Digital Commons Network^™

Primary Care And Behavioral Health Services In A Federally Qualified Health Center, Svetoslav A. Arsov

Walden Dissertations and Doctoral Studies

Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were …

Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata

Walden Dissertations and Doctoral Studies

Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health …

Advanced Practice Nursing In Nigerian Healthcare: Prospects And Challenges, Raymond O. Chimezie, Sally N. Ibe

Journal of Sustainable Social Impact

This study explored the prospects and challenges of introducing advanced practice nursing (APN) in the Nigerian health system. It sought to address the following: career pathways for registered nurses and midwives, advanced duties performed by them and the circumstances, their views and willingness for autonomous practice, and doctors’ degree of acceptance. Research population composed of registered nurses, midwives and medical doctors in primary healthcare. The conceptual framework for this study was based on the scope of practice, standards and competencies of the APN established by the International Council of Nurses (2008). A 12-item checklist of typical duties of APN from …

Population Data Centre Profile - The Western Australian Data Linkage Branch, Steve Hodges, Tom Eitelhuber, Alexandra Merchant, Janine Alan

Research outputs 2014 to 2021

Established in 1995, the Western Australian Data Linkage Branch (DLB) is Australia’s longest running data linkage agency. The Western Australian Data Linkage System (WADLS) employs an enduring linkage model spanning over 60 data collections supported by internally developed and supported software and IT infrastructure. DLB has delivered, and continues to deliver, a range of significant data linkage innovations, many of which have been adopted elsewhere. A current restructure within the Western Australian Department of Health (which we will refer to as the Department of Health) will provide an improved funding model geared toward addressing issues with staff retention, capacity and …

Improving Wound Care Using The Time Framework, Pavel Kulikov

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and purpose:Although wound care guidelines are available for primary care providers, barriers to assessment and treatment remain. This paper examines current evidence, guidelines, and discusses the need for improved training, education, and a simplified approach to wound management in primary care. The goal of the project was to increase the provider’s comfort level in assessing and initiating wound care treatment in the clinical setting. Methods:An evidence-based wound treatment framework, identified as the TIME (tissue, infection, moisture, epithelial) framework, was selected for the project. The framework was tailored by subject matter experts to provide a distinctive approach …

Access To Care And The Use Of Healthcare Services By Women In Rural Cameroon: A Participatory Action Research Study, Grace Tadzong-Awasum

Electronic Theses and Dissertations

Women in rural Cameroon do not access health care as timeously and as often as they should. They fail to get screened for common diseases, with the consequence that such diseases are often diagnosed at a very advanced stage. This accounts for the high morbidity and mortality rates as well as low life expectancy recorded among women. The purpose of this study was to explore and understand the health access experiences of women in rural Cameroon. Methodology: Participatory action research was used guided by a Focused ethnography in phase one. Twenty-five women aged 21-77 years were recruited through local the …

Probiotic Use In Trauma Patients: A Pathway To Determining The Standard Of Care To Improve Outcomes, Heather Vitko

Electronic Theses and Dissertations

The gut microbiome consists of normally non-pathogenic bacteria, viruses, and fungi. These friendly microbes serve to maintain GI barrier function and integrity, play a role in host nutrient and drug metabolism, immunomodulation, and prevent pathogenic bacteria from colonizing or causing disease. The importance of a healthy microbiome for the overall health of the host is just recently being appreciated within the medical and science communities. Disruption of the microbiome places one at greater risk for illness and infection. Patients who suffer a traumatic injury are among those at highest risk for complications associated with microbial imbalance, or dysbiosis. In addition …

Adaptations Made To Evidence-Based Public Health Programs In Low- To Middle- Income Countries: A Concept Mapping Analysis, Elizabeth Holguin

Nursing ETDs

One of the most challenging barriers to implementing successful and sustainable evidence-based programs in public health is the ability to remain faithful to original protocols grounded in scientific evidence while adapting programmatic components to reflect the reality of the communities they are meant to benefit. It is generally accepted that some degree of adaptation should occur in order to achieve positive, sustainable outcomes in public health programs. A concept mapping methodology was used to explore types of adaptation that occur during implementation of evidence-based global health programs in low- to middle-income countries (LMICs). Purposive and snowball sampling produced a sample …

Interference And Control Of The Nosocomial Transmission Of Methicillin-Resistant Staphylococcus Aureus, Sen Pei, Flaviano Morone, Fredrik Liljeros, Hernan Makse, Jeffrey L. Shaman

Publications and Research

Methicillin-resistant Staphylococcus aureus (MRSA) is a continued threat to human health in both community and healthcare settings. In hospitals, control efforts would benefit from accurate estimation of asymptomatic colonization and infection importation rates from the community. However, developing such estimates remains challenging due to limited observation of colonization and complicated transmission dynamics within hospitals and the community. Here, we develop an inference framework that can estimate these key quantities by combining statistical filtering techniques, an agent-based model, and real-world patient-to-patient contact networks, and use this framework to infer nosocomial transmission and infection importation over an outbreak spanning 6 years in …

Improving Infection Management Of The Institutionalized Elderly, Jovel Angela Viloria Broqueza

Doctor of Nursing Practice Projects

Abstract

As the elderly population rapidly grows in the United States, the burden of managing infection in long-term care facilities (LTCF) escalates. The use of evidence-based infection identification algorithms for early recognition and treatment of pneumonia, urinary tract infections (UTI) and skin and soft tissue infections (SSTI) was evaluated at a Midwest suburban 110-bed long-term care facility. Focus group sessions were conducted at the facility with four nurse practitioners, the medical director, eight nurses and certified nursing assistants (CNAs) prior to an educational in-service which was provided to all staff at the facility. As criteria of infection were reported, nurses …

Implementing A Surgical Infection Prevention Practice In An Integrated Healthcare System, Tammy Peacock

Doctor of Nursing Practice (DNP) Projects

Problem: One of the most preventable health care associated infections (HAI) is surgical site infection (SSI). Approximately sixty percent of SSI’s could be prevented. The devastation of an SSI to the patient can be catastrophic. The cost to the health care system for treating SSI’s can be substantial (Ban et al., 2017).

Context: The rate of surgical site infections has been on the increase over the past three years. The concern for the amount of harm affecting our patients was worrisome. The cost of reputation and the bottom line to the organization was recognized by senior leadership. The support from …

Strong Recommendation Towards Hpv Vaccination, Danielle Bogue

Doctor of Nursing Practice Projects

Risk of future HPV related cancers remains high in individuals unvaccinated against HPV, leading to too many people dying from this preventable cancer. However, primary care providers’ strong recommendation to vaccinate and family education about HPV and vaccine efficacy have a positive impact on a family’s decision to vaccinate. The setting for this project was a Midwest suburban family healthcare practice. This process was implemented by providing the guardian with a handout, a short video on HPV, a question and answer period with the provider, and ended with the provider giving a strong recommendation towards HPV vaccination. Of the 35 …

Improving Operating Room Turnover Cleaning Communication, Alexander Lao Jr.

Master's Projects and Capstones

Operating room (OR) turnover cleaning is an important part of perioperative workflow for surgical teams, particularly to prevent cross-contamination of infectious pathogens from the surgical environment to staff and patients. Incomplete OR turnover cleaning ultimately leaves vulnerable surgical patients at risk for surgical-site infections (SSIs) and other types of hospital acquired infections (HAIs), which leads to delays in overall operations of the OR. A microsystem assessment at a large metropolitan hospital revealed an issue with incomplete OR turnover cleaning evident by the presence of dirty canisters, filters, and unclean anesthesia machines/work-areas after sterile surgical supplies had already been opened in …

Screening, Brief Intervention, And Referral To Treatment For Alcohol Misuse In Primary Care, Sai-Han Ackerman Yu

Doctor of Nursing Practice

An annual average of 88,000 deaths in the United States from 2006 to 2010 has been attributed to alcohol misuse, defined as risky or heavy alcohol consumption. Heavy or risky alcohol use for all adults aged 65 and older and for women aged 18 and older is defined as consuming more than 7 drinks per week and/or 3 drinks per day. For men aged 18 to 65 years of age, heavy or risky alcohol use is defined as consuming more than 14 drinks a week and/or 4 drinks a day. Chronic alcohol misuse increases the incidence of heart problems, cognitive …

Implementing Pneumococcal Vaccination Recommendations For Adults Age 19 And Over In A Family Care Clinic, Truc Le

Doctor of Nursing Practice

Pneumococcal vaccines are essential to children and adults. Having pneumococcal vaccines not only prevents pneumococcal infections but can also potentially lessen the severity of the disease. There are many scholarly articles attesting the herd effect in adults who received pneumococcal vaccines. Therefore, the purpose of this quality improvement project was to raise awareness of the pneumococcal vaccine and increase the vaccination rate in a primary care clinic in Texas. The Centers for Disease Control and Prevention’s pneumococcal vaccination schedule was utilized as guide for vaccine administration. The staff and provider were educated on screening, documenting, and administering the pneumococcal vaccine …

Hand Hygiene Among Hospital Staff: A Survey Of Knowledge, Attitude, And Practice In A General Hospital In Syria, Maha Othman, Cornelis Jonker

Jurnal Keperawatan Indonesia

Poor hand-hygiene adherence endangers the safety of both healthcare workers and patients. A cross-sectional Knowledge Attitudes Practicing (KAP) survey (n= 268) and an observation of hand-hygiene compliance (n= 36) were conducted among staff in a general hospital in Syria. The aim of this study was to investigate the degree of compliance with hand hygiene protocols by general health care workers including their knowledge, attitude and practice. The mean overall observed hand-hygiene compliance rate was 45.7% (95% CI 37.1 – 54.3). Nurses were observed to have better compliance than physicians. Staff were observed to be more concerned in performing hand-hygiene after …

The Effects Of Reentry Programs On Healthcare Accessibility And Resulting Emergency Department Strain By Ex-Inmates: An Integrative Literature Review, Kaitlyn Muratori

Grace Peterson Nursing Research Colloquium

THE EFFECTS OF REENTRY PROGRAMS ON HEALTHCARE ACCESSIBILITY AND RESULTING EMERGENCY DEPARTMENT STRAIN BY EX-INMATES

Kaitlyn Muratori

Faculty Sponsor: Dr. Christina Lattner

Background: Ex-inmates are significantly more likely to use emergency rooms to seek treatment for substance abuse, mental health disorders, or poor management of chronic conditions which, if not treated on a community level, ultimately contributes to overboarding in the emergency department.

Objectives: The purpose of this literature review is to use current research to examine the relationship between reentry programs across the US and healthcare accessibility, as well as the resulting strain of emergency room misuse by ex-inmates. …

Effects Of A Visual Artwork Intervention And Personal Progress Factors On Maternal Attitudes Towards Breastfeeding Among Black Women, Erika L. Gathron

Nursing Theses and Dissertations

Exclusive breastfeeding during the first six months of life is the recommended guideline, and the promotion of exclusive breastfeeding is a top priority for both national and international health organizations. The benefits of breastfeeding to both mother and baby reduces the burden of health disparity and promotes long-term healthful outcomes. Continued rates of low breastfeeding among Black women has brought forth the need for a methodological paradigm shift that enables nurses and researchers to explore creative, evidence-based, culturally relevant and population-specific interventions to enhance breastfeeding among Black women. This dissertation is an exploration of the use of art images of …

Setting The Stage: Reviewing Current Knowledge On The Health Of New Zealand Immigrants—An Integrative Review, Blessing Kanengoni, Sari Andajani-Sutjahjo, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peer-reviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search …

Pediatric Peanut Allergy Prevalence Review, Kaitlyn Lynch

Grace Peterson Nursing Research Colloquium

Abstract

Background: The rates of childhood allergies are increasing, prompting the need for continued research. The specific immune reaction to the allergen, peanuts, is the highest reported food allergy in children. The gap in knowledge is regarding the reasons behind the increased prevalence rates and the discrepancies in recommended guidelines for infant introduction of peanuts.

Purpose of Study: The review of studies narrowed down the reasons for prevalence and combined the current research into one integrative review. Additionally, the research standardized protocol recommendations for the early introduction of peanuts in infancy. The integrative review consolidated recent research on peanut prevalence …

Barriers To The Use Of Standard Precautions For Infection Control In Long Term Care Facilities: An Integrative Literature Review., Uyiosa Chu

Grace Peterson Nursing Research Colloquium

Barriers to the Use of Standard Precautions for Infection Control in Long Term Care Facilities.

Uyiosa Chu

Research Advisor: Michelle Neuman

College of Science & Health.

Background: Infection control is essential in long term care facilities (LTCFs) and the practice of standard precaution (SP) remains the main stay at reducing the rate of transmission of infectious diseases. However, compliance with the guidelines remain unacceptably low.

Objective: To identify the barriers that limit the use of standard control precautions in LTCFs and to evaluate how current measures address these barriers in order to improve compliance.

Methods: An integrative literature review was …

Educational Prevention Program Of Surgical Site Infections (Ssi), Carena Leung

Master's Projects and Capstones

Surgical site infections (SSI) cause negative health care effects to patients and hospitals. SSI is one of the most common types of healthcare-associated infections (HAI) accounting for 31% among hospitalized patients (Centers for Disease Control and Prevention [CDC], 2012). It is associated with prolonged length of stays (LOS), higher morbidity and mortality, and increased healthcare costs. The purpose of this quality improvement project is to decrease SSI rates by enhancing patient education and engagement in preoperative care and hygiene before surgery. In a metropolitan pediatric hospital, a microsystem analysis of the preoperative unit was conducted before generating the SSI Prevention …

Improve Effectiveness In Trauma Teamwork, Ginger Miramontes

Master's Projects and Capstones

On average, each Ventilator-Associated Event (VAE) is anticipated to increase the length of stay in the Intensive Care Unit (ICU), resulting in potential adverse events and cost to the organization. The Center for Disease Control (CDC) defines VAE as the increase of daily minimum positive end-expiratory pressure (PEEP) and fraction of inspired oxygen (FiO2) values, after a baseline period of patient stability or improvement on the ventilator (CDC, 2018). Standard endotracheal tube designs have led to the incidence of VAE because of the accumulation of subglottic secretions in the trachea. Untreated VAE can later result in Ventilator Associated Pneumonia (VAP). …

Promoting Adherence To Best Practice Related To Urine Reflex To Culture Testing, Maykel Verdecia Alonso Ba,Rn-Cphn

Nursing and Health Professions Faculty Research and Publications

Over a two week period, the infection control nurse, from a trauma designated facility located in norther California, planned a practice improvement project in collaboration with the laboratory microsystem to educate referring physicians and increase adherence to the Centers for Disease Control (CDC) protocol, which delineates recommended best practices related to urine reflex to culture testing. Urinalysis (UA) is a test that triggers a reflex urine culture when pyuria is present. Frequent urine culturing without the presence of pyuria can cause unnecessary treatment with antimicrobials. From January 2017 to December 2017, 10% of UAs from 200 urine samples from asymptomatic …

Health In Surroundings: Application Of The Theory Of Environment In Nursing Practice, Nasreen Rafiq

School of Nursing & Midwifery

Nursing practices are guided by theoretical frameworks which provide functional basis to nursing care. This paper discusses the application of Nightingale’s theory of environment in nursing practices. The theory highlights and explains 13 environmental cannons which include ventilation, cleanliness of walls/rooms, light, noise, personal cleanliness, bed and bedding, and taking food. Florence exquisitely explains the influence of environmental health on patients wellbeing. The application of the theory in nursing practices will help to understand and reflect the direct relation of environment on patients health.

Barriers To The Administration Of The Influenza Vaccine, Lauren Babb, Heather Bishop, Carrie Dozier, Renea Hopple, Hannah Marlin, Jennifer Sartin

MSN Research Projects

The Centers for Disease Control and Prevention (CDC) estimates that since 2010 influenza has caused between 9.2 million and 60.8 million illnesses. Numbers from the 2015-2016 influenza season indicate that influenza vaccination prevented approximately 5.1 million influenza illnesses. Though most healthy individuals recover from the flu within 2 weeks, there is great concern for those who do not as this can lead to serious complications. Vulnerable populations, such as the elderly, children, pregnant women and individuals with chronic disease that contract influenza, are at risk for more severe illnesses such as sinus infections or bacterial pneumonia. Influenza can lead to …

Employee Influenza Immunization: Education And A Directive To Increase Immunization Rates, Ashley Roman

Doctor of Nursing Practice

Purpose: The aim of this quality improvement project was to improve the influenza vaccination rate of health care workers at an ambulatory care center to meet the national benchmark of 90%.

Background: Influenza is a communicable disease that affects over 130,000 people causing 7,000 deaths (CDC, 2017b). Over the last 3 years the influenza immunization rates at the facility of interest have been on a downward trend despite multiple interventions, resulting in 43% last season. A directive was published at the beginning of the 2017-2018 influenza season mandating each employee to either get a vaccine or decline in writing. This …

Febrile Neutropenia, Tonja Plew

Nursing Student Class Projects (Formerly MSN)

Febrile Neutropenia (FN) is a common, yet potentially life-threatening, complication in cancer patients receiving myelosuppressive chemotherapy. FN occurs when a patient has a temperature of greater than 100.4℉ with an absolute neutrophil count of less than 500cells/mm³, which places the patient at a high risk for infection. Fever may be the only sign of FN. FN is an oncologic emergency, requiring immediate, aggressive treatment with broad-spectrum antibiotics. FN is associated with high morbidity and mortality in cancer patients.

Pathophysiology Of Infective Endocarditis, Blake Splawinski

Nursing Student Class Projects (Formerly MSN)

Infective Endocarditis (IE) is a rare disease that can be difficult to manage and treat due to the complex nature of the disease process. The pathophysiology behind IE involves damage to the cardiac endothelium allowing bacterial infection to occur. Pathogens gain access to the bloodstream adheres to the compromised cardiac tissue. This infection grows and causes a multitude of issues for the patient. Determining the specific bacteria involved allows for the proper antibiotic regimen. Understanding the pathophysiology and treatment plans assist the interdisciplinary team to successfully manage IE. Nursing implications focus on education, monitoring, and identifying patient populations more susceptible …

Clostridium Difficile Infection, Jacobina A. Adamu

Nursing Student Class Projects (Formerly MSN)

Clostridium difficile infection (CDI) refers to bacterium that infects the gut thereby causing diarrhea (Luo & Barlam, 2018). This infection is common among people who have used antibiotics for treatment. There is a growing consensus in literature that the infection of the intestines with Clostridium difficile infection is the fastest growing healthcare issue not only in the United States but globally. Millions of Americans are infected with this bacterium, causing major concerns in the healthcare system. In addition, it is worth noting that Clostridium difficile infection is a burdensome healthcare condition given the fact that it costs the healthcare system …