Diabetes Self-Management Education: A Rural Health Development, Ashleigh A. Heter

Doctor of Nursing Practice Scholarly Project

The purpose of this Scholarly Project was to explore the need for a Diabetes Self-Management Education (DSME) Program in a rural health community in Southeast, Kansas (SEK). Statistics in Crawford County reveal that 10% of the population has been diagnosed with type 2 Diabetes Mellitus (T2DM) and a rising number of patients that are classified as obese. Without serious interventions many of these patients will develop T2DM. DSME programs provide essential skills and resources for patients to maintain glycemic control and reduce risks associated with this life-long disease. This study utilized data from fifty T2DM patients in the SEK area. …

Combating Childhood Obesity With Provider Education: A Quantitative Study, Trina Larery

Doctor of Nursing Practice Scholarly Project

The study included an educational program to providers and nurse practitioner students in order to evaluate whether an increase in knowledge and accuracy occurred based on knowledge of evidenced-based responses to specific indicators of childhood overweight and obesity. It assessed the providers’ knowledge and sought to evaluate if increased knowledge occurred after an educational program presentation. Following the educational program, a follow-up survey was distributed via email to assess the providers self-reported perceived practice change six weeks after the education.

Part one measured if an increase in knowledge of the 5210 components, correct laboratory testing, and assessment of comorbidities occurred. …

Lactation Clinic: Improving Patient Lactation Support, Iana Johnson

Master's Projects and Capstones

Despite the numerous health benefits and recommendations that breastfeeding is the optimal method for nourishing infants, many still choose other ways to feed their babies during the first year of life. This project considers the initiation and future implementation of a Lactation Clinic as an additional patient support service provided in the inpatient and outpatient settings. A Failure Modes and Effects Analysis (FMEA) was conducted in an effort to evaluate and eliminate “what could go wrong” before such an establishment becomes operational. The Risk Priority Numbers (RPNs) from the analysis reveal the lack of use (RPN 50) and streamlining (RPN …

Nurse Shift Handoff Report At The Patient's Bedside: Improving Nurse-To-Nurse Communication, Francis R. Estrella

Master's Projects and Capstones

The purpose of the CNL project is to develop a standardized approach to communication during nurse shift handoffs through utilization of bedside shift reporting (BSR). Shift handoffs are integral to nursing practice; therefore, this process must be accurate, effective, and consistent in order to ensure the delivery of safe and quality care. The project focuses on the CNL curriculum element of Quality Improvement and Safety, under the role of an Outcomes Manager. Prior to BSR implementation, shift handoffs in the sub-acute unit were being conducted at the nurse’s station or by the medication carts. Nurse shift handoffs were often rushed, …

Falls Program On An Acute Psychiatric Unit, Joseph Hunter Rose

Master's Projects and Capstones

In the metropolitan hospital’s acute psychiatric unit there has been an increase in falls incidence as well as need for evaluation of the effectiveness of Schmid Fall Risk Assessment tool in its ability to properly identify those at risk. In the last fiscal year there were 45 falls among 28 patients on the acute psychiatric unit.Falls are harmful to the patients and can cause prolonged hospital stays with non-reimbursable costs to the hospital. Falls amongst psychiatric patients is an even greater challenge to address due to the nature of the mental health disease process. This project addresses general costs of …

Patient Falls: Reducing Patient Falls With Injury, Frederick Comer

Master's Projects

The occurrence of patient falls is a very important health concern facing the healthcare industry. Many patients not only experience falls, but have falls with an injury. This is a patient safety concern that can have serious effects on patient outcomes, is a leading cause of patient injuries in hospitals, and are costly adverse events (Trepanier & Hilsenbeck, 2014). It is important that healthcare professionals determine ways to prevent what has been deemed a preventable event (Bemis-Dougherty & Delaune, 2008). In 2005 The Joint Commission (TJC) included patient falls with injury as part of their National Patient Safety Goals (Bemis-Dougherty …

An Examination Into The Relationship Between Iron Deficiency And Postpartum Depression, Sara A. Burroughs

Senior Honors Theses

Postpartum depression is recognized as the most common complication of childbearing; however, its etiology remains fairly undetermined. Many different influences have been hypothesized as to what may cause postpartum depression, including changes in levels of various hormones (such as estrogen and progesterone), a decrease in serotonin, low levels of vitamin D, social factors, and iron deficiency. The lack of strong evidence for one specific cause makes it fairly clear that there are many factors that play a role in the development of postpartum depression. Iron deficiency is one issue that is thought to contribute to the development of postpartum depression …

An Apn-Led Copd Discharge Education Program To Decrease 30-Day Readmission Rates, Moira Elizabeth Kendra

