Digital Commons Network^™

Inpatient Diabetes Education To Improve Disease Knowledge, Jennifer Miles

The Eleanor Mann School of Nursing DNP Capstone Projects

Diabetes is a complex chronic disease currently affecting almost 25 million people in the United States (Ostling et al., 2017; Saccomano, 2014). The prevalence of diabetes is increasing yearly. Diabetes is a common comorbidity associated with hospitalizations and 30-day inpatient readmissions (Ostling et al., 2017; Chang, Kirby, Phelps, Rhee, Meneghine & Gunasekaran, 2017). Some retrospective studies have shown that inpatient diabetes education can reduce the readmission rate by up to 34% in this population (Healy et al., 2013). The Chronic Care Model (CCM) exemplifies the need to move the education to a proactive and preventative approach for further admissions instead …

Risk For Maternal Infant Bonding Reduction In High Risk Deliveries And The Recovery Phases, Amanda M. Karimi, Corie Vanarsdale Msn

Anna Vaughn School of Nursing Undergraduate Work

Bonding is one of the first developmental tasks for infants and is imperative for successful growth. The bonding phase begins in the periods immediately following birth. Complications that inhibit bonding postpartum may delay this process. Breastfeeding barriers, maternal substance abuse, and poor maternal mental health are among the contributing factors to delayed bonding. The purpose of this research study was to answer the question, “What best practiced nursing interventions assist mothers to promote bonding with the newborn after high risk deliveries?” This research review included a sample size of 10 articles which provided a variety of interventions to promote bonding …

The Perception Of Iron-Deficient Anemia In Bolgatanga, Ghana Among Women Of Childbearing Age, Sydney Albrecht

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Objective: To understand the perception of anemia among the women of childbearing age in Bolgatanga, Ghana, and to correlate the reasoning with the high incidence of anemia in the area.

Method: This research was a qualitative study consisting of 67 interviews over the course of the three weeks that were spent in Bolgatanga. 50 of these interviews were women of childbearing age (15-49), 6 were health professionals, and 11 were women older than the age range provided. Interviews were taken from the maternity clinics nearby as well as from women in a rural area that was a 10-minute taxi ride …

Development And Psychometric Analysis Of The Roy Adaptation Modes Scale (Rams) To Measure Coping And Adaptation, Sandra A. Russo

Dissertations, Theses, and Capstone Projects

Peoples’ lives are often interrupted or changed by experiencing a serious illness. It is important to study and understand the various coping processes that people have in adapting to illness. The purpose of this study was to develop an instrument to measure a person’s coping response to illness-related stimuli using the Roy Adaptation Model (RAM) as its structure and framework. This study is quantitative descriptive design to develop the validity and reliability of a new instrument the Roy Adaptation Modes Scale (RAMS). A review of RAM based measurement instruments found no instrument that measured all four adaptive modes that is …

The Lived Experience Of African American First-Time Breastfeeding Mothers At A Baby Friendly Hospital, Catherine A. Hagerty

Dissertations, Theses, and Capstone Projects

The purpose of this research study was to explore the lived experiences of African-American first-time mothers at a hospital following the Baby Friendly Hospital Initiative (BFHI) guidelines to promote breastfeeding. Breastfeeding rates for African-American mothers are lower than other racial groups. BFHI institutions offer breastfeeding support through adaptation of a set of practices designed to promoted exclusive breastfeeding. Reflection on this experience allows discovery of approaches that help both nurses and patients. The study methodology used is qualitative phenomenology developed by van Maned (1990) with its’ philosophical origin in the work of Merleau-Ponty (2008). Participants were nine first-time mothers who …

Educational Program For The Management Of Low Back Pain, Amanda Johnson

The Eleanor Mann School of Nursing DNP Capstone Projects

Low back pain is one of the most common reasons that patients seek care from their primary care provider as well as the number one cause of disability worldwide. While low back pain is a prevalent condition that is seen in primary care, the outcomes of treatment continue to remain poor. Facilitating effective care for patients with pain is a major public health concern. Clinical practice guidelines are published but it often takes time for the recommendations to be translated into practice. Dissemination of information is needed. An educational program was created for providers within the Mercy Hospital Rogers system. …

A Comparative Analysis Of The Ketogenic, Paleolithic, And Vegan Diets, Megan N. Bahr, Kandise M. Chrisostom, Serena S. Chrisostom, Natalie K. Peters, Pheba M. Thomas, Patricia A. Catts, Aprn, Phd

Anna Vaughn School of Nursing Undergraduate Work

The obesity epidemic in America costs the healthcare system hundreds of billions of dollars every year and takes a toll on the physical and mental health of the patient. Analyzation of different weight loss methods allows healthcare providers to provide accurate and relevant education to patients who are suffering from obesity. A search for the paleolithic, ketogenic, and vegan diets, resulted in fifty-four scholarly studies via purposive sampling. Data was collected on the paleolithic, ketogenic, and vegan diets and all had conclusive positive effects on weight loss. Individuals studied on the paleolithic diet lost up to 2.3 kg in three …

Halo Gravity Traction Can Mitigate Preoperative Risk Factors And Early Surgical Complications In Complex Spine Deformity, Sravisht Iyer, Oheneba Boachie-Adjei, Henry Ofori Duah, Kwadwo P. Yankey, Rufai Mahmud, Irene Wulff, Henry O. Tutu, Harry Akoto

College of Nursing Faculty Research and Publications

Study Design.  Retrospective review of prospective cohort. Objective.  We sought to examine the role of halo gravity traction (HGT) in reducing preoperative surgical risk. Summary of Background Data.  The impact of HGT on procedure choice, preoperative risk factors, and surgical complications has not been previously described. Methods.  Patients treated with HGT before primary surgery were included. The FOCOS Score (FS) was used to quantify operative risk. FS was calculated using patient-factors (ASIA, body mass index, etiology), procedure-factors (PcF; osteotomy planned, number of levels fused, etc.), and curve magnitude (CM). Scores ranged from 0 to 100 with higher scores indicating increased …

A Comparison Of The Curricula Of The Top-Ranked Prelicensure Baccalaureate Nursing Programs In The United States, Silvia Imanda

Graduate Theses and Dissertations

What constitutes an ideal prelicensure nursing curriculum is not well understood. Specifically, what are the strategic curricular sequencing and curricular themes or focus might be included to contribute to producing high quality graduates? The purpose of this qualitative multiple case study investigation was to look at successful programs and identify effective curricular sequencing and curricular themes or focus that might be inferred to have contributed to producing high quality graduates. Seven top-ranked prelicensure baccalaureate nursing programs were selected based on three national college rankings services. Based on data from interviews and publicly accessible documents, seven case studies were compared and …

Eat Better Move More: Educational Program Teaching Healthy Eating Habits To Low-Socioeconomic Elementary School Students, Megan March

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obesity is a growing problem and has shown no signs of improvement over the past decade, with an estimated one in five children between the ages of six and seventeen are overweight. This problem is even more prevalent in ethnic minorities and socioeconomically disadvantaged families. The purpose of this study was to examine the effects of the EBMM program nutrition module on 4th and 5th grade student’s food choices. The study was conducted at an elementary school in Northwest Arkansas. A convenience sample of 4^th and 5^th grade students was chosen to participate in the study. Nursing students …

Human Papillomavirus Vaccination Status And Endorsement Among Undergraduate Nursing Students: A Secondary Data Analysis, Ashley Hollins

Dissertations and Theses (Open Access)

Background: Human papillomavirus (HPV) vaccination has immense potential to prevent HPV-related infections but vaccination rates remain suboptimal. Nurses could potentially increase vaccination rates by providing recommendations and addressing vaccine concerns. As student nurses’ transition into practice, it is important to identify factors that could influence their attitudes and uptake of the HPV vaccine; however, these factors remain unknown.

Purpose: We proposed to: (1) identify factors associated with HPV vaccination status and (2) to identify student nurses’ perception of parental vaccine hesitancy, preferred counseling strategies, and factors associated with intention to counsel parents on HPV.

Methods: The current study was a …

Relationships Among Optimism, Inflammation, And Stroke Recovery, Yun-Ju Lai

Dissertations and Theses (Open Access)

Objective: Post-stroke inflammation is detrimental to the brain and results in an unfavorable recovery. Optimism has been associated with lower inflammation and better health outcomes among people with medical conditions, but no studies have assessed this association in the stroke population. The overall goals were to examine the relationships among optimism, stroke severity, physical disability, and inflammation during hospitalization and evaluate the relationships among optimism, inflammation, and stroke recovery over the three-month post-stroke period.

Methods: This study was a secondary analysis of data collected from the BioRepository of Neurological Diseases biobank. Outcomes included optimism, stroke severity, physical recovery, and inflammatory …

Correlation Between Myostatin And Lean Muscle Mass In Older Adults, Mishann Luedders

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Correlation Between Myostatin and Lean Muscle Mass in Older Adults.

Luedders, M., Gray, M., Patton, S., Washington, T., Binns, A. Exercise Science Research Center, University of Arkansas, Fayetteville, AR.

Background: Our older adult population is growing exponentially and with it, the number of falls and debilitating injuries that afflict their population grows as well. A fall brings with it many possible injuries, healthcare costs, fear and increased mortality. There seems to be a lack of preventative measures in our healthcare system to help protect our elders. One possible measure is a simple blood test that looks at the level of …

The Impact Of Evidence-Based Practice On A Culture Of Safety, Donald C. Hunt

Nursing Theses and Dissertations

Background: 210,000 to 440,000 deaths have been caused by errors in healthcare. Providers who are committed to core values that emphasize safety contribute to a “culture of safety.’ This culture is required for healthcare institutions to achieve high-reliability status demonstrating high potential for error but few adverse outcomes. There is little known about contributors to the culture of safety and the commitment of providers to its core values.

Purpose: To determine relationships among the predictors- EBP culture, individual evidence-based decision making, organizational implementation of evidence-based practice - and a culture of safety.

Design: Correlational Predictive Design.

Sample: Two-hundred seventeen nurses …

How Undocumented Latino Parents’ Legal Status Affects Their U.S. Citizen-Children’S Health, Karla Garcia Hernandez

Senior Theses

The purpose of this paper is to review studies that have assessed how undocumented parents’ legal status have affected their United States citizen-children’s health. This issue involves nurses from different specialties, such as pediatric nursing, mental health nursing and community health nursing. Eight articles were reviewed in regard to how parental legal status affects the child’s access to healthcare services, the child’s physical health and the child’s mental health. The articles revealed that citizen-children of undocumented parents had limited access to health care services, had poorer health, and had higher chances of having mental health illnesses. The paper provided implementations …

The Effect Of Basal Bolus Insulin Administration Vs. Sliding Scale Insulin On Glycemic Control In Patients With Type 2 Diabetes Mellitus At A Community Hospital, Meriam Signo

Doctoral Projects

Evidence of effective insulin delivery by nurses can help prevent fluctuating plasma glucose levels of Type 2 diabetes mellitus (T2DM) in the hospital setting. Information leading to better diabetes care using either basal bolus insulin administration (BBI) or sliding scale insulin (SSI) is essential for safe blood sugar values. The purpose of this project was to measure patient glycemic control after the implementation of BBI vs. SSI during a patients’ stay in the hospital. This study was a quantitative, retrospective exploratory chart review of T2DM in medical-surgical units at a Northern California community hospital. The data were collected from routine …

Health Literacy Intervention For Low Income Uninsured Population, Laura Larson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Health literacy (HL) requires basic skills in writing, reading, numeracy, and communication all within a health context (Berkman et al., 2011). HL is a critical element for individuals to take an active role in managing their health. The National Assessment of Adult Literacy found only 12% of adults had a “proficient” HL level. Hispanics were found to be at greatest risk for lower HL than all other ethnic groups (Kutner, Greenberg, Jin, & Paulsen, 2006). Low HL can lead to poor health outcomes including: decreased utilization of preventative services, difficulty in managing chronic conditions, and increased disparities in access …

Development Of A Breast Cancer Survivorship Care Toolkit, Lauren Elaine Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

A breast cancer survivor’s journey does not end with treatment. After treatment, most breast cancer survivors go on to face many life-long physical and mental challenges caused by their cancer and treatment. Once active cancer treatment is completed, patients enter the next important step in cancer care, cancer survivorship. Cancer survivorship is a comprehensive approach to post-oncology management that promotes the best outcomes for survivors as they transition from oncology care to primary care; and new breast-cancer survivorship guidelines have emerged. Research suggests that primary care NPs’ lack of awareness of the current 2016 American Cancer Society/American Society of Clinical …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods

Dissertations

Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

Assessing Palliative Care Needs In Residents With Alzheimer's, Emily Yarnell

Doctor of Nursing Practice Projects

Current evidence indicates a lack of assessment protocols focusing on palliative care needs for patients with Alzheimer’s disease. This gap in practice supported the need to implement an evidence-based assessment protocol for early identification of palliative care needs in patients with Alzheimer’s disease residing in a long-term care facility. The protocol included using the patient’s Global Deterioration Scale (GDS) score to determine the patient’s palliative care needs according to the Dementia Progression Prioritization of Goals model. If the score indicated moderate to severe Alzheimer’s disease, then their goal was maximization of comfort, indicating a need to begin palliative care plans. …

Hepatitis C Virus Screening And Treatment, Dani Loftus, Emily Machens, Crista Jamous

Doctor of Nursing Practice Projects

Hepatitis C Virus (HCV) is classified as a contagious liver disease that can be either acute or chronic, and the illness ranges in severity from mild to lifelong. It is estimated that 2.7 million people in the United States (US) have HCV, but only half are diagnosed. The CDC recommends testing by birth-cohort, focusing on adults born between 1945 and 1965. Three main objectives for this project included implementation of a clinical decision support system (CDSS) for providers, increasing HCV screening by providing education to the support staff in primary care clinics of a local hospital which would increase the …

Transitioning Pediatric Patients With Special Needs, Dimi Resch

Doctor of Nursing Practice Projects

Transitional care, which encompasses both the sending and receiving aspects, is essential for pediatric patients with complex care needs.A provider in a small, Midwest pediatric primary care clinic agrees with researchers that transitional guidelines are needed for consistency among pediatric and adult providers. This clinic currently has no process in place to guide the transition of patients with special needs. The primary goal of this project was to develop a communication tool that aids in the transition of patients with special needs into the adult primary care setting. The literature reviewed provided a variety of tools used to communicate healthcare …

Familial Aggregation Of Ideal Cardiovascular Health And Cardiovascular Disease Disability-Adjusted Life Years In Parent-Offspring Dyads: Analysis Of The Framingham Heart Study, James M. Muchira

Graduate Doctoral Dissertations

Background: Ideal cardiovascular health (iCVH) is defined as the simultaneous presence of seven health metrics-physical activity, not-smoking, healthy diet, healthy body weight, and blood cholesterol, blood pressure, and blood glucose levels as defined by evidence-based guidelines. Evidence suggests familial aggregation of single cardiovascular disease (CVD) risk factors but research on clustering of seven iCVH metrics and CVD disability-adjusted life years (CVD DALYs) within families is lacking.

Purpose: To examine trends and relationship of parental iCVH and offspring iCVH and CVD DALYs at similar age across the lifespan.

Methods: A secondary data analysis of the Framingham Heart Study (FHS) Dataset-Original and …

Outcomes Of Implementation Of An Evidence-Based Enteral Feeding Protocol In Neonates Weighing Less Than 1800g At Birth, Rebecca Edwards

MaineHealth Maine Medical Center

Background:

Several studies have demonstrated that the implementation of standardized enteral feeding guidelines can lead to positive outcomes in the neonatal intensive care unit (NICU), including improved nutrition, decreased need for parenteral nutrition (PN), central lines and decreased costs. Furthermore, implementation of standard feeding regimens have significantly reduced the incidence of necrotizing enterocolitis (NEC), a devastating gastrointestinal emergency in neonates. It has been reported that NEC has an iatrogenic component related to variations in feeding practices. While the exact mechanism of the reduced risk of NEC and implementation of feeding protocols is unclear, standard feeding regimens likely improve consistency in …

Comparison Of A Numeric And A Descriptive Pain Scale In The Occupational Medicine Setting, George Francis Mcmahon Iii

Doctoral Projects

Pain is a universal phenomenon. The assessment of a patient’s pain is difficult to objectively obtain because the perception of the pain by the patient is influenced by many subjective perception variables. These variables can inflate or deflate the patient’s self-reported pain level which can adversely affect the medical provider’s ability to accurately create a treatment plan for the patient. This study compared the patient’s response to a self-rating of their pain on a numeric pain scale with the response given by the patient on the Mankoski pain scale. Comparison of the numeric pain scale to the Mankoski pain scale …

Barriers In Hypertension Management Among Culturally Diverse Patients In An Urban Urgent Care Setting, Navpreet Kaur

Doctoral Projects

Hypertension is the leading cause of deaths related to cardiovascular disease conditions. A vast number of patients are not taking their medications as prescribed by the physicians. This non-adherence to hypertensive treatment plans results in increased numbers of cases of unstable blood pressure. Medication adherence will help to manage the controllable cardiovascular diseases and will automatically decrease the incidences of emergent cases in hospitals and urgent care clinics. It will further decrease the costs of diagnostic evaluations used during the emergent visits. This decreased patient load in the emergency rooms will improve quality patient care. The study timeframe of data …

Barriers In Health Care In Hmong Men And Women With Cardiac Diseases, Ying Thao

Doctoral Projects

Lauver’s theory of care seeking behaviors is applied to identify perceived barriers to accessing healthcare in Hmong men and women that may influence care seeking behaviors. The purpose of this study is to identify barriers in accessing health care among Hmong men and women ages 50 to 80 with cardiovascular heart disease (CHD) and risk factors for CHD (e.g., diabetes, hyperlipidemia, and hypertension). A quantitative descriptive analysis was used to look at demographic characteristics while a multiple regression analysis was used to statistically compare correlations between barriers to care, risk factors for CHD, sex, and access to health care. The …

Pilot Study Of A Breastfeeding Support Training Program Designed Particularly For Infants With Common Congenital Anomalies And Defects, Gretchen Nelson Ezaki

Doctoral Projects

The American Academy of Pediatrics (American Academy of Pediatrics [AAP], 2018), the World Health Organization (World Health Organization [WHO)], 2018), and The March of Dimes (March of Dimes, 2016) recommend exclusive breastfeeding for the first six months of life. In 2014, 79% of women in the United States began breastfeeding their infants, but only 40.7% and 18.8% continued breastfeeding exclusively at three and six months respectively (Centers for Disease Control and Prevention, 2017). This doctoral project promotes breastfeeding by creating and testing simple teaching algorithms for training registered nurses to support breastfeeding, including for infants with trisomy 21, congenital heart …

Associations Of First Trimester Co-Use Of Tobacco And Cannabis With Prenatal Immune Response And Psychosocial Well-Being, Kristin Ashford, Amanda Fallin-Bennett, Andrea Mccubbin, Amanda T. Wiggins, Sheila Barnhart, Joshua A. Lile

Perinatal Research and Wellness Center Faculty Publications

PURPOSE: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only.

METHODS: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, CRP, MMP8), were collected, although cytokine data were only available for 122 women.

RESULTS: Participant average age was 29.1 years, approximately half had a high …

The Hemoglobin A1c Of African-Americans/Blacks With Diabetes Mellitus Type Two Using Low-Fat Diabetes Plate Diet, Ednah K. Makori

Doctor of Nursing Practice Projects

Diabetes Mellitus type two (DMT2) is a chronic disease that leads to high blood sugar in the body and if not corrected over a period of time, it leads to development of complications. Some of those complications include blindness, kidney failure, and retinopathy, among others. DMT2 continues to affect many people in the USA, especially African-Americans/Black who have the highest prevalence as compared to other races. Proper diet management especially the Low-Fat diabetes diet helps to decrease Hemoglobin A1c, which could result in reduction of risk of developing complications and morbidity related to DMT2. This project was done to educate …