireland, at 5.8% (Zhou et al., Front Public Health 6:351, 2018). This study investigates the successful experiences of Chinese mothers living in Ireland who exclusively breastfeed for between four and 6 months.

Methods: Participants were recruited from the sample of the Ireland Chinese Mother Survey. Qualitative in-depth interviews were conducted with fourteen participants in their homes or public places.

Results: A content analysis revealed that various factors contributed to a successful experience of exclusive breastfeeding among the group …

Use, Adoption, And Effectiveness Of Tippy-Tap Handwashing Station In Promoting Hand Hygiene Practices In Resource-Limited Settings: A Systematic Review, Balwani C. Mbakaya, Fatch W. Kalembo, Maggie Zgambo

Research outputs 2014 to 2021

Background:

Tippy-taps are locally made devices for washing hands with running water. They are simple and low-cost, enabling technology that provides adequate water sources, handwashing stations and motivation for people to prioritise handwashing. This systematic review aimed to establish the use, benefits, adoption and effectiveness of enabling technology; tippy-tap handwashing station, in resource-limited settings.

Methods:

We systematically searched for articles in the PubMed, EMBASE, PsycINFO, AMED, CINAHL, DOAJ and Google Scholar databases guided by the acceptable best practice developed by the PROSPERO and COCHRANE for systematic search and selection of articles. Search terms such as tippy-taps, enabling technology, hand-washing station, …

Evaluation Of The Impact Of An Educational Intervention Aimed At Improving Tuberculosis Infection Control Knowledge Among Health Care Workers In A Military Treatment Facility: A Quality Improvement Project, Allen C. Potter

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Florida (FL) is one of the top five states in the nation for Tuberculosis (TB) infections. A majority of new infections can be found in the minority populations which represents 78% of all TB infections in the state. A combination of TB rates in FL, Orlando located 60 miles away and a transient population who frequently deploys worldwide to austere locations may result in an increased risk of acquiring TB. Literature suggests Health Care Providers (HCPs) obtain training regarding TB Infection Control (TB-IC). The Patrick AFB Military Treatment Facility (MTF) lacked a TB Infection Control (TB-IC) plan. Objective: The …

Integrating Care: Evaluation Of A Hepatitis C Clinic Co-Located With Harm Reduction And Addiction Treatment Programs In A Rural Clinic, Susan Ruth Mckenrick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: West Virginia (WV) is second in the nation for cases of Hepatitis C Virus (HCV) per capita – meaning more than 24,000 residents are living with HCV. Most new cases are in young persons who inject drugs (PWID). However, the no-call, no-show rate for HCV patients coming to clinics in Morgantown is about 50%, indicating the need to do a better job engaging them in care. Literature suggests that integrating HCV clinics with harm reduction and addiction treatment programs increases uptake of HCV treatment.

Objective: The overall objective was to establish an integrated HCV clinic where harm reduction …

Rural Malawian Women’S Resistance To Systematic Oppression, Violence, And Abuse By Their Husbands, Lucy Mkandawire-Valhmu, Wendy S. Bauer, Patricia E. Stevens, Loren W. Galvao, Katarina M. Grande, April Yerges, Lindsay Emer, Thokozani Mwenyekonde, Lance Weinhardt

College of Nursing Faculty Research and Publications

In Malawi, 41% of women aged 15 to 49 report ever experiencing intimate partner violence (IPV). Although there is evidence of the pervasiveness of IPV in Malawian society, the context in which it occurs and how women respond is not well described. The purpose of this study was to describe experiences of IPV of rural Malawian women. In-depth interviews were conducted with 55 rural Malawian women aged 21 to 75 years (M = 39) as part of a larger, mixed-methods study. This qualitative thematic analysis highlights husbands’ IPV against wives and women’s actions to protect themselves and their children, …

Why Won't This Heal?: Actinomyces And Wounds, Christina Wagener

Doctor of Nursing Practice Projects

Why Won’t This heal? Actinomyces and Wounds

Christina Wagener, MSN, Steve Kalish, MD, Mary Lee Barron, PhD, APRN, FNP-BC, FAANP

An incidental finding of Actinomyces europaeus in a refractory healing abscess presents an opportunity to close a knowledge and treatment gap. After finding Actinomyces species in multiple patients within a twenty-month period in an independent hospital in Chicago, IL, the probability exists that Actinomyces is becoming more prevalent in subcutaneous wounds. Chronic, non-healing wounds cause multiple negative consequences including financial, psychological and physical losses and possibly death.

