Digital Commons Network^™

4ms Framework For Aging Healthcare, Christine Zaki

Nursing Capstones

Background: At the beginning of the pandemic, primary care clinics in North Dakota (ND) had just a trickle of daily telehealth encounters. Over time, these encounters increased, primarily for the youngest seniors (55 – 70 years old). Due to increased COVID-19 cases among the elderly population in ND, the Geriatric Workforce Enhancement Program (GWEP) allocated a grant to the University of North Dakota (UND) to promote telehealth use in the elderly residing in rural ND and receiving home care through the desired home care agency. This project aims to promote telehealth to reduce exposure to COVID-19 among the geriatric populations …

Examining The Impact Of Healthcare Providers In Relation To Gaining Patient's Acceptance And Initiation Of The Hpv Vaccine: An Integrative Review, Millie Elizabeth Knox

Doctoral Dissertations and Projects

The human papillomavirus (HPV) is a prevalent virus and the most common sexually transmitted infection (STI) worldwide. Nearly 80 million people, approximately one in four, are currently infected in the United States (US). Given that HPV infections affects over 20 million Americans with possible life-threatening consequences, the importance of adhering to the recommended two-dose or three-dose vaccination series has a significant impact on cancer prevention. Research studies have suggested that adolescents and young adults are at an increased risk of STIs and low HPV vaccination rates. For this integrative review, the target population was adolescents to young adults, ages 9-26 …

The Healthcare Needs Of Families Caring For Patients With Pulmonary Tuberculosis, Astuti Yuni Nursasi, Nadya Tiara Sabila, Muhamad Jauhar

Jurnal Keperawatan Indonesia

Tuberculosis (TB) is a global public health problem. Families need to meet healthcare needs during the treatment of TB sufferers. This study aims to identify healthcare needs of families caring for patients with the disease. The cross-sectional study involved 83 families caring for TB patients. The research was conducted at a Primary Healthcare Center in an urban area in West Java. The results revealed that 60.2% of caregivers were 18–40 years old, 60.2% were female, 51.8% were senior high school educated, 43.4% were housewives, 86.7% had an income under the regional minimum wage, and 55.4% had cared for the TB …

Hypertension Self-Care Management During Covid-19 Pandemic Crisis In The Meranao Tribe: A Phenomenological Inquiry, Jonaid M. Sadang, Sittie Inshirah P. Macaronsing, Narima M. Alawi, Normala M. Taib, Hamdoni K. Pangandaman

Jurnal Keperawatan Indonesia

The COVID-19 crisis has been a challenging and stressful event for individuals with known underlying health problems, not to mention their higher risk of contracting the disease. This phenomenological inquiry was conducted to explore the common self-care practices of the Meranao tribe in the Province of Lanao del Sur, Philippines, concerning their management of hypertension amidst the ongoing pandemic health crisis. This study employed a descriptive-phenomenological approach. Ten known hypertensive adults participated in the study selected using purposive sampling. Data collection employed focus group discussion (FGD) and then analyzed using Colaizzi's approach. Four themes were derived which explained the common …

Pediatric Sepsis-Development Of A Clinical Pathway For The Pediatric Emergency Department, Roslyn Lampkin-Smiley

Student Scholarly Projects

Globally, various researchers have suggested that sepsis is one of the most prominent causes of infant fatalities. Since 2004, countless guidelines have been developed to assist in the early identification and management of sepsis. The PICOT question that guided this project was: Does the implementation of a pediatric sepsis clinical pathway, compared with the standard protocol in emergency departments, decrease delays in treatment times of patients presenting with sepsis? Researchers have suggested that early recognition and interventions for septic patients can result in decreased mortality rates. A pediatric sepsis clinical pathway was implemented during this project. The pathway alerted staff …

Evaluation Of Nurse Staffing, Engagement And Satisfaction In A South Carolina Rehabilitation Facility: Impact On Patient Outcomes, Eileen Klang

Doctor of Nursing Practice (DNP) Manuscripts

An acute care rehabilitation facility in Horry County, South Carolina was the setting for this program evaluation of nurse staffing, engagement and satisfaction and if those factors had any effect on patient outcomes in the facility. Nursing department staffing, engagement and patient outcome data was evaluated for trends and themes. Through stakeholder meetings, data was collected, a qualitative and quantitative satisfaction survey was administered to nursing staff. Evaluation of the data occurred and revealed multiple factors that led to nursing department turnover between 2018 and 2020. During the increase in turnover, it was noted that patient falls, and catheter associated …

Improving Outcomes For Sexual Assault Patients In Alignment With Hiv Npep Clinical Guidelines, Maria Dahlke, Rachel Kanz

Nursing DNP Projects

Purpose and Rationale

The purpose of this project is to improve the follow-up care given to adult patients, 18 years and older, who require human immunodeficiency virus (HIV) non-occupational post-exposure prophylaxis (nPEP) treatment after a sexual assault. The goal is to determine if organizational alignment with HIV nPEP clinical guidelines through staff education improves medication adherence for adult sexual assault patients. Currently, sexual assault survivors have the lowest medication adherence rate to HIV nPEP among those at risk for HIV.

Synthesis of Evidence

The evidence supports the standardization of care for sexual assault patients' individual needs. Educating health care professionals …

Factors Influencing Rural Women’S Physical Activity Behaviors: A Social Ecological Perspective, Karen Lynn Webb

Nursing ETDs

ABSTRACT

Chronic disease and poor mental health are disproportionally impacting adults living in rural America. Regular physical activity has been shown to promote overall well-being and prevent many chronic diseases. Yet, research shows that many rural adults do not engage in enough physical activity to meet the recommended levels put forth by the federal government. The purpose of this descriptive qualitative study was to explore and describe the experiences of physical activity as perceived by rural women in their own words. Data were collected through semi-structured individual interviews of 20 women aged 25 to 34 living in McDowell County, West …

County Youth Athletics Response To Covid-19 Pandemic, Elise Schaller

Dissertations

Problem: To ensure safe participation in youth athletics and prevent COVID-19 transmission during the COVID-19 pandemic, St. Louis County Department of Public Health (DPH) implemented Youth Sports Guidelines on October 14, 2020. This project aimed to identify level of adherence to precautions listed in the guidelines at six county public high school athletic events.

Methods: An observational descriptive study design was used to monitor guideline adherence at high school athletic events. Two observers tallied violations by participants and spectators to Youth Sports Guidelines at St. Louis County public high school athletic events. Six high-frequency contact (basketball and wrestling) events …

Impact Of Social Isolation In Hiv-Positive Individuals During A Pandemic, Corina Jane Bakoylis

Dissertations

Problem: The global pandemic of COVID-19 caused concern for immunocompromised individuals. The purpose of this quality improvement initiative was to assess the impact of social isolation on feelings of loneliness, depression, and social isolation experiences in HIV-positive individuals residing in a long-term care facility.

Methods: A mixed-method convergent design with a purposeful sample of HIV-positive adult residents residing in a long-term care facility was utilized. An evaluation of loneliness using the University of California Los Angeles (UCLA) Loneliness Scale (Version 3) and depression using the Patient Health Questionnaire-8 (PHQ-8) were completed. Personal experiences were also assessed with five predetermined open-ended …

A Standardized Approach To Awakening And Breathing Trials, Maureen Awuor Abongo

Dissertations

Abstract

Problem: Mechanical ventilation with sedation, are crucial co-therapies for the critically ill. Risks of both, known as Ventilator Associated Events( VAEs), can worsen outcomes. Performing Spontaneous Awakening Trials (SATs), with Spontaneous Breathing Trials(SBTs), is a targeted evidence-based strategy in reducing VAE rates. The Intensive Care Unit (ICU) lacked a coordinated approach to operationalizing SATs with SBTs.

Methods: An observational retrospective study involving a review of VAE and patient data for corresponding months in years before, and after an improvement strategy application, and making comparisons. The multimodal strategy includes filling out checklists outlining criteria for performing a SAT with …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

Proactive Text Messaging For Public Health Surveillance During The Covid-19 Pandemic, Daria Kester

Dissertations

Problem

The Department of Public Health (DPH) of a suburban Midwestern county considers surveillance and control of COVID-19 to be sub-optimal, resulting in part from difficulties with completing case and contact interviews.

