Digital Commons Network^™

Self-Care Activities And Nurse Manager Well-Being, Gretchen Eileen Johnson

Walden Dissertations and Doctoral Studies

The role of the nurse manager is important in organizations and influences outcomes such as the safety and quality of care provided on a unit, satisfaction, turnover of nursing staff, and overall health of the work environment. Stressors for managing nurses can impair physical and emotional health and lead to poor patient and staff satisfaction, safety, and outcomes. The evidence-based practice project will explore nurse managers' well-being and self-care activities. The theoretical framework of the project is the Relationship-Based Care Model as well as Kotter's change theory. The literature suggests that self-care activities can reduce stress and improve well-being. A …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

Standardized Assessments, Care Planning, And Improved Quality Of Life For Residents Of Adult Family Homes, John A. Rogers

Walden Dissertations and Doctoral Studies

Quality of life for adults living in adult family homes requires further attention as the elderly population continues to grow and moves from minority to majority. There is a lack of data on residents in adult family home settings and their quality of life. The purpose of this project was to identify if individualized nursing care plans had an impact on the residents' quality of life in the adult family home. In this study, a registered nurse assessed the residents to create an individualized nursing care plan that would be implemented to improve quality of life. These care plans were …

Bedside Nurse Recognition Of Delirium In The Medical-Surgical Setting, Bridget Ann Denzik

Walden Dissertations and Doctoral Studies

Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was …

Type 2 Diabetes Prevention And Management In A Primary Care Clinic Setting, Ada Nwachuku Nwachuku

Walden Dissertations and Doctoral Studies

Approximately 8.3% of the U. S. population has type 2 diabetes. Preventing the onset and improving the management type 2 diabetes are crucial for health care professionals. The purpose of this project was to develop and evaluate a type 2 diabetes prevention and management education program in a primary care setting using group medical appointments (GMAs). The chronic care model provided the framework for the study. The education program consisted of information from the Centers for Disease Control on the management of type 2 diabetes to be delivered by clinic staff using a GMA approach, a timeline for implementing the …

A Comparison Of The Effectiveness Of Two Educational Interventions Developed To Teach Early Infant Hunger Cues To Junior Level Nursing Students., Melissa D. Gainer

Williams Honors College, Honors Research Projects

Due to multiple learning styles, it can be difficult to teach to large groups of students. The purpose of this study is to compare the effectiveness of two different educational interventions designed to teach infant hunger cues to undergraduate nursing students to increase the knowledge and confidence levels needed for the future teaching of infant hunger cues to new parents. Flemings VARK theory was used to guide this quasi-experimental study. A pretest posttest two-group design was used to evaluate both knowledge and confidence levels in the participants (N= 86). Data was analyzed utilizing a paired t-test. The results noted significant …

Stress And Exercise In Undergraduate Health Professions Students, Kristin R. Weismantel, Meghan G. Brickner, Leah N. Rosler

Williams Honors College, Honors Research Projects

Background: Stress is prevalent among undergraduate students, especially students in health professions majors. Exercise as a health promoting behavior decreases stress. At the same time, increased stress may decrease exercise. This study described exercise and stress among undergraduate health professions students. More specifically this study described the intensity and duration of each exercise and the frequency of exercise during a typical week of the semester for students in health professions majors.

Theoretical framework: Pender’s Health Promotion Model guided this study.

Design: Cross-sectional, descriptive survey.

Methods: A convenience sample of 437 undergraduate students in a college of health professions (N =2,700) …

A Systematic Review: Effects Of Breastfeeding On Early And Late Childhood, Kara Campbell, Samantha Fritz

Williams Honors College, Honors Research Projects

Abstract

The topic of the long-term impact of breast milk and formula milk composition on the health status of children continues to be a focus of discussion and research. The aim of this systematic review is to describe and critically appraise current evidence regarding the lasting effects of breastfeeding on health outcomes in children throughout early and late childhood. Twenty-one studies focusing on infant feeding were identified using PubMed, CINAHL, and Medline databases. These studies were then categorized according to health outcomes such as: weight, developmental, and immune system effects. Through a critical appraisal of this evidence, it was found …

The Effect Of School Based Nursing On Health Related Outcomes In Children: A Review Of Literature, Alexandra M. Pianalto, Mitchell C. Wall

Williams Honors College, Honors Research Projects

Background: School nursing staff deal with acute, chronic, screening, and education issues in the school based clinic. It is the school nursing staff’s role to provide care and treatment to children during school hours.

