The Historical Development Of The Midwifery Profession In Bangladesh, Malin Bogren, Farida Begum, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Sexual and reproductive health and rights have been identified as the core areas of practice, theory and research for the midwifery profession. The midwifery profession, as defined by the International Confederation of Midwives Global Standards, is new in Bangladesh. This paper aims to give an overview of the historical process that has taken place in the past decades to develop the midwifery profession in Bangladesh. The professional development of midwives is the result of many years of collaboration and relationship building among stakeholders such as the government, non-government organizations, academia, professional associations, United Nations agencies, and donors. All are working …

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Quality Of Prenatal Care And Pregnancy Outcomes: Centering Pregnancy Versus Traditional Prenatal Care, Lisette M. Allender

Nursing Theses and Dissertations

Prenatal care provides a unique opportunity for healthcare providers to improve outcomes for women and their families and by extension community health. Therefore, prenatal care has the opportunity to become the cornerstone of healthcare in our nation. It can influence the health of the mother, newborn, and family unit long beyond the course of a 9-month pregnancy. However, evidence supporting positive outcomes from current tradition based models of prenatal care is lacking.

The current United States prenatal system limits the patient-provider relationship, does not empower the patient, lacks emphasis on education, and is not woman-centered. The aim of the study …

Effects Of Hypertension Education And Motivation Interviewing By Staff On Patients' Activation, Tammy C. Lu, Kathy S. James, Laura Wolfgang

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project piloted a team-based program using Motivational Interviewing (MI) and 5 A’s (Assess, Advise, Ask, Assist, and Arrange) to promote healthy behavior and reduce blood pressure at an on-site corporate primary care clinic.

Methods: Patients were counseled using MI and the 5 A’s techniques. Patients received an educational booklet and monthly telephone follow up. Patients returned to clinic 3 months afterwards. Data collected included Dietary Screener Questionnaire scores, blood pressure, and self-rating of concern and motivation.

Results: A total of 4 people participated with variable follow-up. Readiness for change remained stable and confidence scores remained stable …

Evaluation Of Hypertensive Clinical Significance In A Primary Care Setting With Veterans With Diabetes, Claire S. Moga Msn, Rn

Doctor of Nursing Practice Final Manuscripts

Analyses of hypertensive confounding factors were identified by looking retrospectively at patient demographics, medications, recent blood pressure and the medical history of hypertensive patients with diabetes. The data trends found in this database highlighted potential areas for improvement with regards to the care of patients with this co-morbidity in the outpatient setting. All prescription anti-hypertensives prescribed for the 102 patients followed the National Joint Committee (JNC-8) Hypertension Guideline Algorithm. Of 102 adult males (over the age of 18), 22 patients had a blood pressure that is out of control (over 140/90). Within this group of patients, 33.3% of the patients …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …

Implementation Of Screening Guidelines To Improve Quality Of Care In A Small, Ethnically Diverse Pediatric Primary Care Practice…Then What?, Brooke Basford

Doctor of Nursing Practice Final Manuscripts

Although best practice guidelines have been shown to be effective, the process of translation into everyday practice can be challenging. The purpose of this evidence-based project (EBP) was the implementation of standardized screening tools into annual well-child visits in a small, ethnically diverse pediatric primary care practice in southern California. Standardized screening is recognized as an important process in identifying conditions early to facilitate early intervention. The practice site identified obesity has a priority and consequently the Department of Health Care Services: Child Health and Disability Prevention (CHDP) Program Guidelines for Diet and Nutrition Screening for Children assessment form was …

Emergency Room Nurses Knowledge Of And Experience With Health Literacy And Their Patient Teaching Methods, Deborah Kennard

Seton Hall University Dissertations and Theses (ETDs)

Health literacy (HL) is the ability one has to understand health information and navigate within the health system. Health literacy is linked to health knowledge and acute and chronic health outcomes. The conceptual model of health literacy outlines the contextual factors related to individual health literacy throughout the health system and the mitigating influence on outcomes. Education is a key factor to health knowledge and behavior changes. Nurses are the primary educators for providing patient teaching and yet research indicates nurses are lacking in knowledge regarding this. One area in the health system where health literacy has a strong effect …

Breast Cancer Patient Preparedness For Transition To Survivorship: Individualized Survivorship Care Plans, Kimberly Beringer

Master's Projects and Capstones

Purpose. For breast cancer survivors, after-effects of surgery, radiation and chemotherapy can be substantial, and recurrence is a concern requiring constant surveillance. National healthcare organizations have promulgated guidelines that include providing individualized survivorship care plans (SCP’s). At a northern California oncology department, SCP’s will be prepared for breast cancer patients and delivered in-person by the oncology nurse navigator (ONN).

