Digital Commons Network^™

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Diabetes Prevention Program, Ashley L. Stine

MSN Capstone Projects

The prevalence of diabetes in Texas has increased 40 percent over the last decade and will continue to rise as of 2019. New onset diabetes, chronic, and children with diabetes has significant rise in hospitalization rates. COVID and its restraints of limiting physical activity, restrictions of gyms and sedentary lifestyles. Chronic diabetics who were frequent flyer hospitalizations rates increase due to poor social support, mental health and stressors increased during COVID also. This diabetes prevention program that consists of 16wks for new and current diabetics would decrease complications of diabetes such as DKA, retinopathy, nerve pain, chronic pain, AMS, amputations, …

Advance Care Planning Evidence Based Practice Benchmark, Natalie K. Waggoner

MSN Capstone Projects

America is aging, with the estimated number of patients over the age of 65 to reach 72 million by 2030, approximately 20% of the population (Sade, 2012). This demographic shift characterized by an increasing elderly population has elevated the subject of death and dying to a crucial component of health care delivery. A study done by Silveira et al. (2010) demonstrated that 70% of individuals aged 60 and older were unable to participate in treatment decisions during their final days. However, most individuals in the United States have no advance directive.

The goal of this evidence-based practice intervention is to …

Stroke Depression And Rehabilitation Willingness: Benchmark Study, India J. Lewis

MSN Capstone Projects

The purpose of this paper is to examine, identify, and treat patients with post-stroke depression. Post-stroke depression can affect a patient's willingness to perform activities of daily living, this may result in poor functional outcomes on discharge. Depression is not regularly screened during the acute stroke phase, therefore not regularly treated with the intent to improve functional outcomes. The Patient Health screening questionnaire (PHQ-9) is an available tool that can assist in recognizing and treating depression. This project will determine that the current literature supports implementation of a protocol needed to improve rehabilitation participation.

Implementation Of An Oral Hygiene Protocol For Adults Patients On Acute Care Units, Sharon J. Boler

Student Scholarly Projects

Practice Problem: Patients diagnosed with non-mechanically ventilated aspiration pneumonia can result in increased levels of care, longer lengths of stay, and are 8.4 more likely to die while hospitalized. Oral hygiene protocols have led to promising outcomes, evidenced by fewer cases of aspiration pneumonia in adult patients on medical surgical units.

PICOT: The PICOT question that guided this project was in adult non-mechanically ventilated hospital patients, does an Oral Hygiene Protocol (OHP) compared to current practice affect hospital acquired aspiration pneumonia during hospitalization.

Evidence: Fourteen studies met inclusion criteria that support the implementation of an evidence – based oral hygiene …

Decreasing Pre-Procedural Fasting Times: A Benchmark Study, Sheila Gasparek

MSN Capstone Projects

On a busy Surgical Trauma unit, scheduled procedures and operations are often delayed for priority emergent cases. Patients admitted to the unit with delayed procedures often endure extended fasting times beyond the six-hour intention of standard nothing by mouth (NPO) after midnight fasting order. With prolonged fasting times, patients inquire about pending surgery times and dietary options. Some providers may allow ice chips, but most doctors prefer patients to remain NPO in case Operating Room availability opens for surgery, leaving already anxious and uncomfortable patients more frustrated as prolonged fasting affects patients’ physical and psychological well-being (Anderson & Comrie, 2009). …

Evidence-Based Individualized Discharge Educational Intervention For Coronary Artery Disease (Cad) Patients; A Benchmark Project, Sumita Thapa

MSN Capstone Projects

Coronary artery disease (CAD) is the leading cause of death worldwide, whereas, in the United States, 16,800,000 people are affected, resulting in 450,000 deaths annually. Patients’ perceptions of self-management related to treatment adherence, lifestyle modifications, and risk-factor management are significant indicators of outcomes following a cardiac event. To promote self-management in CAD patients, this benchmark project aims to determine the impact of individualized education interventions by establishing a standardized nurse-led educational intervention in the cardiac unit that emphasizes adherence to self-management and treatment regimen to improve quality of life and prevent rehospitalization due to worsening cardiac events. The evidence-based findings …

