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Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Implementing The Cdcs Core Elements Of Outpatient Antibiotic Stewardship Program Into The Urgent Care, Deanna Powelson

Dissertations

Purpose: The inappropriate use of antibiotics has led to the development of antimicrobial

resistance which is a severe threat to the public and an increasing global problem. The

Centers for Disease Control and Prevention (CDC) estimates at least two million illnesses

and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States (CDC,

2014). The purpose of this quality improvement (QI) project was to evaluate the

effectiveness of an antibiotic stewardship program (ASP) on urgent care providers'

prescribing on viral respiratory tract infections (RTIs) including the common cold,

pharyngitis, and bronchitis.

Methods: This QI project implemented the CDCs Core …

Measurements That Matter: Assessment & Management Of The Symptoms Of Chronic Illness Using The Integrated Palliative Outcome Scale (Ipos), Deborah Jeffery

Dissertations

ABSTRACT

Measurements that Matter: Assessment and Management of the Symptoms of Chronic Illness Using the Integrated Palliative Outcome Scale (IPOS)

Background: The mission of the Advanced Illness Management (AIM) program at the Visiting Nurse Association of Greater St. Louis (VNA) is to relieve the burden of serious illness by providing exceptional care to patients and families through symptom management. A validated symptom tool was needed for holistic assessment.

Purpose: This is a quality-improvement project aimed at enhancing symptom management in patients experiencing advanced illness in a community-based palliative care program. Provider use of the Integrated Palliative Outcome Scale (IPOS) as …

Differential Well-Being In Response To Incivility And Surface Acting Among Nurses As A Function Of Race, Lauren Sarah Park

Dissertations and Theses

Demand for healthcare services is rising dramatically as the proportion of older adults in the United States increases, and the success of these healthcare organizations depends on cooperation among patients, doctors, and nurses. These interpersonal interactions come with costs associated with managing one's emotions in ways that are in line with completing job tasks effectively, especially as past research has demonstrated that nurses are likely to experience and respond to incivility, and nurses of minority backgrounds even moreso. This study examines the effect of experiencing incivility on engaging in surface acting, or simulating emotions that are not actually felt; how …

Gw Nursing, Summer 2018, George Washington University, School Of Nursing

GW Nursing Magazine

No abstract provided.

The Role Of Peanut Allergy In Anaphylaxis, Jessica Schmelzer

Nursing Student Class Projects (Formerly MSN)

The rise of food allergies directly correlates with the increase in anaphylactic reactions. Food allergies currently affect an estimated 15 million Americans or 4% of children and 1% of adults. Anaphylaxis is a life-threatening reaction that is most commonly caused by food allergies. The top 8 allergens in the United States are: peanut, tree nut, milk, egg, wheat, soy, fish, shellfish. Peanut allergies are on the rise in the United States and are commonly a cause of anaphylaxis. Anaphylaxis causes rapid-onset respiratory compromise, skin/mucosal involvement and hypotensive end-organ dysfunction. Symptoms of anaphylaxis are severe and often occur very quickly after …

The Utilization Of Laryngeal Mask Airways Vs. Endotracheal Tubes In Pediatrics With Upper Respiratory Tract Infection In Reducing Airway Complications, Ruby Foster

Nurse Anesthesia MSNA Student Capstones

According to Tait & Malviya, (2005) children typically experience six to eight upper respiratory infections (URIs) per year with ninety-five percent being viral in etiology (Tait & Malvia, 2005). URIs commonly occur in the pediatric population (Bernando-Ocampo, 2012). An issue surrounding the debate on whether a child with upper respiratory infection (URI) should proceed with surgery or cancel surgery is a debate that has been ongoing for several years (Tait el al. 2005). This review examines whether children who have an URI scheduled for surgery are at an increased risk for adverse respiratory complications when the laryngeal mask airway (LMA) …

Adult Vaccination Rates In The Severely Mentally Ill Population: An Improvement Project In An Outpatient Setting In Utah, Nathalia H. Williams, Leslie Miles, Beth Luthy, Lacey Eden

Student Works

Background: Adults who suffer with severe and persistent mental illness (SPMI) rarely access medical care to address basic medical needs, so they are subsequently less likely to receive preventive vaccines. The aim of this project was to increase the rate of vaccines among the SPMI population. This project started in 2011 and still is ongoing. It took place in an outpatient community mental health center (CMHC) which serves about 4,200 SPMI clients. Personnel managing the project included registered nurses from the local health department, staff from the CMHC, and volunteer nursing students.

