Predictors Of Nonadherence To Radiation Therapy Schedules Among Head And Neck Cancer Patients, Jennifer Lynn Miller

USF Tampa Graduate Theses and Dissertations

Nonadherence to radiation therapy schedules is a documented problem among head and neck cancer patients. This retrospective dissertation study examined whether demographics, clinical characteristics, or physical and psychological symptoms were related to nonadherence in head and neck cancer patients. The electronic medical records of 262 head and neck cancer patients at a southeastern U.S. cancer center were reviewed to determine whether nonadherence was related to symptom scores and other patient and clinical-related factors. Nonadherent patients were more likely to be female, be admitted to the cancer center as inpatients during treatment and receive outpatient IV fluids during treatment. Nonadherent patients …

The Significance Of Bridging The Health Literacy Gap, Ella Bermudez

DNP Qualifying Manuscripts

Objective: In the veteran population, almost one in every five patients has inadequate or marginal health literacy (Haun, Patel, French, Campbell, & Lapcevic, 2015). Having low health literacy predisposes patients to high emergency room (ER) utilization and hospital readmission (Mitchell, Sadikova, Jack, & Paasche-Orlow, 2012) and low treatment adherence (Miller, 2016). This manuscript aims to review the literature about health literacy and to encourage effective, standardized health education delivery to increase health literacy.

Method: An integrated review of the literature from Cochrane, Joanna Briggs Institute (JBI), Scopus, CINAHL, and PubMed databases showed the importance of bridging the health literacy gap. …

Veteran Specific Risk Factors For Delirium, Allison Perkins

Dissertations

Purpose/Aims: This study explored the relationships between military characteristics such as combat experience, mental health issues such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), depression, anxiety and substance use disorder (SUD), physical comorbidities such as coronary artery disease (CAD), other risk factors, and delirium diagnosis among hospitalized veterans.

Background: Delirium is a common disorder experienced by 25% of all hospitalized adults 65 years and older. No published studies to date have examined whether combat, TBI and PTSD are associated with the incidence of delirium in the hospitalized veteran.

Methods: A retrospective cross-sectional cohort design with a sample size …

Eating For Two Without Eating Too Much: Optimizing Gestational Weight Gain, Sandra Pope

Doctor of Nursing Practice Final Manuscripts

This evidence-based pilot project was implemented to optimize gestational weight gain (GWG) among women enrolled for prenatal care at a private practice. Evidence from meta-analyses and large studies show: 1) an association between excess GWG and increased risk of fetal macrosomia and increased cesarean delivery; 2) 66% of women do not know their healthy GWG target; 3) a 20% reduction in excess GWG in women receiving diet or exercise interventions or both. In addition, visual plotting of weight gain has helped overweight adults reduce and maintain weight loss over a one-year period. Nutrition assessment using a validated nutritional screening questionnaire …

Empowering Newly Diagnosed Patients With Hypertension In Reducing Complications Through Self-Managed Care, Ana Pacis

Doctor of Nursing Practice Final Manuscripts

Background: High blood pressure affects millions of people, including children and adults. According to the Centers for Disease Control and Prevention (CDC), about 1 in every 3 adults or approximately 75 million American adults are affected with high blood pressure. High blood pressure often does not cause any signs and symptoms, which is why it is also known as the “silent killer,” and many people are not aware that they have elevated blood pressure (AHA, 2017). If high blood pressure is not controlled, it can lead to other heart diseases such as stroke. It can also cause other health problems, …

The Supplemental Impact Of Telephone-Based Lifestyle Modification Counseling In An Outpatient Weight Loss Clinic, Leslie Rangel Gonzalez Bsn, Rn, Karen Macauley Phd, Dnp, Fnp-Bc, Gnp-Bc, Tony Rosales Dnp, Rn, Cns, Fnp-Bc

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of the project is to implement effective, convenient, and efficient weight loss counseling in today’s fast-paced mobile society. The project will reinforce current physical activity guidelines in correlation with the clinic’s standard dietary guidelines and pharmacological interventions. Patient adherence and motivation will be supported through lifestyle modification counseling via telephone.

Background: The prevalence of obese adults in the United States (US) increased from 33.7 percent in 2007-2008 to 39.6 percent in 2015-2016. Abnormal or excess weight gain may further impair health, as it correlates with the development of multiple preventable comorbidities such as cardiovascular disease, …

Frailty And Post-Operative Outcomes In Adult Hip Fracture Patients, Melissa Yager

Dissertations

Abstract

Background/ Purpose: The majority of adult hip fracture patients never return to their pre-fracture functional level and have a poor quality of life (Kistler, Nicholas, Kates, & Friedman, 2015; Pioli et al., 2016; Sheehan et al., 2018). The prevalence of frailty in adult hip fracture patients is estimated at 51%. Frail patients with hip fractures are twice as likely to have a complication (Kistler et al., 2015). Extant studies have examined frailty and hip fractures independently, nonetheless, a gap in the literature exists with few investigations of the connection between frailty and post-operative outcomes after hip fracture. The purpose …

Screening For Iron-Deficiency Anemia In The Pediatric Population (Ages 1-17) In Gonaïves, Haiti, Cara Rose Fratianni

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this pilot project is to screen for iron-deficiency anemia in pediatric patients (ages 1-17) in a primary school in Gonaïves, Haiti. Patients with anemia will be treated with oral supplemental iron for a period of four weeks according to WHO guidelines (WHO, 2011). All students will be treated empirically for helminths per WHO guidelines, unless treated elsewhere in the last six months (WHO, 2017). Nutritional status will also be assessed using MUAC according to WHO guidelines (2017).

Background Summary: Malnutrition contributes significantly to the problem of iron-deficiency anemia, with one in four children exhibiting stunting …

Patients' Disclosure Of Sexual And Gender Minority Status: A Comparative, Multiple Case Study, Damon B. Cottrell

Nursing Theses and Dissertations

This work explores the healthcare and related experiences of sexual and gender minority (SGM) people. This population faces unique challenges in addressing their health needs. In the context of these challenges, the health outcomes are often poorer than those of heterosexuals. SGM subpopulations experience unique disparities making healthcare needs more complex and necessitating an understanding of SGMs’ being. Essential to addressing SGMs’ healthcare needs is the healthcare provider’s (HCP’s) knowledge of sexual and gender minority status. The first manuscript in this portfolio dissertation, Fostering Sexual and Gender Minority Status in Patients, provides an overview of the issues surrounding disclosure to …

Care After Burn Trauma: A Burn Toolkit For Providers, Whitney Weyhing

DNP Qualifying Manuscripts

Problem: A burn injury can occur in a matter of seconds. Despite advances in medical innovations and scientific progress, accidental burns continue to represent a devastating major public health burden today. Burn traumas represent a great expense to the healthcare system, affect every age and demographic, and continue to possess significant morbidity and mortality.

Context: Due to the current knowledge deficit of basic burn treatment, this Toolkit will provide current best-practice guidelines with evidence-based wound care instruction.

Interventions: An interactive educational instruction, including a pre-test and post-test of overall comprehension, from initial assessment to management of burns. Included will be …

Effect Of Body Habitus On Mortality Risk In Septic Patients, Brita Bush

Nursing Capstones

No abstract provided.

The Use Of Sglt2 Inhibitors Compared To Glp-1 Receptor Agonists In Patients With Type 2 Diabetes And Hypertension, Koree Vivatson

Nursing Capstones

No abstract provided.

A Comparison Of Dietary Changes Versus Elective Cholecystectomy In The Treatment Of Gallbladder Disease, Liza Ystaas

Nursing Capstones

No abstract provided.

Precision Medicine And The Treatment Of Type 2 Diabetes Mellitus, Emily Stunek

Nursing Capstones

No abstract provided.

A National Study Of Undergraduate Nursing Students' Early Consideration Of Doctoral Education: What Characteristics Predict Students' Report Of Intention And Readiness To Continue Graduate Education Toward The Doctorate?, Renee Lynn Buonaguro

Theses & Dissertations

Statement of the Problem The looming nursing faculty shortage has already had a direct effect on schools of nursing. With our current understanding about enrollments needed to meet the demands of an adequately prepared healthcare workforce, attention needs to be directed toward the preparation of an adequate educator workforce. A consequence of not having doctorally prepared nursing faculty would result in an inadequate number of professors to accommodate the 70,000 applicants who are desiring to pursue their nursing degrees. One solution to the faculty shortage is to vastly increase the number of doctorally prepared faculty earlier in their careers. This …

