Digital Commons Network^™

Identifying Risk Factors For High Incidence Of Peripheral Intravenous Catheters Complications: Reducing Infiltration Rate Within The Hospital, Janise Marrisette Banks

Walden Dissertations and Doctoral Studies

This study addressed an increasing number of peripheral intravenous catheter infiltrations within hospitals, leading to problems such as phlebitis and cellulitis, which may result in a longer length of hospital stay. The purpose of this project was to determine how to reduce infiltrations in order to increase the longevity of the catheter. A quantitative, description design was used, guided by Abdellah's classification framework for identifying nursing problems. The target population was 50 patients experiencing incidents of peripheral intravenous catheter infiltration, identified in a patient safety event log used across a 252-bed hospital. Each incident was assessed for several risk factors, …

Evaluation Of Chlorhexidine Bathing Practices In Trauma/ Surgical Intensive Care Units, Kara Willett

DNP Projects

Central venous catheters (CVC) are vital in present-day medical practice, particularly in the intensive care unit (ICU). However, their use puts patients at risk for developing central line-associated bloodstream infections (CLABSIs) which are a major concern in today’s health care system. CLABSIs are a significant source of patient mortality, increased length of stay, and healthcare spending. The heightened awareness of these infections along with their escalating cost has amplified implementation of preventative protocols.This practice inquiry project includes three manuscripts, each of which discusses relevant aspects of CLABSIs prevention utilizing daily whole body chlorhexidine gluconate bathing inlcuding a review of literautre …

Treatment Outcomes For Opiate Addicted Pregnant Women, Jennifer L. Roth Parr

DNP Projects

The problem of opiate addiction is complex enough but compounded when the patient is pregnant. Substance use during pregnancy produces harmful and costly effects to both the mother and the fetus (Veilleux, Colvin, Anderson, York & Hines, 2010). The rate of opiate addiction among pregnant women in the U.S. has been increasing in epidemic numbers since the beginning of the 21st century. This paper looks at research on the origin of the problem, the demographics of the average pregnant opiate addicted patient, the effects on the woman and her unborn child, and available treatment options.

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

Infectious Disease Outbreaks And Increased Complexity Of Care, Joan Musau, A. Baumann, C. Kolotylo, T. O’Shea, A. Bialachowski

School of Nursing & Midwifery, East Africa

Aim: This study examined the effects of healthcare-associated infectious disease outbreaks on nurses’ work in a large acute care hospital in Ontario, Canada.

Background: The incidence of healthcare-associated infections has increased. Previous research focuses on epidemiology, healthcare systems, and the economic burden of outbreaks. Few published studies focus on the impact of outbreaks on nurses’ work in acute care facilities.

Introduction: Since the severe acute respiratory syndrome epidemic in 2003, combating infectious diseases has become a key issue. Hospitals have implemented measures related to healthcare-associated infections. However, nurses experience challenges in preventing, controlling, and contending with outbreaks.

Methods: A retrospective …

Exploring Unprotected Anal Intercourse Among Newly Diagnosed Hiv Positive Men Who Have Sex With Men In China: An Ethnographic Study, Haochu Li, Eleanor Holroyd, Joseph Lau

School of Nursing & Midwifery, East Africa

Background: Unprotected anal intercourse (UAI) is a major pathway towards secondary HIV transmission among men who have sex with men (MSM). We explored the socio-cultural environment and individual beliefs and experiences conducive to UAI in the context of Southern China.

Methods: We employed an ethnographic approach utilizing a socio-ecological framework to conduct repeated in-depth interviews with thirty one newly diagnosed HIV positive MSM as well as participant observations in Shenzhen based healthcare settings, MSM venues and NGO offices.