Purpose: Conduct a systematic review of the literature comparing disposition outcomes of children seen by school nursing staff to answer the PICO question: How does implementation of school based nursing affect health related outcomes in children within and outside the school environment?

Methods: Integrative literature review

Description of Evidence: Twenty research articles chosen from the database CINAHL, articles published within past nine years

Critical Appraisal: …

An Overview Of Antithrombotics In Ischemic Stroke, Patricia A. Schweickert, John R. Gaughen, Elizabeth M. Kreitel, Timothy J. Shephard, Nina J. Solenski, Mary E. Jensen

Ellmer School of Nursing Faculty Publications

The use of antithrombotic medications is an important component of ischemic stroke treatment and prevention. This article reviews the evidence for best practices for antithrombotic use in stroke with focused discussion on the specific agents used to treat and prevent stroke.

Access And Barriers To Care During Transition From Active Duty To Veteran Status In Veterans With Diabetes: A Look At Health Literacy, Change, And Ongoing Diabetes Self-Management Education, Mark R. Malebranche

Dissertations

Background and Rationale: Transition from active duty to veteran status may be a challenging time, especially for veterans with diabetes. These veterans face multiple changes that can cause distress. Most veterans with diabetes have type 2 diabetes, however a diagnosis of type 1 diabetes on active duty is cause for discharge for active duty.

Purposes and Aims: The purpose of this study was to describe the transition experience of veterans diagnosed with diabetes while on active duty from active duty to veteran status. The study describes barriers and facilitators to healthcare and diabetes self-care management. The four aims of the …

In-Hospital Factors Associated With Supplementation Among Healthy, Full-Term, Breastfed Infants, Jodi Kae O'Brien

Dissertations

Background: Formula supplementation of healthy, term, breastfed infants born to mothers who plan to exclusively breastfeed persists at high rates, in spite of global reduction efforts. The identification of modifiable risk factors for supplementation and effective nursing care for successful breastfeeding is understudied.

Purpose: This study aimed to better understand the obstetrical, hospital, and nursing factors associated with supplementation during the hospital stay. The aims were: (1) examine the relationships between aspects of hospital care of infants who are supplemented compared to infants exclusively breastfed and (2) determine what in-hospital risk factors increase the odds of formula supplementation among a …

Allelic Variation Of Bnacc.Tt2.A And Its Association With Seed Coat Color And Fatty Acids In Rapeseed (Brassica Napus L.), Longhua Zhou, Yuanlong Li, Nazim Hussain, Zhilan Li, Dezhi Wu, Lixi Jiang

Publications

Efficient molecular markers for the selection of rapeseed genetic materials with high seed oil content and ideal fatty acid (FA) composition are preferred by rapeseed breeders. Recently, we reported the molecular mechanism of TRANSPARENT TESTA 2 (TT2) in inhibiting seed FA biosynthesis in Arabidopsis. However, evidence showing the association of rapeseed TT2 homologs and seed FA production are still insufficient. In this study, we collected 83 rapeseed (Brassica napus L.) landraces from different geographical backgrounds to conduct association mapping of BnaC.TT2.a in relation to seed coat color and FA biosynthesis. Population background was corrected by 84 pairs of SSR markers …

Understanding Cultural Health Beliefs And Practices In Ghana, Africa, Jamie Wossilek, Rachel Patterson

Williams Honors College, Honors Research Projects

Abstract

Purpose. The purpose of this study is to explore the experiences and perceptions of university students and faculty after going on a medical mission trip to Ghana, Africa related to the health and illness beliefs of the Ghanaian people.

