Digital Commons Network^™

The Effects Of A Plant-Based Diet On Inflammation Of Patients With Cardiac Disease, Rachel L. Butcher

Honors Undergraduate Theses

Cardiac disease is the primary cause of death in the United States of America (CDC, 2017). Despite ongoing efforts and investments to improve cardiac health in the United States, most of the population will suffer from cardiovascular diseases. There is a multitude of research supporting that diet can contribute to cardiac disease, but it is less known that diet can greatly contribute to regulation and reversal of cardiovascular disease processes (Huang et al., 2012; Satija et al., 2017; Kim et al., 2019). Existing research supports the efficacy of plant-based diets to manage and reverse certain cardiac diseases (Tuso et al., …

Trophic Enteral Feeds In Mechanically Ventilated Adult Patients With Acute Respiratory Distress Syndrome/Acute Lung Injury And Associated Clinical Outcomes, Kiersten Ann Tidwell

Honors Undergraduate Theses

Enteral nutrition (EN) is often delayed in critically ill patients despite strong evidence to support that early enteral nutrition feeding is beneficial in this population. Adverse outcomes in critically ill patients in which nutrition is delayed include a longer length of stay and time on the ventilator, and a higher incidence of pneumonia and hospital mortality. The purpose of this literature review was to evaluate the current evidence regarding trophic enteral feeds in mechanically ventilated adult patients with acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) and associated clinical outcomes. A retrospective literature review was performed to identify articles published …

Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens

Walden Dissertations and Doctoral Studies

Adolescent obesity is a worldwide multifaceted epidemic. This disease affects the medical, physical, psychosocial, and family aspects of adolescent life. Identification, diagnosis, and referrals to providers that can initiate early interventions that improve weight status have been recommended as critical steps in curtailing childhood obesity. This evidence-based clinical practice guideline (CPG) was developed for the healthcare providers at a rural clinic in Southwest Arkansas to provide consistency in the identification, diagnosis, and referral of adolescents. The health belief model (HBM) and the trans-theoretical model (TTM) were used to consider adolescents’ individual characteristics and beliefs as well as their readiness to …

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …

Staff Education: Prediabetes Lifestyle Modification Toolkit, Vivian Elege

Walden Dissertations and Doctoral Studies

Prediabetes patients are at a high risk of developing Type 2 diabetes. The purpose of this project was to educate the medical staff of the project site clinic on lifestyle modifications that can help patients prevent prediabetes from progressing to Type 2 diabetes. The project took place at an outpatient clinic in the Southwestern United States. The clinic patient population is mostly African American, a population at risk for diabetes. The theoretical framework to support the project was the Iowa model of evidence-based practice. Staff education on patient diabetes prevention was the goal of the project. The project question focused …

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

Clinical Practice Guideline: Early Screening For Dementia In Diabetes Mellitus, Angelyn Levell-Smith

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus (DM) is a recognized cognitive impairment risk factor. Even with hyperglycemia being a modifiable risk factor in dementia, primary care is without an evidence-based screening tool to screen patients with diabetes for cognitive abilities. Current literature supports developing an evidence-based standardized guideline for early screening for cognitive impairment in elderly patients with DM. The purpose of this doctor of nursing practice (DNP) clinical practice guideline (CPG) project was to develop an evidence-based CPG for early screening of dementia in patients with DM, providing a means for early recognition of cognitive decline in these patients, making early intervention more …

Guiding Nurses To A Healthier Lifestyle, Margaret Yvonne Garcia

Walden Dissertations and Doctoral Studies

AbstractNurses provide continuous patient care around the clock. Nurses who work outside of the 9:00 a.m. to 5:00 p.m. hours are susceptible to fatigue and sleep deprivation that impair their attention to detail, ability to remain focused, information processing, and problem solving. This is especially prevalent among those who work the night shift. Nurses also find that their memory, reaction time, motivation, communication, mood, and empathy are affected with fewer hours of sleep. This project explored the sleepiness that night shift nurses experience and provides nurses with strategies to improve these symptoms. Nurses were provided with a PowerPoint presentation to …

Has Planetree Patient-Centered Care Models Have A Positive Effects On Patient Outcomes?, Jacob Nagle

Student Research Poster Presentations 2020

No abstract provided.

A Model Of Agitated Behavioral Symptoms In Persons With Alzheimer Disease, Katherine Kero

Wayne State University Dissertations

Background: Worldwide population trends are shifting with the population of Elders expected to dramatically increase in absolute and relative numbers in coming years. Alzheimer Disease (AD) is a common and costly disease of aging with agitation being the most poorly managed and detrimental behavioral symptom of the condition. The Nursing Theory of Unpleasant Symptoms provides a conceptual basis for understanding agitated behavioral symptoms associated with AD in the context of its antecedent causes and outcomes of the symptoms.

Purpose: The purpose of this dissertation was to model the predictors and outcomes of agitated behavioral symptoms in persons with AD. The …

Behavioral Symptoms, Inflammation And Cortisol: Relationship To Cardiac Health And Quality Of Life In Cardiac Rehabilitation Patients, Deborah Anne Sindewald

Dissertations

Background: The experience of a cardiac event is associated with psychological stress, which is often accompanied by depressive mood, fatigue and sleep disturbance (i.e., psycho-behavioral symptoms). To assist in recovery, cardiac patients can participate in a structured rehabilitation program, which provides monitored exercise and health education. There is limited knowledge, however, as to the extent to which cardiac rehabilitation reduces psycho-behavioral symptoms; nor is there knowledge of the association of these symptoms with stress-related biological mediators. Cortisol and inflammatory mediators (e.g., interleukin 6; IL-6) contribute to cardiovascular disease, and are also associated with greater stress perception, depressive mood, fatigue, and …

Using Unfolding Case Studies In A Traditional Classroom Setting To Enhance Critical Thinking Skills In Pre-Licensure Bachelor Of Science Nursing Students, Elaine M. Lloyd

Master's Theses and Doctoral Dissertations

Nursing education reform is needed for today’s generational mix of pre-licensure nursing students to prepare them to effectively care for clients’ ever-evolving healthcare needs. This mixed-methods, quasi-experimental study was designed to measure if the use of unfolding case studies (UCS) in a traditional classroom setting (TCS) would (a) enhance critical thinking skills of the experimental group more than the control group as measured by the Health Science Reasoning Test (HSRT), (b) explore if course content examinations were higher in the experimental group versus the control group, (c) explore the perceptions of a subset of Bachelor of Science Nursing (BSN) pre-licensure …

Kujdesi Infermieror Te Pacienti Me Pneumoni, Ernesta Osmanaj

Theses and Dissertations

Qëllimi i temës “ Kujdesi infermieror te pacienti me pneumoni “ ka të bëjë me pacientët që vuajnë nga infamacioni i indit pulmunar ku edhe kryesishtë janë marrë pacientat në spitalin rajonal në Pejë kryesisht në repartin e pulmologjisë për hulumtim . Në kapitullin e parë të punimit zhvillohet hyrja ku filitet për anatominë , fiziologjinë dhe patologjitë e pneumonisë . Kapitulli i dytë përfshinë shqyrtimin e literaturës , kapitulli tretë për diskutimin e problemit , kapitulli katërt metodologjinë dhe kapitulli i pestë hulumtimin klinik . Sëmunjet e mushkërive gjegjësishtë pneumonitë janë mjaftë të shprehura si tek fëmijët ashtu edhe …

Evaluating The Implementation Of A Risk Screening Tool To Decrease The Incidence Of Postoperative Nausea And Vomiting, Lauren E. Stoltzfus

West Chester University Doctoral Projects

Abstract

Postoperative nausea and vomiting (PONV) continues to occur despite medical advances over the years. PONV decreases patient satisfaction, can lead to postoperative complications such as dehydration and suture dehiscence, and it increases hospital costs. Evidence in the literature suggests a preoperative risk assessment screening and prophylactic antiemetic administration can decrease the incidence of PONV. The purpose of this project was to evaluate the effectiveness of a risk assessment tool and to determine if the tool would decrease the incidence of PONV. This quality improvement project involved collecting pre-intervention PONV data over a 6-week time period. The pre-intervention incidence was …

Equipping Early Childhood Educators To Manage "Behaviors That Challenge" In The Early Childhood Years, Shanna Scott

Doctor of Nursing Practice Projects

This scholarly project pursues the development, implementation, and evaluation of techniques to help improve the health and well-being of children ages 1-5, who have difficulties with challenging behaviors, to effectively manage stress and boost resilience through the incorporation of music and educational techniques of the early childhood educator.

This paper will discuss the positive or negative outcomes on external factors affecting child health, such as economic, judicial, societal, cultural, cognitive development, parental separation, and mental health concerns of all members of the family. It will also discuss the positive effects educational strategies and music can have on young children experiencing …

The Effect Of Acuity-Based Nurse Staffing On Nursing Medication Errors, Egidius Maria Eugene Waterval

Electronic Theses and Dissertations, 2020-2023

Nurses spend on average one third of their time on direct patient care, and most on indirect care in hospital settings. However, nursing workload is challenging to measure in a systemized, accurate, and timely way. Patient classification systems are designed to capture information about nursing workload based on the illness severity of the patient (acuity) to determine staffing resources and balance nursing workload. These systems are instruments that group nursing care activities in different categories to determine patient acuity. Electronic health records provide opportunities to use available data sets to accurately, and in real-time, document many direct and indirect patient …

Access And Utilization Of Prenatal Care In Florida And Its Effects On Preterm Birth, Corinne Audette

Electronic Theses and Dissertations, 2020-2023

Preterm birth in the United States is the leading cause of infant morbidity and mortality. The United States spends more per capita on healthcare than any other nation in the world, and still perinatal outcomes are disappointing when compared to other industrialized nations. Research and current clinical practice guidelines support the use of early and consistent prenatal care to lower risks for preterm birth, by acting as a key mechanism to monitor pregnancy and provide timely and appropriate interventions. Significant research has been completed to identify causative factors that lead to preterm birth. Overall, this literature has not had a …

ผลของโปรแกรมการเสริมสร้างพลังอำนาจของมารดาต่อการรับรู้ความสามารถ และปริมาณน้ำนมที่บีบเก็บได้ของมารดา ในการให้นมบุตรที่คลอดก่อนกำหนด, ไฉไล ผาเงิน, ทศา ชัยวรรณวรรต, ธนันต์พร ตรีบุตรดี, ณัฐธิราภรณ์ พูลเพิ่ม, กมลธิดา เหล่าบุตรสา

Journal of Nursing Research, Innovation, and Health

วัตถุประสงค์: เพื่อศึกษาผลของโปรแกรมการเสริมสร้างพลังอำนาจของมารดาต่อการรับรู้ความสามารถ และปริมาณน้ำนมที่บีบเก็บได้ ของมารดาในการให้นมบุตรที่คลอดก่อนกำหนด

แบบแผนการวิจัย: การวิจัยกึ่งทดลอง

วิธีดำเนินการวิจัย: กลุ่มตัวอย่าง คือ มารดาที่คลอดทารกก่อนกำหนด จำนวน 30 คน เครื่องมือที่ใช้ในการวิจัย คือ โปรแกรมการเสริมสร้างพลังอำนาจในการให้นมแม่ในมารดาที่มีทารกคลอดก่อนกำหนด ตึกเด็ก 1-2 โรงพยาบาลสรรพสิทธิประสงค์ จังหวัดอุบลราชธานี แบบสอบถามการรับรู้ความสามารถในการให้นมแม่ในมารดาที่มีทารกคลอดก่อนกำหนด แบบสอบถามพลังอำนาจในการให้นมแม่ มีค่าสัมประสิทธิ์แอลฟาครอนบาคเท่ากับ .92 และ .92 วิเคราะห์ข้อมูล ค่าร้อยละ ค่าเฉลี่ย ส่วนเบี่ยงเบนมาตรฐาน และสถิติ Pair t-test ที่ระดับนัยสำคัญทางสถิติ .05

ผลการวิจัย: หลังได้รับโปรแกรมการเสริมสร้างพลังอำนาจในการให้นมแม่ในมารดาที่มีทารกคลอดก่อนกำหนด พบว่า การรับรู้ความสามารถในการให้นมแม่ในมารดาที่มีทารกคลอดก่อนกำหนด และความสามารถในการบีบเก็บน้ำนมได้สูงกว่าก่อนได้รับโปรแกรมเสริมสร้างพลังอำนาจ อย่างมีนัยสำคัญที่ระดับ .05

สรุป: โปรแกรมเสริมสร้างพลังอำนาจในการให้นมแม่ในมารดาที่มีทารกคลอดก่อนกำหนด ตึกเด็ก 1-2 โรงพยาบาลสรรพประสิทธิประสงค์ จังหวัดอุบลราชธานี เพิ่มการรับรู้ความสามารถในการให้นมแม่ในมารดาที่มีทารกคลอดก่อนกำหนด และความสามารถในการบีบเก็บน้ำนมสูงขึ้นได้

Educational Interventions For Women And Their Support Persons On Breastfeeding Outcomes, Alexandra Cordell

Electronic Theses and Dissertations

n the United States breastfeeding duration and exclusivity rates are not at ideal levels, therefore there is a need to examine existing interventions. The purpose of this systematic review was to examine the effects of education and support interventions during the third trimester, immediate postpartum, and the first six months of life on breastfeeding duration and exclusivity from six weeks to six months. Inclusion criteria were (a) randomized controlled trials or controlled clinical trials, (b) pregnant and/or postpartum women, (c) lactation education and support interventions, (d) measurement of breastfeeding outcomes from six weeks to six months, and (e) published between …

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …

Reducing Congestive Heart Failure Hospital Readmission Through A Practice Guideline, Michelle Hamric

Walden Dissertations and Doctoral Studies

Patients with congestive heart failure (CHF) are at increased risk for hospital readmission within 30 days of discharge. The gap in practice involves the coordination of care for patients with CHF in the transition from hospital to home. Patients with CHF are at increased risk for hospital readmission due to barriers involving self-care, communication, and coordination of care. The purpose of this project was to implement a clinical practice guideline (CPG) that used a predictive tool and clinical pathway for coordination of care for CHF patients at increased risk for hospital readmission within 30 days. The DNP project involved using …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Getting The End Of Life Care Conversation Started, Lisa Ann Mccabe-Evans

Walden Dissertations and Doctoral Studies

AbstractEducation is needed among the health care collaborative team to address the lack of end of life conversation, the underutilization of hospice leading to patients’ end of life wishes not being met, the increased depression among bereaved loved ones, and the increased health care costs at the end of life. Nurses reduce the patient’s physical and emotional stress by helping guide conversations and answer questions to meet the needs of patients and their loved ones. This project addressed the practice-focused question to determine if nursing knowledge and expressed intentions about end of life care increase as shown via the difference …

Heart Failure Self-Care At Home, Dinah Warren

West Chester University Doctoral Projects

Abstract

This evidence-based quality improvement project was implemented to improve self-care behaviors in homebound heart failure patients. Heart failure is a complex disease with significant challenges for patients, caregivers, healthcare providers, and the healthcare system. Educating and engaging patients in self-care management skills can reduce the clinical and financial burden of this disease. Heart failure self-care management skills can decrease 30-day readmission rates, improve quality of life, and reduce mortality. The self-care management program was implemented over a 6-week period. The Self-Care of Heart Failure Index (SCHFI) was administered at baseline to assess self-care and reevaluated after 6-weeks. During the …

Chronic Care Model For Management Of Diabetes Mellitus, Junecia White

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a serious chronic disease affecting individuals at various stages of life. More than 114 million Americans are at risk of developing complications of diabetes. It is the leading cause of kidney failure, nontraumatic lower-limb amputations, heart disease, stroke, and new cases of blindness among adults in the United States. This quality improvement project sought to understand if important clinical indicators of diabetes mellitus such as HbA1c, blood pressure, serum cholesterol, high-density lipoprotein, low-density lipoprotein, serum creatinine; and estimated glomerular filtration rate would improve after implementation of a team-based guideline-informed approach to diabetes care management. The chronic care …

Eating Disorders And The Gap Of Education, Sara Jane Camden

Walden Dissertations and Doctoral Studies

Eating disorders are described as excessive dieting, limiting food intake, and withholding of food. Over 30 million people suffer from eating disorders. Some people may also have preconceived notions that this disease is easily fixable and that eating more and stopping dieting will solve the problem. Registered nurses struggle with having preconceived ideas, a lack of confidence in their assessment skills, and fear of using the eating disorder diagnosis. Barriers that have surrounded the eating disorder mental health disease need to be addressed. The staff development project was based on the question if nursing knowledge would improve on eating disorders …

Minority Pregnant Women Perspective On Health Disparities And Health-Related Outcomes, Lorna Robinson

Walden Dissertations and Doctoral Studies

Health agencies have recognized persistent health care disparities as the primary causes of mortality among minority populations. The emphasis of published studies on the health of minority women in the United States has revealed a knowledge gap in prioritizing prenatal care (PNC). The purpose of this narrative descriptive study was to explore access disparities in PNC and the effect the overall experience had on first-time pregnant minority women in receipt of PNC. The health services utilization framework provided the theoretical lens to analyze and interpret the findings of this study. The key research questions explored how the self-reported experiences of …

Use Of Spanish Audio Podcast To Educate Visually Challenged Hispanics With Diabetes, Baiju Issac

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among the Hispanic population, requiring solutions at the individual, community, and population levels. Self-management helps to manage diabetes and prevent complications, but it is a challenge in nursing practice. Health care providers use printed information to teach patients about self-management of diabetes. However, patients with visual impairment are not able to use these resources. Limited English proficiency, low health literacy, and visual challenges result in the underutilization of health care services within Hispanic communities. Therefore, the purpose of this study was to develop a Spanish audio podcast and lesson plan as teaching tools …

A Systematic Review Of The Literature On Bedside Shift Reports, Dana Wickersheim

Walden Dissertations and Doctoral Studies

AbstractIn 2017, The Joint Commission issued a sentinel event alert regarding inadequate nurse hand-off communication. Inadequate hand-off communication can lead to medication errors, delay in treatment, falls, and wrong-site surgery. To help ensure safe handoff of care between nurses by involving the patient and family, bedside shift report was created. Bedside shift report was developed to help improve patient safety and quality, patient experience of care, nursing staff satisfaction and time management, and accountability between nurses. Despite the implementation of bedside shift report in nursing practice, it continues to be inconsistently applied, which poses risks to patients and can lead …

Preventing Aspiration Pneumonia Using An Aspiration Prevention Protocol, Lee James-Pettway

Walden Dissertations and Doctoral Studies

Hospital-acquired pneumonia, which includes aspiration pneumonia (AP), is a preventable condition that is costly to all healthcare institutions (more than $17,000 to $ 30,000 per episode), because insurance no longer covers the cost of hospital-acquired harms. Each episode in the hospital setting can lead to patient complications, increased use of antibiotics, patient mortality, as well as decreased patient survey scores. Several factors put patients at risk of developing AP, and screening for these risk factors on admission and implementing preventative nursing interventions can decrease the incidence. Based on an extensive literature review, an evidence-based, clinical practice guideline (CPG) was identified …