Digital Commons Network^™

A Lost Tribe In The City: Health Status And Needs Of African Asylum Seekers And Refugees In Hong Kong, William Chi Wai Wong, Sealing Cheng, Eleanor Holroyd, Julie Chen, Kelley Ann Loper, Lynn Tran, Heidi Yin Hai Miu

School of Nursing & Midwifery, East Africa

Background: Hong Kong’s resistance to be a signatory of the 1951 Geneva Convention and lack of domestic policies in this area has resulted in restrictions on access to healthcare amongst asylum seekers and refugees (ASRs). Using social determinants of health framework this study sought to identify health practices, problems and needs of African ASRs in Hong Kong.

Methods: A cross-sectional survey comprising of six domains including health status, health-seeking behaviour and social experience targeted at adult African ASRs in Hong Kong was conducted through three local non-governmental organisations between February and April 2013. Outpatient care and inpatient care in the …

Behavioral Modification And Relapse Rates In Opioid-Dependent Pregnant Women Managed With Subutex, Tammy Lynn Minor

Walden Dissertations and Doctoral Studies

Behavioral Modification and Relapse Rates in

Opioid-Dependent Pregnant Women Managed with Subutex

by

Tammy Minor

MSN, Walden University, 2009

BSN, Marshall University, 1986

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Opioid dependency affects not only the individual who is dependent on opioids but negatively impactsalso the family unit, the community, and society as a whole. Opioid use in the prenatal period can have devastating effects on both the mother and the fetus. The purpose of this paper is to perform a secondary analysis of the effectiveness of …

Evaluation Of Central Line Insertion Bundle Practices In A Trauma/Surgical Intensive Care Unit, Margaret A. Moore

DNP Projects

Central venous catheters, also known as central lines, serve an essential role in critical care settings across the globe. However, these lines put patients at an increased risk for hospital-acquired infections in the form of central line-associated bloodstream infections (CLABSI). In an effort to prevent these infections, evidence-based nursing interventions in the form of insertion and maintenance bundle are undertaken. It is the focus of this practice inquiry project to evaluate nurse adherence to central line insertion bundles before and after implementation of routine reporting of adherence rates within an ICU. The evaluation will provide insight to the degree of …

Supporting Healthy Futures For East Africa: Celebrating 15 Years Of Partnership In Nursing Education. School Of Nursing And Midwifery In East Africa, Aga Khan University, Nairobi, Kenya, Sharon Brownie, Walter Robb, Lyndal Hunter, Cliff Aliga, Isabel Kambo, Atem Machar, Joseph Mwizerwa, Judith Mutyabule, M. Namuguzi, Carolyne Namukwaya, Esther Nderitu, Leah Sande, Victor Skrzypczynski, Muneerah Vastani, Mariana Xavier

Books

This impact evaluation study was designed on the basis of quality and accountability. It focused on sourcing evidence regarding the impact and achievements of a 15-year investment in nursing education and workforce capacity building. The study was also designed to enhance alumni connection and establish sustainable models for monitoring and evaluation.

Comparison Of Body Temperature Of Elderly With Adult In South India, Anu Baby Ms, Sulochana B Ms, Latha T Ms

Manipal Journal of Nursing and Health Sciences

Background: Ageing is a gradual process, characterized by continued development and maturation. Every year there is an increase in the elderly population. Body temperature is an indicator of health status. However, thermoregulatory function is thought to decline with ageing. Therefore, it is significant to know the normal body temperature in elderly. Objective: Compare the normal body temperature among adults and elderly using Omron MC-510 tympanic thermometer. Methods: A cross sectional descriptive survey design was adopted for the study. Elderly (n=360) and adults (n=360) were screened for the presence of factors affecting core body temperature. Readings were recorded using Omron MC-510 …

Improving Quality Of Care For Mechanically Ventilated Patients In Long Term Care Through Full Compliance With The Ventilator Bundle Protocol, Tedgardo Pacal Mercene

Walden Dissertations and Doctoral Studies

One of the most common methods used by healthcare professionals in the ventilator unit to reduce morbidity and mortality due to ventilator-associated pneumonia (VAP) is a group of best practices known as the ventilator bundle. However, evidence from the literature shows that all its components must be in compliance if the bundle is to be effective. The purpose of this quality improvement project was to investigate the level of compliance with the different components of the ventilator bundle protocol at the study site's nursing home and rehabilitation center, as well as to improve compliance with the bundle protocol at the …

Difference In Knowledge Of Mrsa Regarding Sophomore And Senior Baccalaureate Nursing Students, Payton T. Lloyd, Daniel B. Whited, Lori N. Crimaldi

Williams Honors College, Honors Research Projects

Abstract

Background

The risk of infection by antibiotic resistant organisms is a common problem in hospital settings. Methicillin-resistant Staphylococcus Aureus (MRSA) is the most common type of resistant bacteria that can have serious consequences or even lead to death. Nurses' knowledge of how to prevent and treat this problem is essential for patient safety. The purpose of this study is to determine the differences in level of knowledge of MRSA in sophomore and senior level baccalaureate nursing students.