Background. Many organizations plan and conduct health mission trips. Although, many organizations are focused on improving health in developing countries, some may not understand cultural values and the health problems in those countries. “Improving health” is a complicated problem in developing countries and is hard to understand how those in the countries recognize health and illness.

Methodology. A purposeful, convenience …

Using Sbar To Decrease Transfers From The Long-Term Care To The Emergency Room, Phyllis Marie Bowers Garrett

Walden Dissertations and Doctoral Studies

Care of the elderly, long-term care resident in the emergency department is an issue of importance because of the overall impact on healthcare costs, potential for negative outcomes for the resident, and the loss of revenue. The purpose of this project was to decrease avoidable transfer of residents to the Emergency Department. Using the Antecedent, Target, Measurement logic model, poor quality assessment data was deemed the antecedent of the avoidable transfer. The goal of the project was the implementation of a standardized process of assessment that would have decreased avoidable transfer of the resident. The project would have involved training …

Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton

Walden Dissertations and Doctoral Studies

Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining …

The Development And Content Validation Of An Adult Obesity Educational Program, Abel Okuma

Walden Dissertations and Doctoral Studies

Overweight and obesity in patients with intellectual and developmental disabilities (IDD) are at epidemic levels in the United States. The problem identified for this DNP project is the incidence of overweight and obesity in IDD. The framework used involved the quality model for improvement. For this DNP project a new program called the Daily-Enhanced Physical Activities Program (DEPA) was developed to promote weight loss, reduce sedentary activities, and optimal body mass index (BMI) for IDD patients. Local experts consisting of two registered nurses, two physical therapists, and one direct support personnel working with IDD patients were recruited. Each expert reviewed …

Perinatal Nurses: Key To Increasing African American Breast-Feeding Rates, Karen Marie Robinson

College of Nursing Faculty Research and Publications

Breast milk is the ideal source of nutrition for infants for at least the first 6 months of life. Despite women in the United States reaching national objectives for breast-feeding initiation (75%), racial disparities persist. According to the most recent data, 83% of white mothers initiated breast-feeding whereas only 66% African American mothers did so. Breast-feeding initiation may be amenable to perinatal nursing intervention. Breast-feeding may be a practice that helps bridge the racial divide in perinatal outcomes among African American families. Nurses have an essential role in embracing breast-feeding promotion and support to patients who are least likely to …

Evaluating The Role Of Nurses In Educating Women During The Preconception Period, Oluwatoyin Ottun

Walden Dissertations and Doctoral Studies

Nurses play a crucial role in promoting educational programs aimed at informing women about their reproductive health. However, the role of nurses in providing the health related information is not well defined. Guided by the continuum model, this project evaluated nurses' perceived role in promoting the reproductive health of women during the preconception period. Twenty nurses from 2 outpatient offices wrote responses to an open-ended questionnaire. A summary of the responses indicated that 70% of the participants refer women to community-based programs to enhance awareness for preconception care. Twenty percent of the nurses indicated that they have an educational program …

Doctor Of Nursing Practice, Sharon Jean Scott

Walden Dissertations and Doctoral Studies

Evidence demonstrates the health benefits of early breastfeeding for mothers as well as infants. The World Health Organization states, "Breast milk should be given within the first hour of life." This purpose of this project was to develop a breastfeeding educational toolkit to promote breastfeeding in the hospital environment. The question that guided this project was, "Will the development of a breastfeeding education toolkit, designed to serve as a learning tool to support the breastfeeding mothers, be found to be useful and valid by professional staff and lay end-users?" The goals of the project were to provide an educational toolkit …

Infant-Driven Feeding Vs. Scheduled Feeding: The Effect On Hospital Length Of Stay, Lori L. Messer

Walden Dissertations and Doctoral Studies

Developmental delays related to feeding dysfunction in premature infants can lead to lengthy hospitalizations and increased healthcare costs initially and throughout the first year of the child's life. The purpose of this project was to use readiness-to-feed assessments to evaluate the impact of an infant-driven feeding protocol on length of stay. The project compared the length of stay of 2 groups of infants: a demand fed according to a readiness-to-feed protocol (protocol group, n = 14) and a traditionally fed according to scheduled, volume-driven feedings (traditional group, n = 15). The logic model served as the change management framework and …

Evaluation Of Serum Vitamin D Levels In Older Adults Who Fall And Sustain A Fracture: A Retrospective Chart Review, Suzanne L. Pilon

DNP Projects

Purpose: This practice inquiry project was designed to (i) evaluate serum vitamin D levels in individuals aged 65 years and older who had fallen and sustained a fracture and (ii) identify if the serum vitamin D levels were within therapeutic range.