Method. The author worked with the ONN to develop the format and content requirements for the SCP’s. The ONN prepared individualized plans for patients and scheduled in-person appointments to deliver the SCP’s. A feedback survey to assess preliminary impact was then …

Delirium: A Cnl-Led Protocol To Clear Up The Confusion, Shanda N. Whittle

Master's Projects and Capstones

Project objectives: Delirium is a form of organ failure defined as an acute change in cognition, evidenced by altered consciousness and impaired attention that fluctuates over time, and is associated with increased morbidity, mortality, and healthcare services utilization. In the hospital where this evidence-based practice project took place, there was no formal protocol or guideline for assessing or managing delirium. Therefore, this project focused on improving the practice of identifying patients at risk for developing delirium with the AWOL tool and treating patients with signs and symptoms of delirium found using the Short-CAM assessment. Population and setting: This project took …

Pediatric Intensive Care Unit Skin-Care Team, Anna Therianos Konstantin

Master's Projects and Capstones

In the United States, pressure injuries (PIs) cost $9.1–$11.6 billion per year and claim more than 60,000 patient lives. The large Northern California hospital where this CNL project was conducted has had an 8.33% incidence of hospital-acquired PIs at or greater than stage two in the pediatric intensive care unit (PICU). Pressure injury prevention was not a high priority for the nursing staff; nurses were unaware of current PI prevention protocols or the PI prevalence in the PICU. The goals are to reduce PIs by 20% in 3 months, increase PI nursing education, and improve patient outcomes. Nursing skin-care rounds …

Infection Control: Reducing Hospital Acquired Central Line Bloodstream Infections, Bobbie Joy Hollins

Master's Projects and Capstones

Hospital-acquired infections are a leading cause of morbidity and mortality in neonatal intensive care units (Ceballos, Waterman, Hulett, & Makic, 2013). It’s estimated that each neonatal bloodstream infection costs about $35,000 and adds about two weeks to a baby’s hospital stay (Akron's Children Hospital, 2015). This project was formulated to reduce the incidence of central line blood stream infections in the neonatal population. The setting used for this project was a 40 bed Level III Neonatal ICU. The methods executed include: conducting a root-cause analysis and formulating a unit survey. Kurt Lewin’s Three-Step Change Model was also used to complete …

Nursing Assignments Based On Patient Acuity: The Road To Nursing Job Satisfaction, Kristina Tomic

Evidence-Based Practice Project Reports

Challenges in the healthcare industry, including nursing shortages and low nursing retention, have resulted in nurses’ job dissatisfaction. Improving work environment and workload can lead to improved and equitable nursing shift assignments, which may improve nursing job satisfaction. The purpose of this EBP project was to (a) implement a patient acuity tool in the hospital unit, (b) assess its effectiveness in appropriating nursing shift assignments, and (c) evaluate its effect on nursing job satisfaction. The Evidence Based Medicine (EBM) Model was used as a guide to facilitate the transition of the best evidence into practice. As suggested within the evidence, …

Safe Sleep In The Nicu Environment For Sids Prevention, Renee J. Aumua

Master's Projects and Capstones

Abstract

Sudden Infant Death Syndrome(SIDS) remains a leading cause of death for infants less than one year of age. Historically, Neonatal Intensive Care units have been exempt from following SIDS safe sleep guidelines recommended by the American Academy of Pediatrics(AAP) for SIDS prevention due to patient medical status and environment. However, in 2011 these guidelines were updated by the AAP to include NICU specific recommendations. This is a very important change due to this patient population being at a higher risk for SIDS than the term, well newborn. The Safe Sleep project was conducted in a 35 bed, tertiary care …

Improved Postpartum Care After A Participatory Facilitation Intervention In Dar Es Salaam, Tanzania: A Mixed Method Evaluation, Eunice Pallangyo, Columba Mbekenga, Pia Olsson, Christine Rubertsson, Carina Källestål

School of Nursing & Midwifery, East Africa

Background: In order to improve the health and survival of mothers/newborns, the quality and attendance rates of postpartum care (PPC) must be increased, particularly in low-resource settings.

Objective: To describe outcomes of a collegial facilitation intervention to improve PPC in government-owned health institutions in a low-resource suburb in Dar es Salaam, Tanzania.

Methods: A before-and-after evaluation of an intervention and comparison group was conducted using mixed methods (focus group discussions, questionnaires, observations, interviews, and field-notes) at health institutions. Maternal and child health aiders, enrolled nurse midwives, registered nurse midwives, and medical and clinical officers participated. A collegial facilitation intervention was …

Improving Health Outcomes And Lifestyle Choices In An Underserved Community Through The Implementation Of A Wellness Program, Ekaterini Boutos

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was to implement a wellness program with the purpose of bridging the gap in lifestyle and disease knowledge in a socioeconomically vulnerable mentally ill population. The participants were members of an adult day mental health facility which aided the local underserved population. The wellness program emphasized improving knowledge of chronic health conditions, healthy lifestyle habits and the practice of mindfulness meditation.

Significance: The significance of this project is the advancement of health status via health education from a wellness perspective. Vulnerable populations who are at higher risk of chronic physical and mental illness can …

Development Of A Protocol For Implementing A Registered Nurse-Led Annual Wellness Visit In A Primary Care Setting, Jennifer R. Campbell

Doctoral Projects

This project was a quality improvement initiative utilizing a new format to deliver the Medicare Annual Wellness Visit (AWV) to Medicare recipients. The purpose of the project was the development of a protocol for implementing a registered nurse (RN)-led AWV in a primary care setting. The pilot project focused on changing the clinic’s current AWV structure from a provider-led format to a RN-led format. The pilot was geared towards improving care coordination, while enhancing preventive services and early intervention for chronic disease management. The 6-week pilot was used to help identify areas of weaknesses in the registered nurse-led AWV. During …

Alzheimer’S Disease And The Impact Of Music Therapy A Systematic Literature Review, Hayley Guess

Senior Honors Projects, 2010-2019

Currently ranked as the sixth leading cause of death in the United States, Alzheimer’s disease (AD) has become the most prevalent form of dementia, a term commonly associated with memory loss and other progressive cognitive deficits that compromise patients’ lives. What may begin as a mindlessly misplaced object or momentary inability to recall newly learned information will eventually advance to a loss of personal identity, forgotten loved ones, and utter misperception of reality. Although a cure for AD has yet to be discovered, there are several non-pharmacological treatments that can improve patients’ quality of life and provide temporary relief from …

Peer Intervention To Increase Physical Activity Among Working Women, Sheri A. Rowland

Theses & Dissertations

Most Americans do not engage in enough healthy physical activity (PA), with working women particularly at-risk for inactivity. Workplace PA interventions have been effective, however studies using peers as the central theoretical strategy, have not been found. Social cognitive theory and social comparison theory were used to develop a peer-modeling workplace PA intervention. The aims of this experimental, two-group, preliminary study were: 1) assess intervention feasibility, 2) determine the intervention effect on cardiorespiratory fitness (primary outcome), and PA behavior, cardiovascular risk, self-efficacy, motivation, and social comparison, and 3) describe participant perceptions of the intervention using qualitative focus-group data. Female employees …

Effect Of Activity Trackers And Text Messaging On Exercise, Fitness, And Physical Activity Self-Efficacy Of Middle School Students, Alison F. Pittman

Nursing Theses and Dissertations

A decrease in physical activity as children age is a contributing factor to the U.S. obesity epidemic. Middle school children are particularly vulnerable to sedentary activities. Activity trackers show promise as a means to motivate children and adults to increase physical activity (PA). This study examined the effect of a text messaging intervention and use of activity trackers with a companion social website on the body mass index (BMI), body fat percentage, physical fitness, and PA self-efficacy of middle school children. Children aged 11-14 (n=102) were randomly assigned to one of three groups for a 10-week intervention: activity tracker group; …

Delirium Prevention, Identification And Management In The Oncology Setting: A Unique Partnership With Patients And Their Family Caregivers, Mary Kate Eannielo, Christine M. Waszynski, Kerry A. Milner

Nursing Faculty Publications

Significance & Background: Delirium affects a significant number of hospitalized adults each year resulting in negative patient outcomes and family caregiver distress. Clinical identification of delirium by nurses and use of family caregivers as part of a multicomponent delirium prevention strategy are not consistently implemented in the practice setting despite being best practice.Purpose: An interdisciplinary team in this 800 bed level one trauma center has been created to create and implement this best practice delirium protocol. The purpose of this initiative was to incorporate the family caregiver into this existing multicomponent delirium prevention, detection and management protocol. Interventions: Consistent implementation …

De-Prescribing, A Solution To The Issue Of Polypharmacy, Megan R. Kampa

Nursing Capstones

No abstract provided.

Pediatric Hematology/Oncology Outpatient Care: The Effect Of A Standardized Collaborative Medication Reconciliation Process, Traci R. Pulliam

Evidence-Based Practice Project Reports

Pediatric patients are at an increased risk for medication errors and can benefit from processes that facilitate and promote medication safety (Stone et al., 2010). Medication reconciliation (Med Rec) is a valuable tool in improving patients’ medication safety and reducing adverse drug events (The Joint Commission, 2015). The purpose of this evidence-based practice (EBP) project was to improve the accuracy of the Med Rec process in a Midwestern pediatric hematology/oncology outpatient clinic by developing, promoting, and evaluating a standardized, collaborative Med Rec process. The Stetler EBP model guided the implementation of the intervention, with the goal of integrating current evidence …

The Caffeine Consumption Habits, Sleep Quality, Sleep Quantity, And Perceived Stress Of Clinical Nurses, Mykin R. Higbee

Nursing Theses and Dissertations

Caffeine is the most widely consumed psychoactive substance worldwide. Energy drinks are a relatively new beverage type that contain three to five times more caffeine than regular sodas. In several workplace settings, energy drinks have become popular as individuals chose to consume these beverages in an attempt to combat fatigue, deal with stress, and boost energy. There is no information regarding the energy drink and caffeine consumption habits of nurses working in the clinical setting. Clinical nurses provide the majority of patient care in the health care setting. Nursing is a mentally and physically demanding profession due to heavy patient …

The Experience Of Illness In The Daily Lives Of Persons Living With Being Chronically Homeless, William Henderson

Nursing Dissertations - Archive

Individuals from all segments of society are affected by homelessness – the old and young, men and women, single individuals and families. The majority of individuals will experience homelessness only on a short-termed basis. However, about 10-20% will experience homelessness for years. Although, the chronically homeless represent only a fraction of the total homeless population, they utilize the majority of resources available. Current literature has focused primarily on other groups within the homeless community, leaving little to be known about the chronic homeless. Without a better understanding of this unique group, interventions can only be based upon assumptions. The purpose …

Psychosocial Predictors Of Healthy Infant Birth Outcomes In Childbearing Women, Deana J. Furr

Nursing Dissertations - Archive

Low infant birth weight is a persistent problem in the United States. Psychosocial protective factors may confer benefits to vulnerable women, resulting in increased likelihood of healthy infant birth weight (HIBW). Few studies have examined predictors or correlates of healthy birth outcomes. The purpose of this study was to increase knowledge of protective factors and predictors of HIBW among childbearing women. A secondary analysis of the Fragile Families and Child Wellbeing Study public use baseline maternal surveys (1998 – 2000) was conducted (N = 4,759). Main predictors of HIBW were being married (adjusted odds ratio (OR) 2.38, 90% CI 1.12, …

Serious Infectious Events Following Cesarean Section, Janet Burton Glowicz

Nursing Dissertations - Archive

The purpose of this study was to evaluate trends in the incidence of serious infectious events (SIE), defined as organ space infection, sepsis, and Cesarean Section (CS) wound disruption, during the birth admission or resulting in between January 1, 2009 and December 31, 2014 in the State of Texas. A retrospective analysis of the Public Use Data File, maintained by the Texas Health Care Information Collection was conducted. Records of 627,555 women who had CS and 1,023 women readmitted for CS wound disruption, were included. During the study period, there was a large decrease in the rate at which SIE …

Hypertension Now And Then: Hypertensive Adolescents Who Consume Sugar Sweetened Beverages Are Associated With Hypertension In Adulthood, Jenna Thompson

Nursing Capstones

No abstract provided.

Consequences Of Urinary Tract Infections In Older Adults, Kayla M. Kappel

Nursing Capstones

No abstract provided.

A Systematic Analysis On Opioid-Free General Anesthesia Versus Opioid-Based General Anesthesia For Bariatric Surgery, Ina Basha

Nurse Anesthesia MSNA Student Capstones

One-third of the American adult population is considered overweight, a figure that is still on the rise. Obesity negatively impacts every organ system in the human body. When minimally invasive strategies such as life style changes fail, bariatric surgery procedures have become the other option. The purpose of this systemic analysis is to look at the outcomes of post-operative pain, post-operative nausea and vomiting (PONV), and the length of stay required in the postanesthesia care unit (PACU) in obese adults undergoing bariatric surgery using opioid-free general anesthesia compared to opioid-based general anesthesia. The studies included in this systematic analysis conclude …