Establishment Of Neonatal Sepsis Predictors Utilizing Non-Invasive Monitoring Techniques, Dalton Janssen

Dissertations

Neonatal sepsis remains one of the leading causes of global neonatal mortality. Reactionary approaches for diagnosis and treatment have dominated the tactics in addressing neonatal sepsis but clinical intuition is an untapped resource that could lead to earlier prediction of sepsis onset. Nurses and other staff with specialized training and experience who have served as routine caregivers for a specific patient are able to identify when the patient’s status is altered. This clinical intuition may be substantiated by referencing specific patient trends in non-invasive measures over time. This retrospective, exploratory study examined whether variation in non-invasive monitoring variables could serve …

Improving Antipsychotic Compliance By Addressing Client Experience Of Metabolic Syndrome, Lurinda N. Paulsen

Doctor of Nursing Practice

Abstract

Purpose: This project was undertaken to increase medication adherence in clients diagnosed with mental illnesses that necessitate the use of antipsychotic (second generation, atypical or first generation, typical) medications.

Background: Medication compliance in the treatment of schizophrenia, schizoaffective disorder, and bipolar disorder is essential to ensure consistent medication levels and symptom stabilization. There are many reasons clients stop taking their medications, and symptoms of metabolic syndrome are often a cause for self-discontinuation. Metabolic syndrome is a cluster of symptoms including obesity, hypertension, hyperglycemia, hypoalphalipoproteinemia, and/or hypertriglyceridemia, which increases risk for cardiovascular disease and diabetes.

Methods: This project was completed …

Evaluating What Works: A Comparison Of Five Diabetes Prevention Programs For Latino Children, Ruchi Patel

Doctor of Nursing Practice Final Project Abstract

Background: Children in the Rio Grande Valley (RGV) are at increased risk of diabetes due to limited access to effective, culturally appropriate prevention programs. Existing programs are often time-intensive, require transportation, and lack cultural relevance, reducing participation and impacting outcomes. This project aimed to evaluate diabetes prevention programs (DPPs) in the literature and identify five that may benefit children in the RGV by reducing diabetes risk.

Methodology: The Eightfold Path policy analysis approach guided this project. A literature review identified DPPs for children, and the Critical Appraisal Skills Programme (CASP) was used to assess study quality. Limitations included difficulty finding …

Anxiety During Perimenopause: A Narrative Qualitative Study Of The Women’S Lived Experiences, Kayla Mcelhany

Dissertations and Theses (Open Access)

Abstract

Objectives: Perimenopause has been associated with increased anxiety symptoms. However, data is lacking regarding the experiences of women with perimenopausal anxiety and the contributing factors to worsening anxiety symptoms. We explored the experiences of women with self-reported new onset or worsening of anxiety symptoms during perimenopause to better understand contributing factors.

Study design: Twenty women participated in one-on-one interviews to explore experiences of perimenopausal anxiety in the context of their daily lives and perimenopausal physical changes. Inductive thematic analysis was used to develop codes and themes from the transcribed interview data. Analysis was done using MAXQDA software.

Main …

Evaluation Of A Nurse Practitioner-Led Preoptimization Care Management Program’S Impact On Patient Satisfaction For Total Hip And Knee Arthroplasty, Bryttany Chambers

Doctor of Nursing Practice Projects

This evaluation project aimed to assess whether the nurse practitioner-led preoptimization care management program can increase patient satisfaction by improving the quality metrics, such as same-day ambulation post-surgery, discharge to home, and compliance in preoperative education. The evaluation retroactively reviewed 46 charts of primary total knee and hip arthroplasty patients, male (38%) and female (62%), aged 43 to 84. Using Fisher’s exact test to examine the Net Promoter Scores (NPS) for six months of the PCM program, there was no significant increase in patient satisfaction scores, despite PCM patients averaging 89% compared to non-PCM patients at 83%, based on an …

Enhancing Person-Centred Care In The Final Years Of Life: Insights From Emergency Department Visits And Hospitalisations In Victorian Residential Aged Care (2015/16 To 2022/23), Janine J. Alan, Bridget Laging, Peter Cameron, Rohan Laging, James Boyd, Davina Porock, Sean Randall

Research outputs 2022 to 2026

Objective: To explore emergency hospitalisations from Victorian residential aged care facilities (RACFs). Methods: Retrospective descriptive study of Victorian RACFs transfers to ED from 2015/16 to 2022/23. Main outcome measures: (1) ED event rate per 100 RACF beds; (2) Number of ED events, day/time, triage category, reason, comorbidity profile, length of stay, death within 12 months of ED presentation and costs; (3) Relationship between resident characteristics and total ED events; (4) Number of inpatient events, comorbidity profile, length of stay, intensive care use, preventable hospitalisations, diagnosis-related group, deaths and costs. Results: The rate of ED presentations from Victorian RACFs from 2015/16 …

Knowledge And Perceptions Of Modifiable Ischaemic Heart Disease Risk Among Indians: Scoping Review, Kunwar Kaur, Ma'en Zaid Abu-Qamar, Amineh Rashidi, Nilufeur Mckay, Rosemary Saunders

Research outputs 2022 to 2026

Background: Ischaemic heart disease (IHD) causes a significant number of deaths globally. India has the highest IHD burden, with cases up 138% since 1990. Individuals of Indian descent face a greater risk of early IHD and poorer long-term outcomes. Indian people typically develop IHD a decade earlier than other populations, with 52% of IHD-related deaths occurring before the age of 70, compared to 23% in Western populations. Aims: This review aims to synthesise evidence on the Indian population's knowledge and perceptions of modifiable IHD risk factors and identify literature gaps. Methods: Joanna Briggs Institute (JBI) methodology and the Preferred Reporting …

Management Of Neonates In The Special Care Nursery And Its Impact On The Developing Gut Microbiota: A Comprehensive Clinical Review, Ravisha Srinivasjois, Shripada Rao, Gavin Pereira

Research outputs 2022 to 2026

The first few days following the birth are a vulnerable time for the neonate. Sick infants experience various interventions during their stay in the neonatal unit in order to stay alive and grow. Acquisition of gut microbes is critical for the short- and long-term health of the neonate. At a time when the gut microbiome is starting to take shape, crucial interventions directed at improving the growth, development and survival of the neonate impact its development. Events prior to and after the birth of the neonate, such as maternal conditions, antibiotic exposure, type of feeds, supplemental probiotics, and neonatal intensive …

Effects Of An Integrated Nutritional Health Intervention On Energy And Protein Intake In Under Five-Year Malnourished Children, Yani Maidelwita, Tukimin Bin Sansuwito, Faridah Mohd Said

Jurnal Keperawatan Indonesia

Malnutrition is thought to be the cause of more than one third of all child deaths, despite being rarely cited as a cause. In Indonesia, 19.9% of the population is malnourished, which is a very high prevalence. To prevent and treat malnutrition in children, numerous strategies have been developed, including an integrated nutritional health intervention. This research aimed to determine the effectiveness of an integrated nutritional health intervention for the energy and protein intake of malnourished children under the age of five. This study had a quasi-experimental design with a pre- and post- test control group. The research took place …

The Strategies And Interventions For Interprofessional Collaboration To Improving Patient Safety In Hospitals: A Systematic Review, Keumalasari Keumalasari, Krisna Yetti, Enie Novieastari, Evi Martha

Jurnal Keperawatan Indonesia

Interprofessional collaboration strategies and interventions are carried out to improve patient safety in hospitals. This study aimed to analyze the strategies and interventions used in interprofessional collaboration to improve patient safety. Interprofessional collaboration strategies and interventions were searched using five English-language databases, eligible studies were extracted, and the risk of bias was independently evaluated by two authors. The literature search yielded a total of 10,729 registered papers. We conducted an analysis on 3,793 health professionals. The following articles were included: 1) articles that described an intervention interprofessional collaboration to improve patient safety; 2) those focused on interprofessional collaboration in hospitals; …

Community-Based Intervention For Type 2 Diabetes Management In Developing Countries: A Systematic Review, Lutfian Lutfian, Izdihar Javier Wardika, Aufa Azizah, Fahmi Wildana, Yusti Muzdalifa Taplo, Riki Wartakusumah

Jurnal Keperawatan Indonesia

Type 2 Diabetes Mellitus (T2DM) poses a significant public health challenge, especially in developing countries with limited healthcare resources. There is a critical need for community-based interventions (CBIs) to promote healthy lifestyles for individuals with T2DM. This study explores CBIs to improve health behavior among T2DM patients in developing countries. It systematically reviews articles from PubMed, Scopus, CENTRAL, and CINAHL databases. The search strategy employed specific keywords following the PRISMA Extension for Systematic Reviews. The quality of the included articles was appraised using the Joanna Briggs Institute (JBI). A narrative synthesis summarized the key findings across the selected articles. The …

The Processes That Contribute To Readiness To Learn For An Accelerated Nursing Graduate: A Grounded Theory Study, Kaye A.L. Whyte

Theses & Dissertations

The worldwide nursing shortage has led to maintaining an adequate nursing workforce as a global challenge. Increased recruitment efforts have fostered changes to some educational programs, giving rise to the proliferation of Accelerated Nursing Programs (ACCEL). These accelerated nursing programs are a highly successful way of educating future registered nurses, leading to concerns by registered nurses, hospital administrators, and nursing faculty who question the transitional competence of graduates from Accelerated Nursing Programs. The purpose of this study was to understand the transition processes for accelerated nursing graduates. The intended impact of this research was important to nursing for two reasons: …

Food Literacy Program Among Adults In A Primary Care Setting, Marie K. Williams

Student Scholarly Projects

Practice problem: The increase in preventable chronic diseases is associated with food illiteracy, which arises from a lack of understanding of nutritional value and dietary guidelines (Silva et al., 2023).

PICOT: (P) In adult primary care patients aged 30-75 years, (I) does the implementation of evidence-based food literacy program (C) compared to standard practice (O) improve food literacy (T) in eight weeks?

Evidence: Using a validated food literacy questionnaire effectively measures improvements in food literacy. Customized programs that fill knowledge gaps are essential for enhancing overall food literacy. Intervention: Customized educational tools were provided to participants based on their knowledge …

From Surviving To Thriving: The Oxygen Mask Approach For Middle Management, Lydia Marque

Master's Projects and Capstones

Problem: Middle managers in healthcare experience high levels of stress, heavy workloads, and burnout. At a large medical center in Northern California, middle managers reported low perceptions of organizational support for well-being despite an abundance of available resources.

Context: Baseline data indicated a perceived support score of 6.5 out of 10 on the Employee Interest Survey and a People Pulse Culture of Health score of 60 for assistant nurse managers (ANMs), both below regional benchmarks. These findings suggested inadequate engagement with organizational well-being resources.

Interventions: A six-month performance improvement initiative, guided by the ADKAR change model and …

Skin Care Excellence: Increasing Rn Skin Check Frequency To Prevent Hapis, Yu Jian Kwan

Master's Projects and Capstones

Background:
This quality improvement project was implemented in the Transitional Cardiac Unit (TCU), a 32-bed telemetry unit primarily serving older adults recovering from cardiac procedures. A microsystem assessment revealed a hospital-acquired pressure injury (HAPI) rate of 1.49 per 1,000 patient days, exceeding the regional target of 0.82. Key barriers included limited skin assessment frequency, inconsistent documentation, and gaps in staff training.

Problem:
From June to December 2024, six HAPIs occurred in the TCU. Despite existing protocols requiring two-RN skin assessments at admission, transfer, and discharge, early detection of skin breakdown remained insufficient. Contributing factors included inconsistent surveillance, varied assessment skills, …

Policy Review Of The Aha Clinical Practice Guideline For Congestive Heart Failure: Evaluating Best Practices, Brenda E. Garcia

Student Scholarly Projects

Practice Problem: Congestive heart failure (CHF) is a significant public health challenge that impacts various populations and contributes to rising hospital admission rates.

PICOT: The PICOT question that guided this scholarly project was: For healthcare policymakers and interprofessional teams (P), how does a policy review of the American Heart Association’s Clinical Practice Guidelines for Heart Failure (I), guided by the CDC’s Polaris Framework (C), conducted over a 12-week period (T), evaluate alignment with evidence-based practices and potential for adoption in the care of patients with congestive heart failure (O)?

Evidence: This scholarly project focused on reviewing the current clinical guidelines …

Controlling Hypertension In The African American Population Through Dash Diet Education, Tanya K. Mccaskill

Doctor of Nursing Practice Projects

Hypertension disproportionately affects African Americans, contributing to elevated risks of stroke, cardiovascular disease, and kidney failure. Despite the well-established benefits of the Dietary Approaches to Stop Hypertension (DASH) diet, its adoption remains limited due to cultural, socioeconomic, and health literacy barriers. This Quality Improvement (QI) project aimed to evaluate the effectiveness of a culturally tailored DASH diet education intervention in improving nutritional knowledge among African American adults with hypertension (HTN). Using a quasi-experimental pre-post intervention design, 50 participants received a structured educational session during a single clinic visit, which included counseling, printed materials, and sample menus. The intervention was guided …

Implementing A Standardized Protocol To Screen For Depression In A Gastroenterology Outpatient Clinic, Catherine M. Karle

Dissertations

Problem: There is a lack of mental health screenings for depression taking place in outpatient gastrointestinal (GI) clinics. Outpatient gastrointestinal (GI) offices are not consistently screening patients for depression despite a rise in depression rates and the known adverse impact depression can have on the GI tract.

Methods: This Quality Improvement (QI) study used a descriptive research design guided by the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model. Its purpose was to implement a 10-week PHQ-2/PHQ-8 depression screening protocol at a large midwestern health center's gastroenterology outpatient clinic. The study used purposive sampling, including all GI outpatients aged 18+ with …

Implementation Of A Nurse-Driven Process To Decrease Npo Times In A Geriatric Emergency Department, Luke D. Little

Dissertations

Prolonged nil per os (NPO) status for geriatric patients in the emergency department is a critical safety issue, leading to increased rates of delirium, hypoglycemia, and perioperative complications. A quality improvement project was designed to address this problem through a targeted, nurse-driven intervention. In geriatric patients (age ≥70) in a geriatric emergency department, this project aimed to determine if implementing an electronic health record (EHR)-prompted nursing workflow to obtain a diet order would reduce the length of time patients were kept NPO compared with standard practice. An EHR documentation tool was designed and implemented along with targeted nursing education sessions …

Bowel Regimen Protocol Implementation For Pediatric Patients Following Cardiac Surgery, Eryn Watson

Dissertations

Problem: Pediatric patients with congenital heart disease (CHD) are at an increased risk of constipation following cardiac surgery, which contributes to complications and delays in recovery. Standardized protocols are effective tools for prophylactic management of constipation. However, there is no current standardized protocol in place for postoperative bowel management in a pediatric cardiac intensive care unit (CICU).

Method: This quality improvement project (QI) used a descriptive design with pre- and post-implementation data collection to evaluate the effects of a postoperative bowel regimen protocol on constipation rates and compliance with ordering prophylactic bowel regimens. Convenience sampling was used to identify patients …

Implementing Behavioral Management And Social Skills Training For Pediatric Patients With Adhd And Their Caregivers, Meagan A. Conwell

Dissertations

Problem: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 11.4% of children in the United States. Patients diagnosed with ADHD struggle with focus, hyperactivity, and impulsivity, resulting in executive and emotional dysfunction, poor social skills and quality of relationships, and poor school performance.

The American Academy of Pediatrics guidelines recommend that school-age children diagnosed with ADHD should receive both medication management and behavioral management training (BMT) for the best treatment outcomes. Research over the last decade has found that combining social skills training (SST) with BMT results in even better outcomes for these patients. Less than half of pediatric …

Implementing A Turn Team Process To Reduce Hospital-Acquired Pressure Injuries On A Telemetry Unit At A Hospital In The Midwest, Sally Wang

Dissertations

Problem: Pressure injuries (PI) are localized wounds to the skin and soft tissues that typically result from sustained pressure on specific areas of the body (Zaidi & Sharma, 2024). Hospital-acquired pressure injury (HAPI) refers to pressure injuries that develop while a patient is in the hospital (Rondinelli et al., 2018). PI can cause patients to experience pain, decreased feelings of dignity, increased feelings of depression and anxiety, reduced levels of social activity, difficulty sleeping, and impaired cognitive function (Roussou et al., 2023). The Advanced Cardiac Care Unit (ACCU) at Missouri Baptist Medical Center experienced an increase in HAPI cases: …

Community Health Workers: Key To Decreasing Food Insecurity In Pregnant Individuals, Linda Waggener Dnp

Doctor of Nursing Practice Scholarly Projects

Objectives: Food insecurity (FI) in pregnant individuals (PI)s is a global threat to birthing individuals and fetuses with potential immediate and intergenerational impacts on family and community. Community Health Workers (CHWs) facilitate support including food resources for FIPIs. The Family Fresh Rx (FFRx) program, within Food as Medicine (FaM) model provides fresh fruits and vegetables, optimize nutrition, and mitigates threats to health. This Doctor of Nursing Practice (DNP) Quality Improvement (QI) project’s two objectives were CHWs’ FFRx program and referral process satisfaction evaluation through a pre, post, and four-week post refresher presentation (RP) modified System Usability Scale (mSUS) …

A Student-Centered Coaching Program In Jesuit & Mercy Traditions, Sara Gifford, Karen Mihelich, Arthur Ko

Jesuit Higher Education: A Journal

A student-centered coaching program grounded in Jesuit and Mercy traditions, called “Coaching for Care,” was implemented at a midwestern Jesuit and Mercy institution. The purpose of the project was to evaluate the development of future nurse educators’ pedagogy, foster holistic licensure examination preparation among pre-licensure nursing students, and examine students’ perceptions towards the program’s guiding Jesuit and Mercy values. Pre-licensure students who received coaching felt that their uniqueness/holism, accountability, and reflection were important for their licensure exam preparation at significantly higher rates than pre-licensure students who did not receive coaching. Themes identified from the doctoral student coaches included instilling confidence …

What Is Midwifery Work In Low And Middle-Income Countries? A Systematic Review To Enhance Midwifery Practices In Resource-Constrained Contexts, Qorinah Estiningtyas Sakilah Adnani, Ela Nurfitriyani, S. Tr. Keb, Niken Bayu Argaheni, Rufidah Maulina, Victor Abiola Adepoju, Maeve O’Connell

Journal of Asian Midwives (JAM)

Background: Midwifery plays a crucial role in enhancing maternal and newborn health outcomes in low- and middle-income countries (LMIC). This systematic review aims to provide a comprehensive and evidence-based evaluation of midwifery practice in LMIC, beyond specific outcomes and interventions.
Methods: A systematic literature search was conducted using electronic databases including PubMed, Embassy, Scopus, Web of Science, and CINAHL, covering the period from 2019 to 2023. The search strategy employed predefined keywords and Medical Subject Headings (MeSH) terms related to midwives, maternal health, newborn health, and LMIC. The findings were analyzed using a narrative synthesis approach to identify key …

A Tailored Approach To Prep Screening For Awareness And Readiness, Keionda Crumblin Caldwell

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Human immunodeficiency virus (HIV) is a serious health concern in the United States (U.S). Pre-Exposure Prophylaxis (PrEP) is a vital intervention in the prevention of HIV, yet its uptake and adherence are suboptimal due to barriers in identifying individuals who are most at risk and would benefit most from this preventive measure.

Purpose: This evidence-based project aimed to evaluate whether implementing a PrEP readiness tool at a walk-in clinic would identify at-risk adults and adolescents and lead to an increase in referrals for PrEP initiation.

Method: A PrEP Questionnaire from the Department of Wisconsin Public Health was given …

Knowledge, Attitudes, And Practices Of Healthcare Workers Regarding Early Childhood Development: A Mixed-Methods Study At Secondary Care Maternal And Child Care Hospitals In Karachi, Pakistan, Sarosh Hirani, Shelina Bhamani, Hajra Malik, Samira Lakhani, Adeeb Kanji, Khairunnissa Hooda

Journal of Asian Midwives (JAM)

Introduction: Early childhood development (ECD) is a critical period that lays the foundation for a child's future growth and overall well-being. Healthcare settings play a significant role in shaping these developmental outcomes. However, there is limited research evaluating healthcare professionals' knowledge, attitude, and practices on ECD in Pakistan. This study aims to assess the awareness, attitudes, and practices of healthcare providers working in secondary hospitals regarding ECD.
Methods: A sequential explanatory mixed-methods approach was used. The study initially recruited healthcare workers, including physicians, nurses, trainees, and midwives from two secondary care hospitals. Participants completed the Caregiver Knowledge of Child Development …

Development And Validation Of Risk Assessment Tools For Hypertensive Disorder In Pregnancy, Vanitha K, Hepsibah Sharmil, Vijayalakshmi Kandasamy

Journal of Asian Midwives (JAM)

Aims and Background: Hypertensive disorders in pregnancy (HDP) have significant impact on both mothers and newborns leading to complications such as Eclampsia, Preterm delivery, Renal and cardiac problems, Intra Uterine Growth Retardation (IUGR) and Intra Uterine Fetal Death (IUFD). Early screening of hypertensive disorders in pregnancy is essential in the prevention and management of these complications. This research study aims to develop and validate a risk assessment tool for hypertensive disorders in pregnancy.
Materials and methods: A mixed-method research was carried out from December 2023 to December 2024 consisting of two steps. Step one involved the development of …

Implementing A Screening Tool To Increase Palliative Care Referrals For Patients With Metastatic Cancer, Rebecca N. Hegwood

Doctor of Nursing Practice Projects

Background: Palliative care (PC), when prescribed early for patients with metastatic cancer, has proven beneficial to the oncology patient and family by improving quality of life, decreasing stressors, and preventing premature discontinuation of therapy.

Purpose: This Doctor of Nursing quality improvement project aimed to determine if implementing a screening tool for patients newly diagnosed with metastatic cancer would increase PC referrals.

Project Design: The Five Item Palliative Care Screening Tool evaluated patients with a new metastatic cancer diagnosis. Secondary data was used to initiate a PC referral if the patient scored a five or greater on the screening tool. Project …

Identification Of Milk And Milk Product Adulteration By Molecular Methods, Isam Shaker Haza, Saad Sabah Fakhry

Al-Esraa University College Journal for Medical Sciences

The polyacrylamide gel electrophoresis sodium dodecylsulfate (SDS-PAGE) has been extensively used to separate native and denaturalized proteins. In various countries this has been useful to detect milk adulteration with whey, which is a fraud according to the current legal standards. The presence of glycomacropeptide (GMP) constitutes a marker of adulteration. It is released to the serum due to the hydrolysis of --casein peptide catalyzed by rennin incheese elaboration. In this work, the GMP detection was standardized as a pasteurized milk adulteration index, by means of GMP isolation with sequential precipitation in trichloroacetic acid at 24% and 50%, treatment with ethanol-ether …