Digital Commons Network^™

A Clinical Practice Guideline To Improve Education In The Heart Failure Population, Mailey L. Wilks

Walden Dissertations and Doctoral Studies

Managing heart failure patients in the outpatient setting can pose a challenge for nurses and health care staff due to the need to educate patients on self-care skills and management of disease. Several factors, including health literacy and numeracy, need to be considered when developing an education program for heart failure patients to promote self-care management. The purpose of this project was to provide nursing staff with a clinical practice guideline (CPG) that incorporated health and numeracy literacy assessment into an individualized education program. The Johns Hopkins nursing evidence-based practice (EBP) model, the situation-specific theory of heart failure (HF) self-care, …

Nursing Education To Prevent Resident Falls In Long-Term Care, Henrietta Aguwa

Walden Dissertations and Doctoral Studies

Residents in nursing facilities are more prone to falls than those living in the community. Injuries resulting from falls impact residents, their families, and healthcare costs. The gap in nursing practice was the lack of a comprehensive fall-prevention program in a long-term care facility that had experienced high fall rates among residents. This project addressed whether an educational program using the American Medical Directors Association's clinical practice guideline and the Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths, & Injuries) toolkit for fall- prevention improved the self-efficacy of direct-care staff in preventing falls among residents in a …

Educating Staff Nurses For Successful Patient Discharge, Julie First-Williams

Walden Dissertations and Doctoral Studies

The definition of a successful discharge is a discharge that results in patients successfully managing a chronic disease for at least 30 days without requiring an acute inpatient hospitalization. Many chronic disease readmissions are preventable. Successful discharge planning takes a multidisciplinary team that includes nurses who assess the discharge plan and provide additional education where needed. The purpose of this project was to determine staff nurses' understanding of their role in discharge education. Dorothea Orem's self-care deficit theory guided the project and root cause analysis was used in the development of the problem statements. Staff nurses (n=12) from evening and …

Discharge Phone Call On Unplanned Readmission Due To Chemotherapy Among Cancer Patients, Denise Angelo Moreno Prudencio

Walden Dissertations and Doctoral Studies

The transition after hospitalization is a vulnerable period when adverse events like unplanned readmissions may occur. Unplanned readmissions with patients undergoing chemotherapy that are the result of gaps in communicating the discharge plan may be preventable. Several transitional care interventions have been explored, and one of these is the nurse discharge phone call. This project explored the effect of a nurse-led transitional discharge phone call within 30-days after hospital discharge on unplanned readmission due to chemotherapy among patients in the medical-oncology compared to patients without a nurse-led transitional discharge phone call. A nurse-led transitional discharge phone call was implemented within …

Staff Development Introducing Self-Care Within The Nurse Residency Curriculum, Lauren Elizabeth Rogers

Walden Dissertations and Doctoral Studies

Caregiver burnout is an issue for health care organizations, negatively influencing cost, engagement, and workforce stability. Nurse residency programs are intended to address the gap in practice between academia and clinical practice and provide social support during this transitional time. Self-care education can positively affect novice acute care nurses' transition into their new professional role while building connections with the health care organization during the first year of employment. The purpose of this project was to develop a staff educational module to address the nursing practice problem of evidence-based self-care education within a nurse residency curriculum at the doctoral site. …

Pediatric Feeding Disorder: Consensus Definition And Conceptual Framework, Praveen S. Goday, Susanna Y. Huh, Alan Silverman, Colleen T. Lukens, Pamela Dodrill, Sherri S. Cohen, Amy Delaney, Mary B. Feuling, Richard J. Noel, Erika Gisel, Amy Kenzer, Daniel B. Kessler, Olaf Kraus De Camargo, Joe Browne, James A. Phalen

Speech Pathology and Audiology Faculty Research and Publications

Pediatric feeding disorders (PFDs) lack a universally accepted definition. Feeding disorders require comprehensive assessment and treatment of 4 closely related, complementary domains (medical, psychosocial, and feeding skill-based systems and associated nutritional complications). Previous diagnostic paradigms have, however, typically defined feeding disorders using the lens of a single professional discipline and fail to characterize associated functional limitations that are critical to plan appropriate interventions and improve quality of life. Using the framework of the World Health Organization International Classification of Functioning, Disability, and Health, a unifying diagnostic term is proposed: “Pediatric Feeding Disorder” (PFD), defined as impaired oral intake that is …

2019-2020 Nursing Graduate Msn-Fnp Handbook, Morehead State University. Nursing Department.

Nursing Department Publications Archive

2019-2020 Graduate Student Handbook for the Department of Nursing at Morehead State University.

Low Albumin And Mortality, Judith L. Dedeker

DNP Research Projects

Sepsis is a major epidemic worldwide and is a large unmet medical need in this country. Annual costs for the treatment of sepsis are over $3.4 billion dollars, and over 1.7 million people die each year from sepsis. Effective treatment of sepsis has two major obstacles: failure to recognize the early stages of sepsis and misjudging the severity of the disease. Identifying patients who are at higher risk for mortality and morbidity related to sepsis would be beneficial in keeping the numbers of deaths down, as well as decreasing the overall cost to the hospitals, as well as to the …

An Assessment Of Attitudes And Perceptions Of College Students Toward A Suicide Program On A College Campus: A Descriptive Study, Rachel Tolliver

DNP Research Projects

OBJECTIVE: A baseline assessment examines the status of attitudes and perceptions about the suicide prevention program of a small, private, southeastern, Christian university. Gaps in the literature include the lack of baseline evaluations at universities before evidenced-based practice (EBP) interventions.

PARTICIPANTS: A purposive sample of sixty-nine sophomores classified as first-year students for the 2016-2017 school year. The study sample lived on campus both semesters of the 2016-2017 school year.

METHODS: Participants completed the retired Suicide Prevention Exposure, Awareness and Knowledge Survey (SPEAKS) – SV (Student Version) by the Substance Abuse & Mental Health Services Administration (SAMHSA) for the Garrett …

Lipids, Reactive Oxygen Species, And Health, Heather Bowen

DNP Research Projects

Cardiovascular disease (CVD) is the leading cause of death in the United States. Coronary artery disease (CAD), where plaque builds up to create atherosclerosis, puts patients at risk for heart attack or stroke. Mitochondrial Reactive Oxygen Species (ROS) have been implicated as a source of oxidative stress that can lead to the development of CAD, and diets high in fat potentiate this occurrence. As certain fats are heated and experience chemical and physical degradation, they cause an increased risk of obesity, diabetes, various forms of cancer, and CVD. This research study, based on CREATION Health ideals, aimed to evaluate the …

Evaluation Of A Diabetic Point Of Care Education In Primary Care, Mary Cho

DNP Projects

BACKGROUND: Diabetes education is the cornerstone of managing diabetes. The education can be delivered in group or individual sessions. Given that group classes are not always well received, a brief five-minute point of care education was developed and incorporated into patients’ routine diabetic appointment. The effectiveness of the method is yet to be determined.

PURPOSE: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the effectiveness and acceptability of a recently implemented diabetes point of care education as compared to patients’ usual care in an urban primary care clinic.

METHODS: An outcome evaluation using a retrospective …

The Effect Of An Education Plan On Nursing Intervention Compliance With Inpatient Post-Operative Colorectal Surgical Patients Using Enhanced Recovery After Surgery (Eras) Protocols, Jennifer Austin

DNP Projects

Abstract

BACKGROUND: Compliance with the enhanced recovery after surgery (ERAS) protocols for colorectal surgery patients in the post-operative inpatient setting is low, creating a gap in successful outcomes of the program.

OBJECTIVE: The purpose of this project is to evaluate the impact of an education plan on inpatient nursing staff. A second purpose of the study is to examine the relationship between ERAS and specific post-operative nursing interventions linked to length of stay (LOS).

METHODS: A prospective cohort study analyzing the effect of a knowledge to action (KTA) education plan on nursing compliance with ERAS protocols was conducted on bedside …

Provider Adherence To National Heart, Lung, And Blood Institute’S Guidelines On Screening, Diagnosis, And Treatment Of Hypercholesterolemia In The Pediatric Population Aged 9-11 Years, Alanna Cox

DNP Projects

Purpose: High cholesterol levels have been directly linked to atherosclerosis, which is a leading cause of cardiovascular disease (CVD). Risk factors that accelerate the development of atherosclerosis, such as high cholesterol can begin in childhood. The purpose of this project was to evaluate provider adherence to the National Heart, Lung, and Blood Institute’s (NHLBI) Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, specifically the guidelines on universal lipid screening in children aged 9-11 years. The objectives were: 1) determine the rate of lipid screening in children 9-11 years old; 2) determine the number of children who …

Evaluating The Use Of Stopcocks For Lab Collections From Central Venous Access Devices Related To Central Line Associated Blood Stream Infections, Heather Hollingsworth

DNP Projects

PURPOSE: Central line associated blood stream infections pose a threat to patient safety and are costly to healthcare systems. Heath care professional frequently access central venous access device (CVAD) to obtain blood samples for laboratory analysis. A commonly accepted procedure practice involves exchanging 3-4 syringes during the collection process. Each time a syringe is exchanged during the lab collection process the opportunity for bacteria to be introduced into the bloodstream exists. Decreasing the number of times a CVAD is accessed removes opportunities for bacteria to be introduced to the line thus decreasing the risk of infection. Due to the occurrence …

The Effects Of Screening Tool Of Older Persons’ Prescriptions On Potentially Inappropriate Prescribing In Elderly Inpatients, Jamie Leigh Edmiston Franks

DNP Projects

Objective: The purpose of this project is to educate providers and implement the use of the Screening Tool of Older Persons’ Prescriptions (STOPP) on patients 65 and older admitted as inpatients at Owensboro Health and reduce potentially inappropriate medications (PIMs).

Background: Polypharmacy, the use of multiple medications or medications that are not medically necessary, is a persistent and growing problem for elderly patients in the United States. Polypharmacy has become synonymous with medications that are considered potentially inappropriate in individuals 65 or older. PIMs may be medications that, in the elderly, have deleterious effects, no indication, are used for treatment …

Factors Influencing Nurse Practitioners' Weight Management Practices In Primary Care, Suzanne Hyer

Electronic Theses and Dissertations

More American adults are overweight or obese than ever before. Nurse practitioners (NPs) play a critical and expanding role in primary care, which is an ideal setting for the assessment and management of weight loss. NPs can make a significant contribution to tackling the obesity crisis. The study presented here seeks to close the gap in data related to how NPs approach weight management with their primary care patients. This study focused on a comprehensive examination of the current practice patterns of NPs related to weight management, a theoretical concept analysis of weight bias among healthcare providers, along with the …

Adaptation Of Heart Failure Education Materials For The Middle Eastern Population, Nadine A. Williams

Walden Dissertations and Doctoral Studies

Cardiovascular disease, including heart failure, is the leading cause of death among male and female Middle Eastern Americans. In 2016, a medical center located in the northeastern region of the United States had an estimated 35% of heart failure patients readmitted within 30 days of discharge, 10% of these readmitted patients belonged to the local Middle Eastern community. The gap in nursing practice noted by nursing staff, patients, and their families was that the patient education materials on heart failure were not tailored to the cultural beliefs and customs of this high-risk population. The purpose of this project was to …

Achieving Improved Glycemic Control Among Hispanic Type 2 Diabetic Adults, Morenike Oyegbami

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a major chronic health disease in the United States. A main concern of clinicians treating patients with Type 2 diabetes is poor glycemic control. The goal of this project was to improve glycemic control in Type 2 diabetic Hispanic adult patients in a private family practice clinic through the implementation of biweekly telephonic intervention focused on diabetes management by an advanced practice nurse/nurse practitioner. The project was guided by the chronic care model as a framework. The intervention was conducted over a 12-week period with 50 patients, ages 18 to 65. Data were collected from chart …

Social Determinants Of Adolescent Girls’ Dietary Pattern In Suburban Areas In Chennai: A Qualitative Approach, Ponnambily Jobin Ms

Manipal Journal of Nursing and Health Sciences

Background: The idea of adolescent well-being is getting importance all around the world and thus there is a lack of national investigations to survey the factors on the dietary pattern of young girls in suburban regions. Aim: The objective of the study is to explore the social determinants of adolescent girls’ dietary pattern in suburban areas of Chennai. Design: The phenomenological design was used to explore the social determinants of adolescent girl’s nutritional intake. The study population consisted of adolescent girls, who were in the age group of 15-18 years in suburban areas of Chennai. The tool had two sections: …

Nursing Staff Approaches To Providing Oral Hygiene In Stroke Survivors With Dysphagia: A Grounded Theory Study, Willard Edward Brewer

All ETDs from UAB

The purpose of this qualitative grounded theory study was to explore how the nursing staff approaches oral hygiene in stroke survivors with dysphagia during the rehabilitation phase of recovery and what guides their decisions. Oral hygiene is a proven effective task known to prevent systemic health disparities (i.e. aspiration pneumonia, diabetes, gastrointestinal disparities, and even stroke). However, there are no current evidenced-based guidelines that provide instruction on how to execute oral hygiene to stroke survivors with dysphagia. Little is known about how nurses make decisions to implement oral hygiene in stroke survivors with dysphagia. Using a theoretical sampling strategy, data …

Through The Microbial Looking Glass: Premature Labor, Preeclampsia, And Gestational Diabetes: A Scoping Review, Alexis B. Dunn, Lisa Hanson, Leona Vandevusse, Sharon Leslie

College of Nursing Faculty Research and Publications

The influence of microbial factors on adverse perinatal outcomes has become the focal point of recent investigations, with particular interest in the role of the microbiome and probiotic interventions. The purpose of this scoping review was to identify and critique the most recent evidence about these factors as they relate to pregnancies complicated by preeclampsia (PEC), preterm birth (PTB), and gestational diabetes mellitus (GDM). Four databases (PubMed, EMBASE, Web of Science, and Cochrane) were searched for articles published in English in the last 10 years with the concepts of the microbiome, probiotics, and PEC, PTB, or GDM. Forty-nine articles were …

Restrictive Ventilatory Patterns In Residents Of Continuing Care Retirement Communities, Christine R. Kovach, Murad H. Taani, Crystal-Rae Waltons, Sheryl Kelber, Irwin Margolis

College of Nursing Faculty Research and Publications

Restrictive ventilatory patterns (RVPs) in older adults may contribute to morbidity and decreased quality of life. The purpose of this study was to begin to understand (a) the number of older adults residing in Continuing Care Retirement Communities with RVPs, (b) factors associated with RVP, and (c) whether RVP is associated with ambulation level. This descriptive study was conducted at three sites. RVP was evident in 34 of the 65 participants (52%), and 33 (97%) of these were either moderate or severely restricted. Dementia, dyspnea, kyphosis, and lower muscle strength were significant predictors of RVP. Eighty percent of the nonambulatory …

The Effectiveness Of An Ambulatory Care Health System Redesign On Patient Engagement, Healthcare Utilization, And Clinical Indicators, Nancy Johansen Madsen

Dissertations

Diabetes is a lifelong debilitating and deadly chronic disease affecting nearly one out of every eleven Americans. This public health problem costs $245 billion annually in the United States. Long term research trials have shown that diabetes complications can be prevented with good glycemic control, but it is difficult for patients to maintain control without much support from their healthcare team. U.S. healthcare remains fragmented. With the passage of the Affordable Care Act, there are opportunities to redesign health care delivery to minimize fragmentation and improve patient outcomes. The aim of this study is to determine if a redesigned care …

Predicting Decision-Making In Relation To Health-Risk Behavior In College Freshmen, Anne Bijumon Luckose

Dissertations

Method/Measurements: A cross-sectional correlational design explored the relationships between decision-making, health-risk behaviors and social support systems in college freshmen. The aims of the study were: 1) to explore the relationship between decision-making and health-risk behaviors among college freshmen; 2) to determine whether or not family support and social support jointly predict decision-making among college freshmen; and 3) to ascertain whether or not the effect of family support on decision-making is different for male and female college freshmen. Measurement was collected at one time-point and participants in this study completed on-line questionnaires through a web-based online survey software application with measures …

The Effect Of Parent Involvement-Child Behavioral Management Program Among Children With Adhd, Ubon Wannakit

Chulalongkorn University Theses and Dissertations (Chula ETD)

This quasi-experimental pretest-posttest control group design aims to examine the effectiveness of the Parent Involvement-Child Behavioral Management Program (PICBMP) in reducing symptoms among ADHD children. Sixty-four children aged 6–12 years with ADHD were randomly assigned to either the experimental or control group by using a random number table, consisting of thirty-two participants in each group. The participants in the experimental group participated in the PICBMP and usual care with medication, while those in the control group received the usual care with medication. The PICBMP based on Behaviorally-based treatment (Goodman &Scott, 1997), consists of eight weeks of behavior management which included …

Perceived Stress, Salivary Cortisol, And Depression In Adults Diagnosed With Postconcussion Syndrome; A Pilot Study, Christine Fish-Huson

Theses and Dissertations

Traumatic Brain Injury (TBI) affects approximately 1.7 million persons in the United States annually, 75% are categorized as mild (mTBI). Most persons who experience mTBI will recover, however an estimated 10% will develop Postconcussion Syndrome (PCS). Evidence supports a relationship between perceived stress, salivary cortisol, and depressive symptoms in persons after TBI; however, there are no known studies exploring these relationships in the PCS patient population. A sample of 17 men and women diagnosed with PCS were recruited from Southwest and Central Virginia. Data collection included the Rivermead Postconcussion Questionnaire, Perceived Stress Scale-10, Center for Epidemiological Studies-Depression Scale and the …

A Video Decision Aid To Influence Advance Care Planning, Angela Petry

Graduate Theses, Dissertations, and Problem Reports (ETD)

The best mechanism to achieve successful advance care planning has yet to be identified. A randomized, controlled, experimental study was performed with a sample of 54 men and women who met inclusion criteria and were randomized into the intervention versus the control group in an outpatient clinical setting in rural West Virginia (WV) from December 2018 to March 2019. Participant mean age was 72.4 years. For those who chose to participate (n=42), the intervention group received the usual standard of care, which was a face to face advance care planning (ACP) discussion with the new intervention of a video decision …

Appalachian Caregivers Of Persons With Dementia Non Use Of Services, Kristina M. Childers

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Background: The purpose of this current study was to explain factors most strongly associated with Caregiver (CG) of Person with Dementia (PWD) non-use of formal and informal services in Appalachia.

Methods: A correlational explanatory design using validated self-report surveys was used to explain the association of the substructed Andersen’s Behavioral Model for Health Services Use in Appalachian CG non-use of formal and informal services. Data were analyzed using descriptive statistics and ANOVA tests considering eight independent variables in total from each research question, using a sample of 43 CG/CR dyads.

Results: The analyses of four research questions …

Lived Experience Of Tongans With Obesity And Diabetes, Gladys Adjei-Poku

Walden Dissertations and Doctoral Studies

People of Pacific Island descent are afflicted by obesity and diabetes more than other populations. Although interventions have succeeded in reducing these conditions among other groups, they have been unsuccessful among Tongans and other Pacific Islanders. Furthermore, little is known about the cultural perspectives of this population with a high rate of obesity and diabetes. Accordingly, this descriptive phenomenological study was conducted to investigate the lived experiences of Tongans with obesity and diabetes in a western metropolitan area of the United States to understand their predisposition toward these conditions and suggest appropriate interventions. Purposive sampling was used to recruit 11 …

Exploring The Narratives Of Black Male Nurses In Southeast Georgia: Implications For The Implementation Of Culturally Responsive Pedagogy In Nursing Curriculum, Celine M. Pfund

College of Graduate Studies: Theses & Dissertations

ABSTRACT

This dissertation inquiry explores the narratives of two Black male nurses in southeast Georgia. The framework for my research includes a variety of different theoretical components including works from both major nursing and curriculum studies scholars. The nursing workforce remains homogenized despite major recruiting. The intention of my research was to explore the experiences of Black male nurses to identify challenges, barriers, and systems of oppression that they may have encountered working in a profession dominated by White females in order to facilitate development of culturally responsive pedagogy in nursing. Methodologically, I mainly drew upon James Spradley’s work on …