Seton Hall University DNP Final Projects

The purpose of this project was to implement an APN-led COPD discharge education program to decrease 30-day readmission rates. This Doctorate of Nursing (DNP) project combined strategies obtained in the literature search and blended these into a cutting-edge and state-of-the-art discharge education program at a major medical center. The significance of chronic obstructive pulmonary disease (COPD) readmission rates include financial implications, a large number of Medicare patients who return to the hospital within 30 days, poor quality of patient care, and poorly coordinated discharge processes. An APN-led transitional care COPD education discharge plan was implemented on the pulmonary floor at …

The Effects Of Preoperative Education On Readmission Rates For Total Joint Arthroplasties, Michele Gobble

Nursing Theses and Capstone Projects

Background: Primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) are two of the most successful procedures performed in orthopedics. The demand for these procedures is estimated to grow 174% for THAs and 673% for TKAs by 2030, which will have a valued bill of almost $50 billion for Medicare. The bundled payment plan is a way to reduce costs for these procedures, where an estimated 35% of the bill is related to post-discharge care (Schaeffer et al., 2015, p. 723).

Review of the Literature: In 2015, this healthcare reform began including readmission penalties for patients readmitted within 30 …

Socio-Demographics And Exclusive Breastfeeding In The Medicaid/Women Infant And Children (Wic) Population In Spartanburg County, April D. Miller

Nursing Theses and Capstone Projects

Breast milk is recognized as the optimal source of nutrition for infants because of its unique nutritional and immunological characteristics. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of an infant’s life. "Exclusive breastfeeding (EBF)" is defined as no other food or drink except breast milk for the first six months of life. Despite its countless benefits to children and mothers, the continuation rates of exclusive breastfeeding are low in the United States, especially in the Medicaid/Women Infant and Children population. It is vital to understand how multiple factors affect breastfeeding practices in order to …

Depression Scores In Males And Females With Copd, Cynthia Southers

Nursing Theses and Capstone Projects

The purpose of this study was to determine the effect of participation in a pulmonary rehabilitation (PR) program on depressions scores in persons with COPD and if there is a difference between males and females in depression scores prior to and following participation in a pulmonary rehabilitation program. The literature review supported multiple factors on how participating in a pulmonary rehabilitation program can have a positive effect on depression scores. The study utilized a descriptive design with a retrospective chart review. The quantitative descriptive design identified variables and examined the differences in males and females with COPD using pre- and …

Improving Foot Care And Kidney Disease Screening Through Implementation Of American Diabetes Association Standards–2016 In The Primary Care Setting, Maricela Hernandez

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase adherence to the American Diabetes Association Standards of Medical Care in Diabetes—2016 recommendations for foot care and kidney disease screening for patients with diabetes mellitus type II in a primary care setting. Diabetes mellitus type II affects approximately 18.9-19.9 million, or 90-95%, of all diagnosed cases in the United States. Early detection and management decrease the risk of developing microvascular complications that may lead to neuropathy and nephropathy. Adults with diabetes mellitus type II, 20 years of age and older, accounted for approximately 73,000 non-traumatic lower-extremity amputations in 2011. Diabetes …

Implementation Of Quality Improvement Interventions To Increase Provider Adherence To Standards Of Medical Care In Diabetes, Elizabeth A. Betz

Doctor of Nursing Practice

Purpose: To improve a South Texas primary care clinic’s diabetes management system by implementation of a quality improvement intervention to help staff and medical providers increase adherence to the American Diabetes Association standards of care related to screening referrals and orders for urine microalbumin, in order to improve self-care and health outcomes for adult patients with diabetes. Background and Problem: Diabetes is the 7th leading cause of death in the United States and the cause of vision loss, amputations, and end-stage renal disease. The patients at the Wellness Center do not consistently receive routine screenings for neuropathy, retinopathy, nephropathy, microalbumin, …

Oral Carbohydrate Administration Prior To Colorectal Surgery: Practice Change Outcomes And Economic Analysis, Joshua Kendrick Ezelle

Doctoral Projects

Difference in recovery times has been an interest of mine for many years. I observed that an open heart surgery routinely recovered and discharged on the third post-op day, while a colorectal patient often required a hospital stay of five to ten days. I began researching recovery methods of colorectal patients. I found enhanced recovery techniques like decreased narcotic, use of NSAID’s, early ambulation, and the use of medications that assist with bowel peristalsis are being employed nationally. Other techniques are now starting to be used with positive results. One of these is Carb-loading. Carb-loading is the oral intake of …

Enhancing Vegetable Intake In Infants And Toddlers Through Parental Complementary Feeding Education, Sophia Testa

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This research project investigated the outcomes of educating parents of infants between the ages of 6 months and 12 months on the importance of including vegetables in complementary feedings on the infant’s vegetable consumption. The efficiency of teaching was measured by comparing physical measurements and quantity of vegetables consumed by infants whose parents received education with the same data from infants whose parents did not receive education on inclusion of vegetable in complementary feedings. The results found contributed to Dr. Shreve’s research on childhood obesity in the Northwest Arkansas population and to the knowledge of parental education with regard to …

Intergenerational Hispanic Perceptions Of Childhood Obesity, Janelle Weiss

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Childhood obesity is on the rise in the United States especially among minority families. This study investigates how Hispanic parents perceive their child's weight based on years of acculturation, education level, age, child’s gender and 1^st or 2^nd generation status.

Objective: To assess if there are differences in perception between more acculturated Hispanic immigrants and their less acculturated counterparts.

Methods: Data were collected using the Child's Body Image Scale. Participants were asked to arrange the images based on a series of questions inquiring about their perception of their child and health in general. BMI's were then …

Effect Of A Yogurt Intervention On Adiposity And Metabolic Outcomes In Women, Eryn N. Boyet

Nursing Theses and Dissertations

Over 40% of women in the United States are obese. The Strategic Plan for NIH Obesity Research focuses on “ways to hasten the translation of research evidence from discovery to intervention.” The Strategic Plan also calls on investigators to look at influential points in the lifespan which may affect obesity. Few interventional studies on obesity in women during the perimenopausal time period have been completed. Research in broader populations suggests increased dairy, particularly full-fat products, may decrease central adiposity and improve metabolic indicators of diabetes and cardiovascular disease. The objective of this study was to investigate the effects of dairy …

Utilizing Culturally Congruent Educational Interventions To Improve Native American Diabetic Outcomes, Laurie Ann Hamilton

Doctoral Projects

Native Americans suffer from diabetes type II at a proportionately higher rate than other populations. Management of diabetes in this population is problematic and compounded by multiple influences such as socioeconomic, cultural and linguistic variables. The purpose of this DNP project was to investigate cultural influences on Native American diabetic outcomes.

Do cultural influences act as barriers to diabetic medication, diet and education understanding? Would a Native American nurse applied education on medication, diet and exercise improve diabetic outcomes in a 3 month period?

A convenience sample of 6 Native American participants obtained at a primary care clinic were given …

Evaluating The Likelihood Of Use Of Bispectral Index Guided Anesthesia As A Strategy To Reduce Postoperative Delirium In Surgical Patients 65 Years Of Age Or Older, Simon Jack Gibson

Doctoral Projects

Postoperative delirium (POD) is the most common postoperative complication in the elderly, accounting for approximately $164 billion in costs per year in the United States (Inouye, Westendorp, & Saczynski, 2014, p. 911). This complication occurs in as many as 50% of elderly patients, but can be prevented as much as 40% of the time (Inouye et al., 2014). The use of processed encephalographic monitoring, such as Bispectral Index (BIS) monitoring, to guide anesthetic dosage is the single intraoperative intervention with enough evidence to support it as a recommendation for use to reduce POD (American Geriatrics Society, 2015). There were two …

Improving Provider Adherence To Guidelines In Addressing Childhood Overweight And Obesity In A Primary Care Setting, David Hernandez

Doctor of Nursing Practice

The purpose of the quality improvement project was to improve BMI measurement, screening, identification, documentation, and assessment of childhood overweight and obesity among children ages 3 to 18 years old in a primary care setting. Primary care providers continue to fail to address childhood overweight and obesity and have a positive impact on this issue. Delay in early identification and assessment of childhood obesity and overweight may affect patients’ qualify of life and the efficiency of health care. Over the last 30 years, the rates of childhood overweight and obesity have consistently escalated despite the existence of recommended guidelines and …

Leadership Practices Of Supervisory Employees: An Exploration Of Current Practices At A Southeastern Veterans Affairs Medical Center, Melissa M. Zimmerman

Electronic Theses and Dissertations

As the nation’s healthcare system moves through the 21^st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency.

This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related to …

Directly Comparing Handoff Protocols For Pediatric Hospitalists, Elizabeth H. Lazzara, Robert Riss, Brady Patzer, Dustin C. Smith, Y. Raymond Chan, Joseph R. Keebler, Sarah D. Fouquet, Evan M. Palmer

Publications

BACKGROUND AND OBJECTIVES: Handoff protocols are often developed by brainstorming and consensus, and few are directly compared. We hypothesized that a handoff protocol (Flex 11) developed using a rigorous methodology would be more favorable in terms of clinicians’ attitudes, behaviors, cognitions, or time-on-task when performing handoffs compared with a prevalent protocol (Situation Background Assessment Recommendation [SBAR]).

