Digital Commons Network^™

Electronic Symptom Management Using Pros In A Rural, Appalachian Medical Oncologic Population, Andrea Ray Bailey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Systemic chemotherapy is a cornerstone of cancer treatment, but it often leads to significant side effects, which may impact patients' quality of life and lead to increased acute healthcare utilization. Although patients are typically informed of potential symptoms and advised to seek care as needed, many struggle to understand and manage symptoms effectively. Patient-reported outcomes (PROs) have been shown to improve symptom monitoring, decrease symptom burden, and reduce emergency department visits and hospital admissions. Electronic patient-reported outcomes (ePROs), in particular, offer timely and accessible symptom tracking, though their effectiveness has largely been evaluated within urban clinical trial settings and …

Racial And Ethnic Disparities In Hospital Practices That Support Breastfeeding In The United States, Jane Lazar Tucker

Open Access Dissertations

Breastfeeding is the optimal form of infant nutrition and has many health benefits for mothers as well as infants (CDC, 2022a; Victora et al., 2016). Though rates of breastfeeding have improved in recent years, disparities in breastfeeding persist among Black and Hispanic women compared to White women (Beauregard et al., 2019; Chiang et al., 2021), despite similar intentions to breastfeed across all racial/ethnic groups (Hamner et al., 2021). Hospital practices that support breastfeeding, such as the baby being placed skin-to-skin immediately after delivery or staying in the room with the mother throughout the hospital stay, are known to predict breastfeeding …

Development Of An Order Set To Improve Consistency Of Blood Glucose Monitoring For Hospitalized Patients On Enteral Feeding, Kristen Calebaugh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Development of an Order set to Improve Consistency of Blood Glucose Monitoring for Adult Hospitalized Patients on Enteral Feeding

Kristen Calebaugh, BSN, RN

Background

Hospitalized patients often require artificial nutrition through either enteral feeding, placing the patient at risk for glucose alterations related to physiological responses of nutritional metabolism. Historically, there has been no standard of care or consistency aligning tube feedings times with point of care blood glucose testing. Without a standardized order set to guide blood glucose monitoring orders, patients on artificial nutrition may experience undetected hypo or hyperglycemia or inadequate glycemic control, which can cause adverse …

Standardizing Nasogastric Tube Securement: A Quality Improvement Initiative, Shannon Lee Thompkins

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: At a large academic medical center located in the northeastern United States, nasogastric tubes (NGT) were traditionally secured with tape. The institutional policy was nonspecific with no written procedure. The inconsistent use of nasal bridle securement devices (NBSD) and predominant use of tape has the potential to lead to a high rate of NGT dislodgement.

Background: NGT complication and dislodgement rates range from 2%-36% (Gimenes et al., 2019). Stabler et al. (2018) report 29%-63% NGT dislodgement rates in critically ill patients. Patients with intracranial hemorrhage dislodge NGTs in 25% of patients (Rahman et al., 2022)

Available Knowledge: Based on …

Sleep Quantity And Quality: Impact On Nursing Students' Gpa At Georgia Southern University, Jennifer K. Arlow

Honors College Theses

Introduction: Nursing school is a physically and mentally challenging commitment that can result in students sacrificing sleep and compromised sleep quality.

Methodology: A cross-sectional mixed methodology research study of Georgia Southern University’s nursing students was conducted to gauge students' self-perceived sleep habits and current and past academic performance quantified by GPA. Five respondents (whose results were excluded from the data analysis) confirmed the questions were clear and relevant.

Results and Discussion: Thirty-two (n=32) questionnaires were received, of which four were excluded from the final analysis as some questions were not answered. More than 50% of respondents said their GPA decreased …

Emphasizing Self-Regulation In Teaching: Reducing Disruption To Students’ Learning During Unplanned Instructional Mode Transition, Somesh Roy, Amber Young-Brice, Jenna Lassila, Brandon Kyle Johnson

College of Nursing Faculty Research and Publications

In Spring 2020, engineering faculty transitioned to emergency remote instruction due to COVID-19. This mixed-methods study was done to understand the correlation between self-regulated learning and how students experienced the emergency transition to remote learning. The participants were from an upper-level engineering course, with 33 students surveyed four times during the semester. Seven students were interviewed after the semester. Findings revealed that during the transition to remote learning, students perceived less change if they had higher degrees of self-regulation. The qualitative analysis also revealed that transparency in learning and teaching also played an important role in students’ perceptions.

Cardiovascular Disease In Firefighters, Emily Jordan Baldwin

Doctor of Nursing Practice Projects

This quality improvement project aimed to address the problem of increased cardiovascular events in firefighters in a county in the foothills of North Carolina. Nola Pender and Dorothy Orem’s theories were utilized for this project. The literature review exhibits the prevalence and significance of cardiovascular disease in firefighters. The literature review demonstrates the benefits healthy eating and exercise have on the heart and towards the prevention of cardiovascular disease. A pre- and post-test was utilized for this project and allowed for the collection of data appropriately. The results showed education on cardiovascular disease, exercise, and healthy eating increased the knowledge …

Essential Collaborations Among Case Managers And Providers Regarding Discharge Processes, Lashawnda Richardson

Doctor of Nursing Practice Projects

Communication is vital between case managers and providers when patients need care coordination post-discharge. This includes but is not limited to facilitating home health services, ordering durable medical equipment, sending referrals to rehabilitation facilities, and sponsorship for uninsured or underinsured patients. This gives case managers the opportunity to educate providers on the discharge needs they ordered for their patients. The collaboration between case managers and providers allows for timely discharge planning and providing patients and their families with accurate information regarding their discharge needs.

Remodeling Breastfeeding Education, Rhonda Coffey

Doctor of Nursing Practice Projects

Mothers face important decisions regarding how to feed their infants, and successful breastfeeding requires commitment, support, and education. The numerous health benefits of breastfeeding for both mothers and infants are well-documented throughout the literature, and experts recommend exclusive breastfeeding for the first year of life. Healthcare teams play a crucial role in supporting breastfeeding success by providing education, guidance, and troubleshooting assistance when complications arise. Reassurance from healthcare providers can also influence mothers' overall experiences with breastfeeding. The facility where participants deliver assists most mothers in initiating breastfeeding within 1 to 2 hours after delivery, with approximately 75% meeting this …

The Early Prevention Of Diabetic Foot Ulcers, Aruodo Ukpai

Doctor of Nursing Practice Projects

Frequent and proper foot exams and foot care are fundamental in decreasing the incidence and morbidity of diabetic foot ulcers, yet many patients are still not screened at appointments or educated on the importance of foot exams. This research planned to address the lack of foot care education and foot assessments amongst patients with Type 2 diabetes. Past research done on this focused on providing education to diabetic patients either at home or in a setting where patients can come and receive the education. To our knowledge, no research has been done on the use of video teaching to provide …

Benefits Of Patient-Centered Education For Type 2 Diabetes Mellitus, Paige Bortnick

Doctor of Nursing Practice Projects

Type 2 diabetes is a chronic, lifelong illness that affects millions of individuals in the United States. The rate of diabetes has doubled over the last 20 years in America and has climbed to be the seventh leading cause of death amongst Americans. The purpose of this project was to determine if participants in the target community demonstrated increased knowledge and awareness of diabetes after receiving education. A pre-intervention and post-intervention survey was given to determine if the education was effective. Data collected revealed an increased awareness and knowledge regarding the prevalence of type 2 diabetes, lifestyle, and diet modification.

Community Education: Impact On Earlier Recognition Of Stroke, Lauren Kahn

Doctor of Nursing Practice Projects

Cerebrovascular disease was identified as the fourth leading cause of death in Cleveland County, North Carolina from 2014 to 2018 (Cleveland County Public Health Center, 2020). Community education was identified as a potential solution to decreasing the number of community members affected by cerebrovascular disease and resulting death and disability. Five community classes were taught with 97 participants. Pre-, post-, and 1-week post-class surveys were distributed to assess baseline knowledge, knowledge gain, and knowledge retention, with 74 pre-class, 72 post-class, and 28 1-week post-class surveys returned. Of these surveys, after exclusionary criteria were used, 40 pre-class, 53 post-class, and 22 …

The Benefits Of Prenatal Education Via Virtual And Mobile Applications Before, During, And After Pregnancy: A Quality Improvement Project, Lindsay Farland