Actinomyces is a Gram-positive, filamentous, non-acid-fast and anaerobic-to-microaerophilic bacteria first identified in 1997 …

Infection Control: The Nurse's Responsibility, Marisa Francis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over the last century and a half, infection control measures implemented by nursing staff have continued to evolve, resulting in improved patient outcomes. While this progress is impressive, a decline in rates of hospital acquired infections (HAIs) seems to have slowed, with only a 0.5% decrease in the last seventeen years. Unfortunately, nurses are rarely provided educational support on infection control practices beyond undergraduate and new employee trainings. Meanwhile, the Centers for Disease Control (CDC) is frequently updating their infection control practice recommendations.

The purpose of this project was to observe the current rate of infection control compliance by nurses, …

Use Of A Prevention Bundle To Reduce Colon Surgical Site Infections, Stephanie Kimberly Leong

Master's Projects and Capstones

Site Infections (SSIs) are the second highest amongst healthcare-associated infections (HAIs). SSI rates are disproportionally higher among colon surgeries, resulting in significant complications with adverse clinical and economic impacts (Keenan et al., 2014). The overall upward trend in SSI rates, including the increase colon SSI rates in 2018 called for immediate action in a 120-bed community medical center. A multidisciplinary team was assembled to implement an improvement initiative using evidence-based guidelines. An evidence-based care bundle was designed and implemented to prevent and reduce colon SSI rates. There are seven process measures: the use of chlorhexidine wipes preoperatively, hair clipping outside …

Improving The Rate Of Hand Hygiene Immediately Before And After Wound Care In The Street Nurse Microsystem, Amanda Ramos Sandoval

Master's Projects and Capstones

The street nurse team of Sacramento, CA provides many services to patients who are experiencing homelessness, including a substantial amount of wound care. While the street nurses were performing hand hygiene (HH) prior to and after wound care, they would often not be performing it immediately prior and post-wound care. Because the nurses hike to their patients (who are living on the streets or in out of the way camps) the street nurses would often perform hand hygiene while at their cars prior to going to the patient and again when they returned to their cars after performing wound care. …

An Approach To Increase Education In The Flu Vaccination Clinic Process, Koki Guangxi Inlow, Lucy Dale, Devante Lindsey, Nancy Tran Manalo, Elena Teresa Cleary

Master's Projects and Capstones

The Health Ministries Program, located in Orange County, is supported by a large faith-based community hospital and provides community resources such as flu vaccinations that are overseen by the Faith Community Nurse (FCN). In collaboration with the program, University of San Francisco (USF) nursing students researched and developed an implementation of a multi-purpose educational flyer to increase education and better streamline the process at flu vaccination clinics throughout Orange County faith-based organizations. Research shows that many individuals still do not get vaccinated due to misconceptions, misinformation, and lack of knowledge on the importance of flu vaccinations. The cost of flu-related …

Improving Identification Of Ssi In Snf, Jennifer Teng Yuan Yu

Master's Projects and Capstones

Educational deficit in basic wound assessment can lead to failure to recognize early signs of infection or wound deterioration. Despite many challenges towards wound care, there are potential opportunities to reduce patient injury and clinical outcomes through continuing education. The purpose of this paper is to review literature on current wound care knowledge in nurses and assess existing wound care knowledge in nurses at a skilled nursing facility. A 10-question pre-test wound assessment quiz based on the Bates-Jensen Wound Assessment Tool (BWAT) selected by the Wound Care Coordinator (WCC)/Wound Care Specialist (WCS) was given to 22 nurses: 5 Registered Nurses …

Medication Management In A Primary Care Practice, Melissa Fowler

Doctor of Nursing Practice

Improving medication management has become the 3rd National Patient Safety Goal. Medication errors cost $42 billion annually. A 5-month quality improvement project was conducted in a primary care clinic located in a south Texas metropolitan city to address medication reconciliation problems. The project improved medication management by implementing 7 tools to decrease preventable medication errors: One Source Medication List, staff knowledge pre- and post-tests, visual signs and staff badges, staff templates, Beers Criteria pocket guide, patient brochure, and a quality improvement tracking form. There were two objectives: 1. Staff would improve medication reconciliation documentation by 50%. 2. For patients 65 …

Kujdesi Infermieror Te Pacientët Me Infeksione Të Organeve Urinare, Blerinë Zeqiri

Theses and Dissertations

Qëllimi i këtij hulumtimi është që të konstatohet se sa janë të përhapura infeksionet e traktit urinar në rajonin e Ferizajit, shkaktarët, mosha dhe gjinia më e prekur .

Nga protokollet e repartit të urologjisë të Spitalit rajonal në Ferizaj rezultonë të jenë të regjistruar 172 pacientë të prekur në periudhën shtator 2018 – shtator 2019 ku gjinia më e prekur është gjinia femërore me 120 raste si dhe mosha më e prekur 45-74 vjeç.

Disa nga këshillat infermierore për ti evituar infeksionet urinare janë: të pihet shumë ujë, të shmangen pijet që mund të irritojnë fshikëzën, të mbahet higjena …

Increasing Asymptomatic Chlamydia Screening In The Ed, Mikyung Kim

Doctoral Dissertations and Projects

The Centers for Disease Control and Prevention (CDC) recommends chlamydia screening in young women and others who are at risk based on scientific evidence related to the effectiveness of screening to prevent chlamydial infection. Female patients may visit the emergency department (ED) with symptoms such as urethritis, abdominal pain, or vaginal spotting. For men, most complaints are urinary problems, discharge from the penis, and testicular pain. However, most infected patients are never symptomatic and have no abnormal physical findings. Therefore, the question that spurred this project was, “Why aren’t asymptomatic patients screened more often?” Furthermore, “Why are the CDC screening …

Addressing The Problem Of Sterile Drug Injecting Supply Acquisition For People Who Inject Drugs., Barbra Ann Cave

Electronic Theses and Dissertations

This dissertation contains five chapters, including three manuscripts, covering harm reduction and some of the challenges people who inject drugs (PWID) face in their effort to reduce the risk of injection drug-related harms through sterile injecting supply acquisition and use. Chapter One discusses some background related to PWID and provides an overview of the issues addressed in this dissertation. Chapter Two includes a literature review covering the harm reduction concept, important aspects of syringe exchange programs as a harm reduction tool, and the social determinants of health model as a potential tool for future research. Chapter Three is a two-phase …

Vasopressor Titration In Medical Intensive Care Patients With Septic Shock: A Descriptive Study, Daniel Arellano

Dissertations and Theses (Open Access)

Background: Vasopressor therapy in patients with septic shock can lead to harmful effects.

Objective: To describe vasopressor titration in patients with septic shock.

Methods: Single-center descriptive study of 60 intensive care unit (ICU) patients to calculate rates for events of failure to titrate, incorrect titration, and correct titration in 15- minute intervals for the duration of vasopressor therapy. Total hospital and ICU days, mortality rate, vasopressor dose and time, and the impact of hydrocortisone on vasopressor use were examined.

Results: During the total vasopressor infusion time of 2598 hours, 5395 failure-to-titrate events were noted. There were 316 incorrect titrations and …

Mhealth Acceptance And Usage Among South Asian Adults In The U.S., Padmavathy Ramaswamy

Dissertations and Theses (Open Access)

Background: Modifiable lifestyle factors such as physical inactivity and unhealthy diet contribute to the increased risk of cardiovascular diseases (CVD) and diabetes (DM) in South Asians (SAs) (Volgman et al., 2018). Interventions using mobile health (mHealth) have demonstrated feasibility and potential efficacy for ethnic minorities (Bender et al., 2018), and have the potential to be of preventive and therapeutic value in reducing the burden of CVD and DM in SAs living in the US. However, there is a gap in knowledge regarding the usage and acceptance of mHealth among SAs.

Purpose: The objectives were to examine the overall …

Refugees' Perceptions Of Primary Care: What Makes A Good Doctor's Visit?, Anne Mutitu, Bev Zabler, Jeana M. Holt

Patient Experience Journal

Redesigning primary care is a national priority, as the United States (US) struggles with issues of poor access, high cost, and suboptimal quality. Refugees are among the populations who suffer from America’s disjointed health care system, resulting in disproportionate health disparities. Although there are many studies on refugee health, few share refugees' perceptions of primary care. We asked local refugees who were seen for primary care services at a midwestern academic nurse-led clinic, what makes a good doctor's visit?  The clinic served as the hub of a federally funded refugee Community Centered Health Home (CCHH) pilot project. This qualitative study …

The Implementation Of An Open Source Electronic Medical Record At A Faith-Based Community Clinic, Gabri Warren

Graduate Theses, Dissertations, and Capstones

Faith-based nursing and healthcare is increasingly gaining popularity as the industry looks to minimize costs and improve health outcomes. Historically, qualitative studies have not shown the extent to which individuals and communities are impacted by health initiatives initiated by faith institutions. Healthcare technology can help support the specialty by providing increased quantity and quality data to analyze. Traditional, proprietary EMRs are too costly; however, open source systems offer a low cost, and easily modifiable option to non-profit, or smaller organizations. The data collected by an open source system allows organizations to improve the care that patients receive, and helps guide …

Noninvasive Ventilation Protocol Development, Janise Pierce Tinsman

Doctoral Dissertations and Projects

Endotracheal intubation results in many serious complications including regurgitation, vocal cord paralysis, and death. Noninvasive ventilation using bi-level positive airway pressure has been shown to provide the necessary support without intubation and is also associated with better outcomes if trialed prior to endotracheal intubation. A noninvasive ventilation protocol was applied in a rural acute care facility. Results: The average length of stay for acute respiratory failure decreased from 5.32 to 4.44 days, while intubations fell from 41.9% to zero, and mortality fell from 9.7% to zero during the pilot period. Five cases met criteria for noninvasive ventilation, and three received …

Step It Up Macks Creek, Mo: A Community Walking Program, Amy Butler

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Amy Renee Butler, MSN, FNP-C

Physical inactivity is a major risk factor for chronic disease. Despite goals, guidelines and interventions physical inactivity continues to rise. Rural residents are at even higher risks of sedentary lifestyles highlighting the need for research and interventions focusing on this particular population.

The purpose of this study was to develop a community walking program to create an environment of favorable health resources in a rural area of mid-Missouri. The walking program provided residents with an educational meeting followed by a five week walking intervention that evaluated participants step …

Back To The Basics With Environmental Hygiene, Shanna D. Stowe

Doctoral Dissertations and Projects

Environmental hygiene is fundamental in preventing the transmission of pathogens that can cause health care-associated infections (HAIs). Inanimate surfaces within the patient’s environment are defined as high-touch surfaces and include areas such as bedrails, tray tables, call lights, telephones, any equipment that is attached to the patient, and the computer on wheels. HAIs develop during hospitalization and occur within 48 to 72 hours of admission or within 10 days after hospital discharge (CDC, 2014; Collins, 2008). HAIs increase the morbidity, mortality, and hospital expenditures; and critically ill patients are at greater risk for HAIs because of their compromised immune systems, …

Examining Opportunities To Increase Flu Vaccine Uptake On College Campuses Through Pharmacy Partnerships, Kristi Hargrave

Electronic Theses and Dissertations

The purpose of this project was to examine a university health clinic’s influenza vaccination program in a suburban city in a western U.S. state, and to explore the effects of partnering with a local pharmacy to overcome billing issues. A program evaluation was conducted to identify the potential barrier of cost for students. The health clinic was not set up to bill private health insurance for students; therefore, if students wanted to get a flu shot, they had to pay out of pocket for it. A pilot program was created in conjunction with the program director, partnering with the local …

Encephalopathic Presentation Of West Nile Virus Neuroinvasive Disease Confounded By Concomitant History Of Acute Alcohol Withdrawal, Alyssa Profita, Kristin Haglund

College of Nursing Faculty Research and Publications

West Nile neuroinvasive disease (WNND) is a rare and severe manifestation of West Nile virus (WNV) infection that occurs in less than 1% of infected persons. It should be considered in patients who present with fever, neurological symptoms, and a history of recent outdoor activity where mosquitoes were active. This article highlights a case of a 55-year-old man whose history and symptoms of WNND were confounded with an alternate diagnosis, acute alcohol withdrawal. An overview of WNV infections, and important historical clues and objective findings characteristic of neuroinvasive disease, is discussed to increase readers' knowledge of WNV and awareness of …

Reduction Of Catheter Associated Urinary Tract Infections (Cauti) In A Critical Care Setting, Deborah Jackson, Lindsey Lucas, Shawn Taylor, Jonathan Archibald, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

Urinary tract infections (UTIs) are the most common type of healthcare associated infections. Seventy five percent are related to indwelling urinary catheters. These infections come with increased morbidity and mortality risk. A team of intensive care providers at a large academic tertiary medical center initiated a quality improvement project to reduce the number of CAUTIs.