Results: Some men (6/31) reported continuing to practice UAI after an initial diagnosis of being HIV positive. For MSM who had existing …

Stigma, Subsistence, Intimacy, Face, Filial Piety, And Mental Health Problems Among Newly Hiv-Diagnosed Men Who Have Sex With Men In China, Haochu (Howard) Li, Eleanor Holroyd, Joseph Lau, Xiaoming Li

School of Nursing & Midwifery, East Africa

High rates of mental health problems among people living with HIV (PLWH) have been widely reported in the literature; however, an understanding of the socioecological contexts of these presentations remains limited, particularly in China. In order to explore potential socioecological factors associated with mental health problems among newly diagnosed HIV-infected migrant men who have sex with men (MSM), we employed a life profile approach conducting semistructured in-depth interviews with 31 newly diagnosed HIV-infected MSM residing in a city in Southern China. Participants’ life profile accounts outlined their concerns, including internalized stigma, subsistence living, difficulties finding a lover or a stable …

Use Of An Electronic Educational Module To Educate Advanced Practice Nurses On Preventive Care Protocol For Immunocompromised Patients, Simi Jesto Joseph Dr, Audrey Klopp Dr

Manipal Journal of Nursing and Health Sciences

Immunocompromised patients are at increased risk of infections and certain cancers due to the immunosuppressed body as well as the immunosuppressive agents. Despite American national organizations’ specific guidelines for immunocompromised patients, reported vaccination rates and provider compliance on preventive services is low. The aim of this study was to assess knowledge, attitude and clinical practice among Advanced Practice Nurses (APN) in preventive care for immunocompromised patients and educating APNs to improve their knowledge and practice skills using an evidence-based preventive care protocol. Methods: APN members of Illinois Society of Advanced Practice Nurses (ISAPN) organization were surveyed by a needs assessment …

Clinico Epidemiological Profile Of Hiv-Tb Co-Infected Patients In Coastal South India, Bhaskaran Unnikrishnan Dr, Ramesh Holla Dr, Darshan B. B Dr, Arjun B. Y Dr

Manipal Journal of Nursing and Health Sciences

Introduction: Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) co-infection is considered to be one of the important public health problems globally. Tuberculosis is a leading cause of mortality among people living with HIV/AIDS. Objectives: To find out the trends of HIV and TB co-infection, socio-demographic and clinical profile of HIV and TB co-infected patients. Methods: A hospital based descriptive study was done at a tertiary care teaching hospital in Mangalore. The hospital records of all HIV-TB co-infected patients admitted between January 2008 and December 2013 were reviewed and data were captured in data capture sheet. The data obtained was analysed …

Educational Intervention To Impact Parental Decisions To Consent To Human Papillomavirus Vaccine, Tawa Bimbola Ibikunle-Salami

Walden Dissertations and Doctoral Studies

Educational Intervention to Impact Parental Decisions to Consent to Human Papillomavirus Vaccine

by

Tawa B. Ibikunle-Salami

MSN, Indiana Wesleyan University, 2010

BSN, Indiana Wesleyan University, 2005

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

September 2015

Human Papillomavirus (HPV) is a global health issue that is transmitted sexually and affects both genders. Evidence shows that approximately 79 million people are affected in the United States with 14 million newly affected yearly. The Centers for Disease Control and Prevention indicates that teens and young adults under age 25 are at particular …

Ventilator-Associated Pneumonia Prevention Bundle, Patricia Cal

Walden Dissertations and Doctoral Studies

Ventilator-associated pneumonia (VAP) is a serious complication in critically ill patients; it can prolong intubation, increase intensive care unit and hospital length of stay, and increase mortality to twice the level of patients who do not develop VAP. The purpose of this project was to determine the effect of an evidence-based educational program to prevent VAP on ICU nurses' actual and documented practices for preventing VAP. The research questions addressed whether an educational program focused on VAP prevention will affect critical care nurses' compliance with a VAP prevention bundle, and whether the education will result in maintenance of a rate …

Barriers To The Influenza Vaccination In Veterans, Zina Floyd

Walden Dissertations and Doctoral Studies

Influenza is the eighth leading cause of death in the United States, accounting for 56,000 deaths annually and leading to an average of more than 200,000 hospitalizations every year. Adults 65 years of age and older account for 50% to 60% of influenza-related hospital admissions and an estimated 90% of influenza-associated deaths occur in people age 65 and older. During the 2011 to 2012 influenza season, approximately 50 % of veterans between 45 and 70 years of age refused the influenza vaccine within the metro-area outpatient Veteran Administration (VA) facility in Atlanta, Georgia. The aim of this project was to …

Improving Influenza Vaccination Rates Through Nursing Journal Clubs, Lily Yan

Master's Projects and Capstones

The objective of this CNL Internship Project is to improve patient compliance with the flu vaccine for the 2015 fiscal year. Currently the project is set at a teaching hospital in Northern California on the Abdominal Transplant Unit. Participants include six staff nurses who care for End Stage Renal Disease (ESRD), End Stage Liver Disease (ESLD) and abdominal transplant patients. To address the barriers to vaccination, specifically patients’ fear of adverse effects, nursing journal clubs (NJC) were implemented on the unit to educate nurses about the current research on flu vaccination for this patient population. As the facilitator, the CNL …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

The Case Of Reintegration Of Women Post Incarceration, Deana Raley Noble Phd

Dissertations

Women released from prison or jail face particular obstacles and challenges on reentry to the community, many of which are related to their childhood and to gender roles as women and mothers. This study relates the lived experience of one woman's successful transition to economic and mainstream societal reintegration and family reconnection after release from prison and the insights gained by the researcher. Case study methodology congruent with Miller's Relational-Cultural Theory philosophical framework was utilized in this in-depth, single case design and represents a unique case. The overall purpose of this descriptive and explanatory research was to explore precursors to …

Nurse Knowledge Of Clostridium Difficile, Ashley E. Frosch

Honors Theses

The purpose of this study is to determine the amount of knowledge nurses have about Clostridium difficile. Seventy-five nurses participated in this study. A 25-question true/false survey was distributed via email to graduates of The University of Southern Mississippi. The survey consisted of a brief demographic section and 25 questions addressing Clostridium difficile knowledge. A total of 582 surveys were sent out with a total of 75 completed. Out of 25 questions in the survey, the majority of respondents (>50%) only answered 7 questions incorrectly. Overall, the nurses in this study possessed accurate knowledge about C. difficile; although, there …

Use Of Complementary Therapies By Individuals With Or At Risk For Cardiovascular Disease And Diabetes: Results Of The 2007 National Health Interview Survey, Katrina Michelle Embrey

Dissertations, Theses and Capstone Projects (Full IR Collection)

Costly, debilitating and largely preventable, cardiovascular disease (CVD) and diabetes mellitus (DM) place a heavy disease burden of high morbidity, mortality, and rising health care costs on people of the United States. With mortality reports from the two diseases of over 600,000 per year and costs in excess of $176 billion, identifying alternatives to traditional models of care must be considered. Complementary and alternative medicine (CAM) therefore becomes a viable option for prevention and treatment. Using secondary data analysis of the 2007 National Health Interview Survey, the aim of the current study was to determine whether CAM use was associated …

Knowledge And Acceptance Of Hpv And The Hpv Vaccine In Young Men And Their Intention To Be Vaccinated, Brenda Renee Jasper

USF Tampa Graduate Theses and Dissertations

Sexually active young men are at high risk of contracting HPV and developing genital warts and penile/anal cancers. They contribute significantly to the incidence of HPV in women. The HPV vaccine, Gardasil, was approved in 2009 for use in preventing HPV 6 and 11 in young males ages 9 to 26. Knowledge and awareness of the virus and the vaccine is limited among young men. Promoting education and prevention measures regarding HPV and reducing personal risks to HPV is significant in narrowing the gap between acquisition of the HPV virus and cancer sequelae. A correlational design utilizing cross-sectional survey methodology …

Method For Investigating Nursing Behaviors Related To Isolation Care., Elizabeth L. Beam, Shawn G. Gibbs, Angela L. Hewlett, Peter C. Iwen, Suzanne L. Nuss, Philip W. Smith

Journal Articles: College of Nursing

BACKGROUND: Although an emphasis has been placed on protecting patients by improving health care worker compliance with infection control techniques, challenges associated with patient isolation do exist. To address these issues, a more consistent mechanism to evaluate specific clinical behaviors safely is needed.

METHODS: The research method described in this study used a high fidelity simulation using a live standardized patient recorded by small cameras. Immediately after the simulation experience, nurses were asked to view and comment on their performance. A demographic survey and a video recorded physical evaluation provided participant description. A questionnaire component 1 month after the simulation …

Prevention Of Central Venous Catheter-Associated Blood Stream Infections In Pediatric Patients: A Review Of The Literature, Shanna Giedl, Brittany Cain

Nursing Student Work

No abstract provided.

Fever Management In The Acutely Iii Hospitalized Patient, Vanessa Edgar Bsn, Rn, Elena Brinker Rn, Tiffany Lopez Bsn, Rn, Cmsrn

Patient Care Services / Nursing

No abstract provided.

Innovations Volume 1: Issue 1, Ron And Kathy Assaf College Of Nursing

Innovations Magazine

No abstract provided.

Necrotizing Fasciitis, Holly Herron

Nursing Student Class Projects (Formerly MSN)

Necrotizing fasciitis also known as necrotizing soft tissue infections (NSTIs) is a rare life-threatening infection that involves the skin and soft tissue. A rapid and accurate diagnosis of NSTIs must be identified by healthcare providers to diminish morbidity and mortality. NSTIs are characterized by progressive necrosis of subcutaneous tissue and fascia involving large areas of tissue (Lin, Chang, Lai, Lin, & Chen, 2013). Hippocrates (500 BC) described necrotizing fasciitis as “diffuse erysipelas caused by trivial accidents [where] flesh, sinews, and bones fell away in large quantities, [leading to] death in many cases” (Lancerotto, Tocco, Salmaso, Vindigni & Bassetto, 2012). In …

Necrotizing Fasciitis: The “Flesh Eating” Disease, John Neukam

Nursing Student Class Projects (Formerly MSN)

Necrotizing fasciitis, often referred to as the “flesh-eating disease”, is a rare bacterial infection with an extremely high mortality rate with symptoms that begin subtle but can quickly ravish the human body.1 While the prevalence of this disease is relatively low, evidence of this disease can be traced back as far as the 5th century BC where it was initially described by Hippocrates.2 It wasn’t until 1952 however that Dr. Bob Wilson termed the disease “necrotizing fasciitis”.3 The rapid progression of this disease and the acute deterioration it causes in a patient is extremely intriguing. This “flesh-eating disease” can present …

Barriers To Immunizations, Megan England

Graduate Research Projects

No abstract provided.

Myasthenia Gravis: A Closer Look, Erin L. Ricker

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG) is a rare, chronic autoimmune disease that affects the neurotransmitter acetylcholine and the acetylcholine receptors at the neuromuscular junction (Mestecky, 2013). MG causes fluctuating skeletal muscle weakness and fatigue. According to the Myasthenia Gravis Foundation of America (MGFA) (2010), 20 per 100,000 patients are diagnosed with MG, although researchers believe several more patients are misdiagnosed or missed entirely. Several neurological disorders have similar clinical presentations to MG making it difficult for inexperienced practitioners to identify and properly diagnose patients. Patients are often misdiagnosed and delayed proper treatment for one to two years after initial presentation of symptoms …

Global Burden Of Tuberculosis, Diana Moses

Nursing Student Class Projects (Formerly MSN)

Tuberculosis (TB) is a major health concern not only in the United States, but in the entire world. TB is an airborne communicable infection which has affected human beings from immemorial times, evidenced by TB being found in the skeletal remains of ancient mummies (Gough & Kaufman, 2011). There are many patho physiological events in TB that concern the entire body, especially the respiratory and immunological systems. According to Knechel, TB prevalence is rising due to the increased number of patients infected with HIV, bacterial resistance to medications, increased international travel and immigration from countries with high prevalence of TB, …

Enterovirus: What Everyone Should Know, Debra Mccorkle

Nursing Student Class Projects (Formerly MSN)

Enterovirus is capturing the attention of everyone; but what is it, who is affected by it, and can it be treated and/or prevented? Like any virus the enterovirus has many different strains. The strain capturing everyone’s attention lately is human enterovirus 68 (HEV68). This strain was first detected in California in 1962 (Oberste et al., 2004). Most cases of HEV68 are mild and do not require medical attention, however some can become severe and may cause serious heart or brain infections according to the Center for Disease Control and Prevention (CDC) website (Updated September 8, 2014). HEV68 is a respiratory …

Ebola: Protecting Healthcare Workers, Martha Mccoy

Nursing Student Class Projects (Formerly MSN)

Ebola is a hemorrhagic disease that has been seen throughout Liberia, but because of international travel it is spreading. Gilsdorf, Morgan and Leitmeyer (2012) researched air travel and reported that, “In 2010, 5.04 billion passengers arrived and departed from 1318 airports worldwide… and travel to and from Africa almost doubled between 1995 and 2005.” (p.1471). In the last few months there have been cases of Ebola reported in Spain and the United States linked to travel. These are recent developments because as of July, 2014 the Center for Disease Control and Prevention (CDC) reported “to date there are no cases …