Master's Theses and Capstones

Background: The advancements of technology has led to a substantial increase in the use of pregnancy applications among expecting parents. Studies indicate that a majority of pregnant individuals utilize virtual education platforms for various purposes, including accessing information on nutrition, exercise, baby development, and pregnancy symptoms. Despite the potential benefits, participation in these platforms remains low, emphasizing a need for enhanced resources and engagement strategies. Research shows that engagement with antenatal education through mobile applications can lead to improved maternal and fetal outcomes, such as reduced rates of caesarean births and fewer complications related to hypertension or preeclampsia.

Methods: …

Implementing A Nurse-Driven Protocol To Reduce Routine Gastric Residual Monitoring: A Quality Improvement Project, Alondra N. Abreu Carlo

Master's Theses and Capstones

The American Society for Enteral and Parenteral Nutrition (ASPEN) and the Society for Critical Care Medicine (SCCM) updated the Adult Patient Enteral Nutrition Guidelines in 2016. These updates included discontinuing routine gastric residual monitoring due to its contribution to poor patient outcomes and mentioning the lack of evidence proving its relevance to gastric motility. Per ASPEN and SCCM, best practice suggests monitoring patients for intolerance symptoms and then checking gastric residual volume (GRV) if symptoms are present. If the GRV is greater than 500ml and intolerance symptoms are present, the recommendation is to perform further assessment, potentially leading to stopping …

Educational Interventions To Improve Icu Nurses’ Knowledge And Confidence Related To Pressure Injuries: A Quality Improvement Initiative, Benjamin R. Maltais

Master's Theses and Capstones

Background: The prevalence of pressure injuries (PI) in critical care is highest amongst inpatient units, and are associated with significant complications, decreased quality of life, increased cost of hospitalization, and poor patient care (Agency for Healthcare Research and Quality, 2019; Cox et al., 2022; Gorecki et al., 2014; Mervis & Phillips, 2019). Similarly, many PI are considered to be avoidable (Pittman et al., 2019). Despite an increase in focus on PI awareness and prevention, there still remains a challenge for patients in critical care units. In addition, research has indicated that nurses’ lack of basic knowledge of PI (risk assessment, …

Study Protocol For A Stepped-Wedge Cluster (Nested) Randomized Controlled Trial Of Antenatal Colostrum Expression (Ace) Instruction In First-Time Mothers: The Ace Study, Cassandra Cuffe, Roslyn Giglia, Matthew N. Cooper, Julie Hill, Desiree Silva, Anita M. Moorhead, Valerie Verhasselt, Joshua R. Lewis, Deborah Ireson, Jill R. Demirci, Talea Cotte, Kathryn Webb, Frances Patey, Therese A. O’Sullivan

Research outputs 2022 to 2026

Background: Although many mothers initiate breastfeeding, supplementation with human-milk substitutes (formula) during the birth hospitalization is common and has been associated with early breastfeeding cessation. Colostrum hand expressed in the last few weeks before birth, known as antenatal colostrum expression (ACE), can be used instead of human-milk substitutes. However, evidence is lacking on the efficacy of ACE on breastfeeding outcomes and in non-diabetic mothers. Methods and Planned Analysis: This multicenter stepped-wedge cluster (nested) randomized controlled trial aims to recruit 945 nulliparous pregnant individuals. The trial is conducted in two phases. During Phase 1, control group participants are under standard care. …

Western Australian Mothers' Experiences Of Breastfeeding Support In Hospital After Birth: A Mixed Methods Study, Justine Van Der Watt

Theses: Doctorates and Masters

Background: The benefits of breastfeeding are well established for infants, mothers and the community, with the World Health Organisation recommending that infants be exclusively breastfed up to six months of age with an achievable goal of 70% globally. Yet in Australia only 15-37% may be reaching that goal. There have also been reported benefits and desires for mothers to be supported with their breastfeeding in order to increase and prolong breastfeeding duration and exclusivity, especially early after birth. However, there is limited research or literature exploring what experiences mothers are having with breastfeeding support, especially during their hospital admissions in …

Maternal Health Considerations: Highlighting And Advancing Opportunities For Improved Maternal Health, Caitlin Fox-Harding