Baseline data established the total number of catheter days and CAUTIs by month. A subsequent root cause analysis was completed and several counter measures were developed to include a KPI implementation to track that all intensive care providers are educated in CAUTI and creation of …

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Carmen Contreras, Ganmaa Davaasambuu, Wafaie W Fawzi, Molly F Franke, Jerome T Galea, Daniel Garcia-Ferrer, Maria Gil-Fortuño, Barbará Gomila-Sard, Amita Gupta, Nikhil Gupte, Rabia Hussain, Jesus Iborra-Millet, Najeeha T Iqbal, Jose Vicente Juan-Cerdán, Aarti Kinikar, Leonid Lecca, Vidya Mave, Noemi Meseguer-Ferrer, Grace Montepiedra, Ferdinand M Mugusi, Olumuyiwa A Owolabi, Julie Parsonnet, Freddy Roach-Poblete, Maria Angeles Romeu-García, Stephen A Spector, Christopher R Sudfeld, Mark W Tenforde, Toyin O Togun, Rosa Yataco, Zibiao Zhang, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.

METHODS AND FINDINGS: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Creation And Implementation Of A Pediatric Advanced Practice Nurse Critical Care Fellowship Program, Bonnie Stojadinovic, Christine A. Schindler, Margaret Faut Callahan, Maureen O'Brien, Tom B. Rice, Theresa Mikhailov

College of Nursing Faculty Research and Publications

Advanced practice registered nurses (APRNs) who begin their careers in the pediatric intensive care unit (PICU) may be challenged in this practice environment. Inadequate prior experience as a staff nurse, limited opportunities for clinical placements in the PICU during graduate education, and being in a fast-paced, high-acuity practice environment without prior exposure to critically ill children are practice challenges in the PICU setting. The goal of postgraduate education training programs (fellowship programs) for the acute care pediatric nurse practitioner (ACPNP) is to prepare students to become beginner practitioners who can function effectively in the acute care setting within a few …

Expedited Partner Therapy: Advancing Health Policy In Kentucky., Brianna C. Tomlinson

Doctor of Nursing Practice Papers

Innovative strategies have become necessary in the treatment of patients diagnosed with sexually transmitted infections (STIs) and their partners due to increasing rates of infection, transmission, and reinfection. Expedited Partner Therapy (EPT) is an evidence-based approach for providers to improve partner treatment and decrease reinfection rates in patients with certain STIs. However, state-based legislation governs practice implementation and EPT remains prohibited in Kentucky (KY) despite Centers for Disease Control and Prevention (CDC) endorsement. Delay in policy change presents increased risk for reinfection and continued transmission in KY. John Kingdon’s Multiple Streams framework (2003) was used to analyze EPT policy in …

The Use Of Simulation To Practice Pre-Exposure Prophylaxis Sexual Health Risk Screening, Management, And Follow-Up Within A Doctor Of Nursing Practice Program., Skyler K. Frye

Doctor of Nursing Practice Papers

Introduction: Incidence and prevalence for human immunodeficiency virus (HIV) has yet to experience a significant decline. Increasing provider knowledge regarding use of Pre-Exposure Prophylaxis, an HIV prevention drug, correlates with increased provider risk screening & prescribing PrEP. Standardized patient (SP) simulation is an effective teaching method for healthcare students to increase knowledge and confidence in providing sexual healthcare.

Purpose: The purpose of this project was to evaluate an educational program aimed at increasing participant knowledge attainment and self-confidence in the ability to ascertain a sexual health history and advance the participant’s ability to manage PrEP candidates in a primary …

Acute Flaccid Myelitis Awareness, Olivia Ballard

Nursing Student Class Projects (Formerly MSN)

Acute Flaccid Myelitis (AFM) awareness is expanding in pediatric intensive care units(PICU) around the world. The underlying etiology and protocols of management remain unclear to many medical professionals today. As of 2014, a correlation to the disease is associated with an enterovirus pathology. Unfortunately, its presentation can be easily missed and lead to detrimental outcomes. The mysterious polio-like disease leaves the patient in a state of paralysis, frequently requiring feeding and ventilatory support. With the lack of scientific knowledge and surveillance in the hospital, clinicians and nurses feel guilt in not knowing if AFM was missed. As new research continues …