Digital Commons Network^™

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

Effectiveness Of Breastfeeding Shift Champions On Exclusive Breastfeeding, Comfort Obi

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Purpose. This project evaluated the effect of breastfeeding support on breastfeeding and exclusive breastfeeding rates among postpartum mothers in immediate postpartum period. The breastfeeding support was provided by breastfeeding shift champions (BFSC) following childbirth.

Design. A convenience sample of BFSCs, aged between 18 and 44 years, was utilized.

Method. Pre-and post-intervention questionnaires were used to evaluate breastfeeding knowledge of BFSC. Breastfeeding and exclusive breastfeeding rates were extracted, pre- and post- intervention, from electronic medical records of newborns and their mothers.

Data analysis. Descriptive and inferential statistics were used for data analyses. Descriptive data were displayed using frequency …

Modeling The Influence Of Early Skin-To-Skin Contact On Exclusive Breastfeeding In A Sample Of Hispanic Immigrant Women, Ana Maria Linares, Karen Wambach, Mary Kay Rayens, Amanda Wiggins, Elizabeth Coleman, Mark B. Dignan

Nursing Faculty Publications

Using data from a longitudinal study of breastfeeding in Hispanics, this study evaluated the influence of early skin-to-skin contact (SSC) on initiation and sustained exclusive breastfeeding (EBF) at 1 month postpartum. Two-thirds of the women in the sample participated in early SSC. At discharge, over half of the women were EBF; this proportion decreased to one-third at 1 month postpartum. Controlling for demographic and clinical variables in the model, participation in early SSC was associated with a greater than sevenfold increase in the odds of EBF at discharge (p = .005) but was not predictive of EBF at 1 …

Clustering Diabetes Appointments And Education, April Pugh

Doctoral Dissertations and Scholarly Projects

Diabetes impacts the lives of millions of Americans, and the number is growing rapidly every year. Diabetes education has been demonstrated to have a positive impact of the self-management of this chronic disease and effective in the reduction of A1C, weight, and blood pressure. Barriers to attendance at both diabetes education classes and provider appointments are varied with lack of transportation and available time cited as two of the many reasons, especially in the rural and medically underserved regions of the country. The project assessed a process improvement intervention clustering diabetes education with provider appointments to increase attendance and decrease …

Strategies To Promote Health In North American French Jewish Immigrants, Balkys L. Bivins, Rosemary F. Hall

Faculty Articles

Anti-Semitism in the form of violent acts is on the rise in France and throughout Europe. These incidents and the looming threat of targeted violence are leading to the outmigration of Jewish individuals in France to Israel, Canada, and the United States. The health impact of this migration on individuals of the French Jewry who are now residing in the United States has not been studied. This paper will propose and address the need for culturally tailored nursing strategies to make a positive impact on the health, well-being, and lives of these individuals. Additionally, the writers will discuss the challenges …

A Whooping Cough Education Module For Wic Clients In Utah, Karlen E. Luthy, Alicia Anderson, Janelle L. B. Macintosh, Renea L. Beckstrand, Lacey M. Eden, Ryan Amy, Christopher I. Macintosh

Faculty Publications

Background: Clients in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are required to complete education modules quarterly to maintain eligibility. The purposes of this project were to: (1) create a whooping cough vaccination education module for WIC clients; (2) evaluate baseline perceptions of WIC clients on the whooping cough vaccine and disease; and (3) evaluate whooping cough knowledge following completion of the module. Problem: A decline in vaccination rates among infants and children using WIC services was reported by a local WIC program director who requested whooping cough vaccination education materials. This quality improvement project included …

Physical Activity, Functional Ability, And Obesity In Older Adults: A Gender Difference, Kimberlee A. Gretebeck, Leann M. Sabatini, David R. Black, Randall J. Gretebeck