Resiliency Can Be Taught: The Impact Of An Evidence-Based Training On Nurse Resilience, Margaret Maxtin

MSN Capstone Projects

A small project team implemented a resiliency training class as part of an evidence-based nursing intervention. Nurses at a tertiary care facility who work on a pediatric hematology/oncology unit participated in the 2-hour training course and learned multiple skills directed at improving resiliency. All participants surveyed responded positively to the class. Future directions for the project include long term follow-up and continued resiliency classes with varied topics to continue improving resilience and decreasing burnout.

A Need For Change: Patient Education And Diabetic Control, Meredith Sexton

MSN Capstone Projects

Type II diabetes is a difficult diagnosis for patients to receive. Patients must work through the stigma attached to the diagnosis and understand how it affects their daily lives. It is important for our patients to understand the disease, how to control their blood sugars and how to reduce the risk of preventable complications. This project is based on the following question: “In patients diagnosed with Type II diabetes, how does going to a formal support and education session at least once per week compared to not going to a formal support group affect diabetic control, as measured by patients’ …

Reducing 30-Day Hospital Readmissions Through Interprofessional Collaboration/Multidisciplinary Team-Based Care Approach: A Benchmark Project, Julius Solis

MSN Capstone Projects

Hospital readmissions are a costly burden that hospitals often must sustain because of current reimbursement policies. The Hospital Readmission Reduction Program (HRRP), a value-based purchasing program, was established to reduce or penalize payment to hospitals for excessive readmissions (Centers for Medicare & Medicaid Services, 2020). Lower financial payments by payors often have a negative impact on a hospital’s overall performance through the inability to purchase new and up to date equipment and materials, budget cuts, downsizing of personnel and departments, amongst all other things. Auerbach et al. (2016) estimate that approximately one-quarter or 26.9% of hospital readmissions were preventable. The …

Type 2 Diabetic Education Benchmark Study, Amy Lynd

MSN Capstone Projects

Evaluating the implementation of verbal and written education on diet for newly diagnosed type 2 diabetics.

Change Project Using A Fall Prevention Action Program To Decrease Falls On A Behavioral Health Unit, Amy Shuptrine

Student Scholarly Projects

Practice Problem: Fall rates are increasing in the behavioral health units of the East Texas hospital. Due to the worldwide COVID-19 pandemic, the units are short-staffed, which further supports the urgent need for a targeted intervention to reduce fall risk.

PICOT: The PICOT question that guided this project was: “In adult behavioral health patients (P), what is the effect of the Edmonson Psychiatric Fall Risk Assessment Tool (I), compared with previous use of the Morse Fall Risk tool (C), on the fall rate (O), in 8 weeks (T)?”

Evidence: Falls are the most reported incidents in acute care hospitals and …

Formalizing A High-Risk Obstetrical Initiative: Focus—Hypertensive Disorders, Elena Vulgamott Rodrigue

Doctor of Nursing Practice

Background: Hypertensive disorders during pregnancy have a detrimental effect on maternal and fetal outcomes, causing low birth weights, preterm births, and stillbirths. During pregnancy, hypertensive disorders affect up to 13% of all pregnancies and make up 10% of all maternal mortality in the United States (Centers for Disease Control and Prevention [CDC], 2019). Purpose: The purpose of this DNP project was to implement and standardize a high-risk obstetrical initiative for hypertensive mothers. Summary of Evidence: Data suggest that increased education and increased surveillance for high-risk obstetric patients decreases the need for obstetric services and decreases the evolution of hypertensive …

Senior Nursing Students’ Confidence In Communicating And Providing Patient Teaching, Carmen Bandy

Honors College Theses

In the field of nursing, effective nurse-patient communication and teaching are among the most important indicators of patient satisfaction. Research shows that improved communication can result in more favorable patient outcomes and compliance with treatment. Additionally, improved communication with other members of the healthcare team can create a better work environment and result in increased patient outcomes, as well as decreased errors. The aim of this thesis is to assess the confidence of seniors in the Murray State University Nursing program in communicating with patients and other healthcare professionals and in providing thorough, accurate teaching to patients. Strategies to improve …

Stress As A Contributing Factor For Pediatric Obesity: Literature Review And Internship Experience, Jessica Handley

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article is an examination of how stress drives diet and physical activity behaviors that contribute to pediatric obesity in the United States. An increasing rate of childhood obesity is being reported in the United States and therefore a multitude of studies and reviews have been conducted on the topic. This review of the literature systematically analyzes how stress, diet, and physical activity behaviors contribute to this rising rate of pediatric obesity. An analysis of the chosen articles for review indicates that stress and its counterpart (resilience) tend to be driving forces in how American children and adolescents participate in …

Implementing 2nd Milk’S Use Of The World Health Organization Standardized Growth Charts To Better Track The Growth And Development Of The Malnourished And Orphaned Infants In Their Supplemental Nutrition Program In Malawi, Allie Wycoff

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article considers the history and implications of the World Health Organization (WHO) standardized growth charts as well as the significant impact that growth chart utilization may have on 2^ndMilk’s ability to understand and track the nutritional status of the malnourished orphaned infants in their formula program. Specifically, this literature review examines whether or not the WHO growth charts are a meaningful tool for 2^ndMilk to adopt into their monthly baby assessments. The WHO growth charts are calibrated to express an accepted international “norm” for what an adequately nourished child looks like. In a recent service-learning …

The Physiological Benefits Of A Plant-Based Diet On Cardiovascular Health, Jenevieve Petray

Nursing | Senior Theses

Cardiovascular disease (CVD) is increasingly more prevalent in today’s society and is attributed to an alarming percentage of American hospitalizations and deaths. Americans are unhealthier than ever before, and the main contributor is the Western diet. Diet is a double-edged sword that can offer benefits or detriments to one’s health. CVD encompasses numerous diagnoses originating from various underlying physiological alterations. These alterations are downstream effects of increased body weight and BMI, increased cholesterol levels, decreased insulin sensitivity and increased arterial plaque buildup. Research shows that a plant-based diet has the potential to manage and reverse all fundamental physiological alterations that …

Discerning The True Dilemma Of Diabetes Among Hispanics, Ramon Ponce

Nursing | Senior Theses

There is a common misconception that the primary role of nurses is to follow doctors’ orders and treat patients who are currently suffering and experiencing pain. Chronic illnesses such as diabetes can be prevented and better managed if the population who is greatest at risk is better informed and educated on the disease. Different cultures and ethnicities have different foods that unfortunately puts them at risk to get diabetes. Hispanics typically follow a diet that is high in carbohydrates, saturated fats, and sugars that greatly contribute to the development of diabetes. Often, Hispanics are not educated enough to comprehend the …

Formalizing An Obstetrical Program For High-Risk Patients: Focus—Diabetes During Pregnancy, Valeria Jimenez

Doctor of Nursing Practice

Within the last 10 years, the number of pregnant women with gestational diabetes increased 56%, and the number of women with Type 1 or Type 2 diabetes before pregnancy increased 37% (CDC, 2018). The management of a pregnancy complicated by diabetes involves a multidisciplinary approach, medical nutrition therapy, glycemic control, and occasionally, pharmacological therapies (Nurain et al., 2019). In 2017, the total cost of diabetes in the United States was $237 billion (Riddle & Herman, 2018). The purpose of this DNP project was to standardize a Federally Qualified Health Care’s (FQHC) High-Risk Obstetrical (OB) Initiative, which attempted to provide in-person …

The Relationship Between Gestational Diabetes And Stress: A Literature Review, Morgan Mcgrath

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The incidence of gestational diabetes has been increasing over the past ten to twenty years. The purpose of this literature review is to gather existing literature to examine the relationship between gestational diabetes and oxidative stress. Twenty peer-reviewed articles from two databases were selected to be examined in this review. From these studies, it was found that oxidative stress was higher in women who were diagnosed with gestational diabetes, and supplementation with vitamins and minerals was beneficial in decreasing stress in these women. While these studies can help healthcare providers in educating women who have been diagnosed, more research should …

Social Support Of Mexican Immigrant Women With Gestational Diabetes Mellitus: A Constructivist Grounded Theory Study, Angela Sojobi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the perception of social support among Mexican immigrant women with gestational diabetes mellitus (GDM) within the context of their culture and discern the process through which social support can influence their adherence to the GDM management protocols. The incidence of GDM is highest in low-income, ethnic minority communities such as the Mexican immigrant community. Adhering to the GDM management protocols may prove challenging for some women, especially if social support is lacking. If uncontrolled, GDM can result in adverse maternal-fetal outcomes. Among Mexican immigrant women, the incidence of poor glycemic control and …

Best Practice Recommendation On Anesthesia Involvement In Preoperative Interdisciplinary Rounding On Surgical Inpatients, Elizabeth Davis

Doctoral Projects

Healthcare professionals are always seeking methods to improve patient care and patient outcomes and increase efficiency while reducing errors. By improving communication through the implementation of interdisciplinary communication, improved care quality, fewer variations in care, and enhanced collaboration among the healthcare team may be an outcome (Hoke & Falk, 2012). While anesthesia is involved in patient care throughout the perioperative period, their expertise may impact the patient’s outcome and quality of surgical care. With the involvement of anesthesia in interdisciplinary rounding, the patient may be optimized, and the plan of care may be more appropriate and individualized.

The potential for …

Factors Associated With Gestational Diabetes Among Women Registered At Secondary Hospitals In Karachi, Pakistan, Sumaira Feroz Ali, Tazeen S. Ali, Arusa Lakhani, Zaib Nadeem

Journal of Asian Midwives (JAM)

Introduction: Few things are proven, there are modifiable and non-modifiable factors that could impact on the health of pregnant women who have Gestational Diabetes Millitus (GDM). However, case control studies are lacking that explore the modifiable factors and identify which modifiable factors are associated with GDM.
Purpose: The aim of this study was to identify the modifiable associated risk factors of GDM among women at 32 to 40 weeks of gestation.
Methodology: A case-control study design was conducted at secondary hospitals for women and children in Karachi, Pakistan. The data were collected from 100 cases and same number of controls, …

Investigating Acculturation, Health-Promoting Lifestyle, And Health Status Among Nigerian Immigrants In The United States, Frank Uche Akpati

UNLV Theses, Dissertations, Professional Papers, and Capstones

The United States has a significant number of immigrants from Africa. More come from Nigeria than other African countries. Even though acculturation influences health behavior in other cultures, this relationship is understudied in the Nigerian immigrant community in the United States which can influence their health care. This study examined the relationship between acculturation, health-promoting lifestyle, and health status of Nigerian immigrants. Key constructs from Berry’s acculturation model guided the study. Acculturation was conceptualized as occurring through varying levels of ethnic society immersion (ESI) and dominant society immersion (DSI). The study also examined the influence of education on acculturation using …

Factors Associated With Medication Decision Making In African American Families Of Children With Adhd: A Mixed Methods Study, Amy Glasofer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral pediatric disorder in the United States. Pharmacotherapy is a recommended component of treatment for ADHD. While medication treatment of ADHD is not optimized overall, minority groups experience medication treatment disparities. The persistently lower rates of medication treatment in minority groups may have culturally specific origins which cannot be generalized across minorities. The purpose of this dissertation was to assess and extend knowledge regarding medication decision making (MDM) in African American caregivers of children with ADHD. To assess the state of the science on ADHD disparities, a review of 41 descriptive studies exploring …