Methods

This descriptive, comparative study will examine differences in knowledge of MRSA between sophomore and senior baccalaureate nursing students and determine if …

I'M Still Standing, But I'M Not Standing Still, Janice E. Hawkins

Ellmer School of Nursing Faculty Publications

(First paragraph) When I made the decision to return to school for a PhD, I anticipated hard work, challenges, and a demanding schedule. Two years into my part-time program, I proudly informed readers of Reflections on Nursing Leadership that I was still standing and happy with my decision (Hawkins, 2014). Two years later, I'm not quite done.

Understanding Cultural Health Beliefs And Practices In Ghana, Africa, Jamie Wossilek, Rachel Patterson

Williams Honors College, Honors Research Projects

Abstract

Purpose. The purpose of this study is to explore the experiences and perceptions of university students and faculty after going on a medical mission trip to Ghana, Africa related to the health and illness beliefs of the Ghanaian people.

Background. Many organizations plan and conduct health mission trips. Although, many organizations are focused on improving health in developing countries, some may not understand cultural values and the health problems in those countries. “Improving health” is a complicated problem in developing countries and is hard to understand how those in the countries recognize health and illness.

Methodology. A purposeful, convenience …

An Evidence-Based Strategy To Improve Influenza Vaccination Rates Among Registered Nurses In Hospitals, Terri Lynn Spoltore

Walden Dissertations and Doctoral Studies

Seasonal influenza, or the flu, impacts over 3 million people each year. Within the health sector, nosocomial infection and absenteeism are frequently associated with the flu. The Centers for Disease Control and Prevention (CDC) recommend flu vaccination for all eligible individuals, especially health care workers (HCWs). Interventions associated with increased HCW vaccination include educational programs and occupational health campaigns to address misconceptions regarding vaccine safety and efficacy. This project evaluated the impact of a voluntary, web-based education module to encourage registered nurse (RN) vaccination. The logic and health belief models served as the theoretical frameworks. In a nonequivalent group design, …

Post Foley Removal Guideline Process And Outcome Evaluation, Sarah E. Gabbard

DNP Projects

When patients are admitted to a hospital patient safety should be a priority in all aspects of the care they receive. Preventing patients from acquiring hospital infections (HAIs) is one example of patient safety. All hospital employees have the responsibility to ensure that standard workflow and processes are in place to ensure this safety. The purposes of this Practice Inquiry Project (PIP) were to examine and develop interventions to decrease the risk of catheter associated urinary tract infections (CAUTIs), incorporate an effective process and standard workflow to implement evidence practice practices (EBP), and to evaluate the effectiveness of implementing the …

Impact Of The Advanced Practice Registered Nurse On The Stroke Patient Population, Jessica Moldenhauer

DNP Projects

PURPOSE: The purpose of this study is evaluate the APRN care model utilized for stroke patients by examining the pre and post impact on outcomes of the stroke clinical practice guidelines (CPGs), patterns of service use, stroke patient outcomes, and patient satisfaction.

METHODS: This study was a single-center, pre-post implementation retrospective study of the impact for the stroke APRN care model on the stroke patient population at Norton Brownsboro Hospital. The sample consisted of 145 patients for the pre-implementation period, March 2012 to August 2012, and 202 patients for the post-implementation period, March 2014 to August 2014.

RESULTS: No differences …

Evaluating Hepatitis C Screening In Primary Care, Nicole A. Brink

DNP Projects

Purpose: The purpose of this study was to evaluate primary care provider screening for hepatitis C virus (HCV) in three high risk populations. The specific aims were to determine the percentage of patients born between 1945-1965 who had a one-time screening for HCV, to determine what proportion of patients with a history of human immunodeficiency virus (HIV) or intravenous drug use (IVDU) have been screened for HCV, and to examine providers’ thoughts on their HCV screening practices.

Methods: A retrospective chart review of patient electronic medical records (EMR’s) from 2015 was conducted in an urban primary care site. SPSS was …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

An Evaluation Of The Screening And Management Of Patients With Type 2 Diabetes, Laura A. Cahoe

DNP Projects

Purpose: This purpose of this project was to evaluate preventive screening practices and adherence to guidelines for patients with type 2 diabetes (T2DM) as recommended by the American Diabetes Association (ADA) and United States Preventive Services Task Force (USPSTF) in the primary care setting. The specific aims were to: 1) determine the percentage of patients who received recommended screenings from the ADA, 2) determine the percentage of patients who received recommended screenings from the USPSTF, and 3) determine if the proportion of patients to receive the recommended screenings met established benchmarks set by Healthy People 2020 (HP2020).

