Digital Commons Network^™

Prescribing Probiotics In Tandem With Antibiotics In A Pediatric Setting., Allyson Riggs

Doctor of Nursing Practice Papers

Gastrointestinal (GI) discomfort including antibiotic associated diarrhea (AAD) is a common side effect of antibiotic therapy. As antibiotic use continues to increase, more patients are affected by AAD. Significant evidence has been found on using probiotics for the treatment and prevention of GI distress and AAD. Provider education is needed in the clinical setting to share evidence and make recommendations on best practice. The goal of this intervention was to increase the rate at which providers prescribe probiotics in tandem with antibiotics, via increased provider education. A retrospective Electronic Health Record (EHR) review was conducted once before and once after …

Hypermobile Ehlers-Danlos Syndrome (Heds), Jocelyn Akers

Nursing Student Class Projects (Formerly MSN)

Ehlers-Danlos Syndrome is a genetic connective tissue disease with varying expressions and phenotypes. Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most prevalent subgroup within this disease category. It is estimated to make up about 80% of the total population of those with EDS (Tinkle et al., 2017). New and updated diagnostic criteria was established in 2017 for hEDS as a way to categorize the syndrome apart from other connective tissue diseases on the hypermobility spectrum of diseases. The disease expressive itself through a complex pathological process and in varying degrees and levels of severity for those who inherit it (Castori et …

An Intervention To Improve Emergency Room Nurses' Swallow Study Implementation And Documentation., Amanda B. Hicks

Doctor of Nursing Practice Papers

Stroke is the 5^th leading cause of death when isolated from other cardiovascular diseases in the United States (U.S.) (CDC, 2017). The Centers for Disease and Control (CDC) indicated that 795,000 people have a stroke each year with 65% suffering from some form of dysphagia, or difficulty swallowing. Implementing a simple screening by a trained nurse can detect dysphagia and prevent adverse outcomes, such as aspiration. In the emergency department (ED) of a suburban acute care facility, a pattern of inconsistent Toronto Bedside Swallow Screening Tool (TORBSST) was noted for 24 consecutive months. The purpose of this quality improvement …

Implementing An Updated Evidenced-Based Maintenance Central Line Bundle (Clb) Policy: Monitoring Adherence And Central Line Associated Blood Stream Infections (Clabsis) In A Medical Intensive Care Unit (Micu)., Kimi Hart

Doctor of Nursing Practice Papers

Purpose: The purpose of this project was to update the current policy of CLB maintenance of CVCs by incorporating the latest recommendations from the literature, providing education and disseminating the new policy. Outcomes were measured by evaluating the effect on policy adherence and incidence of CLABSIs in a medical intensive care unit (MICU). Policy adherence was defined by the completion of CLB maintenance components.

Methods: This study included a pre- and post-interventional design utilizing a retrospective chart review to evaluate adherence to CLB maintenance interventions and incidence of CLABSI rates pre and post-implementation of a new CLB maintenance policy that …

Pediatric Discharge G-Tube Toolkit., Kimberly Hall

Doctor of Nursing Practice Papers

Surgically placed gastrostomy tubes (G-tubes) are used in pediatric patients to provide proper nutrition and hydration when illness or trauma renders the child unable to consume adequate oral intake. Parents/caregivers are given education and training on their child’s G-tube, which varies from hospital to hospital. Parents/caregivers are responsible for all aspects of the G-tube once discharged from the hospital. Studies have shown that after discharge, ER visits and/or unscheduled clinic visits are necessary for G-tube complications, many of which could be dealt with at home given the proper education and resources. The aim of this project was to provide a …

Childhood Lead Poisoning Prevention: Healthcare Provider Knowledge And Self-Reported Practice, Lydia Ruth Rice, Mari Caitlyne Minga, Laken Fulcher, Eric Yarborough

MSN Research Projects

The purpose of this research study is to determine if primary care providers are knowledgeable of the CDC recommendations for childhood lead poisoning prevention and to evaluate the self-reported practices of primary care providers regarding these recommendations.

Improving Caregiver Coping And Reducing Recidivism With A Pediatric Burn Discharge Education Toolkit., Lindsay Hack

Doctor of Nursing Practice Papers

In 2015, 4,506 children from 0-19 years of age were hospitalized with burn injuries in the United States (Center for Disease Control and Prevention, 2017). From 2013-2014, 325 out of 11,940 pediatric burn patients discharged from US facilities had unscheduled readmissions within 30 days (Wheeler et al., 2018). Adequate discharge education and quality of transitions from hospital to home will help prevent negative health outcomes and readmissions (Braet, Weltens, Bruyneel, & Sermeus, 2016). In this quality improvement project, caregivers of pediatric burn patients were assessed on their day of discharge with the Readiness for Hospital Discharge Scale (RHDS)- Parent Form …

An Educational Intervention On Daily Chlorhexidine Gluconate Bathing And Central Venous Catheter Infection Rates In The Pediatric Population: A Quality Improvement Initiative., Jennifer Cothern

Doctor of Nursing Practice Papers

The use of Central Venous Catheters (CVCs) in the healthcare setting is essential to patient survivability. While convenient, the utilization of such devices places patients at risk for Central Line- Associated Bloodstream Infections (CLABSI). The US spends nearly $2 billion dollars annually treating CLABSIs. The utilization of CLABSI bundles has shown to be effective in infection prevention. Daily bathing with Chlorhexidine Gluconate (CHG) is recommended by the Centers for Disease Control and Prevention (CDC) and is often included in CLABSI bundles. In an attempt to reduce the incidence of CLABSIs at a metropolitan pediatric hospital in the Southern US, a …

A Flavor Perception Game Designed To Introduce Basic Chemical Sensation Of Taste Modalities To Undergraduate Nursing And Exercise Sciences Students, Angela L. Mahaffey

Nursing: School of Nursing Faculty Publications and Other Works

The Flavor Perception Game was designed with the goals of developing an interactive and hands-on activity, providing a platform to review chemical senses of the five tastes, promoting student investment in the course material, and providing a basis for discussion on chemical senses of the five tastes. Knowledge of taste sensation is useful for nursing and exercise sciences students, as human physiology is integral to both baccalaureate curricula. The game is inexpensive, easy to incorporate into a 50-minute lecture period, and free of chocolate allergens. Student participants (N=34) tasted three candies and completed a voluntary anonymous poll regarding their detection …

The Implementation Of The Teach-Back Method In Dash Diet Education To Improve Blood Pressure Control In Patients With Hypertension And Low Health Literacy, Patrice Helen Spencer

Doctoral Dissertations and Projects

Low health literacy is closely correlated with poorly-managed chronic disease conditions. Hypertension is a common chronic disease condition which can be better controlled through compliance with the dietary approaches to stop hypertension (DASH) diet; however, patients with low health literacy may have difficulty understanding the DASH diet without proper education. The teach-back method is an evidence-based education tool which can empower patients with low health literacy to better control the management of hypertension through adherence to the DASH diet. This is an evidence-based project which purposes to reveal the effectiveness of the teach-back method in providing DASH diet education in …

An Educational Intervention To Raise Obesity Awareness, The Importance Of Follow-Up, And The Need To Utilize Recommended Strategies And Interventions Among Advanced Care Practitioners In A Sleep Center Setting, Cindy L. Thomas

Doctoral Dissertations and Projects

Obesity is a national epidemic that affects approximately 40% of adult Americans. A lack of advanced practitioner (AP) knowledge about obesity and follow-up may contribute to the obesity epidemic. Diagnosing obesity and beginning prompt weight loss (WL) management with the aim to prevent the development or progression of chronic illnesses associated with obesity is imperative. Research has shown that WL of 5% to 10% of initial body weight can reverse or reduce the onset of chronic illnesses. The purpose of this evidence-based practice (EBP) scholarly project was to raise the awareness of weight management resources among APs caring for patients …

Evaluation Of Patient Education To Facilitate Advance Directives Completion With Dialysis Patients, Xuesi Liu

Doctoral Dissertations and Projects

Completion of advance directives (ADs) is an important part of identifying a patient’s treatment preferences. Lack of patient understanding regarding the scope and importance of advance directives is a common barrier to AD completion. This project reports on the effectiveness of a patient education intervention in facilitating patient understanding in an outpatient dialysis facility in rural Virginia. Thirty patients were selected by convenience sampling to participate in a 10-minute verbal presentation based on a brochure entitled “Advance Care Planning: Tips from the National Institute on Aging” and completed two short questionnaires, one before and one after the education session. Patients …

A Quality Improvement Project To Enact Evidence-Based Guidelines To Improve Documentation Of Hemoglobin A1c For Inpatient Diabetes Populations, Karyn C. Kinney

Master's Projects

The purpose of this paper is to describe a quality improvement project aimed to improve the documentation of hemoglobin A1c in the discharge instructions for patients with a diagnosis of diabetes prior to a transition from the acute care setting. Clinical practice guidelines from the American Diabetes Association and patient education recommendations from The Joint Commission are the impetus for this process improvement. The Plan-Do-Study-Act (PDSA) model was utilized to identify, design, and implement the process change in collaboration with an interprofessional team. The documentation rate of hemoglobin A1c was measured on two medical-surgical inpatient hospital units both pre- and …

Adolescent Pregnancy: A Clinical Guideline For School Nurses In New Mexico, Karin Ludi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall purpose of this project is to ensure that school nurses and health assistants are knowledgeable and have the resources to care for pregnant adolescents in the public school system. New Mexico has consistently ranked in the top 10 in the United States for teen births to women aged 15-19 years. The New Mexico School Health Manual is currently used to guide school nurses and health assistants in the care of pregnant adolescents, but it is vague and addresses emergencies such as labor and bleeding.

From this author’s experience as a school nurse in the public school system, it …

Differential Placing Of Flexion Creases Contributes To Sex Differences In The Second-To-Fourth Digit Ratio (2d:4d), Sanjay Kumar, Martin Voracek, Maharaj Singh

College of Nursing Faculty Research and Publications

The present research examined whether differential placing of the basal flexion creases contributes to the occurrence of sex differences in digit ratio (2D:4D) derived from palmar digit lengths. The ratio of palmar-to-dorsal digit length, a measure of the placing of the basal flexion crease in the finger, was derived for the digits 2 and 4 of the right hand in two independent samples (Study I: N = 100; Study II: N = 200), in accordance with discovery-replication sample approach. The results show that men have lower palmar-to-dorsal digit ratios than women, and this effect is significantly stronger for digit 2 …

Contemporary Nursing In Rural Appalachia: A Hermeneutic Study, Evelyn Brewer

Electronic Theses and Dissertations

Nurses make up a significant source of direct care for individuals, families, and communities. The problematic distribution of nurses and the potential to lose practicing nurses emphasizes the importance of retention and support of nursing professionals, especially in rural locations. One of the best ways to discover what is important to nurses is to ask and listen to the replies.

The focus for this dissertation is the lived experience of registered nurses in a six-county area in three adjoining states in rural South Central Appalachia. The purpose of this study is to interpret and understand the lived experience of contemporary …

Case-Based Insights: Arab Muslim Mothers’ Experiences Of Managing A Child Newly Diagnosed With Type 1 Diabetes Mellitus, Rachel Cathrine Rossiter, Jennifer Louise Cooper, Suhad Issa Marjei, Sharon Brownie

School of Nursing & Midwifery, East Africa

Mothers frequently fulfill the role of primary caregiver for children diagnosed with type 1 diabetes mellitus (T1DM). A T1DM diagnosis has a significant impact on the child and the wider family unit. The objective is to develop understanding of mothers’ experiences caring for children diagnosed with T1DM in the cultural context of the Middle East to facilitate enhanced health service provision and support. This study used a qualitative design. Data were collected in individual semistructured interviews. Participants were mothers of Arabic descent and Muslim belief who had a child diagnosed with T1DM within the last 12 months. All mothers were …

Effectiveness Of Educational Intervention On Diabetic Knowledge & Hba1c Levels On Kenyan Adults With T2dm, Sabina Jeruto Bett

Doctor of Nursing Practice Projects

Background

Type II diabetes mellitus (T2DM) is a common chronic metabolic disease affecting millions of people globally, which causes many long-term complications such as high blood pressure, chronic kidney disease, improper wound healing and loss of sight. Literature supports that most people, in general and diabetic patients specifically, in Africa, including Kenya are currently not taught about the importance of proper management of their disease. Therefore, many have difficulty following treatment plans, resulting in improper eating, poor glucose control, and diabetic complications. The limited knowledge concerning T2DM contributes to the negative impact this serious disease has on those who live …

Knowledge Of Women Of Childbearing Age Regarding Preconception Counseling, Allison Britt, Shelby Jackson, Jessica Mcgee, Jenna Pugh

MSN Research Projects

The purpose of the current research study was to assess the knowledge of women of childbearing age regarding key components of preconception counseling and look at relationships between demographics and knowledge of preconception health care.

Culturally Appropriate Education In Managing Hypertension In African Americans, Kristina Jones

Doctoral Dissertations and Projects

Abstract The historical treatment of African Americans with events such as the Tuskegee experiment and Jim Crow laws combined with distrust of the healthcare system may be affecting health outcomes in African Americans with hypertension. Cultural appropriate education by a provider of the same race is a method that can be utilized to bridge the trust gap between African Americans and providers and assist African Americans in managing their hypertension. A community based culturally appropriate educational intervention by a provider of the same race was implemented over the course of eight weeks to assist African Americans with hypertension to improve …

Type 2 Diabetes (T2d), Janice Loney

Nursing Student Class Projects (Formerly MSN)

ABSTRACT

Type 2 diabetes (T2D) is a devastating disease predisposing individuals to a myriad of serious health complications such as: heart disease, stroke, retinopathy, neuropathy, renal disease, dementia, amputation and early death. Diabetes care has a major economic impact worldwide, as a future family nurse practitioner (FNP) patient education on T2D risk factors, disease process and medical management are vital to halt this growing epidemic. A literature search was conducted and five peer reviewed articles were chosen addressing T2D pathophysiology, risk factors, effects of self-care behaviors and emerging treatment options.

Focused efforts from the literature reviews indicate education and adherence …

Improving The Health And Functional Status Of Institutionalized Older Adults Through The Nurse, Caregiver And Older-Adults Partnership Model (Miradasia), Junaiti Sahar, Dwi Nuviyandari Kusuma Wati, Etty Rekawati

Jurnal Keperawatan Indonesia

Health and functional status are standard measurements in older adult’s services that showed physical and mental condition. However, institutionalized older adults with several adjustments and their limited source might cause compromised health and functional status. The quasi-experimental study aimed to investigate the effect of MiRaDaSia (nurses and caregivers joined the partnership model) on health and functional status among institutionalized older adults in Jakarta. It included 106 participants as intervention groups and 106 participants as control groups, who selected by multistage random sampling. We used the SF-12 and Barthel index to measure older-adults health and functional status. MiRaDaSia model was implemented …

Determinan Epidemiologi Penyakit Pada Mahasiswa Akademi Keperawatan Pemerintah Kabupaten Garut, Jawa Barat Tahun 2015, Iwan Salahuddin, Theresia Eriyani, Sandra Pebriamti

Jurnal Keperawatan Indonesia

Determinants of Epidemiology of Disease in Nursing Academy Students in Garut, West Java in 2015. The process of adaptation and interaction of students with the new environment can result in physiological balance disorders of the body, thus becoming susceptibleto disease. This cross-sectional study aimed to identify the epidemiological determinants of disease in 2015 Garut District Nursing Academy students. A total of 235 students were involved. Data collected included respondent characteristics, the characteristics of the place of origin of the students, morbidity using a questionnaire about the history of previous illness or morbidity. The results showed that 70.2% of students experienced …

Older Adults Learning Technology In An Intergenerational Program: Qualitative Analysis Of Areas Of Technology Requested For Assistance, Dara Lobuono, S. N. Leedahl, E. Maiocco

Rita & Larry Salva School of Nursing and Health Professions Departmental Research

Adults 65 and older are adapting to technology at a slower rate compared to the overall population. Research has shown that programs can assist older adults in learning and embracing technology. However, little information exists about what specific forms of technology older adults are interested in learning and for what purposes. To describe areas of technology older adults are interested in learning and why this study examined qualitative data from an intergenerational service-learning program in which students in higher education assist and mentor older adults with and about technology that older adults want to learn. Data was analyzed from in-depth …

Presenting The Good Mother: Experiences Of Canadian Adolescent Mothers Living In Rural Communities, Karen A. Campbell, Corinne Hart

The Qualitative Report

Adolescent mothers and their children are at risk for suboptimal health outcomes making adolescent motherhood a public health concern. However, the experiences of rural-living adolescent mothers are not well understood. Using Lieblich, Tuval-Mahiach, and Zilber’s (1998) narrative methodology approach, the experiential accounts of three rural-living adolescent mothers was explored. Reflecting Goffman’s (1959) presentation of self, the findings of this study revealed how adolescent mothers attempted to construct and present their notion of being a good mother, while coping with complicating rural factors. The need to present as a good mother, the lack of anonymity associated with rural living, and geographical …

Implementation Of An Inpatient Diabetes Team: Impact On Hypoglycemia Recurrence, Martha Bertin, Elva Diaz

All Publications

No abstract provided.

Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff

Dissertations

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

Practice Vs. Evidence: Predicting Insertion Length And Verifying Placement Of Feeding Tubes In Neonates., Brittany L. Tipton

Doctor of Nursing Practice Papers

The placement of nasogastric (NG) and orogastric (OG) feeding tubes is one of the most common procedures performed in the Neonatal Intensive Care Unit (NICU). According to the literature, as many as 44% of feeding tubes are placed in the incorrect location in children (Parker, Withers, & Talaga, 2018). The purpose of this process evaluation project was to analyze the current processes and human factors in predicting insertion length and verifying placement of feeding tubes in neonates. The goal was to use the data obtained to compare current practices to current evidence. If warranted, the ultimate goal was for the …

Dementia And The Role Of Alzheimer Disease, Jodi Kiessling

Nursing Student Class Projects (Formerly MSN)

Alzheimer disease is a progressive disease causing cognitive and functional decline with the hallmark sign of plagues and tangles within the brain. Genetics, inflammation, accumulation of beta-amyloid protein and breakdown of the blood brain barrier are all contributing factors in the disease. Treatment is not curative and is focused on symptom management and management of pre-existing chronic diseases.