Methods: A review of the literature identified a …

Immune System Overdrive: A Case Study Of An Obstetric Patient With Hemophagocytic Lymphohistiocytosis., Jaime Kupillas Msn, Rn, Laurie Griesel Rn, Rnc-Ob

Patient Care Services / Nursing

No abstract provided.

Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph

Doctor of Nursing Practice Final Manuscripts

Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. …

Promoting Antibiotic Stewardship For Uti Management In Long Term Care Residents Through Standardized Clinical Practice Guidelines., Juliana M. Enoakpa

Doctor of Nursing Practice Projects

Urinary tract infections (UTIs) are the most diagnosed infections requiring antibiotics in long-term care (LTC) facilities. The rising prevalence of antimicrobial resistance (AMR) threatens treatment of infections that were once responsive to antibiotic therapy. The inappropriate use of antibiotics in this Midwestern LTC facility provided the impetus for implementing a standardized clinical practice guideline (CPG) for diagnosing UTIs among the LTC residents. A data collection tool was developed for the audit that identified the specific assessment criteria for UTI management and eligibility criteria for antibiotics. Physicians and NPs at the LTC facility were administered a questionnaire prior to implementation of …

Assessment Of The Validity Of Patient-Stated Allergies: De-Labeling And Education, Tawny Thomas, Angelina Leitschuh

Doctor of Nursing Practice Projects

The initial direction of the project was to develop and implement a research-based protocol to de-label hospitalized patients with a patient-stated penicillin allergy who were not truly allergic (Phase I). The project was abruptly halted due to the lack of data to justify the need, lack of sufficient communication among stakeholders, questions regarding financial cost of implementation, and strong concerns regarding educational needs of nursing staff. After developing the initial protocol, the project team was redirected to provide evidence-based allergy assessment education to the nursing staff to foster reliable and accurate patient interviews and documentation of the results (Phase II). …

Effects Of A Multi-Tiered Approach To Impact Immunization Compliance Of Students Attending A Medium-Sized Public University, Emily Watson, Stephanie Muertz, Kate Traum

Doctor of Nursing Practice Projects

Background: College students in Illinois must comply with laws regarding proof of immunity for specific vaccines. These laws, however, do not guarantee compliance with immunizations. Unvaccinated persons living in highly-vaccinated communities, such as college campuses, are at risk for many preventable diseases. Objective: The primary aim of this project is to collaborate with Southern Illinois University Edwardsville (SIUE) Health Service to develop, implement, and evaluate the effects of multi-tiered interventions to increase immunization compliance rates of first-semester college students. Methods: A brief YouTube video was presented to freshmen students, an eye-catching educational flyer was distributed by advisors and throughout campus, …

Emergency Preparedness Among College Students At The University Of Arkansas, Mary Gadberry

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Students at the University of Arkansas could be susceptible to multiple forms of disaster including severe winter weather, earthquakes, tornadoes, lightning, floods, toxin release, radiological release from nuclear power plant, infectious diseases, food contamination, fires, active shooters, and bomb threats (Federal Emergency Management Agency [FEMA], 2013). The unpredictability of natural disasters, coupled with the increase in targeted school violence, served as the impetus for various federal initiatives intended to protect university populations (FEMA, 2003). The purpose of this study was to determine the emergency preparedness levels of college students at the University of Arkansas. Only 50% of students were concerned …

Culture Care Needs Of Puerto Rican Women Receiving Hiv Care From Nurse Practitioners In New York City, Michele Crespo-Fierro

Dissertations, Theses, and Capstone Projects

The purpose of this mini-ethnonursing research study was to discover, describe, and interpret culture care values, beliefs, expressions, practices and needs of Puerto Rican women receiving HIV care from nurse practitioners (NPs) and other providers in New York City. The emic, or insider, perspective of Puerto Rican women living with HIV was the focus of this study and Leininger’s Culture Care Theory (CCT) provided the theoretical framework. Various enablers of the CCT, including Leininger’s Sunrise Enabler to Discover Culture Care, guided the design andimplementation of the study. Six key and twelve general informantswere interviewed and data from the interviews were …

Most Effective Interventions For Disaster Relief Preparation, Elizabeth Keating, Faith Edwards, Cheryl Swanson Phd, Rn

Anna Vaughn School of Nursing Undergraduate Work

Because disasters are sometimes unpredictable and difficult to measure, it is exceedingly important to have properly trained healthcare professionals that are prepared for a variety of natural and manmade crises. Victims affected by disasters may be numerous and have severe injuries, but nurses, as first-responders, with proper education and experience can drastically reduce the amount of casualties in a particular disaster. However, it is clear that nurses currently feel unprepared in the event of a natural or manmade disaster, and therefore need more training and preparation for such occurrences. This systematic research review set out to find the most effective …

Serum Proteomics In African American Female Patients With Irritable Bowel Syndrome: An Exploratory Study, Kristen R. Weaver-Toedtman Phd, Acnp, Anp, Gail D.Eramo Melkus, Jason Fletcher, Wendy A. Henderson

Publications

Background Sex and subtype differences within patients with irritable bowel syndrome (IBS) complicate the understanding of disorder pathogenesis and hinder the design of efficacious, therapeutic interventions. Objectives The aims of this study were to harness the power of shotgun proteomic analysis, identify circulating proteins that differentiate African American female patients with IBS from healthy controls (HC), and gain biological insight on symptomatology. Methods Serum proteome analysis was performed upon a cohort of overweight, African American female participants with constipation predominant IBS symptoms (n = 5) and HC (n = 5), matched on age, sex, years of education, body mass index, …

Assessment Of Nurse Behaviors That Influence Care And Maintenance Of Pediatric Oncology Central Venous Catheters, Susan Elizabeth Mckenna

Doctoral Projects

Central venous catheters (CVC) are devices necessary to medically treat pediatric patients diagnosed with conditions such as cancer. Central line associated bloodstream infection (CLABSI) is a complication associated with utilizing a central line. Nurses are responsible for maintaining and complying with strict prevention protocols. The aims of this quality improvement project are to: (a) gain an understanding of perceptions of CLABSI prevention, (b) observe adherence to the CLABSI prevention bundle, (c) measure adherence to the current CLASBI prevention bundle (post-training), (d) identify ways to improve adherence to the CLASBI bundle, and (e) ascertain potential strategies for further compliance efforts. Three …

A Journey Through Homelessness: A Photovoice Project With Youth Experiencing Homelessness In Minnesota, Bonnie D. Paulsen

Theses and Graduate Projects

The purpose of this project was to conduct a photovoice project with youth experiencing homelessness who frequent a drop-in center in the Midwest. Youth experiencing homelessness are a marginalized population whose numbers continue to grow. Photovoice is a method by which marginalized populations have an opportunity to express their lived experiences through photographs and what those photographs mean to them. Four youth from the drop-in center in the Midwest participated in the photovoice project. The youths were given cameras and instructions to take photographs of three broad areas: what homelessness means to them, their dreams for their futures and how …

Influenza Vaccine Effectiveness In The Elderly, Sheryl Rudolf

Nursing Capstones

No abstract provided.

Vaccine Refusal Dilemmas, Yessica Garcia

Honors Theses

The topic of the thesis is vaccine refusal dilemmas. The focus is on the current issue of the decreasing immunization rates in children. Children are a vulnerable population and rely on their parents to make healthcare decisions for them. This thesis will address the parents’ standpoint on immunizations, the providers’ standpoint on the situation, and the sources of vaccination information available, then determine vaccine refusal dilemmas that may result. The main population of focus will be pediatric patients including their families and their providers. Dilemmas associated with vaccine refusal and/or hesitancy will include present and existing issues as well as …

Nursing Compliance With Vap Bundle, Taylor Meadows

Scholars Week

It has been proposed that by initiating the highest percentages of nursing compliance, overall patient outcomes will improve along with a decrease in the number of ventilator-associated events (VAEs). The aim of the study is to appraise the association between nursing compliance with a ventilator bundle and a successful decline in the number of events of ventilator-associated pneumonia (VAP) in the intensive care unit (ICU). The study also provides evidence-based direction on the best nursing practices essential to reducing the rates of VAP. Objectives include expanding the awareness of critical care staff on prevention and compliance and to improve teamwork …

Prevention Of Central Line-Associated Bloodstream Infection (Clabsi) In Adult Oncology Patients, Christina Winkelman

Doctoral Projects

Central Line-Associated Bloodstream Infection (CLABSI) is a preventable issue in healthcare. CLABSI contributes to negative patient outcomes and increased healthcare cost. Research demonstrates that many interventions are effective in reducing the rate of CLABSI. The implementation of CLABSI bundles can significantly reduce the occurrence of CLABSI. This quality improvement project implemented a CLABSI bundle that specifically targeted identified areas of weakness in CLABSI prevention at an organization with a focus on adult oncology care. The three part CLABSI prevention bundle focused on: (a) registered nurses (RN) changing and documenting endcaps in the electronic health record after blood administration, (b) RNs …

Outcomes Of Allogeneic Hematopoietic Stem Cell Transplantation For Gata2 And Dock8 Immunodeficiencies: Demographics And Transplantation Variables, Kristen M. Cole, Dnp, Msn, Rn, Bmtcn, Ocn

Doctor of Nursing Practice Projects

Background/Purpose: GATA2 and Dedicator-of-Cytokinesis-8 (DOCK8) deficiencies are two recently described genetic immunodeficiency diseases for which allogeneic hematopoietic stem cell transplant (HSCT) represents the only definitive therapy. The patient characteristics and HSCT variables that relate to the outcomes in these two diseases following HSCT remain unclear. Therefore, we described these variables in these two patient populations and explored their relationships with HSCT outcomes.

Methods: Data were obtained from retrospective chart reviews of all patients with GATA2 deficiency and DOCK8 deficiency who underwent HSCT on clinical research protocols at the National Cancer Institute. The outcomes included overall and disease-free survival status, graftversus-host …

Peer To Peer Review: Professional Development To Improve Feedback Skills And Self-Efficacy, Brittany H. Gnilka, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Peer to peer review is the most essential form of peer review as it encourages nurses to evaluate the quality, safety, and effectiveness of nursing care amongst peers. Poor communication skills for providing feedback during peer review is a barrier identified in the literature, which can be addressed in professional development training.

Objectives: The purpose of this study was to evaluate the effect of communication-focused professional development sessions on the ambulatory care nurses’ perceived self-efficacy to successfully provide meaningful feedback during peer to peer review.

Results: The results showed a statistical significance difference between the mean pre and postGSES …

Nurse Practitioner Clinical Education: Evaluation Of A Clinical Residency Model, Lisa Wilson Hood

Doctoral Projects

A new clinical residency education model was developed and implemented in response to a family nurse practitioner program’s difficulty in securing and maintaining qualified preceptors and clinical sites for students in the program, and a community hospital’s shortage of nurse practitioners for their rural healthcare clinics. This Doctor of Nursing Practice project conducted an evaluation on this new model. The evaluation results showed that the clinical residency model met standards of nurse practitioner education, incorporated nursing leader recommendations for new clinical models, and proved to be an effective model for clinical education.

Differences In Work Environment For Staff As An Explanation For Variation In Central Line Bundle Compliance In Intensive Care Units., Yuna S.H. Lee, Patricia W. Stone, Monika Pogorzelska-Maziarz, Ingrid M. Nembhard

College of Nursing Faculty Papers & Presentations

BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals.

PURPOSE: The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs).

METHODOLOGY/APPROACH: A cross-sectional study of hospital medical-surgical ICUs in the United States was done. …

Penicillin Allergy Testing And Antimicrobial Stewardship, Vanessa J. Sundeen

Nursing Capstones

No abstract provided.

Evidence-Driven Diagnosis And Treatment Of Acute Urinary Tract Infections In Long-Term Care, Morgan K. Clouse

DNP Projects

Misdiagnosis of asymptomatic bacteriuria as a urinary tract infection continues to occur, leading to the overuse of antibiotics. Due to the growing elderly population in long-term care facilities (LTCFs), LTCFs can play a critical role in antimicrobial stewardship. Urinary tract infections are a starting point for moving toward antimicrobial stewardship, since urinary tract infections are common in LTCFs. A retrospective chart review of 156 cases with suspected urinary tract infections (UTIs) was completed in a LTCF. The purpose of the scholarly project was to assess diagnostic and treatment practices for UTIs and compare them to a diagnostic and treatment algorithm. …

Student Nurses Perception Of Ability To Provide Care Internationally, Cassie A. Williams

Honors College Theses

PUPOSE: With diversity expected to increase in the future, Bachelor of Science in Nursing (BSN) education regarding international nursing care and cultural competency was explored. Specifically, the purpose of this research was to determine whether current BSN students believe they are capable of providing appropriate care to international patients and/or patients of different cultural backgrounds.

METHODOLOGY: A mixed-methods survey was designed to assess student’s perception of ability to care for and interact with international patients and patients of different cultural backgrounds. Additionally, it was assessed whether students believed more cultural education should be provided by the School of Nursing.

RESULTS: …