Methods

To increase the success rate of case investigation, proactive messaging using short message media (SMS) alerts is used in a quality improvement initiative based on the PDSA framework. Participants are sent text message alerts prior to receiving a call from a DPH case investigator. Results are recorded in a statewide database.

Results

Individuals who received text messages prior to receiving a case investigation interview phone call were …

Attitudes Toward Sars-Cov-2 In Frontline Healthcare Workers And First Responders, Michelle Tiffany Arrington

Dissertations

Problem: To date, little evidence exists to understand attitudes of SARS-CoV-2 in frontline healthcare workers (HCW) and first responders (FR), related to best practices in mitigating virus spread. The purpose of this project was to assess attitudes toward COVID-19 in young adults, ages 18-44 years old, who are frontline workers related to their adherence to PPE guidelines, social distancing, hand hygiene, community exposures, and vaccinations.

Methods: A descriptive survey design using five-point Likert scale questions and 26 open-ended questions and was implemented one-year after onset of the pandemic. A purposive sample working in a large, urban, Midwest metropolitan area was …

Youth Sports In A Pandemic Age, Robert Bohnert

Dissertations

Abstract

Problem: Youth sporting events is a public health concern as infected youth with coronavirus disease 2019 may unknowingly spread the virus, as many show little to no symptoms (Zimmerman & Nigel, 2020). This project aimed to identify level of adherence to posted Youth Sports Guidelines, which were designed to mitigate the spread of virus at youth sporting events.

Methods: An observational descriptive design was utilized. Two observers tallied guideline violations by participants and spectators at six high-contact (basketball) and six low-contact (swimming) public high school youth sporting events.

Results: A total of 726 youth sport participants and 139 …

Coccidioidomycosis (Valley Fever) Awareness, Kelly Dzialowski

Nursing Student Class Projects (Formerly MSN)

The overall purpose of this poster is to describe the fungal infection, Coccidioidomycosis, and bring awareness to this infection. The poster describes the history of the infection, pathophysiology, risk factors, and clinical presentation. Diagnosis, treatment, and complications of coccidioidomycosis are also addressed. The poster discusses the implications for nursing practice, information about the search for a vaccine, and comparisons of coccidioidomycosis and Covid-19. Finally, the conclusion discusses the key points within the poster and the importance of prompt and accurate diagnosis.

Implementation Of A Quality Improvement (Qi) Intervention To Increase Influenza Vaccination Uptake In A Pediatric Primary Care Setting., Lisa Gaines

Doctor of Nursing Practice Papers

Background: Internal and external evidence demonstrates that there is a suboptimal uptake of influenza vaccination (flu vaccine) in all settings, despite national objectives to achieve 80%- 90% immunization rates across all populations. In 2002, the Advisory Committee on Immunization Practices (ACIP) issued a recommendation that all children 6 months of age and older be immunized annually with the influenza vaccine. Despite these recommendations, influenza vaccination is not required for school entry in the Commonwealth of Kentucky and immunization rates continue to fall below local, state, and national targets. Being considered an optional vaccine leaves the decision to vaccinate (or not) …

Improving Pneumonia Immunization Rates Among Adult Residents Of A Long-Term Care Facility., Salma Hegazi

Doctor of Nursing Practice Papers

Background: Pneumonia is a significant cause of morbidity and mortality in long-term care facility (LTCF) residents (Stamm et al., 2020). Vaccination of LTCF residents is a reasonable prevention strategy, (Andre et al., 2018; Centers for Medicare & Medicaid Services, 2020; Kaiser Family Foundation, 2019). Improving immunization rates among LTCF residents remains to be a challenge (Rehm et al., 2012; Stamm et al., 2020).

Purpose: The purpose of this quality improvement (Q.I.) project is to improve the pneumococcal pneumonia immunization rates at an LTCF in Louisville, KY.

