Digital Commons Network^™

Strategic Plan For Genomic Competencies Into Undergraduate Nursing Curriculum, Myerann Royce M. Mangalino

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: As genomics research continues to grow in medicine and in popular culture, an educational gap in nursing is inevitable. Nurses must have a strong understanding of genetics and genomics to effectively integrate them into current practice.Objectives: The objective is to identify gaps in the current undergraduate curriculum and build threads that may be incorporated into the current curriculum to fill the identified gaps. Methods: The foundation of this project was the Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines, and Outcome Indicators, 2nd Edition (Consensus Panel on Genetic/Genomic Nursing Competencies, 2008). A strategic plan was created to increase …

Improving Diagnosis And Treatment Of Prediabetes Among Primary Care Providers By Increasing Awareness Of Prediabetes Education, Sonia Walker

Doctoral Projects

Prediabetes is a precursor to diabetes and requires treatment most of the time. Prediabetes is a health condition characterized by high blood sugar levels, but it has not developed into type 2 diabetes mellitus (T2DM). According to the Centers for Disease Control and Prevention (CDC) recent estimates, about 88 million Americans have prediabetes (CDC, 2020). This project's main aims were to determine the effectiveness of implementing a structured prediabetes education intervention in diagnosing and screening prediabetes among primary care providers caring for African American females (AA) aged 30 to 60 years. Moreover, to evaluate the outcomes of implementing the educational …

Associations Between Postpartum Depression And Child Overweight And Obesity: Mediating Effect Of Maternal Feeding Behaviors And Beliefs, Michelle Harrison

Theses and Dissertations (ETD)

Purpose. Postpartum depression (PPD) is a mental condition that significantly affects 10% to 25% of women within the first year after the birth of their child. The mother-infant relationship is key to child growth. Previous studies have shown that PPD has a detrimental effect on children’s physical and psychological well-being as it affects the child through the mother’s parenting behavior. Depressed mothers show a lack of engagement with their children, which could extend to feeding practices influencing weight gain. The prevalence and severity of childhood overweight and obesity is a global public health problem. An increase in weight gain in …

Saliva Cortisol Diurnal Variation And Stress Responses In Term And Preterm Infants, David Q. Stoye, James P. Boardman, Clive Osmond, Gemma Sullivan, Gillian Lamb, Gill S. Black, Natalie Z. M. Homer, Nina Nelson, Elvar Theodorsson, Evalotte Mörelius, Rebecca M. Reynolds

Research outputs 2022 to 2026

Objective:

To determine if preterm birth is associated with adaptation of the hypothalamic–pituitary–adrenal (HPA) axis and whether HPA axis programming relates to the degree of prematurity (defined as extremely preterm birth at < 28 weeks or very preterm birth at 28–32 weeks gestation).

Design:

This study reports findings from a prospective birth cohort. Saliva cortisol concentrations were measured prevaccination and postvaccination, and in the morning and evening, at 4 months chronological age.

Setting:

Infants born at a single Scottish hospital.

Participants:

45 term-born, 42 very preterm and 16 extremely preterm infants.

Outcomes:

Cortisol stress response to vaccination (postvaccination minus prevaccination cortisol concentrations), diurnal slope (log-transformed morning minus log-transformed evening cortisol values) …

Exposure To Substance And Current Substance Among School-Going Adolescents In Timor-Leste, Abigail Esinam Adade, Kenneth Owusu Ansah, Nutifafa Eugene Yaw Dey, Francis Arthur-Holmes, Henry Ofori Duah, Pascal Agbadi

College of Nursing Faculty Research and Publications

Few studies have examined how exposure to substance influences adolescent’s use of substance in Timor-Leste. We assessed this relationship using nationally representative data from Timor-Leste to address this gap. Data was pulled from the 2015 Timor-Leste Global school-based student health survey. Data of students aged 13-17years (N = 3700) from class 7–11 across schools in Timor-Leste were analyzed for this study. Second-hand smoking exposure (AOR = 1.57 [1.31, 1.89] and parental tobacco use, AOR = 1.94 [1.54, 2.44]) was significantly related to in-school adolescent’s current use of substance after adjusting for covariates. Current substance use was also positively associated with …

Relationship Of Nursing Management Functions With Missed Nursing Care: A Cross-Sectional Study, Putri Nilasari, Rr Tutik Sri Hariyati, La Ode Abdul Rahman

Jurnal Keperawatan Indonesia

A crucial role of the nurse is to provide safe nursing care without missing anything. Unsafe care is a key contributor to morbidity and mortality in the world. This study aimed to identify the relationship between management functions and nursing care that were missed at three inpatient installations at regional general hospitals. The research used a quantitative approach with an analytic research and cross-sectional design. The sample consisted of 238 nursing staff comprising team leaders and implementing nurses who worked at Regional Hospitals A, B, and C. The management function (p = 0.001) and all its components of planning, organizing, …

Factors Related To Father’S Behavior In Preventing Childhood Stunting Based On Health Belief Model, Eka Mishbahatul Mar'ah Has, Candra Panji Asmoro, Wilhelmus Petrus Gua

Jurnal Keperawatan Indonesia

Childhood stunting is still a significant public health burden in Indonesia. Fathers' engagement in childcare could improve a child's health and help to prevent stunting. This study aimed to analyse factors related to the father's behaviour in preventing childhood stunting based on Health Belief Model. This study was used a correlational study design with a cross-sectional approach. This study involved 199 fathers who had children under five years old, recorded at Puskesmas (Public Health Center) Maronggela, East Nusa Tenggara, Indonesia. Samples were taken using the cluster random sampling technique. The independent variables were the father's perceived susceptibility, perceived severity, perceived …

Mental Health Problems Among Adolescent Students, Windu Astutuk, Ni Luh Made Asri Dewi

Jurnal Keperawatan Indonesia

Concern for adolescents usually focuses on physical problems, such as reproductive health and nutrition, including anemia and obesity. Nowadays, adolescent mental health has been recognized as essential, particularly in low- and middle-income countries. Mental health problems that often occur in adolescents include anxiety, depression, and the risk of suicide. This study aimed to determine the prevalence of mental health problems and the risk of suicide among adolescent students in Bali Province, Indonesia. The sample consisted of 435 students from four junior high schools (Grades 7, 8, and 9) aged 12–15 years who were selected with a multistage sampling technique. This …

Evaluation Of An Australian Neurological Nurse-Led Model Of Postdischarge Care, Judith Dianne Pugh, Kathleen Mccoy, Merrilee Needham, Leanne Jiang, Margaret Giles, Elizabeth Mckinnon, Kym Heine

Research outputs 2014 to 2021

Neurological disorders are a leading cause of disease burden worldwide, placing a heavy demand on health systems. This study evaluated the impacts and cost savings of a community-based nursing service providing supported discharge for neurological patients deemed high-risk for unplanned emergency department presentations and/or hospital readmissions. It focused on adult patients with stroke, epilepsy, migraine/headache or functional neurological disorders discharged from a Western Australian tertiary hospital. An observational design was used comprising prospective enrolment of patients receiving nurse-led supported discharge and follow-up (Neurocare), 21 August 2018 to 6 December 2019 (N = 81), and hospital administrative data, 1 February …

Chronic Obstructive Pulmonary Disease Pathophysiology, Alex Thompson

Nursing Student Class Projects (Formerly MSN)

This poster presentation overviews the pathophysiologic process and accompanying disease characteristics associated with Chronic Obstructive Pulmonary Disease (COPD). COPD is a leading cause of mortality worldwide. Studies suggest that its incidence will only increase in the future. COPD risk factors include smoking tobacco, environmental chemical/pollution irritants, and genetic predisposition. Smoking is the most common cause of COPD, and cessation can improve patient outcomes drastically. This chronic obstructive pulmonary disease overview discusses the importance of knowledge of COPD, signs, symptoms, pathophysiology, peri-operative management, treatments, and prevention.

Acute Kidney Injury, Chelsey Benner

Nursing Student Class Projects (Formerly MSN)

Acute kidney injury (AKI) is a common complication of surgical procedures and can lead to increased morbidity and mortality. AKI can be described by a sudden decline in kidney function, evidenced by elevation of serum creatinine, elevated blood urea nitrogen levels, and a decreased glomerular filtration rate (McCance & Huether, 2018, p. 1360). Optimal perioperative management and recognition of patients at high risk for AKI is important in preventing the development of acute kidney injury.

Analyzing The Relationship Between Non-Pharmacologic Interventions And Pregnancy-Induced Hypertension: An Integrative Review, Karen Ann Ellis

Doctoral Dissertations and Projects

Maternal and fetal health outcomes are threatened due to pregnancy-induced hypertension, which complicates nearly 6%–10% of pregnancies worldwide. This disease carries a high risk of maternal and fetal morbidity and mortality. Medications are commonly used to reduce blood pressure and physical consequences related to high blood pressure. However, the use of medications does not resolve the disease as there is no pharmacological cure. Current evidence demonstrates the detrimental long-term effects of pregnancy-induced hypertension and the increased risk of future cardiac disease. Close surveillance and effective treatment during pregnancy is needed to prevent serious complications. The aim of this integrative review …

The Importance Of Education In The Management Of Diabetes, Taylor Nicole Henry

Doctoral Dissertations and Projects

Type 2 diabetes continues to affect millions of people every day across the United States. Uncontrolled blood sugars pose a risk to individuals’ overall health by causing microvascular and macrovascular changes and ultimately lead to an earlier mortality. One’s blood sugar levels can be checked at any time, but an individual’s hemoglobin (hgb) A1c is a three-month average that allows the diabetic to have an overview on how they are managing their diabetes. Appropriate nutrition and having someone hold the diabetic accountable have proven to limit these risks by lowering the patient’s hgb A1c. Providers and staff need to do …

Walking To Improve Outcomes In Patients With Type Ii Diabetes, Kelley Leigh Sanders

Doctoral Dissertations and Projects

Walking is a simple, feasible, and effective exercise modality in which providers can instruct patients as a component of type II diabetic treatment plans. Many patients are overwhelmed when given instructions to exercise and therefore never begin. Lack of exercise contributes to poor glycemic control and adverse outcomes. Also, gym memberships can be expensive resulting in patients forgoing exercise altogether. The purpose of this DNP scholarly project was to conduct research outcomes which may enlighten providers to prescribe exercise interventions by providing evidence walking 45 minutes three times a week can improve glycemic control among type II diabetic patients. Also, …

Performance Of Machine Learning Classifiers In Classifying Stunting Among Under-Five Children In Zambia, Obvious Nchimunya Chilyabanyama, Roma Chilengi, Roma Chilengi, Michelo Simuyandi, Caroline C. Chisenga, Masuzyo Chirwa, Kalongo Hamusonde, Rakesh Kumar Saroj, Najeeha Talat Iqbal, Innocent Ngaruye

Department of Paediatrics and Child Health

Stunting is a global public health issue. We sought to train and evaluate machine learning (ML) classification algorithms on the Zambia Demographic Health Survey (ZDHS) dataset to predict stunting among children under the age of five in Zambia. We applied Logistic regression (LR), Random Forest (RF), SV classification (SVC), XG Boost (XgB) and Naïve Bayes (NB) algorithms to predict the probability of stunting among children under five years of age, on the 2018 ZDHS dataset. We calibrated predicted probabilities and plotted the calibration curves to compare model performance. We computed accuracy, recall, precision and F1 for each machine learning algorithm. …

Assessment Of Vitamin D Among Male Adolescents And Young Adults Hospitalized With Eating Disorders, Jason M. Nagata, Anna Grandis, Paola Bojorquez-Ramirez, Anthony Nguyen, Amanda E. Downey, Kyle T. Ganson, Khushi P. Patel, Vanessa I. Machen, Sara M. Buckelew, Andrea K. Garber

Publications

PURPOSE: Medical complications of eating disorders in males are understudied compared to females, as is the case of vitamin D deficiency. The aim of this study was to assess vitamin D levels among male and female adolescents and young adults hospitalized for medical complications of eating disorders. METHODS: We retrospectively reviewed electronic medical records of patients aged 9-25 years (N = 565) admitted to the University of California, San Francisco Eating Disorders Program for medical instability, between May 2012 and August 2020. Serum vitamin D (25-hydroxy) level was assessed at admission as was history of prior calcium, vitamin D, or …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Metabolic Monitoring For Veterans Newly Prescribed Antipsychotic Medications: Enhancing The Process With Nursing Interventions, Charles W. Langnehs Jr

Graduate Theses, Dissertations, and Capstones

People who have severe mental illness are known to experience comorbidities and have shorter lifespans than those in the general population. There are many confounding reasons for those in this population to experience comorbidities that shorten their lives. However, it is commonly recognized that metabolic changes caused by medications taken to treat severe mental illness play a major role in the development of comorbidities and early mortality in those who take them. Drug manufacturers and several major organizations recommend the close monitoring of the metabolic status of those prescribed drugs in the class of medications known as antipsychotics. However, literature …

Newborn Weight Change And Predictors Of Underweight In The Neonatal Period In Guinea-Bissau, Nepal, Pakistan And Uganda, Valerie J. Flaherman, Amy S. Ginsburg, Muhammad Imran Nisar, Muddassir Altaf, Khushboo Liaquat, Benazir Baloch, Najeeb Rehman, Yasir Shafiq, Shabina Ariff, Fyezah Jehan

Department of Paediatrics and Child Health

In low- and middle-income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea-Bissau, Nepal, Pakistan and Uganda. In this cohort of 741 infants, the mean birth weight was 3036 ± 424 g. For 721 (98%) infants, weight loss occurred for a median of 2 days (interquartile range, 1-4) following birth until weight nadir was reached 5.9 ± 4.3% below birth …

Reducing Pediatric Morbidity Through Development Of A Clinical Practice Guideline, Deanna Kroh

Dissertations

Peripheral intravenous therapy is a commonly utilized treatment modality for the care of acutely ill pediatric patients. Two risk factors include infiltration and extravasation injuries. These injuries, peripheral intravenous infiltration or extravasation injuries (PIVIEs), can vary in their clinical manifestations from minor discomfort to harm as severe as loss of limb or disfigurement. Clinicians caring for patients at risk of developing PIVIEs need to be able to act quickly to reduce potential morbidity. The purpose of this project was to create a clinical practice guideline (CPG) that would guide staff intervention if a PIVIE occurs, with the ultimate goal of …

An Evaluation Of Mindstrong™ Implementation With Graduate Nursing Students, Angela B. Sabblut

Dissertations

Problem: Nursing graduate students are at increased risk of greater stress, anxiety, and depression (Hoying, 2020; Melnyk et al., 2020). Cognitive Behavioral Therapy is the gold standard in the treatment of anxiety and depression (Hoying et al., 2020; Melnyk et al., 2015; Melnyk et al., 2020). MINDSTRONG™, a CBT-based training program, has been proven in many studies to be effective in helping individuals prevent or cope with these issues (The Ohio State University College of Nursing, 2020).

Methods: This Quality Improvement (QI) project was a descriptive-observational, pre-post design. Sample and setting were nursing graduate students from a Midwestern, middle-sized urban, …

Evaluation Of An Education Program Implementation For Adults With Stage 4 And 5 Chronic Kidney Disease, Dana Marie Carter

Dissertations

Abstract

Problem: Patients with long-term medical conditions represent a significant public health issue. Therefore, patients diagnosed with a chronic illness must have a high level of health literacy (HL) to manage their condition effectively. This Quality Improvement (QI) project evaluated the impact of an existing education-based program for stage 4 and 5 chronic kidney disease (CKD) patients and its effect on laboratory values compared before and after an NP-led education program that included vascular access, and modality choices.

Methods: A retrospective chart review was completed on 20 patients with an inclusive diagnosis of CKD stage 4 or 5 from …

Healthcare-Associated Pressure Injury Prevention In The Intensive Care Unit, Ross Quinton

Dissertations

Problem: Healthcare-associated pressure injuries (HAPIs) occur when prolonged pressure is on the sacrum, coccyx, elbows, and heels, during a hospital stay. HAPIs can result in increased morbidity and mortality, and prolonged hospital stays, which consequently requires excess expenditure on treatment. Early specialty mattress placement can prevent HAPI acquirement.

Methods: This quality improvement (QI) pilot project aimed to increase specialty prevention mattress usage in the intensive care unit (ICU). A sleep surface decision tree was implemented into the admission process in a 30-bed ICU. A retrospective record review was used to examine demographics, comorbidities, HAPI risk, length of stay, and when …

Effect Of A Turn Clock On Hospital-Acquired Pressure Injury Incidence, Sydney Warren

Dissertations

Problem: Hospital-Acquired Pressure Injuries (HAPIs) are the only quality metric increasing in incidence and are preventable. HAPIs are wounds to bony prominences during a hospitalization and can increase hospital costs, morbidity, and mortality. HAPIs could be prevented through interventions, including repositioning patients every 2 hours and using a turn clock method. The aim of this quality improvement (QI) pilot project was to decrease HAPI incidence.