Background: Older adults are at increased risk of falling and sustaining a fracture as a result of falls. Vitamin D has been shown to be effective in fall prevention yet vitamin D is deficient in the older population worldwide. Evaluating current serum vitamin D levels in older adults who fall and sustain a fracture may provide additional insight in …

Outcomes Experienced By Patients Presenting With Ventral Hernias And Morbid Obesity In A Surgical Clinic, Margaret A. Plymale

DNP Projects

Surgeons generally agree that morbid obesity is a contraindication to ventral hernia repair surgery due to risk of adverse outcomes. The purpose of this study was to describe the experience of patients with ventral hernia complicated by morbid obesity by reviewing a population of patients that were seen by a surgical service to determine the characteristics of those patients that had favorable and unfavorable outcomes. A retrospective medical record review was conducted of new patients with ventral hernias and morbid obesity (body mass index (BMI ) ≥ 40 kg/m²) seen by one surgical service over a two and …

A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy

DNP Projects

Objectives: The purpose of this study is to assess the current practices of providers for overweight and obese children at well visits, and how the demographics of age, sex, race, ethnicity, primary language spoken, insurance type, and provider type influence the care provided to overweight and obese children at the study site, which is a rural primary care clinic in eastern Kentucky.

Methods: This study is a retrospective design auditing well child charts (n = 571) from the study site over a two year period. Charts were audited for the data points of age, sex, race, ethnicity, primary spoken language, …

Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter

DNP Projects

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …

Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews

DNP Projects

Purpose: The purpose of this pilot project was to test the effectiveness of a simulation exercise using standardized patients on nurses’ perceived confidence in caring for patients with drug and alcohol problems.

Method: The project was a mixed methods pre-test and posttest design to assess whether simulation using standardized patients was effective in improving nurses’ confidence in caring for patients with problematic drug and alcohol use issues. Qualitative data was obtained by interviewing participants using a semi structured interview.

Results: All nurses reported a positive experience as a result of participating in the simulation exercises. Use of simulation as …

Assessment Of Depression Screening In Women’S Primary Care Clinic, Susanna Gorton

DNP Projects

Purpose: The purpose of this practice inquiry project was to evaluate provider adherence to depression screening documentation in the ambulatory electronic health record (AEHR) before and after changing locations of the depression screening questions within the AEHR. Provider knowledge about depression screening and barriers related to depression screening were also examined.

Methods: A retrospective chart review was completed for patients seen for an annual exam by a physician provider in a women’s primary care clinic. Data collected included demographic data, co-morbid conditions, depression screen documentation (PHQ-2 & PHQ-9), and interventions documented. A questionnaire was sent to providers in the primary …

Retrospective Analysis Of Body Mass Index Screening And Obesity Counseling In A Primary Care Setting: Comparative Analysis Of Demographic Variables And Co-Morbidities, Christina Fisher Higdon

DNP Projects

Study Purpose: To assess obesity screening and counseling in patients at annual wellness exams in an urban primary care clinic. Specific aims of the study: determine percentage of patients with documented body mass index (BMI), ICD-9/ICD-10 diagnosis of overweight or obesity, documentation of education or a follow-up plan for weight management, follow-up visit for weight loss and documentation by provider, and comparative analysis of co-morbidities and demographic variables during well-exam visits.

Target Population and Measures: Adults over the age of 18 in an urban primary care clinic with a BMI greater than 25 kilograms (kg)/meters squared (m2). BMI screening and …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …