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Intent To Stay, Moral Distress, And Nurse Practice Environment Among Long-Term Care Nurses, Amil Tan

Dissertations, Theses, and Capstone Projects

Background: Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed at least in part to moral distress and a negative nurse practice environment. Licensed nurses working in long-term care facilities experience ethical challenges such as lack of resources, use of restraints, end-of-life issues, and caring for residents with dementia that, if not resolved, can lead to moral distress- especially if left unresolved. Long-term care administrators and nurse managers increasingly strive to improve leadership support for long-term care staff that will positively affect the nurse practice environment.

Aim/Purpose: The purpose …

Factors Associated With Health-Promoting Behaviors Of Adult Protective Service Workers And Professionals Who Support Vulnerable Adults, Cynthia Sterling-Fox

Dissertations, Theses, and Capstone Projects

Background: Adult protective services encompass social services provided to vulnerable adults: abused, neglected and exploited elderly and adults with significant disabilities in the United States. Adult Protective Services (APS) workers investigate allegations of abuse, neglect, and exploitation of vulnerable adults. APS workers work closely with multidisciplinary teams and professionals in various fields to assist with the investigations. APS workers and other professionals are exposed to individual and work environment stressors that result in a lower professional quality of life. There is evidence, however, that health-promoting behaviors mitigate the negative effects of stressors.

Purpose: Using the Health Promotion Theory by Nola …

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Promoting Patient Engagement: A Scoping Review Of Actions That Align With The Interactive Care Model, Georgia Tobiano, Teresa Jerofke-Owen, Andrea P. Marshall

College of Nursing Faculty Research and Publications

Background

Conceptual clarity for the term patient engagement is growing. However, there is variability in patient engagement in healthcare, which could be due to the absence of models to guide practice or a myriad of organisational, nurse and patient factors. The recently developed ‘Interactive Care Model’ provides guidance on how to genuinely promote individualised patient engagement. An understanding of how to action this model in nursing is required.

Aims

The aim of this scoping review was to examine actions in the published scientific literature that align with the Interactive Care Model, in the context of nursing care of hospitalised patients. …

Elevated Lipid Oxidation Is Associated With Exceeding Gestational Weight Gain Recommendations And Increased Neonatal Anthropometrics: A Cross-Sectional Analysis, Jill M. Maples, Samantha F. Ehrlich, Nikki B. Zite, Kevin J. Pearson, W. Todd Cade, Courtney J. Riedinger, Maire M. Blankenship, Rachel A. Tinius

Pharmacology and Nutritional Sciences Faculty Publications

BACKGROUND: Deviations from gestational weight gain (GWG) recommendations are associated with unfavorable maternal and neonatal outcomes. There is a need to understand how maternal substrate metabolism, independent of weight status, may contribute to GWG and neonatal outcomes. The purpose of this study was to explore the potential link between maternal lipid oxidation rate, GWG, and neonatal anthropometric outcomes.

METHODS: Women (N = 32) with a lean pre-pregnancy BMI were recruited during late pregnancy and substrate metabolism was assessed using indirect calorimetry, before and after consumption of a high-fat meal. GWG was categorized as follows: inadequate, adequate, or excess. Shortly …

Neonatal Orogastric & Nasogastric Tube Placement: Evidence Based Improvement Prospectus, Jessica K. Nagra

Master's Projects and Capstones

Problem: Variation in gastric tube placement practice has resulted in incorrect placement depth, resulting in four gastric tube perforations in a level III neonatal ICU within the last year. Gastric perforations have increased infant length of stay, increased surgical interventions, delay in oral feeding, increased hospital cost, and potentially lower family satisfaction with care.