METHODS: Using a between-groups, randomized control trial design (Flex 11 versus SBAR) during a pilot study in a simulated environment, 20 clinicians (13 attending physicians and 7 residents) received 3 patient handoffs from a standardized physician, managed the patients, and handed off the patients …

Braden Risk Assessment, Kelly A. Hartley Bsn, Rn, Jessica A. Lobien Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Introducing Allergenic Food Into Infants' Diets: Systematic Review, Katelin Larson, Jessica Mclaughlin, Mallory Stonehouse, Brittany Young, Kristin Haglund

College of Nursing Faculty Research and Publications

Purpose: The purpose of this systematic review was to explore the association between timing of introduction of potentially allergenic foods to infants and development of food allergies.

Methods: CINAHL, Medline, PubMed, Science Direct, and Web of Science were searched using the terms solid food, complementary food, or infant feeding combined with allergy or hypersensitivity for articles published in English in 2000 or later. Inclusion criteria were 1) primary research articles with 2) a focus on association between introduction of complementary foods including potentially allergenic foods into diets of infants less than 12 months of age and development of food allergies. …

Bariatric Surgery Weight-Loss Maintenance Among Hispanics: A Multiple Case Study, Minerva Aguilera

Nursing Theses and Dissertations

Obesity significantly contributes to human illness and to subsequent rising healthcare expenditures. Bariatric surgery has been identified as the only effective option to achieve the weight loss necessary for those who are morbidly obese. Previous research indicated that maintaining significant weight loss has been a problem for individuals who undergo bariatric surgery. The number of bariatric surgeries is increasing and factors that contribute to or interfere following bariatric-surgery weight-loss maintenance need to be determined. Research on weight-loss maintenance following bariatric surgery is very limited, particularly among the Hispanic population. This case-study research used an explanatory, multiple-case-study design to gain greater …

Developing A New Specialty Multi-Disciplinary Clinic While Orienting As A Novice Nurse Navigator, Angela Miller Rn, Jeanne Kenna Rn, Ocn, Laura Beaupre Bsn, Ocn, Cbpn-Ic, Jane Zubia Rn, Ocn, Cbpn I-C, Martiza Y. Chicas Rn, Pccn, Raizalie Roman-Rosado Bsn, Ocn, Cmsrn, Cynthia Smith Rn, Alyssa Pauls, Kathy Sevedge Rn, Ma, Aocn

Patient Care Services / Nursing

No abstract provided.

Emergency Education To Students In A Rural Healthcare Area, Stacie L. Hearell

Posters-at-the-Capitol

Stacie Hearell

Murray State University, Department of Nursing

Emergency Education to Students in a Rural Healthcare Area

Dr. Jessica Naber

Abstract

The purpose of this research process was to bring emergency healthcare education to advanced students in their Junior and Senior years of high school. The subjects were students enrolled in an advanced physical education program at local rural high schools. A pre-test was given to each student involved to assess their skills involving basic healthcare and how to respond in an emergency situation. The topics covered in the presentation were emergency room etiquette and processes, treatment for basic injuries …

Processing Information After A Child's Cancer Diagnosis-How Parents Learn., Cheryl C. Rodgers, Kristin Stegenga, Janice S. Withycombe, Karen Sachse, Katherine Patterson Kelly

Manuscripts, Articles, Book Chapters and Other Papers

Parents of a child newly diagnosed with cancer must receive an extensive amount of information before their child's initial hospital discharge; however, little is known about best practices for providing this education. An interpretive descriptive study design was used to describe actual and preferred educational content, timing, and methods among parents of children newly diagnosed with cancer prior to their child's first hospital discharge. Twenty parents of children diagnosed with various malignancies participated in individual interviews 2 to 12 months after their child's diagnosis. Data were analyzed using constant comparative analysis. Education delivery occurred in a telling manner at diagnosis …

A Pressure Ulcer And Fall Rate Quality Composite Index For Acute Care Units: A Measure Development Study., Diane K. Boyle, Ananda Jayawardhana, Mary E. Burman, Nancy E. Dunton, Vincent S. Staggs, Sandra Bergquist-Beringer, Byron J. Gajewski

Manuscripts, Articles, Book Chapters and Other Papers

Background: Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement.

Objective: The study objective was to develop a unit-level inpatient composite nursing care quality performance index-the Pressure Ulcer and Fall Rate Quality Composite Index.

Design: Two-phase measure development study.

Settings: 5144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors® during the year 2013.

Methods: The Pressure Ulcer and Fall Rate Quality Composite Index was developed …

Improving Burn Nursing Skills And Knowledge With Burn Specific Competencies, Reena M. Mishory Bsn, Rn, Julie Ashenfalder Bsn, Rn, Katherine S. Wreath Bsn, Rn

Patient Care Services / Nursing

No abstract provided.