Digital Commons Network^™

Telehealth Assessment In The Elderly Using The 4ms, Melissa Koehl

Nursing Capstones

The current 2019 novel coronavirus, or COVID-19, has presented new threats and challenges in healthcare, especially when attempting to conduct wellness exams amongst the most vulnerable. Older adults with underlying medical conditions are at great risk for exposure and infection of COVID-19. The Geriatric Workforce Enhancement Program (GWEP) grant was given to the University of North Dakota (UND) to create a geriatric telehealth team and implement a telehealth project, promoting the use of telehealth technologies amongst older adults utilizing the 4Ms (mentation, medication, mobility, and what matters). A modified wellness assessment tool was created and administered through telehealth technology to …

Impact Of Simple Breastfeeding Initiatives Led By Nurses In A Primary Care Setting, Jessica Semin, Carolyn Hanus, Megan Scott, Amy Ford, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Background: Breastfeeding is recognized by health experts as the preferred infant feeding method. Health professionals, especially nurses, play a vital role in influencing mothers’ infant feeding decisions. This quality improvement project designed, implemented, and evaluated by nurses explores how the implementation of three simple initiatives impacted healthcare staff’s attitudes, beliefs, and perceptions related to breastfeeding.

Materials and Methods: The project was led by three Doctor of Nursing Practice (DNP) students with guidance from their DNP prepared advisor. It took place in a primary care setting at a federally qualified health center. Prior to and after implementation, staff were …

Respite For Acute Care Nurses With The Use Of A Resilience Room, Marisella Perales

Doctor of Nursing Practice

Background and Significance of the Problem. Nurses are exposed to higher levels of occupational stress in acute care units when compared to other departments within the hospital (Faraji et al., 2019). A qualitative assessment identified a need for resources to be provided for acute care nurses experiencing occupational stress. Purpose. To establish an area for respite and increase nurses’ knowledge about a Resilience Room and a support system to manage occupational stress. Objectives. To educate 75% of acute care nurse on respite care, have 50% of the nurses report utilization of Resilience Room, and increase the nurses use of a …

Examining Predictors Of Attitudes And Knowledge Of Registered Nurses And Nursing Students In Tennessee Toward Pregnant And Perinatal Women With A Substance Use Disorder, Jessica Patrylo

Electronic Theses and Dissertations

Substance use disorders (SUDs) among pregnant and perinatal women continue to be a national public health crisis. Furthermore, nursing students and perinatal nurses have historically negative and punitive attitudes toward this vulnerable population of women. As nurses are primary care providers for pregnant and perinatal women, this is troublesome as perinatal patients express feeling stigmatized by nurses whom they should be able to trust. This contributes to the reluctance of women to seek needed medical and prenatal care. Tennessee was the first state to criminalize drug use in pregnancy and has higher neonatal abstinence syndrome (NAS) rates, which were more …

Developing Outpatient, Clinic-Based Education For Patients With Diabetes And Prediabetes, Ruth Ann Slayton

Electronic Theses and Dissertations

Abstract Education and support provided to the newly diagnosed prediabetic or Type 2 Diabetic are inadequate in the outpatient arena. In rural areas, instruction for diabetes is minimal to nonexistent, and patients are paying for this with their health and lives many times. The financial burden of diabetes in the United States is astronomical. The loss of life and life quality is significantly high as well. A systems-based approach to education in the rural health clinic would be of great benefit and has proven to be enough to reverse or avoid the progression of the disease. A clinic or field-based …

Maternal Factors In Stunting Among Vulnerable Children, Stefanus Mendes Kiik, Muhammad Saleh Nuwa

Jurnal Keperawatan Indonesia

Children with stunting in Indonesia and other low-middle countries remains a serious problem. This study aimed to identify the association between maternal education, maternal age, maternal height, preceding birth interval, and ANC clinic visits, and stunting among vulnerable children in Kupang Regency, Indonesia. A cross-sectional study was con- ducted of two villages in Kupang Regency. The study sample comprised female ex-refugees from Timor Leste who had children aged 24–59 months. The subjects were chosen using consecutive sampling, with a total number of 154. Data were collected from both primary and secondary sources. There was a significant relationship between maternal education …

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

Jurnal Keperawatan Indonesia

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

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

Jurnal Keperawatan Indonesia

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

Bringing Hospital And Community Together: Interventions To Bridge The Transitional Care Gap, Jeremy Yates

Dissertations

Abstract

Problem

As healthcare spending continues to increase and overall quality lags in comparison to other developed countries, hospital readmission has been targeted to increase quality while decreasing cost. Components of the Affordable Care Act (ACA) have placed an emphasis on preventative and transitional care which has created programs aimed at reducing readmission, including the Community Health Access Programs (CHAP). One program in St. Louis, Missouri consisted of advanced practice paramedics and an occupational therapy assistant that performed discharge follow-up through in-home, in-office, and telephone visits. An in-depth program evaluation can create a foundation to build other programs in communities …

Face-To-Face Nursing Promotion Of Cardiac Rehabilitation, Marika Whitaker

Student Scholarly Projects

Practice Problem: The burden of cardiovascular disease is rising at global and national levels, and cardiac rehabilitation is recognized as one of the most beneficial and cost-effective strategies to manage it. One significant problem globally, nationally, and locally is the low numbers of eligible patients who enroll in cardiac rehabilitation.

PICOT: In patients with isolated coronary artery bypass graft (CABG) (P), how does face-to-face nursing promotion of cardiac rehabilitation (I) compared to the patients who do not have face-to-face nursing promotion (C), affect the percentage of patients enrolling in cardiac rehabilitation after discharge (O) within 8 weeks (T)?

Evidence: …

Stressors And Resilience Are Associated With Well-Being In Young Adult College Students, Kimberly R. Hartson, Lynne A. Hall, Sara A. Choate

Faculty and Staff Scholarship

Objective: The purposes were to describe stressors and resilience behaviors of college students and examine the relationships among stressors, resilience, and well-being. Hypothesis: Resilience will modify the relationship between stressors and well-being. Participants: The sample included 1,010 college students, ages 18–26, from an urban Midwestern university. Methods: A secondary analysis of cross-sectional data from an anonymous survey was conducted using multiple regression and simple slopes analysis. Results: Resilience did not modify the relationship between stressors and well-being. Stressors (β = −.44, p < .0001) and resilience (β = .33, p < .0001) accounted for 42% of the variance in well-being (adjusted R2 = .42, F2,999 = 365.98, p < .0001). The most frequently endorsed stressors were sleep problems, anxiety, and relationships. Conclusions: Stressors and resilience …

Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton

Dissertations

Abstract

Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.

Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …

Blood's Concentration Of Lead And Arsenic Associated With Anemia In Peruvian Children, Ana Maria Linares, Jason M. Unrine, Amanda Thaxton Wigging, Juan C. Tantalean, Vlad C. Radulescu

Nursing Faculty Publications

This exploratory, descriptive cohort study (N = 60) determined lead (Pb) and arsenic (As) blood concentrations in Peruvian children and their association with hematological parameters of iron-deficient anemia (IDA) and anthropometric measurement. The mean age of children was 10.8 months (SD = 4.7) and ranged from 3 to 24 months old. Anemia (Hb levels below 10.5 g/dL) was found in 20% of this cohort. Additionally, microcytosis (MCV < 70 fL) was present in 54%, and hypochromia (MCH < 23 pg) in 42% of the group of children. Chi-square analysis showed that 88% of the children with anemia also had microcytosis and hypochromia (p < 0.001). Pb and As were detected in 100% of the infants’ blood samples, and the concentrations were significantly higher in older infants than in younger ones. Pb and As were not associated with the sex, anthropomorphic parameters, or infant hemogram changes. Infants who received iron supplementation were 87% less likely to have low Hb compared with those who did not (OR = 0.13, 95% CI = 0.02–0.88, p = 0.04). Herbal tea intake was significantly associated with microcytosis and hypochromia. Our finding uncovered that hematological parameters for anemia are modified in Peruvian children with high levels of microcytosis …

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

Nursing ETDs

ABSTRACT

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

Evaluation Of Depression, Anxiety And Stress In Graduate Nursing Students, Rachel Dunston

Dissertations

Mental health issues are growing in the United States. Postgraduate school is widely known to increase the level of psychological difficulties (Dyrbye et al., 2006) experienced by students. There is a need to address mental health care in graduate nursing students. This project was a descriptive observational comparison pre-post-intervention design used to see if online modes of delivery would aid in decreasing mental health issues for nursing graduate students. Participants were provided with access to three podcasts and encouraged to use the Sanvello mobile application provided to all students at this university. The first podcast focused on using the Sanvello …

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

Dissertations

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

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

Increasing Extubation Awareness During Interdisciplinary Rounds With A Rounding Tool In The Pediatric Intensive Care Unit (Picu)., Lilly Giang

Doctor of Nursing Practice Papers

Purpose: Prolonged duration of mechanical ventilation and endotracheal tube intubation are associated with longer length of stay and increases risk for infection by about 3% per day when mechanically ventilated (Mirzarahimi et al., 2020). Evidence suggests that the use of a rounding tool during interdisciplinary rounds improves clinical outcomes, reduce duration of mechanical ventilation, and decrease length of stay in the PICU. The aim of the project was to measure registered nurses and PICU providers perception of the extubation prompts and determine if the extubation prompts decrease duration of mechanical ventilation and length of stay. Methods: After extensive review of …

Integrating Mhealth In A Virtual Prenatal Class To Promote Behavior Modification In Pregnant Women., Brittney Corniel

Doctor of Nursing Practice Papers

Background: Occurrences of pre-term births are disparagingly higher among women from vulnerable populations. Prenatal classes provide healthcare professionals an opportunity to educate pregnant women about mitigating their risk factors for perinatal complications.

Purpose: To introduce the use of pregnancy mobile applications in a prenatal class to assist women in obtaining optimal maternal health for fetal development.

Methods: A pre/post-test design was used to explore the relationship between increased mobile health (mHealth) use and achievement of health behavior goals. The project intervention included a 15-minute PowerPoint presentation about optimal use and effectiveness of mobile apps in pregnancy, pregnancy health behaviors, and …

Implementation Of An Evidence Based Quality Improvement Project To Improve Bathing Practices In The Neonatal Intensive Care Unit., Kimberly Johnson

Doctor of Nursing Practice Papers

Background: Conventional bathing practices in the NICU have shown to be a stressful, and even painful, activity for neonates and one that can negatively impact the developmental and physiological outcomes of premature infants. To negate these negative outcomes, and provide a positive experience for neonates and their parents, AWHONN recommends the implementation of immersion swaddle bathing [ISB] over conventional bathing practices, in premature infants and newborns. Purpose: The purpose of this quality improvement project was to implement and evaluate an evidence-based bathing practice in a Level III NICU that includes clinical practice guidelines and staff education. Methods: A live, education …

Developmentally Supportive Positioning In The Neonatal Intensive Care Unit., Taylor Morganti

Doctor of Nursing Practice Papers

Background: An estimated 15 million infants worldwide are born prematurely each year. These infants are at an increased risk of poor physical and neurodevelopment because of increased stress and inappropriate sensory stimuli experienced in the neonatal intensive care unit (NICU). The provision of developmentally supportive care can mitigate some of these noxious effects. By decreasing stress and conserving energy, developmentally supportive positioning can enhance sensory, motor, and neurodevelopment. Purpose: The purpose of this quality improvement project is to improve the positioning of premature neonates through an educational intervention and staff training on the importance of developmentally supportive positioning. Improved positioning …

Program Evaluation: Assessing The Effectiveness Of Diabetes Group Education Utilizing The Diabetes Knowledge Test., Aminata Gueye

Doctor of Nursing Practice Papers

Background: Diabetes Mellitus (DM) is the 7th leading cause of death in the United States (HHS ODPHP, 2019). It is also the leading cause of chronic disease complications such as adult-onset blindness, kidney failure, and lower-limb amputations (HHS ODPHP, 2019). It is recommended that all people with diabetes should participate in diabetes self-management education (ADA, 2018). Purpose: The purpose of this DNP project is to evaluate the effectiveness of diabetes group education by assessing participants’ knowledge utilizing the diabetes knowledge test (DKT) at an outpatient diabetes care center in Louisville KY. The evidence from the literature review supports the importance …

Effectiveness Of An Evidence Based Cognitive Behavioral Therapy Program (Creating Opportunities For Personal Empowerment [Cope]) To Improve Childhood Mental Health Outcomes In A Private School., Carlatesha Flippin

Doctor of Nursing Practice Papers

Background: When mental health issues are left untreated in children, there is an increased risk for poor school performance, substance abuse, and missing essential experiences in life. School-based cognitive-behavioral therapy programs improve negative emotions, increase student positive experiences, increase coping skills knowledge, and provide adequate resources for effective mental health management of symptoms. School-based -behavioral therapy programs improve childhood mental health outcomes and promote coping skills utilization amongst pediatric populations.

Purpose: To implement Creating Opportunities for Personal Empowerment (COPE) a cognitive behavioral therapy program in a private school-based setting to assist children in obtaining optimal mental health outcomes.

Methods: Seven …

Knowledge, Attitude And Practices On Contraceptives In Married Women Of Odisha, Smitha Moonjelly Vijayan Dr, Mamata Das Mrs, Kajal Patwal Ms, Prachi Parichita Ms, Chhaya Sharma Ms, Vidya Seervi Ms

Manipal Journal of Nursing and Health Sciences

Introduction: In developing countries, maternal and new-born mortality and morbidity rates can be reduced with apt contraceptive usage. This study aimed to assess the knowledge, attitude, and practices regarding contraception among married women

Methods: A descriptive study was conducted among 110 married women attending Obstetrics & Gynaecology OPD of AIIMS Bhubaneswar.

Result: The mean ± S.D. age of participants was 29.13±3.51 years. About half of the women (50.9%) had poor knowledge of contraception. More than half of women (65.17%) had a positive attitude on contraceptive use; however, only 24% of the subjects used a contraceptive, the most preferred contraceptive being …

Increasing Referrals To School Counselors By Integrating An Evidence-Based Program For Educators Identifying Adolescents At Risk For Suicide In A Rural High School, Wendy Holloway

Doctor of Nursing Practice Projects

Background: Addressing suicide in America's youth is imperative. Teachers play an essential role in identifying and intervening with adolescents experiencing psychological distress leading to suicide. Teachers and staff lack professional development addressing the identification of students in psychological distress.

Purpose: This project aimed to increase referrals to school counselors by integrating an evidence-based program for educators identifying adolescents at risk for suicide in a rural high school.

Design Method: This was a quantitative quality improvement project with a pre-/post-test design. Additionally, referrals to the school guidance counselors before implementing the program and after the completion of the program were …

Nurses’ And Patients’ Perceptions Of The Availability Of Post-Hospital Instrumental Support As A Predictor Of 30- And 60-Day Acute Care Utilization, Beth E. Schultz

Theses and Dissertations

Social support is now part of the social determinants of health objective in Healthy People 2030. Positive social support improves health and well-being. Social support is concerned with people having the support they need within the community, including interacting and communicating with others on a regular basis. Instrumental support is a type of social support that is action oriented, involving one person directly assisting another person. A concept analysis of instrumental support was completed and revealed that the concept is well defined, but the terms used to describe it vary. Other terms in the research literature, most commonly “tangible support”, …

Neuroinflammation & Mood Disorders, Andrea Zanders

Nursing Student Class Projects (Formerly MSN)

The world of mental health treatment is evolving as more information is discovered about its multifaceted pathophysiology. This poster takes a glimpse at one of these factors: the role of neuroinflammation in mood disorders. Above normal levels of inflammation are found in patient’s suffering from depression and bipolar disorder. Elevated inflammation has significant negative effects on the brain that as a result cause dysregulation in mood. Mental health treatments that have been found to effectively address neuroinflammation include nutritional and exercise interventions. The progression of neuroinflammation research in mood disorders gives a positive outlook for patient outcomes as individuals continue …

Chronic Disease Self-Management Support In Rural Areas: An Integrative Review, Karla A. Callahan

Doctoral Dissertations and Projects

Millions of Americans live with chronic health conditions which require careful attention and specific actions for optimal management. Chronic Disease Self-Management Education (CDSME) has been effectively utilized to improve health outcomes and quality of life for individuals with chronic disease, enhancing knowledge and self-efficacy. Traditional CDSME programs are less available for rural residents. An examination of successful CDSME programs highlights common interventions that yield success and may be utilized in a variety of settings. Self-management is more complex, but also more essential, for individuals with more than one chronic condition. Clinicians can provide individualized support for appropriate self-management techniques, thereby …

Web-Based Applications For Weight Loss And Management: An Integrative Review, Linda Lawton Smith

Doctoral Dissertations and Projects

Obesity is associated with the leading causes of death in the United States and the world. Internationally, 39% of the world’s population was overweight or obese, in 2014, with 9% having diabetes. These causes include diabetes, stroke, certain types of cancer and heart disease. Obesity can lead to poorer mental health outcomes and cause a decrease in the quality of life. This integrative review is to determine if health and dietary smart-phone apps are effective tools to help overweight and obese people lose weight and maintain that loss.

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

Doctor of Nursing Practice Projects

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

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

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

Doctor of Nursing Practice Projects

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

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

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

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