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Effect Of Increased Confusion Assessment Method For The Intensive Care Unit Delirium Assessments On Patients In The Surgical Intensive Care Unit, William Lemon

Doctor of Nursing Practice Projects

Delirium is an acute syndrome of the central nervous system (CNS) that affects patients of all ages and all hospital areas. Furthermore, delirium can lead to frequent complications for these patients, especially those in intensive care units (ICU) (Kanova, Sklienka, Burda, & Janoutova, 2017). Nationally delirium affects 20-80% of patients that require ICU care (American Nurses Association, 2019). In the Surgical intensive care unit (SICU) at the acute care hospital used in the project, the average number of patients suffering from delirium is about 23%. The purpose of this project was to provide a more in-depth analysis of delirium, and …

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …

Diabetes Education Empowerment Program (Deep): Evidence-Based Practice Measures For Self-Care Management, Nakeshia Rutledge

Doctor of Nursing Practice Projects

Background: Prediabetes and Type 2 diabetes (T2DM) are major health challenges among the patient population at a family medical clinic in northwest Alabama. Poorly managed T2DM can cause complications which could decrease individuals’ quality of life and lead to mortality.

Purpose: The purpose of this project was to assess the feasibility and efficacy of a self-management intervention aimed at empowering prediabetic and T2DM patients to achieve better diabetes management and glycemic control (hbA1c < 5.7 percent).

Design Methods: A mixed-methods design was utilized with pre/post-questionnaires for analysis of data collected before and after the implementation of an educational intervention on diabetes self-management …

Effect Of Dietician Consultation On Glycaemic Control: A Cross-Sectional Survey From Western-Coast Of India., Prabhath Matpady, Gundmi Arun Mayya, Praveena Mogan, Jeevan K. Shetty, Shashikiran Umakanth

Manipal Journal of Nursing and Health Sciences

Background: Type 2 diabetes mellitus (T2DM) is a complex, chronic condition that can cause acute and chronic complications due to poor glycaemic control. This highlights the importance of self-management in achieving optimal glycaemic control. Dietary advice plays a vital role in the self-management of T2DM.

Objective: To study the effect of dietician consultation on the glycated Hb levels in T2DM patients and to compare it with T2DM patients, not on dietician consultation.

Methods: This is a cross-sectional study amongst people with type 2 diabetes mellitus (T2DM) was conducted in predominantly rural and suburban communities of Udupi taluk, Karnataka, South India. …

Analyzing The Relationship Between Breastfeeding And Postpartum Depression: An Integrative Review, Sarah K. Johnson

Doctoral Dissertations and Projects

Treating maternal mental health and identifying contributing factors are priorities in health care. Postpartum depression is a very prevalent and burdensome illness in the United States that negatively affects the health and well-being of postpartum mothers as well as their infants. While breastfeeding is known to be advantageous to both maternal and infant health, it may be implicated in the development of postpartum depression in some scenarios. The purpose of this integrative review is to examine the relationship between breastfeeding and postpartum depression to promote the best health outcomes for both the mother and the child with goals of determining …

Securing Nasogastric Tubes In Children, Julie Ann Lavoie

Dissertations (1934 -)

Nasogastric tubes (NGTs) are commonly placed in children at risk for malnutrition in order to provide temporary nutrition support until the child achieves independent oral feedings or requires durable tube placement. Accurate securement of NGTs is necessary to safely provide nutrition, particularly in infants and toddlers who are at highest risk for dislodging their NGT. Dislodgement of an NGT has a cascade effect on the medical management, requiring increased exposure to the healthcare system with every replacement. Nasal bridles are widely used to secure NGTs in adults but are not widely used with children. The purpose of this retrospective, correlational …

Demographics, Activities, And Environmental Factors Impact Burnout In A National Survey Of Emergency Medicine Residents, Nicole Battaglioli, Tim P. Moran, Simiao Li-Sauerwine

Journal of Wellness

Introduction: Burnout in emergency medicine and in residency training has been well-described. The impact of demographic, individual, and programmatic factors on burnout have not previously been determined in a national survey of emergency medicine residents. This study aimed to identify personal and environmental factors impacting resident burnout in a national sample of emergency medicine residents.