Research outputs 2022 to 2026

The special collection on Maternal Health Considerations offers a comprehensive exploration of critical issues surrounding maternal well-being across diverse contexts and disciplines. Recognising that maternal health extends beyond the physiological realm, this collection delves into the multifaceted dimensions of maternal well-being, including physical, mental, and socio-ecological factors. The collection comprises a series of interdisciplinary studies that investigate various facets of maternal health, from conception to postpartum stages. It addresses the complex interplay between biological, psychological, and socio-cultural determinants that influence maternal health outcomes. By adopting a holistic approach, the contributors shed light on the interconnectedness of maternal well-being. Key themes …

Self-Efficacy And Home Dialysis: An Integrative Review, Nicola A. D'Souza, Ma'en Zaid Abu-Qamar, Lisa Whitehead

Research outputs 2022 to 2026

Background: Enhancing patient confidence in their ability (self-efficacy) is vital to ensure people are equipped to maintain home dialysis protocols. Bandura's social cognitive theory provided a framework for understanding the role of self-efficacy in patients managing home dialysis. Objectives: To identify self-reported levels of self-efficacy, the measurements used to assess self-efficacy and the effectiveness of interventions to enhance self-efficacy in patients undergoing home dialysis. Design: An integrative review approach was employed using Whittemore and Knafl's methodology. Methods: A comprehensive search was conducted to identify literature on self-efficacy in patients managing home dialysis. Searches were conducted in CINAHL, MEDLINE, Embase and …

Age, Body Mass Index, Physical Activity And Quality Of Life In Turkish Pregnant Woman With And Without A Diagnosis Of Gestational Diabetes Mellitus: A Comparative Study, Yaren Nur Tayyar, Hatice Kahyaoglu Sut

Makara Journal of Health Research

Background: This study aimed to examine and compare the age, body mass index (BMI), physical activity (PA), and quality of life (QOL) of third-trimester Turkish pregnant women with and without a diagnosis of gestational diabetes mellitus (GDM).

Methods: A comparative study was conducted in the obstetrics clinic of a university hospital in Turkey, and it included 210 women (GDM women = 105 and non-GDM women = 105). Personal Information Form, International Physical Activity Questionnaire-Short Form (IPAQ), and World Health Organization Quality of Life-Short Form-Turkish (WHOQOL-Bref-TR) were used.

Results: The age and BMI of GDM women were higher …

Associated Factors Related To Self-Management Behaviors Among People With Type 2 Diabetes In Myanmar, Aye Nyein Oo, Jiraporn Lininger, Sirirat Leelacharas

Makara Journal of Health Research

Background: Diabetes is a global health concern that affects individuals and the healthcare system. This study aimed to describe the relationships between personal and environmental factors and self-management behaviors in individuals with type 2 diabetes mellitus (T2DM).

Methods: This research included 100 individuals with T2DM who were recruited through convenient sampling from three government hospitals in Myanmar. Data collection was fulfilled using a standardized interviewer-administered questionnaire consisting of demographic information, the Diabetes Management Self-Efficacy Scale, the New Short-Form Health Literacy Instrument, the 24-item version of the Diabetes Knowledge Questionnaire, the Social Support Questionnaire, and the Summary of Diabetes …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Cariesthe Effect Of Sweet Taste Perception On Dental Caries Experience In Relation To Age And Gender In Primary School Children, Mohammed H. Abdulaziz, Suha T. Abd

Al-Esraa University College Journal for Medical Sciences

This study aims to investigate the impact of sweet taste perception (sweet taste threshold and preference) on dental caries experience in relation to age and gender among a sample of schoolchildren. The research follows a cross-sectional observational design and includes 181 schoolchildren of both genders aged between 6 and 12 years from the Al-Risafa district of Baghdad city. The participants were divided into two age groups (6-8 and 9-12). Dental caries were assessed using the decayed, missing, and filled indices for primary and permanent teeth (dmfs, dmft, DMFS, and DMFT). Additionally, the sweet taste threshold and sweet taste preference were …

Determination The Effect Of Glucose On Btp, Lfabp Levels In The Patients With Diabetic Nephropathy, Zahraa Khalid Mahmood, Suhayr Aesa Al-Qaysi, Alaa Jafear Mahrath

Al-Esraa University College Journal for Medical Sciences

Everywhere in the globe, kidney illness is becoming more common, and there is no medication that can stop the progression of chronic kidney disease to end-stage renal disease, which is extremely expensive. Diabetes, kidney stones, accidents, and bleeding are the main contributors to kidney disease. The study was designed as a case control study. The study was involved (80) participants, only (36) were involved in this study and divided into two groups patients with nephropathy (23) and diabetic nephropathy (13) with age (20-65years) and BMI (19 -29 kg/m2). All these patients were diagnosed by nephrologist conducted in nephrology Clinic at …

Using Mindfulness In Nursing Burnout. An Integrative Review., April Day Branham

Doctoral Dissertations and Projects

The purpose of this integrative review is to evaluate if mindfulness is effective in decreasing nursing burnout. Nursing burnout has negatively affected the nursing profession for many years, and since the COVID-19 pandemic, it appears to be worse. Mindfulness is a practice that has been used for decades, however, it is gaining more attention in the nursing realm. Mindfulness consists of being present in a moment without judgment. It can consist of individual exercises that are completed using an instructor in person, in an application on a smartphone or computer, or yoga-based mindful activities. A preliminary literature review was completed …

The Nurse's Lived Experience Of Transferring Nutrition Knowledge To Patients: A Descriptive Phenomenology, Kendrah Lynne Cunningham

Doctoral Dissertations and Projects

This descriptive phenomenological qualitative study aimed to gain insight into the nurse’s lived experience of transferring nutrition knowledge to patients. Nurses play an important role in assisting the patient to become more proficient in health and nutrition literacy to make proper choices related to their nutrition. It is necessary to evaluate the lived experience of the nurse in transferring nutrition knowledge to patients. There is a gap in the literature on nurses’ experience in providing nutrition knowledge to their patients. This descriptive phenomenological qualitative study examines the lived experience of nurses in transferring nutrition education to their patients. This was …

Promoting Culturally Accessible, Community-Centered, Midwifery Care In The Rural Anabaptist Population Of Southwestern Ontario, Canada, Cynthia Soulliere

Journal of Amish and Plain Anabaptist Studies

The experience of providing midwifery care in a rural Southwestern Ontario community is discussed, highlighting specific approaches to providing culturally accessible and community-centered care among the Old Order Anabaptists. Midwives in Ontario are primary care providers for perinatal care and the clinic described in this paper works primarily with families from Anabaptist communities. Success in providing culturally accessible care has come from community engagement and responsiveness to ways to improve access to healthcare in this region. Highlighted in this article are the scope of midwifery care in Ontario, home and hospital births, collaboration with other community agencies, and community-based genetic …

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

Diabetes Health Coaching Program In An Eastern Virginia Health Center: A Retrospective Program Evaluation, Moniqueia Flint

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The primary goal of diabetes management is to assist patients in controlling their diabetes and minimizing complications. Diabetic patients require continuous medical care that encompasses medication management, multifactorial risk-reduction strategies, and a multidisciplinary team. Health coaching is an emerging tool used to provide education and motivational techniques to individuals for better self-management of their chronic condition. Health coaching is a proven strategy with favorable effects on hemoglobinA1c (HgbA1c), blood pressure, weight, and health behaviors. A diabetes health coaching program (DHCP) was implemented at an eastern Virginia healthcare center (EVHC). The DHCP’s objective was to assist patients in meeting their individualized …

Mindfulness Based Self Care Toolkit For Psychiatric Healthcare Staff, Harkirat Kaur Bajwa

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Healthcare personnel (HCP) are at high risk of stress, burnout, and compassion fatigue (CF). Up to 50% of physicians and 33% of nurses experience burnout in the United States. Higher rates of burnout were noted during the recent SARS-CoV-2 (COVID-19) pandemic due to the increased need for mental health services among patients and HCP.

Problem: Stress, burnout, and CF are associated with increased medical errors, poor patient safety, and higher staff turnover rates. One-third of nurses report they intend to leave the profession because of burnout which contributes to financial burden for hospitals. A higher nurse turnover rate …