Methods: A review of each residents' medical record to obtain immunization status, evaluating the …

Community-Based Wound Care Intervention Utilizing Non-Clinical Personnel In The Intravenous Drug Use Population., Jennifer Fox

Doctor of Nursing Practice Papers

Background: Wounds resulting from injection drug use can increase morbidity and mortality in intravenous drug users (IVDU) (Kerr, et al., 2004; Phillips, et al., 2012; Pieper, 2019). Lack of access to healthcare contributes to self-treatment, worsening wounds, and severe co-morbidities (Robinowitz et al., 2014). Needle exchange programs (NEP) offer clean injecting equipment and infectious disease testing. NEP employees have close contact and high rapport with this population (Robinowitz et al., 2014). NEP can be utilized to assess skin for infection and high-risk injecting behaviors contributing to wound development. Early detection of wounds through assessment and prevention through cleaner injecting behaviors …

Increasing Pneumococcal Polysaccharide Vaccination Rates In Adults Age 65 Years And Older In A Primary Care Clinic, Ashley Sandbothe

Doctor of Nursing Practice Scholarly Project

The purpose of this study was to increase PPSV23 vaccination rates in adults over the age of 65 years in a Midwestern primary care clinic.

For this project, staff was educated regarding interventions including patient awareness, provider recommendation, staff and provider education, vaccine access, use of the immunization information systems (IIS) and appropriate use of electronic health record (EHR) reminders that have been shown to increase vaccination rates.

Prior to the intervention, data was retrieved, and it was found that between April 1^st-May 31^st 2020, there were 162 patients over the age of 65 that presented to …

Improving Health Literacy For Diabetics In A Rural Community, Elissa Purvis

Doctor of Nursing Practice Projects

Adults with type II diabetes mellitus need to understand the disease and manage their chronic condition to live a healthy and comfortable life. This project aimed to educate adults with type II diabetes mellitus in self-management of their chronic illness to increase their health literacy to improve their heart health, kidney health, nutrition, and exercise. The project utilized a Doctor of Nursing Practice (DNP) approach to education for adults with type II diabetes mellitus on the disease process.

METHODS: This project is a quality improvement project focused on educating adults with type II diabetes mellitus in managing their chronic conditions …

Using Infographics To Improve Completion Rates Of The Sepsis Protocol Bundle, Stephen Newbern

Doctor of Nursing Practice Projects

Hospitals have sepsis protocols that must be implemented when a patient shows positive signs and symptoms of a septic infection. Nurses learn about sepsis in nursing school and rarely further their education beyond this basic understanding of the disease. So, when nurses fail to comply with organizational instructions outlined within a defined sepsis protocol bundle, this often leads to a progression of severe sepsis in a patient and, most likely, increased cost for the healthcare facility. Multiple sepsis protocol bundle failures negatively impact organizational ratings established by The Joint Commission for patient care and are highly associated with increased sepsis …

Re-Educating Healthcare Workers In Long-Term Care Facilities To Improve Hand Hygiene Compliance, Jennifer A. Ukeje

Doctor of Nursing Practice Projects

Hand hygiene is one of the most significant measures for protecting nursing home residents from healthcare-associated infections (HAIs). An estimated 1.6 million to 3.8 million infections occur each year; of these infections, 32% of all healthcare-associated infections (HAIs) are urinary tract infections (UTI), 15% are pneumonia (lung infection), and 14% are bloodstream infections. The high incidence of HAIs in nursing homes is due to multiple factors such as understaffing, inadequately trained staff, staff to resident ratio, lack of antibiotics stewardship, and the increasing clinical complexity of the average nursing home. In addition, most long- term care (LTC) residents are older …

Can Provision Of Additional Education For Nursing Staff Increase Breastfeeding Knowledge And Feelings Of Self-Efficacy?, Akeba Deqwan Thompson

Doctor of Nursing Practice Projects

Background: Post-partum nurses are responsible for preparing new mothers with the necessary skills to feed and care for their infants and need proper education to effectively and confidently discuss feeding options with their patients.

Purpose: This quality improvement project aims to increase nursing knowledge of breastfeeding and their feeling of self-efficacy in promoting breastfeeding as an option to new mothers.

Design Methods: A quasi-experimental design including a pre-test/post-test used to quantify the effect of education on therapeutic communication, nursing responsiveness, and feelings of self-efficacy.

Conclusion: An overall increase in feelings of self-efficacy and knowledge of breastfeeding was noted amongst nursing …

Implementing An Antibiotic Stewardship Education Program To Decrease Antibiotic Prescriptions In An Urgent Care Clinic, James Gramling

Doctor of Nursing Practice Projects

Antibiotics are often prescribed for respiratory infections. These infections often have a viral rather than a bacterial source. Overuse of antibiotics is associated with increased potential for adverse effects, increased healthcare costs, and increasing antibiotic resistance. The purpose of this DNP project was to determine if implementing an antibiotic stewardship program at an urgent care clinic would decrease the number of antibiotic prescriptions written for acute respiratory tract infections. An educational session consisting of didactic and PowerPoint presentations was provided to each provider at the urgent care clinic. Medical records were reviewed for four weeks after completion of the session …

Differences In Student Perceptions With Virtual Clinical Simulation, Melissa Wheeles

Doctor of Nursing Practice Projects

Background: Simulation has been a part of nursing education since its inception, with virtual clinical simulation gaining expanded use since the Coronavirus Pandemic. Once considered only a supplemental teaching method, this form of education has become an imperative means of program progression for nursing students when hospital clinical spaces are limited.

Purpose: The purpose of the study is to evaluate potential differences in nursing student perceptions of anxiety and self-confidence with clinical decision making in virtual clinical simulation compared to traditional face-to-face clinicals.

Design Methods: A descriptive, quantitative study using the NASC-CDM© tool completed by 5th (final) semester …

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …

Methods Of Educating Nursing Students On Proper Handwashing To Enhance Infection Control During The Covid Pandemic, Yulanda King

Doctor of Nursing Practice Projects

Background: Medical professionals have commonly been urged to use soap and water to sanitize their hands to prevent contamination and disease transmission. However, thorough handwashing requires a couple of minutes to clean hands thoroughly. Considering that health professionals must sanitize their hands' multiply times during a day, handwashing consumes a significant amount of time away from bedside care. Time spent away from patients may also result in a substantial decrease in the quality of healthcare services provided by the medical institution.

Purpose: This project evaluates the current policy and procedure for appropriate use of handwashing versus hand sanitizer in the …

The Conundrum Of Low Covid-19 Mortality Burden In Sub-Saharan Africa: Myth Or Reality?, Janica Adams, Mary J. Mackenzie, Adeladza Kofi Amegah, Alex Ezeh, Muktar A. Gadanya, Akinyinka Omigbodun, Ahmed Sarki, Paul Thistle, Abdhalah K. Ziraba, Saverio Stranges, Michael Silverman

School of Nursing & Midwifery, East Africa

The burden of coronavirus disease (COVID-19) in sub-Saharan Africa (SSA) has been substantially lower compared to other regions of the world. Extensive morbidity and mortality were not observed among countries in SSA during the first wave of the COVID-19 pandemic. To explain this phenomenon, several hypotheses have been formulated, including the low median age of the population in most SSA countries, lack of long-term care facilities, cross-protection from other local coronaviruses, insufficient testing and reporting resulting in an undercounting of COVID-related deaths, genetic risk factors, or the benefit of early lockdowns that were extensive in many SSA countries. Early lockdowns …

Risk Perception, Knowledge, Attitude, And Preventive Practice Towards Covid-19 Outbreak: A Cross-Sectional Online Survey In Kerala, Swapna K G

Manipal Journal of Nursing and Health Sciences

Introduction: The COVID-19 pandemic affects people of all ages; healthy and unhealthy. The only measure for prevention of the spread of infection is SMS (social distance, mask and sanitation) in the absence of an effective drug or vaccine. The lockdown had affected people’s mobility and livelihood.

Objectives: This study assessed the risk perception, knowledge, attitude and preventive practice of people of Kerala towards Covid-19 outbreak immediately after the fourth phase of lockdown and the association between the risk perception, knowledge, attitude and preventive practices and sociodemographic variables and the factors associated with risk perception.

Methods: The online …