Context: IHI’s 5 Why’s: Finding the Root Cause identified a lack of standardization in policy and practice and lack of consistent staff education as the primary reason for misplaced gastric tubes. Additionally, a cost-benefit analysis projected the estimated cost of additional infant length of stay for …

Global, Regional, And National Progress Towards Sustainable Development Goal 3.2 For Neonatal And Child Health: All-Cause And Cause-Specific Mortality Findings From The Global Burden Of Disease Study 2019, Katherine R. Paulson, Nicholas J. Kassebaum, Arianna Maever L. Amit, Veincent Christian F. Pepito, Gbd 2019 Under-5 Mortality Collaborators, 735 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include …

Utilizing Group Prenatal Care To Support Underserved Pregnant Women, Kathleen Shrader

Doctor of Nursing Practice (DNP) Projects

Background

Prenatal care is a valuable time for pregnant patients to ideally receive holistic care that considers their psychosocial and physical needs. It is a vital service that decreases morbidity and mortality.

Problem

Individual prenatal care visits may not provide enough support for patients with complex psychosocial needs. Group care offers a longer visit, and education and community for pregnant women. The Native American Health Center (NAHC) offers group visits that have not been streamlined, and due to staff turnover, have left new staff under-resourced in planning visits.

Intervention

A toolkit was provided to NAHC staff on how to provide …

Evaluating Self-Management Of Adults With Multiple Chronic Conditions Residing In Rural Communities: A Descriptive Cross-Sectional Study, Jessica J. Miller

Theses & Dissertations

Background

Chronic diseases are the leading cause of death and disability in the United States and are on the rise. Multiple chronic conditions are increasing in frequency with 1 in 4 adults affected. Behaviors of adults from rural communities are at an increased risk of developing MCC because of limited access to health care resources and behaviors. Supporting the development of self-management skills can help adults be more active in their own health and promote healthy lifestyle behaviors. The Individual and Family Self-management was the guiding framework for this cross-sectional study.

Purpose

The purpose of this study was to determine …

Social Determinants Of Health Assessment For Skilled Nursing Patients, Heather Welch

Master's Projects and Capstones

Section I: Abstract

Problem: Skilled nursing facility (SNF) patients are vulnerable, aging, and have complex medical histories. Readmissions from an SNF impact healthcare costs and hospital resources and indicate poorly coordinated transitions home. Patients discharging from SNFs are at risk for higher social determinants of health (SDOH) disparities, such as limited caregiver support, transportation, housing insecurity, and food access. These SDOH risks can significantly increase an SNF patient's risk for hospital readmissions. Assessing and addressing SNF patients' social needs to reduce 30-day post-SNF readmissions can improve health outcomes and positively impact healthcare costs and a patient's financial liabilities.

Context: Frailty, …

Type 2 Diabetes And A Plant Based Diet, Adrian Brown

Nursing Student Class Projects (Formerly MSN)

I was diagnosed as a Type II diabetic a few years ago when I was living in South Korea working as an English teacher. I, like many of the diabetics that I now take care of, said many of the same excuses that they tell me:

Patient: I heard that I might be pre-diabetic.

Nurse: You are on metformin and your morning glucose is in the 180s.

Patient: I’m not diabetic.

Nurse: You have peripheral neuropathy.

Patient: I watch what I eat. I’m ok.

Nurse: You have hypertension high cholesterol and don’t exercise.

I've said all over those things. But …

Enhanced Recovery After Surgery Ambulation Project, Jennifer M. Rose

Master's Projects and Capstones

Abstract

Problem: The enhanced recovery after surgery (ERAS) Ambulation Project aims to increase early ambulation of cesarean section patients in the maternal child inpatient unit. The current data has shown inconsistency with the application of the ERAS program with the maternal population. Instituting standardization of care and documentation, along with increasing patient centered care, has the potential to decrease the hospital length of stay (LOS).