Methods: A retrospective …

Preschool Attendance: A Parental And Teacher Perspective Of Barriers And Behaviors Using Grounded Theory Research, Anne Meoli

Electronic Theses and Dissertations

Background: Preschool children from single-parent households with lower socioeconomic status (SES) are absent from preschool at rates higher than any other group. Some children are chronically absent, missing more than 10% of the school year. The phenomenon of preschool attendance related to behaviors, practices, and parental decision making associated with health and illness in lower SES households has not been previously studied using grounded theory methodology. Aim: The purpose of this study was to explore decision making related to supporting attendance in a preschool of 67 children (aged 3 to 4 years) with primarily low-income, single parents and preschool teachers …

Barriers To Exclusive Breastfeeding Among Mothers During The First Four Weeks Postpartum, Jessy V. Thomas

Walden Dissertations and Doctoral Studies

According to the World Health Organization, breastfeeding is natural and the most effective way of nourishment to feed infants and young children to ensure child health and survival. Currently, the World Health Organization, the American Academy of Pediatrics, and other health organizations recommend exclusive breastfeeding during the first 6 months of life. Although exclusive breastfeeding has been shown to reduce the occurrence of adverse health outcomes to the infant and mother, the duration of exclusive breastfeeding remains relatively low in the United States. The theory of planned behavior was used as a theoretical framework for this study. The purpose of …

Nutritional Status And Tuberculosis Risk In Adult And Pediatric Household Contacts, Omowunmi Aibana, Xeno Acharya, Chuan-Chin Huang, Mercedes C Becerra, Jerome T Galea, Silvia S Chiang, Carmen Contreras, Roger Calderon, Rosa Yataco, Gustavo E Velásquez, Karen Tintaya, Judith Jimenez, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children.

METHODS AND FINDINGS: We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used …

Symptom Experience And Influenza-Like Illness In A Military Population, Monique Bouvier

Dissertations

AIMS: The primary objective of this study was to identify if symptom presentation expressed over the course of an influenza-like illness (ILI) can predict virus type by use of unsupervised machine learning. The secondary objective was to describe clinical characteristics of strain specific coronavirus. Finally, examine the psychometric properties of the Canadian Acute Respiratory Illness and Flu Scale (CARIFS).

BACKGROUND: ILI outbreaks have been a significant source of non-battle injury among military personnel. Many different viruses cause ILI, and it is difficult to determine which virus is causing the illness. Recent studies have examined the etiology and epidemiology of ILIs. …

Breastfeeding Education For Women With Diabetes, Pregnancy-Induced Hypertension And Multiple Gestations, Oluwapelumi Adefunmike Adeboyejo

Walden Dissertations and Doctoral Studies

Breastfeeding is considered a public health concern due to increased maternal/infant mortality and morbidity rates associated with persistent low rates in breastfeeding. Providing early breastfeeding education for women with diabetic, pregnancy-induced hypertension and multiple gestations can result in higher persistence rates and a decrease in maternal and infant mortality and morbidity rates. This quality improvement project provided early prenatal breastfeeding education for women with diabetes, pregnancy-induce hypertension and multiple gestations at a private clinic in Long Beach, Southern California. Evidence-based literature reviews were conducted through CINAHL and Medline (2009-2014). The descriptive study used for the project was made up questionnaires …

Engaging In Culturally Informed Nursing Care With Hmong Children And Their Families, Shoua Xiong, Nora Degroote, Hayley Byington, Jamie Harder, Krystal Kaminski, Kristin Haglund

College of Nursing Faculty Research and Publications

The Hmong are an ethnic hill tribe group originally from Southern China with concentrated populations throughout Southeast Asia, especially the mountains of northern Laos. Following the Vietnam War, the Hmong started immigrating to the United States in waves to escape prosecution for fighting communism alongside the United States. Today, the Hmong population in the United States is growing rapidly, with a median age of 20.4 years. As the Hmong move and redistribute themselves across the country to be with family or pursue new opportunities, it is more and more likely that nurses everywhere will interact with Hmong children and their …

Increasing Hpv Awareness And 3-Dose Series Compliance Among The Female Population (Ages 11-26) In A Community Health Clinic, Vanessa Orozco

Master's Projects and Capstones

Abstract

The overall goal of this project was to increase HPV 2nd and 3rd dose compliance rates by a combined 10% among the female adolescent population (ages 11-26). This was to be achieved by implementing EBP follow-up calls to not only schedule appointments but also to serve as a reminder for patients to come into previously scheduled appointments. This project was chosen as prior clinic and organization-wide meetings had delineated compliance rates at just 7%. There were various methods employed to implement this project including an initial microsystem assessment, which entailed a Root Cause Analysis, Process Mapping, SWOT analysis, Cost-Analysis, …

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …

Reducing Clostridium Difficile, Norabel V. Zafra

Master's Projects and Capstones

This CNL project aims to reduce the number of laboratory identified Clostridium Difficile Infections (CDI) events by 20% by December 2015. This CNL projects focuses on reducing CDI in an 8 unit bed specifically designated for medically ill geriatric patients above 70 years old residing in the West Texas region. A majority of the geriatric patients living with multiple co-morbidities require maximum assistance with activities of daily living and medication management. The geriatric patients will be discharge to a skilled nurse facility, long-term acute care, rehabilitation, independent living, or home with home health. A variety of methods such as reinforcing …

Reducing Clabsi In The Nicu With Iv Tubing Competency, Tessa A. Toscano Ms

Master's Projects and Capstones

Central line-associated bloodstream infection (CLABSI) is a significant problem in a Level IV neonatal intensive care unit (NICU) on the West Coast of California. A clinical nurse leader (CNL) student joined a team consisting of the unit’s nursing manager, nursing educator, clinical nurse specialist (CNS), and CNS student. Literature review highlighted the association between the development of CLABSI and the practice of changing central line intravenous (IV) tubing. Five interviews of nurses and 15 observations of nurses performing IV tubing change revealed practice variations within six major steps of the procedure. The team revised the IV tubing change policy to …

Evaluation Of Vaccination Policies Among Outpatient Oncology Clinics In Utah: A Pilot Study, Karlen Beth Luthy, Sarah L. Stocksdale, Janelle L B Macintosh, Lacey M. Eden, Renea L. Beckstrand, Katherine Edmonds

Faculty Publications

Background: In Utah, all major hospital facilities have employee vaccination policies. However, the presence of health care worker vaccination policies in the Utah outpatient oncology setting was unknown.

Objectives: The objectives were to identify Utah oncology outpatient employee vaccination policies and to identify what consequences, if any, were present for unvaccinated employees.

Methods: This was a cross-sectional, descriptive study design in which clinic managers from outpatient oncology clinics in Utah were asked, via questionnaire, to describe the clinic’s employee vaccination policy and the consequences for refusing the policy.

Findings: Most vaccination policies applied to employees primarily assigned to work in …

Assessing The Need For A New Oral Care Protocol In The Non-Ventilated Patient Population, Talia J. Johnson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Purpose: Nonventilator-associated hospital acquired pneumonia is a nosocomial infection that has not been heavily researched. With hospital-acquired pneumonia accounting for some of the most frequent nosocomial infections in the United States, it is important to determine ways to decrease rates of infection. The purpose of this study was to determine the rate of nonventilator-associated pneumonia in a hospital patient population, to determine charting compliance of nurses, and to determine whether there was a need for a new oral care protocol.

Design: A retrospective electronic record review was performed to determine the rate of nonventilator- associated hospital acquired …

An Evidence Based Approach To Sepsis: Educational Program, Dolores Perez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Evidence-based guidelines for recognizing and treating sepsis have been available for decades, yet healthcare providers do not adhere to the recommendations. Sepsis can progress rapidly if not recognized early. Literature reports reveal that sepsis is the leading cause of death in non-cardiac intensive care units (ICUs), and it is one of the most expensive conditions to treat. A hospital in the Las Vegas, Nevada area had previously introduced sepsis management prescriptions in 2011 with no formal education of sepsis guidelines to nurses. The original hospital’s sepsis management prescription sets followed guidelines dated 2008. The purpose of this project was to …

Reinventing The Medical Request Process In A Correctional Healthcare Setting, Leah Murphy

Master's Projects and Capstones

This project was developed as part of a Clinical Nurse Leader course of study with the goal of gathering and evaluating microsystem data, and the creation and implementation of a process improvement project. The project was conducted in a correctional setting which houses male and female detainees with a wide variety of medical needs. The project addressed long wait times for detainees who have submitted a request for services from the medical department. The goal of this project was to reduce wait times for medical requests, and provide service for a greater number of patients. This project is needed because …

Routine Vs. Clinically Indicated Peripherally Inserted Intravenous Catheter Changes, Juliet Hahn Bsn, Rn, Zinah Heisel Bsn, Rn, Devin Pond Bsn. Rn

Patient Care Services / Nursing

No abstract provided.