College of Nursing Faculty Research and Publications

Disability, institutionalization, and loss of independence may be directly caused or exacerbated by physical inactivity and obesity. The purpose of the current cross-sectional survey was to explore the impact of gender and obesity on functional ability tasks, physical activity, and psychosocial factors in older adults. Participants comprised 964 University retirees (55% female, mean age = 75.3 years, SD = 6.7 years) with a mean body mass index (BMI) of 26.1 kg/m² (SD = 4.7 kg/m²). Results revealed significant gender and BMI interaction effects. Women were less active than men and obese women were most functionally impaired, …

A Minimal Contact Diet And Physical Activity Intervention For White-Collar Workers, Kimberlee A. Gretebeck, Tatiana Bailey, Randall J. Gretebeck

College of Nursing Faculty Research and Publications

Minimal contact lifestyle interventions with multiple components coupled with health screening have the potential to improve worker health. The purpose of this study was to test a minimal contact multiple component lifestyle diet and exercise intervention. The multiple components that were included in this project included a worksite health screening, brief counseling session, emailed newsletter, and a pedometer. In response to the intervention, participants reported an increase in green salad, fruit, and vegetable consumption as well as an increase in self-efficacy for consuming three servings of fruits and vegetables a day. Study participants also demonstrated a significant increase in physical …

Improving The Early Identification Of Acute Appendicitis Using Ultrasound In Pediatric Patients, Teresa De Jesus Sanchez Rodriguez, Karen Sue Hoyt, Babak Khazeani

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project was to improve early identification using ultrasound in pediatric patients who met the diagnostic criteria for acute appendicitis in the emergency department.

Background: One of the most common diagnoses of pediatric patients seen in the emergency department with an abdominal complaint is an acute appendicitis (Mostbeck et al., 2016).

Methodology: A quality improvement program in an emergency department was led by a nurse practitioner. Retrospective baseline data was collected for 12 months and 8 weeks post intervention.

Results: An increased utilization of ultrasound by 18.2% and a decrease utilization of computed tomography …

General Nutrition Knowledge And Perceived Stress In A Rural Female Faith Community, Lori Alexander, M. Laurie Branstetter Dnp

International Journal of Faith Community Nursing

In rural America, high rates of obesity are influenced by a lack of education and limited community resources. The purpose of this study was to assess the effect of an educational intervention on recommended nutrition and body mass index knowledge and to describe the perceived stress in a rural female faith community. A quantitative quasi-experimental pre-test post-test research design was used. English speaking female participants (N=49) 18 years of age and older from two rural community churches received an educational intervention based on the Health Belief Model. Participants completed a demographic survey, self-reported height and weight, general nutrition …

The Effects Of Perinatal Oxycodone Exposure On Behavioral Outcome In A Rodent Model, Thitinart Sithisarn, Sandra J. Legan, Philip M. Westgate, Melinda E. Wilson, Kristen Wellmann, Henrietta S. Bada, Susan Barron

Pediatrics Faculty Publications

Opiate addiction is now a major public health problem. Perinatal insults and exposure to opiates such as morphine in utero are well known to affect development of the hypothalamic–pituitary–adrenal axis of the offspring adversely and are associated with a higher risk of developing neurobehavioral problems. Oxycodone is now one of the most frequently abused pain killers during pregnancy; however, limited data are available regarding whether and how perinatal oxycodone exposure (POE) alters neurobehavioral outcomes of the offspring. We demonstrated that exposure to 0.5 mg/kg/day oxycodone in utero was associated with hyperactivity in adult rats in an open field. No significant …

Strategies To Improve Control Of Blood A1c In Diabetics, Jennifer Aronson, Leanne Bellino, Elizabeth Eisenhardt, Diane Bryant, Haley Pelletier, Internal Medicine Team, Adult Outpatient Clinic

MaineHealth Maine Medical Center

A1c monitoring is an important aspect of controlling the health of a diabetic patient. An adult internal medicine clinic noted that the percentage of their diabetic patients who had an A1c higher than 9 or no reading within the past year exceeded the national average. As a result, operational excellence methods were implemented with the overall goal to reduce their percentage to 18% or less.

A root cause analysis identified several deficiencies to includelack of essential equipment, variations in

staff education and the absence of daily reminders.