Methods: A turn clock method was implemented on a general medicine floor at a mid-sized, suburban medical center utilizing a descriptive retrospective observational design. Data was collected for the pre-intervention timeframe from June through August …

Implementing Patient Acuity Scale On A Medical-Surgical Unit, Coreen Ladd

Dissertations

Problem: Nurses commonly report dissatisfaction with their workload levels due to inequity of shift assignments. Imbalanced workload distribution has been shown to lead to missing or delayed care. Increased nursing workload has been linked to increased fall rates, healthcare associated infections, and avoidable deaths. Research has shown that patient classification is more accurate when an instrument is used. The purpose of this quality improvement project was to implement a patient acuity tool to aid nurse-patient shift assignments on a medical-surgical unit. The project aimed to provide a standardized and objective method of measuring patient acuity.

Methods: The project took place …

Evaluating The Rass And Cap-D In A Pediatric Cardiac Intensive Care Unit, Sarah Anderson

Dissertations

Abstract

Problem: Pediatric delirium is highly prevalent in the intensive care setting, as much as seventy to eighty-seven percent. Kalvas & Harrison (2020) found that sixty-six percent of critically ill children in a pediatric intensive care unit suffered from a diagnosis of delirium. Delirium has been widely linked with increased costs, mortality, and length of stay.

Methods: The quality improvement (QI) project used a descriptive design to collect retrospective and prospective data before and after an individualized bedside education session was completed. The QI project used a purposive convenience sampling to assess the ability to accurately identify the presence of …

The Effects Of Early Lactation Support On Breastfeeding Exclusivity Rates, Alexa Fleming

Dissertations

Abstract

Problem Breastfeeding exclusively for the first 6 months of a child’s life is the recommendation across medical professionals. Unfortunately, exclusive breastfeeding rates are on the decline due to insufficient support, lack of self-efficacy and inadequate hospital interventions.

Methods For this quality improvement (QI) project, a descriptive observational study design was used to identify appropriate participants who were planning to have a full-term, healthy, exclusively breastfed newborn. Within one hour after delivery, a lactation specialist provided the mother with breastfeeding education and assistance with the initial latching process. At the time of discharge, data was collected to examine if the …

Implementing A Child Friendly Menu Guide In A Pediatric Unit: Promoting Healthful Choices, Lauren Hull

Dissertations

Problem: Over 1/3 of children in the United States are overweight or obese and children’s nutritional status while hospitalized worsens rather than improves. Hospital meals have too many calories, too much sugar, and too few nutrients compared to recommended guidelines for children. The primary purpose of this quality improvement project is to increase the amount of healthy foods ordered by children in a southeastern pediatric hospital unit through implementation of a menu guide.

Methods: A quality improvement pre-post interventional pilot study was done through implementation of a child friendly menu guide promoting healthful eating. Data was collected by retrospective and …

Improving Recognition And Treatment Of Depression Among Women Using Phq-9 During Office Visits, Victoria Nwokocha, Heather Owens, Chris Webb

Graduate Theses, Dissertations, and Capstones

Depression can affect productivity and earnings among women, slow down the pace of active participation in social and family life, and increase health costs as well as distract attention from optimal health targets. Depression is the highest source of disability in NYC, with billions of dollars annually in related productivity losses. Although healthcare spending on depression affected patients is largely on hospital admissions, an estimated 40% of affected persons in New York do not get the adequate attention and care needed, with women most often affected by depression. This is an indication that the bedrock of preventive medicine for mental …

Diabetic Ketoacidosis In Pediatric Patients, Jarrod Genther

Nursing Student Class Projects (Formerly MSN)

Diabetic Ketoacidosis in Pediatric Patients

Jarrod Genther

Otterbein University

NURS 6810- Advanced Pathophysiology

Deana Batross, DNP & Shivani Bhatnagar, DNP

July 29, 2022

Diabetic Ketoacidosis in Pediatric Patients

Abstract

Diabetic ketoacidosis is a life-threatening complication in children with type 1 diabetes. Children with type 1 diabetes cannot produce endogenous insulin and must receive exogenous insulin to allow glucose influx into cells throughout the body for energy consumption. Without insulin, the child will progress to diabetic ketoacidosis. The covid-19 pandemic introduced new obstacles for patients with a predisposition for type 1 diabetes, presenting with a more profound acidosis, greater need for …