Context: This quality improvement project standardizes the education provided to staff nurses and patients; allotting more time for staff to create meaningful relationships with their patients. A microsystem culture utilizing patient centered care …

Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao

Master's Projects and Capstones

Abstract

There are multiple layers of oversight across the healthcare delivery system. Measuring acute hospital readmissions has been identified as an important outcome measure of quality care. Our patients are one of the major stakeholders in the healthcare system. One role of a clinical nurse leader is to integrate evidence-based leadership practices that identify and assess outcomes, mitigate risk, enhance health promotion, deliver highly effective patient care, and ensure transparent relationships with stakeholders. Rationales for examining and re-designing the readmission analysis workflow based on the customer’s experience are discussed in this paper. The global aim of the project is to …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

Improving Mammography Rates Among The Hispanic Population: An Evidence-Based Project Utilizing A Promotora Intervention, Dawn Mirowski

Student Scholarly Projects

Practice Problem: Breast cancer is the leading cause of death in Hispanic women in the U.S., with mammography being the most effective means of reducing breast cancer mortality. Promotoras have been shown to improve health promotion, including mammography, among the Hispanic population.

PICOT: The PICOT question that guided this project was: In Hispanic women 40 years or older (P), how does the use of a promotora intervention (I), compared to no promotora intervention (C), affect mammography rates (O) within an 8-week period (T)?

Evidence: Twenty-one studies that met the inclusion criteria supported the use of promotoras to improve mammography …

Acute Respiratory Distress Syndrome, Amanda Kleinfelder

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a life-threatening condition caused by damage in the lungs leading to persistent hypoxemia. The alveoli in the lungs become filled with fluid from damage to the pulmonary capillaries due to inflammatory mediators. The buildup of fluid in the lungs ultimately result in intubation of the patient and mechanical ventilation (Senapathi et al., 2020). ARDS has become more prevalent today with the 2020 Covid-19 pandemic affecting 200 countries resulting is 1.1 million deaths so far (Weiss et al., 2021). Multiple therapies exist for the management of ARDS including prone positioning, deep sedation, and mechanical ventilation …

Delirium, Angela Lee

Nursing Student Class Projects (Formerly MSN)

Delirium is a severe neurocognitive syndrome characterized by acute changes in consciousness and cognition (American Psychiatric Association, 2013; Wilson et al., 2020). The syndrome is found to be prevalent within the adult intensive care population resulting from various triggers and stressors in the critical care setting (Wilson et al., 2020). On average, the prevalence of delirium is 23%, but the incidence significantly increases to 50-70% in mechanically ventilated patients (Wilson et al., 2020). As a result of the extension of cognitive deficits, if left untreated, delirium may lead to long-term impairments in cognitive disfunction (Wilson et al., 2020). Current studies …

Current Management Of Acute Hyperglycemia: Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome, Cary Bedinghaus

Nursing Student Class Projects (Formerly MSN)

The purpose of this poster is to review and promulgate current best practices in management of the two forms of hyperglycemic crises: diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Reviews of literature showed large agreement on efficacious protocols in acute hyperglycemic treatment, while also noting wide prevalence of the disorder. Given the high human and financial cost of hyperglycemia, the dissemination of high quality, evidence-based interventions, to the widest possible audience participating in patient care, is imperative. This poster outlines signs and symptoms, basic pathophysiology, and implications for the treatment team with emphasis placed on areas of settled best …

Reduction Of Clabsi In Telemetry Patients Through Limiting Central Line Blood Draw, Caselyn Lok

Student Scholarly Projects

CLABSI is known to be one of the many healthcare-associated infections that has led to an increase in health complications, length of hospital stays, and increased in healthcare cost. There is about 25000 bloodstream infection that occurs annually (Haddadin, Annamaraju, & Regunath, 2020). The PICOT question that guided this project was “How does limiting blood-draw from central venous catheter lines influence the rate of central-line associated bloodstream infections (CLABSI) post-implementation compared to rate of CLABSI pre-implementation after eight weeks?” CLABSI prevention bundles were already being used to guide healthcare providers in handling CVC access. There were 15 scholarly articles that …

Testing The Effects Of Two Field-To-Fork Programs On The Nutritional Outcomes Of Elementary School Students From Diverse And Lower-Income Communities, Kimberly R. Hartson, Kristi M. King, Carol O'Neal, Aishia Brown, Toluwanimi Olajuyigbe, Shakeyrah Elmore, Angelique Perez

Faculty and Staff Scholarship

The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N  =  264) and the Field-to-Fork After-school Club (N  =  56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar’s and Wilcoxon signed rank tests. The …

Assessment And Oral Care: An Essential Nursing Activity For Patients Receiving Cancer Treatment, Radhika R. Pai, Ravikiran Ongole, Sourjya Banerjee

Manipal Journal of Nursing and Health Sciences

Head and neck radiation therapy and chemoradiation are inherently associated with severe oral complications such as oral mucositis, infection, and functional issues of the oral cavity, significantly affecting the quality of oral cavity health in cancer patients. Oral care in cancer patients is a vital part of nursing care but can be seen as a most neglected job, along with other duties or a tedious task to undertake. Recognizing the effect of cancer treatment and delivery of oral care as per the specific guidelines to cancer patients is not well known, and it is not clear. Literature review reports that …

Menstrual Pattern, Practices, Problems And Its Impact On Activities During Menstruation Among Adolescent Girls At Chennai, India, Prema Janardan, R Sudha

Manipal Journal of Nursing and Health Sciences

A descriptive correlational study was undertaken to assess the menstrual pattern, practices, problems, and its impact on activities during menstruation among adolescent girls. Total of 123 adolescent girls were selected by using the non-probability convenience sampling technique. Demographic proforma and self report checklist was used to collect the data.The results revealed that the majority of the adolescent girls had a partially abnormal menstrual pattern and all used sanitary napkins as absorbent. The majority had reported some problems during menstruation with dysmenorrhea being the predominant one and had reported some impact on the activities during menstruation with special reference to absenteeism …

Systematic Review Protocol Examining The Effect Of Prefeeding Oromotor Stimulation On Preterm Neonate’S Feeding Outcomes, Suvarshi Sasmal, Asha P. Shetty

Manipal Journal of Nursing and Health Sciences

Introduction: Feeding difficulty is a common problem among preterm babies as sucking-swallowing and breathing coordination matures by 32-34 weeks of postmenstrual age. There is a growing consensus among healthcare providers worldwide that oromotor stimulation influences feeding outcomes of preterm babies, but limited evidence influences its clinical applicability. Objectives: To critically appraise the available evidence on the effect of prefeeding oromotor stimulation (OMS) on preterm neonate’s feeding outcomes. Methods and analysis: This review will include only randomized controlled trials (RCTs). Electronic databases will be searched from January 2000 to December 2019. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) …

Evaluation And Implementation Of A Video Intervention To Increase Adherence In A Rural Phase Ii Cardiac Rehabilitation Program., Holly Yahyawi

Doctor of Nursing Practice Papers

Background: In the U.S., heart disease affects over 30 million adults and is the leading cause of death. Cardiac rehabilitation (CR) decreases cardiac hospital readmissions, decreases the risk of additional cardiac events, and increases life expectancy. Environment: This project was implemented at a CR program which serves rural Indiana and Kentucky counties. Purpose: This QI project uses a Plan-Study-Do-Act framework to evaluate patient adherence to a rural CR program, implement a video intervention for patients, and measure patient’s perceptions. Procedures: CR patients watched four videos describing what CR is, what to expect at CR, CR benefits, and a patient CR …

Hair Toxicology Testing Among Children Evaluated For Physical Abuse: Evaluation Of A Practice Change., Ashley Dejarnette

Doctor of Nursing Practice Papers

Background: Despite a complete medical evaluation for child physical abuse, many suspected victims have indeterminant findings. The lack of a definitive diagnosis can impede child protection agencies’ ability to protect those children at high risk for abuse, leaving them vulnerable to subsequent injuries and potentially escalating violence by caregivers. Oftentimes, allegations of child physical abuse are accompanied by concerns for substance abuse by the caregiver as well. While we know that children living in homes where caregivers use illicit substances are at substantially higher risk for physical abuse, drug testing children for environmental exposure to illicit substances is not yet …

Improving Pediatric Delirium Prevention To Decrease Pediatric Delirium Prevalence In The Pediatric Intensive Care Units., Kelsie Houchens

Doctor of Nursing Practice Papers

Background: Pediatric delirium has emerged as a common complication of childhood illness in the intensive care setting, with estimated delirium prevalence ranging from 15.9% to 65.6%. Critically ill pediatric patients in the ICU are at risk for pediatric delirium due to modifiable risk factors including mechanical ventilation, sedating medications, physical restraints, and nutrition. In 2019, the pediatric intensive care unit (PICU) in a Kentucky children’s hospital reported only 18 % of chart audits revealed that physicians activated the physician-directed pediatric ICUs Delirium Prevention and Treatment Order Set (DPTOS) on pediatric patients. A quality improvement (QI) project was developed to identify …

Mediating Effect Of Cognitive Function On Health-Related Quality Of Life Among Older Adults With Cardiovascular Disease In The United States, Julie K. Peterson-Newman

Nursing Dissertations - Archive

Cardiovascular diseases (CVDs) are related to disorders of the heart and blood vessels. They may become serious problems, especially in older adults. They could also negatively affect the health-related quality of life (HRQoL) of patients. Moreover, patients with CVDs may also experience cognitive issues, such as memory loss, that could be considered as a mediator in the association of CVD with HRQoL. The purpose of the study was to analyze the relationship among cognitive function, HRQoL, and CVD among older adults using a cross-sectional sample from a secondary database, including the 2019 Behavioral Risk Factor Surveillance System (BRFSS) representing the …

Pre-Admission Patient Education For A Prostatectomy Enhanced Recovery After Surgery Pathway, Vanessa C. Cotton

Doctor of Nursing Practice

Background. In the United States, prostate cancer is the most common cancer diagnosed in men and a common treatment choice is a radical prostatectomy. The Enhanced Recovery After Surgery® Society developed evidence-based guidelines to optimize treatment and improve outcomes in prostatectomy patients, yet not all hospitals are utilizing these guidelines or employing all of the elements, including pre-admission education. Purpose and Objectives. The purpose of this quality improvement project was to develop, implement, and evaluate a pre-admission patient education component for a prostate surgery pathway based on the Enhanced Recovery After Surgery guidelines. Objectives included assessing the nurse’s intention to …

Diabetes And Physical Activity Among Saudi Women, Zainab Mohammed H Alyousef

Nursing Dissertations - Archive

Given the fact that Saudi women with DM have more obesity but lower levels of physical activity compared to men, and have additional cultural barriers to physical activity, new interventions are needed. Home-based interventions would be ideal as the women would not need to rely on transportation to a gymnasium or park for exercise. Although, home-based interventions are relatively low-cost, for both the patient and the healthcare system, no studies were found in which researchers tested an exercise intervention in Saudi women with DM delivered at home using the Internet. The purpose of this proposed study will be to evaluate …

Glucose Gel As A Treatment For Neonatal Hypoglycemia, Karen Christine Stanzo

Nursing Dissertations - Archive

This article-based dissertation consists of two complete manuscripts related to oral glucose gel, which is used to treat neonatal hypoglycemia (NH). In the first manuscript, a pre and post-intervention retrospective study was completed to examine the effects of the introduction of glucose gel on the exclusive breastfeeding rate and the admission rate to the neonatal intensive care unit (NICU) on neonates over 35 weeks gestation who were at risk for NH in a mother-baby unit of a Baby-Friendly hospital. There were 198 newborns in the pre-intervention sample and 203 in the post-intervention sample. The exclusive breastfeeding rates in the pre-intervention …