Strategies To Prevent Hospital Acquired Pressure Injuries In The Intensive Care Unit, Theresa Ann Pomerleau

Doctor of Nursing Practice

Background. Despite prevention strategies, hospital acquired pressure injuries continue to occur, especially in intensive care units. This led to an impetus for nurses to have a robust knowledge of pressure injuries to promulgate prevention strategies in their practice. Significance of the Problem. The hospital acquired pressure injury rate in the medical surgical intensive care unit for the year 2019 at Hospital X was greater than the national benchmark. Purpose. The global aim statement was to improve the quality of patient care by developing an evidence based educational suite in collaboration with interdisciplinary team members for prevention of hospital acquired pressure …

Relationship Between Mothers’/Caregivers’ Reported Learning Difficulty And Internalizing Symptoms (Anxiety And Depression) Of Children Aged 5–17 Years In Ghana, Queen Angela Norman, Nutifafa Eugene Yaw Dey, Kenneth Owusu Ansah, Francis Arthur-Holmes, Henry Ofori Duah, Pascal Agbadi

College of Nursing Faculty Research and Publications

Studies have reported different factors associated with anxiety and depression among children and adolescents. However, studies examining the relationship between learning difficulties and internalizing symptoms of Ghanaian children is scarce. The only study available found that 152 students with learning difficulties who visited a psychology clinic for psychological assessment had high levels of stress and anxiety (Asare & Danquah, 2016). While the study provided preliminary evidence of the relationship between learning difficulties and internalizing symptoms, it had some methodological challenges. For instance, the study used a relatively smaller sample size and subsampled children in Accra. Our study used a nationally …

Chronic Liver Disease Lowering Physical And Mental Health Dimensions, Apriliani Siburian, Cheng Fen Chang

Jurnal Keperawatan Indonesia

The most prevalent diseases within the world related to major illness and mortality are chronic liver diseases. The developing pervasiveness of chronic liver disease has resulted in increased interest in health-related quality of life, which incorporates the physical well-being of a patient and his emotional and social well-being. This study aimed to define the quality of life of patients with chronic liver disease. This study used the Quality-of-Life Short Form 36 Indonesian version to examine 102 patients with chronic liver disease from two hospitals with a descriptive design. The quality of life of the patients was comparatively low (M ± …

Cardiac Rehabilitation Benchmark Study, Catherine Cottle

MSN Capstone Projects

This benchmark study attempts to evaluate the effectiveness of cardiac rehabilitation in reducing mortality and hospital readmission rates of post-myocardial infarction patients. Several peer-reviewed articles were reviewed assessing the efficacy of cardiac rehabilitation. It was discovered that cardiac rehabilitation reduced several negative effects regarding heart disease, including the reduction of mortality and hospital readmission rates.

Exclusive Breastfeeding And Professionals From The Family Health Strategy, Marialda Moreira Christoffel, Ana Leticia Monteiro Gomes, Cássia Leoneuza Augusto Julio, Julia Florentino De Barros, Elisa Da Conceição Rodrigues, Fernanda Garcia Bezerra Góes, Ana Maria Linares

Nursing Faculty Publications

OBJECTIVES: to analyze the perception of health professionals about exclusive breastfeeding in Family Health Strategy units in the city of Macaé.

METHODS: qualitative study carried out in four units of the Family Health Strategy in the city of Macaé, Rio de Janeiro. Thirty health professionals were interviewed from March to May 2019. Textual contents were processed in the IRaMuTeQ^® software by the Descending Hierarchical Classification.

RESULTS: professionals use different strategies for actions to promote, protect and support breastfeeding in prenatal consultations, but social and cultural determinants are important issues that interfere in this process, the involvement of the family …