Determining The Knowledge And Practices Of Obstetrics Healthcare Professionals Regarding Maternal Intrapartum Pertussis Vaccination Administration, Kristie Mattix

Doctor of Nursing Practice Scholarly Project

Pertussis is a contagious respiratory disease that can occur in all age groups. Signs and symptoms of pertussis, however, are worse in infants and young children; likewise, the rates of severe cases, hospitalizations, and deaths are higher in this group as well. Vaccination against pertussis is the most effective way to combat this illness. In the last 15 years, there have been a number of changes in the recommendations regarding vaccination against pertussis. In order for these recommendations to be followed, healthcare professionals must be aware of the guidelines as well as be knowledgeable about the condition they are trying …

Using Provider Education About Self Care To Reduce Compassion Fatigue Among Nurses, Priscella Caron

Doctor of Nursing Practice Scholarly Project

Many have scrolled through Facebook and news stories highlighting nurses as “heroes” of the current coronavirus pandemic. Pictures of nurses in personal protective equipment while at work or clips of nurses making fun tiktok video’s celebrating recovered COVID -19 patients. Social media does not capture the sheer emotional, physical, and spiritual wear that nurses experience providing compassionate care to patients facing light threatening illness or events. Health care organizations are under pressure to control cost, increase productivity, and increase patient satisfaction scores, all while facing a pandemic crisis. This type of pressure can create inadequate staffing and increase clinical responsibilities …

Impact Of Diet On Gallbladder Disease In Adult Women, Raina Weyrauch

Nursing Capstones

No abstract provided.

Preventing Childhood Obesity With Increased Education On Responsive Feeding Practices In Parents Of Newborns In A Community Health Center, Heather Burns

Doctor of Nursing Practice Scholarly Project

This project sought to increase healthcare providers’ responsive feeding education to parents of newborns at a community health center in Southeast Kansas. An educational offering was held for participating providers who provided health services throughout infancy. The offering reviewed the projects’ methodology, instruments, and intervention to increase responsive feeding education. Parents of newborns who met the inclusion criteria and who presented for an initial newborn visit with their healthcare provider were invited to participate. Parents completed surveys prior to receiving education at the initial appointment and the a follow-up survey at the infant’s two-month well child appointment to analyze parental …

Dnp Final Report: Pressure Injury Prevention Patient Initiative (Pippi), Melissa A. De Los Santos

DNP Final Reports

Background: Pressure injuries have been known to affect approximately 2.5 million patients each year, with roughly 60,000 patients dying as a direct result of a pressure injury. Associate healthcare costs are between $9.1-$11.6 billion per year in the United States. The cost of individual patient care was estimated between $20,900 and $151,700 per pressure injury. During the last three years, pressure injury prevalence has risen within the local long-term care organization. Pressure injury prevention interventions have been developed to improve healthcare outcomes, cut costs, and increase revenue for long-term care organizations.

Purpose: Deliver evidence-based educational intervention that incorporates strategies for …

Postpartum Thyroiditis – Should Postpartum Mothers Be Routinely Screened For Thyroid Dysfunction Without Prior Indication Of A Thyroid Condition?, Jessie M. Kier

Nursing Capstones

No abstract provided.

Is There An Ideal Preoperative Glycated Hemoglobin For A Patient With Type 2 Diabetes Mellitus For Prevention Of Postoperative Complications?, Tammy Branden

Nursing Capstones

No abstract provided.

Case Report: Nsaids And Obesity In Breast Cancer, Janine Cook

Nursing Capstones

No abstract provided.

Wound Care Education For Primary Care Providers At A Regional Medical Center, Zaira Torres

Doctor of Nursing Practice (DNP) Projects

Problem. Due to the aging population and the high prevalence of chronic diseases such as diabetes and cardiovascular disease, in the US, millions of people suffer from chronic wounds secondary to these chronic conditions. Wound care treatment is very expensive, costing the US health care system approximately $10 billion annually. San Mateo Medical Center treats many patients with wounds. However, the treatment is suboptimal as most primary care providers (PCPs) are not trained to perform wound care according to best practice. This creates several problems such as a large number of referrals to the Vascular Clinic, visits to the emergency …

Reducing Frustration With Wait Times Utilizing Technology And Education: A Patient Satisfaction Improvement Model, Tiffany Brown

Doctor of Nursing Practice (DNP) Projects

Problem: Patients spend considerable amounts of valuable time waiting to be seen by physicians in outpatient clinical settings. Many consider waiting as wasted time, inactive time, or as a lost opportunity which can cause frustration. Research suggests that long clinic wait times have a major impact on patients with cancer causing a significant amount emotional distress. Context: At the hospital and thoracic oncology clinic implementation site which is located in northern California, the target time for a New Patient Visit (NPV) is less than or equal to 90 minutes, and less than or equal to 60 minutes for a Return …

Evaluation Of Obstructive Sleep Apnea In Veterans With Coexisting Psychiatric Symptoms, Zenith Perpignani

Doctor of Nursing Practice Projects

Abstract

There is a growing body of evidence that suggests a correlation between post-traumatic stress disorder (PTSD), nightmares with broken sleep, obstructive sleep apnea (OSA), and worsening of symptoms by OSA, Veterans who received treatment at a Midwest Veteran Affairs (VA) Center for Behavioral Health were often subject to variable wait times between scheduling of behavioral health and primary care providers (PCP). The purpose of the doctoral project was to reduce a Veteran's wait time for evaluation by a PCP after having been identified as at risk for OSA during routine psychiatric evaluation. The project examined Veteran's reports and measures …

The Role Of Extracellular Vesicles In Cancer-Related Fatigue And Its Co-Occurring Symptoms, Dilorom M. Sass

Theses & Dissertations

Cancer survivors report many debilitating symptoms associated with cancer and its treatments. About 30% will report long-term cancer-related fatigue (CRF) which often co-occurs with depressive symptoms, sleep disturbances, cognitive fatigue, and poor overall health-related quality of life. The underlying causes of these co-occurring symptoms have been related to systemic processes such as inflammation. Extracellular vesicles (EVs) contain systemic markers such as genetic and protein materials that inform about cell-to-cell interactions that influence immune signaling and inflammatory processing. No study to date has explored the associations of EVs with cancer-related symptoms. So, the purpose of this dissertation was to investigate the …

Steep Trendelenburg Associated Postoperative Vision Loss Prevention Education, Mitchell Coval

Doctor of Nursing Practice Projects

Postoperative vision loss (POVL) is a rare, but devastating complication that has been reported following robot-assisted laparoscopic surgeries that require prolonged steep Trendelenburg positioning. A central Illinois hospital had recently established a robot-assisted surgical program but lacked active interventions to reduce POVL risk due to a knowledge gap of the anesthesia providers. Following a comprehensive literature review, a PowerPoint educational program was provided at an anesthesia staff meeting. An evidence-based cognitive aid to provide a quick reference of POVL risk reduction strategies was created by the author in collaboration with the stakeholder. Once approved, the cognitive aid was attached to …

Evaluation Of An Interdisciplinary Ketogenic Diet Clinic For The Treatment Of Pediatric Refractory Epilepsy, Britt Schloemer

Graduate Theses, Dissertations, and Capstones

Pediatric refractory epilepsy affects approximately 30% of all children diagnosed with epilepsy. Childhood refractory epilepsy patients pose a challenge for traditional approaches to epilepsy management due to their complex and unique needs. Refractory epilepsy negatively impacts a patient’s ability to attend school or hold a job, and patients have a generally poor health status related to seizures as well as pharmaceutical side effects (Conway et al., 2016). The ketogenic diet (KD) is an alternative option for the treatment of pediatric refractory epilepsy due to established efficacy, manageable side effects, and reduced health care-associated costs due to reduced emergency department (ED) …

Assessing The Health Literacy Levels Of Diabetic Patients Located In Rural Southeast Kansas, Meghan Murray

Doctor of Nursing Practice Scholarly Project

Data shows that limited health literacy is prevalent throughout the United States. This data has also found a correlative relationship between limited health literacy and poor health outcomes. An individual’s health literacy level affects many areas of their health, including their ability to effectively manage chronic diseases, such as diabetes mellitus. Awareness of an individual’s health literacy level allows for targeted interventions and a potential improvement for a patient’s health outcomes. The Newest Vital Sign (NVS) is a validated screening tool that allows for the identification of a patient’s likely health literacy level. The purpose of this Doctor of Nursing …