Post KPI implementations, an overall decrease in the percentage of patients with poorly …

Efficacy Of A Weight Loss Intervention For African American Breast Cancer Survivors, Patricia M. Sheean, Melinda Stolley, Ben Garber, Claudia Arroyo, Linda Schiffer, Anjishnu Banerjee, Alexis Visotcky, Giamila Fantuzzi, Desmona Strahan, Lauren Matthews, Roxanne Dakers, Cynthia Carridine-Andrews, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Susan Hong, Kent Hoskins, Virginia Kaklamani, Lisa Sharp

Nursing: School of Nursing Faculty Publications and Other Works

African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior.

Food Addiction And The Effective Treatment Of Adult Food Addicts: An Integrative Review Of Literature, Sara Bourque

Grace Peterson Nursing Research Colloquium

Abstract

Background: In a survey conducted between the years of 2011 and 2014 it was suggested that 36% of adults in the U.S. were obese with over 40.2% being middle aged adults. Obesity is associated with a number of comorbid conditions including diabetes, heart attacks, and strokes. Due to this it is one of the major factors driving up our annual medical care costs. It is also one of the leading causes of death not only in the U.S. but worldwide. With one third of the adult population in the U.S. being obese food addiction may very well be a …

Early Life Antibiotic Exposure And Its Association With Overweight/Obesity: An Integrative Review Of The Literature, Margaret Pfaff

Grace Peterson Nursing Research Colloquium

Early Life Antibiotic Exposure and its Association with Overweight/Obesity: An Integrative Review of the Literature

Margaret Pfaff

Faculty Sponsor: Dr. Shannon Simonovich

Background: Prevention of or treatment for obesity could improve quality of life for many people. Infancy may be a critical period during which efforts should be focused to mitigate modifiable factors that may influence the risk for developing obesity.

Objectives: This integrative literature identified factors associated with greater incidence or effects of antibiotic exposure during infancy and examined the connection between early life antibiotic exposure and later in life overweight/obesity.

Method: This analysis followed the Whittemore and Knafl …

Clinicians’ Perspectives And Utilization Regarding Harm Reduction In Nursing Practice In Care Of Persons With Addiction: A Literature Review, Audrey Killarney

Grace Peterson Nursing Research Colloquium

Clinicians’ perspectives and utilization regarding harm reduction in nursing practice in care of persons with addiction: A literature review

Audrey Killarney, BS

Prof. Michelle Neuman, MSN, APN, RN

NSG 598: Graduate Research Synthesis

18 August 2017

Introduction

Background & Significance

Harm reduction is a concept best described as the recognition that individuals will engage in unhealthy behaviors, and the goal is to minimize the associated potential harm. (Stockwell, Reist, Macdonald, Benoit, & Jansson, 2010). Classically, it was used an alternative model of care for treating smokers and controlling the spread of HIV and hepatitis B (Henwood, Padgett, & Tiderington, 2014). …

Food Insecurity And Its Impact On Health Status Among Homeless Individuals: An Integrative Literature Review, Jacqueline Munyasya

Grace Peterson Nursing Research Colloquium

FOOD INSECURITY AND ITS IMPACT ON HEALTH STATUS AMONG HOMELESS INDIVIDUALS:

AN INTEGRATIVE REVIEW

Jacqueline Munyasya

Faculty Sponsor: Dr. Shannon Simonovich

Background: Food insecurity is a serious problem in the United States and the number of people affected by food insecurity in the United States has risen dramatically in recent years. The homeless population is disproportionately affected. The combination of homelessness and food insecurity is a problem has the combined effect that is extremely costly to the public and the overall health of the population. As nurses, we will encounter these populations and treat them in both community and acute …

The Health Benefits Of Intermittent Fasting, Michael Bacol

Grace Peterson Nursing Research Colloquium

Abstract

Background: The practice of voluntarily abstaining from food has traditionally been seen as a religious observance. However, as the nation’s prevalence of obesity continues to rise along with diabetes and cardiovascular disease, the concept of fasting has recently gained momentum as a means of achieving weight control. Intermittent fasting (IF) as a weight control protocol has become a popular intervention in weight control.

Objective: The purpose of this literature review was to examine the health benefits of intermittent fasting.

Methods: A computerized online search was utilized to populate research articles. Databases used included PubMed, CINAHL, & PsychInfo, using a …

Delirium Rates Increasing In Elderly Hospitalized Patients, Sarah Jane Soffel

Grace Peterson Nursing Research Colloquium

Delirium commonly affects hospitalized elderly patients, and is associated with increased mortality and morbidity, among other detrimental outcomes. Delirium is increasing in prevalence, yet remains under detected. Many of the negative effects of hospitalization, such as immobility, dehydration, and polypharmacy, increase the risk for developing delirium. Early detection of delirium remains an important factor for treatment and reversal. The aim of the integrative literature review was to determine whether delirium rates are increasing among elderly hospitalized patients, as well as to identify risk factors associated with delirium and nursing interventions that may prevent the increasing prevalence of delirium. The study …

Impact Of Socioeconomic Status On Prenatal Nutrition And Postpartum Depression, Kelsey Moran

Grace Peterson Nursing Research Colloquium

Background: Postpartum depression (PPD) is the most common complication of childbirth, affecting 11-20% of women who give birth each year. Women suffering from PPD may experience feelings of guilt, worthlessness, and anxiety related to birth, and may think of suicide or harm towards their baby. Nutrition plays a key role in the onset, severity, and duration of general depression. Although nutritional deficiencies can be prevalent among all Americans, they disproportionately affect low-income individuals. There is currently a knowledge gap regarding postpartum depression causation in low-income women. It is important to understand the cause of postpartum depression to provide appropriate intervention …

Effect Of Body Image On Health Outcomes In Individuals With Weight-Related Disorders, Anna Gertsberg

Grace Peterson Nursing Research Colloquium

Weight related disorders are on the rise in the United States with a prevalence rate for anorexia nervosa of 0.6% and obesity of 20%. The increase is attributed to emphasis on body image. Body image is the combined perception of how one feels about their appearance with how others perceive them. The purpose of the integrative literature review was to analyze the effect of body image on individuals with anorexia nervosa and obesity and the mechanisms underlying such. A literature search was conducted through Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, PubMed, ProQuest Nursing and Allied Health …

Self-Care Management Strategies Used By Black Women Who Self-Report Consistent Adherence To Antihypertensive Medication, Willie M. Abel, Jessica S. Joyner, Judith B. Cornelius, Danice B. Greer

Nursing Faculty Publications and Presentations

Background: Black women in the USA have the highest prevalence rate of hypertension (HTN) contributing to a higher risk of organ damage and death. Research has focused primarily on poorly controlled HTN, negative belief systems, and nonadherence factors that hinder blood pressure control. No known research studies underscore predominantly Black women who report consistent adherence to their antihypertensive medication-taking. The purpose of this study was to describe self-care management strategies used by Black women who self-report consistent adherence to their antihypertensive medication and to determine the existence of further participation in lifestyle modifications, such as eating a healthy diet and …

A Demonstration Project To Address Juvenile Drug Addiction, Mary Ellen Broaddus

Graduate Theses, Dissertations, and Capstones

The rise in adolescent drug use and addiction is becoming a worldwide phenomenon. An eleven year study of youth in European countries found drug use widespread and increasing (Molinaro, Sicilian, & Curzio, 2011). In 2013 there were over 2.8 million new users of illicit drugs, over half of whom were under 18 years of age (‘Drug Facts’, 2015).

Adolescents are at unique risk because biochemical distinctions in their brains, when compared with adults, prompt more risk-taking behaviors (Gallager, 2014). Health risks are considerable and include hypertension, stroke, convulsions and seizures, and liver disease such as cirrhosis and hepatitis. In 2013 …

Fall Prevention In The Inpatient Setting, Verna Bautista

Master's Projects and Capstones

Fall Prevention in the Inpatient Setting Abstract

This project focuses on patient and family fall prevention education through an educational brochure. 4South is a mixed medical/surgical and medical/surgical-telemetry unit, specializing in dialysis and stroke patients. Since January 2017, there has been eight falls on the unit. The project’s objective is to decrease the number of falls in 4South by 50% by the end of the 4^th quarter 2017.

An identified weakness was inconsistent patient and family education. The CNL roles of data analyst and clinician were utilized. With the feedback from the Fall Task Force committee, an educational brochure …

Pursuing Equity In Diabetes Population, Aisha Rawlinson

Master's Projects and Capstones

Abstract

Background

Poor glycemic control (HbA1c >8) overtime leads to microvascular and macrovascular complications after the first and third years respectively, ultimately resulting in death after five years (Karter, 2016). Current Kaiser Permanente (KP) data stratified by race, ethnicity, age, and gender shows a significant disparity gap between Hispanics/Latino and Caucasian populations. The Pursuing IHI initiative is over a 2-year period completed at a microsystem that is focusing on health equity practices to reduce disparity gaps.

Project aim

KP Riverside, microsystem selected has a large population of Hispanic/Latino KP members, with focus on health equity. The project aim is to …

Early Ambulation For Colorectal Enhanced Recovery Patients In A Surgical Specialties Unit, Jessica P. Pelletier

Master's Projects

Early ambulation is a key concept in surgical recovery and overall improvement of medical conditions. The initiation of Enhanced Recovery programs (ERP) for surgical procedures have used evidence-based research to bundle best practices for a quicker and more effective recovery.

The author evaluated the consistency of early ambulation on a surgical specialties unit using the ERP method. Through process improvement methods, data and practice were evaluated to show inconsistencies in documentation, data report abstraction, and understanding of complete collaborative bundle components.

Chronic Obstructive Pulmonary Disease (Copd), Jenna Trimmer

Nursing Student Class Projects (Formerly MSN)

COPD is said to be unappreciated with half of COPD patients going undiagnosed or under treated. The research of this assignment will help to increase the APNs knowledge of the disease, its pathophysiology, presentation of symptoms, and disease management for better patient outcomes.

Sepsis, Sarah Jones

Nursing Student Class Projects (Formerly MSN)

Sepsis is a dysregulation of the inflammatory response, termed systemic inflammatory response syndrome or SIRS, caused by stimulation of an infectious process. Sepsis often leads to organ dysfunction and increased morbidity, mortality and financial burdens. The goal of treatment is to initiate appropriate antimicrobial therapies, target the underlying infection, optimize intravascular volume, provide fluid resuscitation and maintain adequate perfusion and stroke volume (Taeb, Hooper & Marik, 2017).

Timing of treatment and early detection of sepsis is critical to patients with early warning signs. Sharing this information and potentially making a difference in the outcomes of patients presenting with early signs …

“A Study To Assess The Knowledge, Stress And Coping Patterns Of Grandmothers Involved In Child-Rearing Practices Of Children Of Employed Mothers In Selected Areas Of Udupi District, Karnataka., Reena M Dsilva

Manipal College of Nursing, Manipal Theses and Dissertations

ABSTRACT A study to assess the knowledge, stress and coping patterns of grandmothers involved in child-rearing practices of children of employed mothers in selected areas of Udupi district, Karnataka was carried out by Mrs Reena M D’Silva in partial fulfilment of the requirement for the degree of Master of Science in Nursing at Manipal College of Nursing, Manipal University, Manipal, Karnataka.

The objectives of the study were to assess the knowledge of grandmothers involved in child-rearing practices, to assess the stress level of grandmothers involved in child-rearing practices, to assess the coping patterns of grandmothers involved in child-rearing practices and …

2017-2018 Graduate Studies In Nursing Handbook, Otterbein Office Of Graduate Programs

Graduate School

A graduate handbook for the Graduate Studies in Nursing programs at Otterbein University.