Methods: A prospective Emergency Medicine Resident Wellness Survey was administered in 2017. We surveyed respondents on demographic, personal, and environmental factors; each respondent also completed the Maslach Burnout Inventory - Human Services Survey. Linear regressions were used to identify variables associated with the Maslach Burnout …

Enhancing The Braden Scale Pressure Ulcer Risk Assessment In Long-Term Care Facilities: A Cohort Study, Rachel Deutsch

College of Science and Health Theses and Dissertations

The development of pressure ulcers remains challenging as they are associated with overwhelming costs, pain and suffering, prolonged hospitalization, and morbidity and mortality. In the United States, the Braden scale is the most widely used risk assessment tool among all healthcare organizations to identify high-risk individuals for pressure ulcer development. The objective of risk assessment is to detect high-risk patients, implement immediate interventions, and evaluate patients not at risk who do not require intervention. The purpose of this cohort study is to determine the pressure ulcer predictability of the Braden score in comparison to the Braden score with additional predictor …

Moderating Effects Of Parental Feeding Practices And Emotional Eating On Dietary Intake Among Overweight African American Adolescents, Mary Quattlebaum, Dawn K. Wilson-King, Allison M. Sweeney, Nicole Zarrett

Faculty Publications

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child’s weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ± 1.74; MBMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit …

Mapping Inequalities In Exclusive Breastfeeding In Low- And Middle-Income Countries, 2000–2018, Natalia V. Bhattacharjee, Laauren E. Schaeffer, Simon I. Hay, Arianna Maever L. Amit, Veincent Christian F. Pepito, Local Burden Of Disease Exclusive Breastfeeding Collaborators, 477 Co-Authors

Ateneo School of Medicine and Public Health Publications

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target …

Pilot Testing A Novel Tool To Assess Resilience Among Nurses Delivering Direct Patient Care In Teams In The Hospital Setting, Tiara Benson, Ma Fe Chase, Amanda Miles

2021 Providence Nurse Research Conference

Background: With the appearance of the COVID-19 pandemic, nurse emotional well-being has suffered, with burnout being highly reported. Team resilience may mitigate feelings of burnout, and is defined as homeostasis among the healthcare team while experiencing continuous change. Strategies for enhancing resilience of individuals are prevalent, yet nurses often deliver care in a team setting. While some literature offers insight on nurse team resilience, no valid and reliable tools currently exist to measure this concept. Purpose: To develop and pilot test a tool to measure team resilience among nurses delivering direct patient care in an acute care hospital in …

Employed Mothers’ Satisfaction With The Breastfeeding Provisions In The Patient Protection And Affordable Care Act In Two Northwestern U.S. Hospitals, Rebecca Penders

2021 Providence Nurse Research Conference

Background: Breastfeeding is the gold standard for infant nutrition. Many workplace barriers to lactation exist for mothers returning to work after the birth of an infant. In 2010 the Breastfeeding Provisions in the Patient Protection and Affordable Care Act (BP-PPACA) was enacted as the first federal breastfeeding law which outlined specifically break time and a place to pump for businesses with over 50 employees who employed hourly wage workers. There is little known about the satisfaction of hospital employees pumping/lactation experience after the BP-PPACA.

Purpose/Aims: The purpose of this study was to determine the extent to which employed mothers' …

The Benefits Of Fasting For Patients Who Are Immunocompromised And Undergoing Cancer Treatment: An Integrative Research Review, Lori Burnett

2021 Providence Nurse Research Conference

Background: In the past several decades, remarkable advances in the treatment of cancer have been made. However, a gap remains regarding best practice strategies to reduce the amount of short and long-term side effects and adverse or emergent events related to cancer treatment that may negatively impact patient quality of life. Recent evidence suggests that if patients undergoing cancer treatment fast for a period of time, they may experience reduced chemotherapy-related side effects and enhanced immune potential. Weight loss and malnutrition associated with cancer treatments highlight the importance of evidence appraisal associated with fasting prior to recommending this practice …

Feasibility Of Launching A Multi-State Nursing Health Study In The Midst Of The Covid-19 Pandemic, Ross Bindler, Shaekira Niehuser, Trisha Saul, Teresa Bigand

2021 Providence Nurse Research Conference

Background: The Quadruple Aim recommends that healthcare institutions support clinician well-being as a strategy to improve patient and caregiver outcomes. During the COVID-19 global pandemic, Registered Nurses (RNs) working full-time, 12-hour shifts have reported increasing health concerns. Therefore, research documenting objective information on preventive health habits of RN’s is needed to support nursing well-being. Yet, conducting bio-behavioral research in this population, especially during the pandemic, presents with unique challenges. Purpose: The purpose of this pilot study to assess the feasibility of collecting and evaluating health data from RNs working full-time, 12-hour shifts across the United States during the COVID-19 pandemic. …

The Effect Of Covid-Related Changes In Diet, Exercise, Sleep Patterns, And Mood On Stress Levels Of Rns Who Work 12-Hour Shifts During The Pandemic, Amber Norman, Trisha Saul, Ross Bindler, Teresa Bigand

2021 Providence Nurse Research Conference

Background: Registered Nurses (RNs) working 12-hour shifts are regularly exposed to high stress situations which has intensified during the COVID-19 pandemic. Chronic stress exposure may lead to changes in health habits and impact sleep, exercise or diet, augmenting risk for adverse health outcomes and taking a negative emotional toll. While nursing staff educate patients on reducing stress and engaging in health promotion behaviors, there is little research on perceived stress and relationships to COVID-related changes in sleep, diet, exercise, and mood of nurses working full-time, 12-hour shifts during the pandemic.

Purpose: The purpose of this pilot study was to gain …

Blind Taste Testing: A Case Study Of An Emergency Room Rn With Covid-19 Anosmia & Hypogeusia (Loss Of Taste & Smell), Marietta Sperry, Kimberly Kohlieber

2021 Providence Nurse Research Conference

Background: Anosmia, or the loss of taste and smell, is an important symptom for nurses to screen for among patients, as this can result in a poor appetite which impairs healing. In the early stages of the COVID19 pandemic, anosmia was not a known symptom indicative of infection with the virus. Yet, one Registered Nurse who was working in an Emergency Room received a positive COVID test following a workplace exposure to the virus while wearing personal protective equipment, and began to complain of anosmia shortly thereafter. Because the anosmia persisted, his spouse conducted blind taste test on him …

Commencement Program 2021 (School Of Nursing), Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

2 | 2021 Events of Commencement

4 | University Administration

5 | Significance of Academic Regalia

6 | University History Highlights

8 | Criteria for Institutional Awards

10 | Loma Linda University Health and Loma Linda University Honorees

23 | The Program, The School Honorees, and The Speaker

25 | Candidates for Degrees

40 | Nurse's Pledge

Smoking Cessation Interventions In South Asian Region: A Systematic Scoping Review, Sajid Iqbal, Rubina Barolia, Pammla Petrucka, Laila Ladak, Rameesha Rehmani, Abdul Kabir

School of Nursing & Midwifery

Background: Cigarette smoking is one of the most preventable causes of morbidities and mortalities. Since 2005, the World Health Organization Framework Convention for Tobacco Control (WHO-FCTC) provides an efficient strategic plan for tobacco control across the world. Many countries in the world have successfully reduced the prevalence of cigarette smoking. However, in developing countries, the prevalence of cigarette smoking is mounting which signifies a need of prompt attention. This scoping review aims to explore the extent and nature of Smoking Cessation (SmC) interventions and associated factors in South Asian Region (SAR) by systematically reviewing available recently published and unpublished literature. …

Cilësia E Jetës Te Pacientët Me Diabet Tip 2, Arta Rama

Theses and Dissertations

Hyrja: Diabeti mellitus i tipit 2 (T2DM) është një problem global shëndetësor në zgjerim, i lidhur ngushtë me epideminë e mbipeshes. Individët me diabet mellitus tip 2 janë në rrezik të lartë për të dy ndërlikimet mikrovaskulare (përfshirë retinopatinë, nefropatinë dhe neuropatinë) dhe komplikimet makrovaskulare (të tilla si sëmundjet kardiovaskulare) për shkak të hiperglikemisë dhe përbërësve individualë të sindromës së rezistencës ndaj insulinës (metabolike).

Qëllimi: Ky punim ka për qëllim ngritjen e cilësisë së jetës te personat që vuajnë nga diabeti mellitus tip 2, pra përmirësimin e jetesës, këshillimin që të mirren me sporte të ndryshme, përfshirë këtu ecjen …

Gut Microbiota In Covid-19 Treatment, Tella Sadighpour, Audrey C. Tolouian

Nursing Faculty Publications

A novel coronavirus (severe acute respiratory syndrome coronavirus [SARS-CoV-2]), has been causing a COVID-19 pandemic of acute respiratory syndrome in humans since December 2019. It appears to be similar in structure to the virus that caused the SARS-CoV outbreak of 18 years ago. However, in addition to the respiratory disorders, the COVID-19 patients might suffer extra-pulmonary disorders, including gut dysfunction or liver dysfunction complications, which show as gut–lung crosstalk. Fecal specimens should be considered as a source of detection of SARS-CoV-2 as one of the routine diagnostic tests in order to guide hospital’s liberation and release of quarantine of patients.

Socioeconomic And Demographic Correlates Of Nonenrolment Onto The National Health Insurance Scheme Among Children In Ghana: Insight From The 2017/18 Multiple Indicator Cluster Survey, Pascal Agbadi, Joshua Okyere, Alberta Lomotey, Henry Ofori Duah, Abdul-Aziz Seidu, Bright Opoku Ahinkorah

College of Nursing Faculty Research and Publications

The goal of Ghana’s health insurance scheme is to achieve universal coverage. Despite NHIS’ benefits to children, not all children in Ghana are covered. This study investigates the sociodemographic covariates of nonenrolment onto the national health insurance scheme among children in Ghana. We used the child dataset of the 2017/18 Ghana Multiple Indicator Cluster Survey (G-MICS). We used STATA version 14 for the data analyses. We described each study variable using frequency and percentages. We used Poisson regression to estimate crude and adjusted prevalence ratios of the relationship between the covariates and the outcome variable. Approxi­ mately 57% of children …

Development Of A Competency Model For Placement And Verification Of Nasogastric And Nasoenteric Feeding Tubes For Adult Hospitalized Patients., Jan Powers, Britta Brown, Beth Lyman, Arlene A Escuro, Lorraine Linford, Kim Gorsuch, Kris M Mogensen, Jessica Engelbrecht, Amanda Chaney, Carol Mcginnis, Beth A Quatrara, Jennifer Leonard, Peggi Guenter

Nursing Publications, Posters, & Presentations

Nasogastric/nasoenteric (NG/NE) feeding tube placements are associated with adverse events and, without proper training, can lead to devastating and significant patient harm related to misplacement. Safe feeding tube placement practices and verification are critical. There are many procedures and techniques for placement and verification; this paper provides an overview and update of techniques to guide practitioners in making clinical decisions. Regardless of placement technique and verification practices employed, it is essential that training and competency are maintained and documented for all clinicians placing NG/NE feeding tubes. This paper has been approved by the American Society for Parenteral and Enteral Nutrition …

Implementing A Program Of Lifestyle Modification In Pregnancy To Reduce The Risk Of Recurrent Gestational Diabetes Mellitus (Gdm), Connie Van Baah

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

The occurrence of Gestational Diabetes Mellitus (GDM) has significantly increased globally, as has the threat of GDM recurrence in subsequent pregnancies. GDM recurrence rate can range from 40% to 73% in some populations. GDM is associated with acute maternal health problems and long-term diseases, such as type II diabetes and recurrent GDM. Fetuses and infants of mothers with GDM can experience primary health complications early and late in life. Although lifestyle changes such as healthy eating and physical activity in high-risk patients are effective in reducing diabetes risk factors, limited attention has been paid to the possible benefits of translating …

Clinical Nurses Research Priorities In Hospital Settings: A Delphi Survey., Mariann Fossum, Marlene Z. Cohen, Vivi Haavik Tønnessen, Mette Dobler Hamre, Agno Lisbeth Vabo Ødegaard, Ingjerd Lind, Kari Olsen Håheim, Anne Opsal

