Digital Commons Network^™

Perinatal Mood And Anxiety Disorders, Stigma, And Social Support Among Postpartum Women, Ellen K. Fleischman

Dissertations

Purpose/Aims: The purpose of this descriptive, correlational, cross-sectional study was to examine the relationships among perinatal mood and anxiety disorder (PMAD) symptomatology, select demographics, stigma of mental illness, and social support, among inpatient postpartum women. Rationale: PMADs affect as many as 21% of childbearing women, yet these disorders are identified and treated less than half the time. There is a gap in the literature regarding the relationships among stigma, social support, and PMADs in postpartum women.

Conceptual Basis/Background: Despite recommendations from professional organizations, screening for PMADs is not consistently completed using a valid, reliable instrument. Stigma contributes to the low …

Patient’S Utilization Of Health Information Technologies For Disease Self-Management, Mahmoud Hamzeh Altawalbih

Dissertations

Background: The rapid growth of Health Information Technologies (HITs) provides

patients with greater opportunity to take control over their health. HITs utilization has

been proven to be a critical component of disease self-management and can result in

positive outcomes. Its widespread adoption and utilization is still relatively low among

patients with chronic disease. It is important to understand the factors that may impact

HITs utilization, such as the perceived Task-Technology Fit (TTF). A very limited

number of studies have examined the relationship between HITs utilization and the

perceived fit between task and technology in the context of TTF theory.

Aims/ …

Promoting Diabetes Self-Management Education And Support In Primary Care Clinic: An Evidence-Based Project, Maricel Veluz Delacruz

Doctor of Nursing Practice Final Manuscripts

Objective: Self-care disease management is a crucial component in achieving healthy glycemic targets among type 2 diabetes mellitus (T2DM) patients to improve health outcome resulting in reduced healthcare cost. The purpose of this evidence-based practice (EBP) project is: 1) to improve hemoglobin glycated (A1C) levels to

Research Design and Methods: The EBP project took place in a private primary clinic in National City, California. A total of eight T2DM respondents with an A1C level of >7% were included to partake in the EBP project. A 30-minute Diabetes Self-Management Education and Support (DSMES) utilizing the designated seven self-care behaviors of the …

The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell

Doctor of Nursing Practice Final Manuscripts

The Roles of an Evidence-Based Weight Management Protocol in Hypertension Control

Abstract

Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led protocol for patients with hypertension (HTN) and weight loss needs to improve weight control, cardiovascular risk and quality of life.

Background: Evidence shows that a 1.2-kg weight loss can reduce systolic blood pressure (SBP) by 3.8mmHg. Thus, a 10kg (22lbs) weight loss is likely to yield a SBP decrease of as much as 32mmHg. Such results would positively impact quality of life and costs. The simple approach of instructing patients to eat less …

Exploring Help-Seeking Intentions Of Homeless Veterans Attending A Stand Down Event, Tara Vaughn

Nursing Theses and Dissertations

Lack of help-seeking behavior among homeless veterans results in higher burden of disease and lower quality of life. No studies have been conducted involving help- seeking intentions of homeless veterans within the veteran stand down population. Pender’s Revised Health Promotion Model was used to guide this descriptive correlational study with the aim of exploring the extent selected personal characteristics and experiences and behavior-specific factors affect help-seeking intentions among homeless veterans attending a stand down event.

A convenience sample of 86 homeless veterans (mean age 56) was recruited from a 3-day veteran stand down event in Northern California. Each participant was …

Anesthetic Implications For Patients With Friedreich’S Ataxia, Clara Hoss

Nursing Capstones

No abstract provided.

Improving Access To Youth-Friendly Health Services In A Rural California Community, Elena Higley

Doctor of Nursing Practice (DNP) Projects

Adolescents and young adults experience relatively high rates of preventable morbidity and mortality due to injuries, mental health disorders, suicide, substance use, and reproductive health issues. It is paramount for healthcare providers to address risky behaviors early to thwart future adverse outcomes. Rural communities especially struggle with meeting the healthcare needs of their youth because there are fewer resources specifically dedicated to serving adolescents and young adults. This issue is evident in Grass Valley, California, a rural community in Nevada County, an area located in the foothills of the Sierra Nevada mountains. In response to limited access to youth-friendly healthcare …

Enhancing Nutrition Education For School Aged Children; A Preventive Health Measure And Quality Improvement Project, Fanny M. Powell

Doctor of Nursing Practice (DNP) Projects

Objective: The purpose of the DNP project was to improve nutritional knowledge of the adolescents at Kings Canyon Unified School District while also improving their perceived ability to choose healthy food. This project was enveloped in a larger community outreach mission utilizing a free school-based clinic for the purposes of providing sports physicals to students and health screening and physicals to the community. Additionally, nurse practitioner students engaged in a cultural immersion experience through clinical rotations in Central Valley.

Methods: Adolescent students who registered for the clinic watched a nine-minute nutrition video, created by the DNP student, while waiting …

Enhancing Health Literacy Using Teach Back Method To Increase Patient Adherence To, Tram Mendoza

Doctor of Nursing Practice (DNP) Projects

Background: Health literacy is a complicated and perplexing topic for those not trained in the medical field. Patients possess pieces of health literacy to some degree, while some have none at all. Limited health literacy can pose a very threatening risk on a patient’s well-being, interfering with their self-care and health maintenance, possibly creating more obstacles for the patient if health instructions and education are not clearly understood. This can lead to increased health expenditures due to treating the effects of poor health maintenance in addition to emergency room visits that may have not been necessary had the patient understood …

Clinical Practice Guideline Adherence: Primary Prevention Of Cardiovascular Disease In At-Risk Adults, Sharnita L. Rice

Evidence-Based Practice Project Reports

The American College of Cardiology (ACC) and the American Heart Association (AHA) (2013; 2016), as well as the American Diabetes Association (ADA) joined forces to create clinical practice guidelines (CPGs) recommendations for healthcare providers (HCPs) to follow with the aim of preventing cardiovascular disease (CVD). Cardiovascular disease is the leading cause of morbidity and mortality in the United States. The Centers for Disease Control (2017a) estimates CVD costs 325 billion dollars annually. Although CVD has an astronomical cost associated with it, CPG adherence continues to be an issue among HCPs and improvement is warranted. The purpose of this EBP project …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

The Implementation Of A Behavioral Intervention Program In Obese Elderly Patients, Zandra Brown

Doctor of Nursing Practice Projects

Abstract

The prevalence of obesity is increasing in American and patients are living longer. Research suggests that behavioral lifestyle interventions help optimize elderly patient’s health and improve their quality of life. A successful behavioral weight loss program had been in place in one clinic within a large healthcare organization. The need at another metropolitan Midwest location seemed even greater due to having a patient population consisting of elderly, demographics, obesity trends, and high rates of obesity linked morbidities such a diabetes, hypertension, and heart disease. Thirteen elderly obese patients with ages ranging from 65-75 years old were enrolled in an …

The Efficacy Of An Educational Intervention To Improve Low Influenza Vaccination Rates Among Federal Health Care Workers, Cynthia Berfect-Shelby

Electronic Theses and Dissertations

Influenza is a preventable communicable illness that has a significant impact on people of all ages. In 2018 it was estimated that 80,000 people died of influenza-related illnesses. Infants and elderly people are among the most vulnerable populations. The Centers for Disease Control and Prevention and Healthy People 2020 recommend that health care facilities have a 90% vaccination rate. Despite the recommendations and a mandatory directive, many facilities within the Veterans Health Administration struggle to reach influenza vaccination rates above 60%. Pender’s health promotion model was used as the theoretical framework to explore the reasons why health care workers refuse …

Implementation Of An Advance Care Planning Protocol To Increase Advance Directive Completion Rates, Christine Engle

Evidence-Based Practice Project Reports

Advanced directives (AD) allow an individual to retain autonomy in end-of-life decisions and can prevent unnecessary costs and treatments associated with aggressive life-prolonging measures. As of 2017, only an estimated 36.7% of the United States adult population had a form of advance directive documented (Yadav et al., 2017). The purpose of this evidence-based project was to determine if implementation of an advanced care planning (ACP) protocol would increase ACP discussions, AD completion, and result in a modification in stage of change or behavior. The Transtheoretical Model (TTM) and Stetler Model of evidence-based practice were used as the framework to guide …

Fat For Life: The Development Of A Low-Carbohydrate High-Fat Dietary Toolkit For Type 2 Diabetes In Rural Southeast Kansas, Curtis Beall

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to identify the feasibility of a low-carbohydrate high-fat (LCHF) diet in less affluent type 2 diabetics in rural Southeast Kansas, specifically, Crawford County. The author assessed this through the identification of the resources offered in Crawford County, and ultimately, the development of an LCHF dietary toolkit utilizing these resources. The toolkit offers an array of LCHF resources including compliant foods, grocery prices, shopping lists, phone applications, books, internet websites and blogs, accountability forums, and fitness centers. Upon completion of the dietary toolkit a select few healthcare providers directly involved with diabetes in Crawford County …

A Pre And Post Survey To Evaluate Patient Perception Of Group Diabetes Self-Management Education In Rural Health Clinics, Stormy Carter

Doctor of Nursing Practice Scholarly Project

Diabetes is a significant clinical issue in the primary care setting. Providers struggle to overcome barriers to facilitate therapeutic interventions for populations served. The specific aim of this study was to assess group diabetes self-management education from a patient perspective. Evaluation of diabetes knowledge and confidence of diabetes management was conducted in rural primary care clinics. This study utilized a one-group pretest-posttest design to patients receiving group diabetes self-management education in Southeast Kansas rural primary care clinics by a certified diabetes educator. The surveyed population included individual’s ages 18-65 with prediabetes, type 1, or type 2 diabetes who received DSME …

Provider Awareness Associated With Lifestyle Interventions And Adult Obesity, Reilly Tackett

Doctor of Nursing Practice Scholarly Project

The obesity epidemic cannot be solved through a single solution. A complex problem like obesity requires an intricately designed approach, comprised of both behavioral and environmental changes (Centers for Disease Control, 2015). Obese adults who attempt to alter their lifestyles often experience barriers to success. One such barrier is a provider who may be unfamiliar with evidence-based lifestyle interventions. Research suggests large variances both in provider knowledge levels and practice recommendations associated with adult obesity. This study’s purpose was; to determine if provider recommendations reflected clinical practice guidelines (CPG) associated with adult obesity, to measure current levels of provider knowledge, …

Knowledge And Attitudes Of Registered Nurses On Palliative Care, Amy Marpu

Doctor of Nursing Practice Scholarly Project

The purpose of this DNP scholarly project (SP) was to evaluate the knowledge and attitudes of registered nurses (RN) regarding palliative care (PC) before and after an educational presentation. This SP strived to answer these questions: What is the current knowledge in RNs of PC and end of life (EOL) patients before and after the education presentation? What is the anxiety level RNs feel regarding medication administration and symptom management in PC and EOL patients before and after the educational presentation?

A multimethodology, cross-sectional study design was used. The participants were currently enrolled in the RN-BSN program at PSU. These …

Exploring Maternal Factors Linked To Weight Status In Salvadorian Infants, Carmen M. Kiraly, Melanie Turk, Melissa Kalarchian, Cheryl Shaffer

Electronic Theses and Dissertations

Background: Obesity rates in the US have risen dramatically, especially among Hispanic adults and children. Because of the high prevalence of overweight and obesity in Latino children by preschool age, it is prudent to examine maternal factors potentially linked to weight status during an infant’s first year of life. The literature on risk factors of child obesity has focused primarily on children of Mexican descent, and little research exists for other Latino populations, such as Salvadorans. Objective: To investigate maternal physiologic and infant feeding factors associated with infant overweight and/or obesity in a sample of Salvadoran mother-infant dyads. Methods: A …

The Lived Experience Of Recovery Following Transoral Robotic Surgery (Tors) For Head And Neck Cancer, Katharine Mahalik

Electronic Theses and Dissertations

Abstract

Ongoing advances in minimally invasive surgical techniques, such as transoral robotic surgery (TORS), has enabled select patients with head and neck cancer to receive treatment that results in less disfigurement and dysfunction compared with traditional approaches. While TORS research has focused mainly on functional surgical outcomes, a need exists to understand recovery following TORS from the patient perspective. A hermeneutic phenomenological approach was used to recruit patients who had recently undergone TORS at a major academic health system in northeastern US. Data were collected using audio-recorded telephone interviews and field notes and analyzed concurrently. Participants included 17 HNCS (12 …

Use Of Smartphone Application To Facilitate Weight Loss And Promote Accountability In Obese And Overweight Patients, Angela M. Turner

Evidence-Based Practice Project Reports

In 2015, the U.S. Department of Health and Human Services published a National Health and Nutrition Survey (NHANES) on obesity from 2011 through 2014. From the survey, it was determined that the prevalence of obesity in the U.S. was 36% in adults and 17% in young adults/children (Ogden et al., 2015). Lifestyle modifications including moderation of caloric intake and increased exercise have been shown to be effective for both prevention and treatment of obesity. The purpose of this evidence-based practice (EBP) project involved the design, administration, and evaluation of a technology-assisted weight loss intervention to address the health problem of …

Implementing An Enhanced Recovery After Surgery Protocol In A Critical Access Hospital, Joseph Grazaitis

Doctor of Nursing Practice Projects

Enhanced recovery after surgery (ERAS) protocols provide numerous benefits for patients undergoing colorectal surgery. The goal of the protocol is to decrease surgical complications, patient’s length of hospital stay, recovery time, and increase patient satisfaction. The purpose of this doctoral project was to create and implement an ERAS protocol for a 25-bed critical access hospital. The findings obtained from the literature review were presented to the multi-disciplinary team. The specific needs of the surgical team were identified, and the ERAS protocol was created. Lastly, the ERAS protocol was finalized and implemented in the institution. The outcome measures examined were the …

A Qualitative Study Into The Communication Surrounding The Initiation And Withdrawal Of Non-Invasive Ventilation (Niv) In People With Motor Neurone Disease, Charlotte Chapman

Theses: Doctorates and Masters

Introduction

Motor neurone disease (MND) is a degenerative disease that adversely affects the nervous system and muscular control. Eventually respiratory muscles weaken, causing breathing, communication and swallowing difficulties, and ultimately, respiratory failure and death. Improved quality of life and potentially a short extension of life can be provided with non-invasive ventilation (NIV), which is offered to people with MND when symptoms of respiratory distress become evident.

It is recommended that end-of-life communication, encompassing the benefits and burdens of symptom-relieving interventions (NIV and percutaneous gastrostomy tube to assist with nutrition), NIV withdrawal (proposed when continued use is considered futile) and other …

A Lifestyle Modification Program For Adult Patients With Coronary Artery Disease, Amanda M. Yarbrough

Evidence-Based Practice Project Reports

As a leading cause of death worldwide, coronary artery disease affects people of all races and ethnicities. The foundation for the prevention of secondary fatal cardiac events, such as stroke or myocardial infarction, is lifestyle modification to effectively lower cholesterol levels. Lifestyle change impacts diet, physical activity, smoking habits, vital sign measures, and stress management. The purpose of this evidence-based practice project was to reduce implement a lifestyle intervention to lower LDL-C levels and promote healthier lifestyles. This practice change was developed utilizing Stetler’s Research Utilization model to promote evidence-based practice changes in the clinical setting. Nola Pender’s Health Promotion …

Mississippi Registered Nurse Perceptions When Communicating With Limited-English-Speaking And Non-English-Speaking Patients, Mary Pipper Widdig

Dissertations

Communication serves as the foundation for safe and effective healthcare practice. Effective nurse-patient communication is the cornerstone of the nurse-patient relationship and is vital for the delivery of safe and effective healthcare. Research has shown patients who are communication impaired are at a greater risk of medical error and poorer health outcomes. A review of the literature revealed various nurse perceptions of barriers when providing care for limited-English-speaking patients and non-English-speaking patients. LEP and NEP patients also identified similar perceived barriers when receiving care. Both nurses and patients revealed a distrust for interpreters and interpreter services. The literature review revealed …

Nursing Interventions That Address Barriers In The United States That Impact Neonatal Mortality, Victoria D. Sullivan, Ashton J. White

Anna Vaughn School of Nursing Undergraduate Work

In 2016, four out of every 1000 babies born in the US died within one month of age. This systematic research review explored nursing interventions that addressed barriers that impact neonatal mortality. The most significant barriers nurses faced in reducing and preventing NM were maternal access to healthcare and education during pregnancy, which can be influenced by maternal age, low socioeconomic status, lack of familial support, poor health literacy, and geographic location. The articles examined included nursing interventions that were evidence-based and addressed barriers relating to NM. Interventions promoting the reduction of NM included education of women’s health and prenatal …

Managing The Effects Of Poor Sleep Quality In Nurses, Emily Huene, Sarah Rausch, Georgia Vasiu, Hannah Lopez, Rachael Valentz, Msn, Rn, Ccrn

Anna Vaughn School of Nursing Undergraduate Work

Staffing shortages, high turnover rates, and prolonged work shifts has caused decreased sleep quality in nurses due to fatigue. The fatigued nurse causes concern for safety, coordination and agility, patient avoidance, lack of compassion, impaired cognitive function, risk for chronic diseases, and patient care errors. This systematic research review was designed to identify evidence-based practice nursing interventions currently being used to manage the effects of reduced sleep quality. Methods for performing this systematic research review were to search multiple databases using keywords, scanning article titles and abstracts, and critiquing for relevance and quality. Findings from this systematic review found multiple …

The Impact Of A School-Based Program On Diabetes And Cardiovascular Risk Factors, Lindsey Thielman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obesity is an increasing health issue both in the United States and worldwide. Furthermore, childhood obesity is increasing in prevalence. Childhood obesity is associated with an increased risk of comorbidities in adulthood. Obesity in childhood and adolescence makes one more likely to become obese during adulthood. This study sought to determine the effect of a school-based obesity prevention program on diabetes and cardiovascular risk factors such as body mass index (BMI), blood pressure, waist circumference, and acanthosis nigricans. Measurements were taken before education in the fall semester, and again after two education sessions in the spring semester. Student and faculty …

Implementing An Early Progressive Mobility Protocol In The Intensive Care Unit, Jennifer Mattone

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: More people are requiring intensive care unit stays for their illnesses due to the complexity of individuals care needs. Many patients remain in bed during their hospital stay due to the severity of their illness, resulting in increased time spent on the ventilator and increased length of stay in the intensive care unit (ICU). There are many risks to of being bed bound, including decreased muscle mass, development of pressure ulcers, increased hospital stay and increased time on the ventilator. All of these factors drive up hospital costs for the hospital and the consumer. Purpose of Project: The purpose …