Journal Articles: College of Nursing

This study aimed to identify the research priorities of clinical nurses to develop a research program at a health care services system that includes three hospitals. A Delphi survey was emailed to all clinical nurses in two rounds. The Delphi method was used to collect data from the nurses in regards to their priority research themes, and the data were analyzed using descriptive and comparative statistics. A total of 933 clinical nurses returned the first round of the Delphi survey and 543 nurses answered the second round. Clinical nurses identified 89 potential research themes. Patient safety and ethical challenges were …

Serum Micronutrient Status, Sleep Quality And Neurobehavioral Function Among Early Adolescents, Xiaopeng Ji, Charlene W. Compher, Sharon Y. Irving, Jinyoung Kim, David F. Dinges, Jianghong Liu

Nursing Faculty Research

Objective: To examine associations between serum micronutrients and neurobehavioral function and the mediating role of sleep quality in early adolescents. Design: In this cross-sectional study, peripheral blood samples were analyzed for iron and zinc levels. The Pittsburgh Sleep Quality Index and Penn Computerized Neurocognitive Battery were used to assess sleep quality and neurobehavioral function, respectively. The generalized linear regressions (bootstrap) were performed to estimate the associations. Setting: Jintan, China Participants: 226 adolescents (106 females) from the Jintan Child Cohort study. Results: Adolescents with low iron (< 75 ug/dl) (OR=1.29, p=0.04) and low zinc (< 70 ug/dl) (OR=1.58, p0.05). Conclusion: Iron and zinc deficiencies may possibly be associated with poor sleep and neurobehavioral function among early adolescents. Poor sleep may partially mediate the relationship between micronutrients and neurobehavioral function.

Timing Of Home Health Care Initiation And 30-Day Rehospitalizations Among Medicare Beneficiaries With Diabetes By Race And Ethnicity., Jamie M Smith, Haiqun Lin, Charlotte Thomas-Hawkins, Jennifer Tsui, Olga F Jarrín

College of Nursing Faculty Papers & Presentations

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health …

Implementation Of The Center For Disease Control (Cdc) Prediabetes Risk Test In The Medical Weight Loss Setting, Gabriela Miller, Rn, Bsn

Doctor of Nursing Practice Final Manuscripts

Background: Prediabetes is a serious health condition where blood sugars are higher than normal which increases risk of developing type 2 diabetes mellitus (T2DM), heart disease and stroke. One in three US adults have prediabetes and 90% of them do not know. Losing 5-7% of body weight and regular physical activity can lower the risk of developing T2DM by more than half.

Methods: Screening patients for prediabetes at a medical weight loss clinic using the evidence-based Centers for Disease Control (CDC) Prediabetes Risk Test. A score of five or higher on the screening tool indicates the patient is at risk …

Sunscreen Use And Screening In College Athletes: An Evidence-Based Pilot Project, Nicole Brustkern Bsn, Rn, Cpn, Sharon Boothe-Kepple Phd, Msn, Fnp-C, Phn (Chickasaw)

Doctor of Nursing Practice Final Manuscripts

Background: Melanoma is the third most common cancer in individuals ages 15 – 29. The greatest risk for melanoma is ultraviolet (UV) radiation from the sun. Collegiate athletes are exposed to 1,000 more sun hours per year than the average adult, placing them at higher risk for melanoma. Evidence supports sunscreen education and screening to promote protective behaviors in young adults.

Objective: This evidence-based pilot project implements the standardized screening of sunscreen use and sun protective behaviors in women’s soccer players ages 18 to 21 years old at the University of San Diego.

Methods: The Sun Exposure and Protection Index …

Managing Pediatric Atopic Dermatitis In The Allergy Clinic: Use Of An Eczema Action Plan To Improve Caregiver Understanding And Self-Efficacy, A Pilot Study, Danielle Hubacek

Doctor of Nursing Practice Final Manuscripts

Eczema, or atopic dermatitis, is a complex and chronic condition that affects approximately 10% of children throughout the United States (Brown et al., 2018). The American Academy of Allergy Asthma & Immunology (AAAAI) (2017) estimates the average cost of eczema management for each patient is approximately $3,302 per year. The complex nature of atopic dermatitis indicates a need for individualized treatment plans. Research has shown that standardized patient teaching, written education materials, and Eczema Action Plans (EAP) reinforce patient teaching, parental understanding, and improve quality of life. This evidence-based practice (EBP) project introduces the use of a written Eczema Action …

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …