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Decreasing Inappropriate Wound Consults, Arpita Hinton

Master's Projects and Capstones

Abstract

Background: This project was centered around the wound nurses and their workload. It also highlighted the opportunity for education for frontline staff. The wound nurses at this northern California hospital are a group of five nurses that support the whole hospital. Usually there are two staffed per day to support a facility that continues to have three to four overflow areas open to accommodate its high census.

Problem: My project focused on decreasing inappropriate wound consults. There are many consults places that do not need the intervention of a skilled wound nurse. These consults lead to time that is …

Patient Experiences With An Mhealth App For Complex Chronic Disease Care: Connections Despite Lack Of Traditional Clinical Interactions, Jenney Lee, Melissa Cheyney, Michael A. May, Marit L. Bovbjerg

Patient Experience Journal

Chronic diseases are costly to treat and burdensome for patients. Mobile health (mHealth) technologies might reduce costs of care and increase patient self-efficacy in chronic disease management, but the patient experience of mHealth is poorly understood. Our objective, therefore, was to evaluate patient experiences with using an mHealth app for complex chronic disease management, within a U.S. population of low-income patients. We used nurse/patient text messages from an mHealth complex chronic disease management tool, and exit interviews from patients, to assess qualitatively Medicaid patients' experiences with a remote monitoring mHealth app. Salient themes about the patient experience included: (1) Visibility …

Preventing Hospitalization-Associated Disability, Elizabeth M. White

Master's Projects and Capstones

Problem: Hospital-associated disability (HAD) affects one-third of hospitalized adults, diminishing post-discharge independence and contributing to high mortality rates. Identifying at-risk patients through early assessment of nutritional and functional status upon admission is critical to personalizing care and improving discharge outcomes.

Context: A 24-bed adult medical-surgical unit in a 173-bed suburban hospital in Northern California is part of a large not-for-profit healthcare organization. Interventions: Nursing staff received education on the Enhanced Recovery Medicine (ERM) pathway designed to prevent HAD. A visual display board, maintained and updated by unit champions, gave staff performance feedback. Nursing leadership reviewed admission assessments and addressed barriers …

Quality Improvement Project: The Bidirectional Relationship Among Type Ii Diabetes Mellitus And Periodontal Disease, Sarah Martinez

Doctor of Nursing Practice Projects

Individuals with Type 2 Diabetes Mellitus (T2DM) are at increased risk for oral health conditions such as periodontal disease. Moreover, there is an established bidirectional relationship that has been well documented in the literature among periodontal disease and T2DM. However, oral health is rarely being discussed with patients who have T2DM from the primary care setting. The objective for this Doctor of Nursing Practice (DNP) project was to bridge the gap in this area by assessing the efficacy of implementing an educational program to promote education and awareness in individuals with T2DM who are at risk for periodontal disease. This …

Reducing Hapi On A Medical Surgical Telemetry Unit, Emily Nicole Johansen

Master's Projects and Capstones

Abstract

Problem: Hospital-acquired pressure injuries (HAPI) are a global issue that harms patients, prolongs lengths of stay, and increases hospital costs and financial burdens. Because HAPIs are preventable, hospital organizations worldwide are implementing prevention strategies to improve the quality of care and quality of life and decrease costs associated with them.

Context: The 24-bed medical-surgical telemetry unit is one of five adult inpatient units within a Northern California hospital. The patient population includes an increased number of patients who are at risk of HAPI. The unit struggles with HAPI prevention, and the staff is challenged with implementing proper HAPI prevention …

A Bundle Of Care For Prevention, Early Recognition, And Treatment Of Hyaluronic Acid Dermal Filler Associated Vascular Occlusion, Genny Sanders

Doctor of Nursing Practice Papers

Background: Hyaluronic acid (HA) dermal fillers, an injectable used for cosmetic use, are gaining popularity, and are expected to continue to do so in the projected future. With the rise in the number of patients seeking these procedures there is a correlated rise is adverse events, including the complication of vascular occlusion. Vascular occlusion has the potential for detrimental outcomes, and clinicians performing these procedures are responsible for educating patients about these risks. As whole, the healthcare community must be prepared.

Purpose: A quality improvement (QI) project was created to help clinicians prepare, prevent, recognize, and treat hyaluronic acid dermal …

Investigating Nature-Based Mindfulness In Nurse Anesthesia Students: A Pilot Study, Douglas Lovern

Dissertations

Across the country, the mental health crisis continues to rage. Varying degrees of depression, stress, and anxiety are commonly found in college-age students. The COVID-19 pandemic augmented this crisis, but the pandemic is not the sole culprit for the escalation of mental health disorders in the United States. Students across the globe suffer mental health disorders that include depression, anxiety, and stress. Research has shown that graduate students are six times more likely to develop anxiety and depression than the general population. Student registered nurse anesthetists (SRNAs) are vulnerable to mental health disorders. SRNAs enter labor-intensive doctoral programs fraught with …

Supporting Nursing Care Transition For Late Preterm Infants From Nicu To The Level 1 Nursery, Megan R. Deans

DNP Projects

Late preterm births are increasing each year due to increasing rates of IVF, multiple births, and advancing maternal age (Visruthan et al., 2015). This group has been traditionally cared for in the NICU, but facilities may consider transitioning this care to the level 1 nursery due to the relative physiologic stability of this population (Visruthan et al., 2015). The transition, without appropriate planning, creates a potential for inconsistencies in caring for the diverse needs of 35.0-35.6 week late preterm infants (LPIs), including variations in education provided to parents and care of the LPI (Visruthan et al., 2015). This project aimed …

A Descriptive Study: Aging In Place In The Rural Southeastern United States, Dama G. Cooley

Electronic Theses and Dissertations

Older Americans will soon outnumber children and younger adults. In 2022, there were 58 million older adults. By 2050, older adult numbers will grow to 82 million, and by 2060, 100 million. The National Institute on Aging calls for ongoing research on the impact that a historically large aging population will have on health, well-being, and quality of life. A key concern is how to meet needs while decreasing costs associated with institutional long-term care.

Most of these elders reside in the community and wish to live in their homes throughout their lives, but they will experience an increased need …

Quality Improvement Project: Fall Prevention Among Older Adults In Snf Through Staff Education And Hourly Rounding, Reshmi Abraham

Doctor of Nursing Practice Projects

Falls among elderly individuals in Skilled Nursing Facilities (SNF) pose a widespread and significant healthcare challenge, often resulting in severe injuries, reduced quality of life, and increased healthcare expenses. Despite the current efforts to prevent falls, they still occur frequently, underscoring the importance of effective interventions for prevention. This Doctor of Nursing Practice (DNP) project focuses on quality improvement (QI) in healthcare. It aims to reduce fall rates among older adults in SNF by providing staff education and implementing scheduled hourly rounding. This approach aligns with existing research, emphasizing the importance of proactive patient monitoring and improved staff knowledge in …

A Scoping Review Of The Role Of Policy In Mitigating Childhood Obesity In Underserved Populations Using The Re-Aim Framework, Bonnie Gance-Cleveland, Marilyn Frenn, Nancy T. Browne, Cindy Smith Greenberg, Julia A. Snethen, Eric A. Hodges, Alissa Fial, Leigh Small, Sharon Y. Irving

College of Nursing Faculty Research and Publications

Background

Childhood obesity is an escalating crisis in the United States. Health policy may impact this epidemic which disproportionally affects underserved populations.

Aim

The aim was to use the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to assess health policy impact on preventing or treating school-aged children (5 > 18 years) with obesity in underserved populations.

Methods

A scoping review of 842 articles was conducted. Twenty-four articles met the inclusion criteria and underwent data extraction.

Results

Twelve studies included subgroup analysis, with four suggesting an impact of policy on at-risk groups. None of the 24 studies fully applied the RE-AIM …

A Qualitative Exploration To Inform An Oral Health Training For Disability Care Workers In Burkina Faso, Ave Põld, Dan Filwendé Kientega, Jocelyne Valérie Garé, Michael Lorenz

Faculty, Staff and Student Publications

AIM: To explore enablers and barriers to the creation of an oral health training for care workers at specialized centres for children with disabilities in Ouagadougou.

DESIGN: This was a formative study informed by the Theoretical Domains Framework using qualitative methods.

METHODS: Qualitative observations and 14 semi-structured interviews were conducted with care workers from six specialized centres for disability.

RESULTS: Carer workers emphasized that a successful oral health training must account for available resources and competencies in each specific centre. Part of the training must be dedicated to oral hygiene targeted for people with disabilities and provide knowledge about risk …

Effect Of Cvd Education On The Perception And Modifiable Health Behaviors Of College Students, Sanitha Douglas

Doctor of Nursing Practice Projects

Background

Research reports that cardiovascular disease (CVD) has been a national and global health problem for many years, and that knowledge has increased regarding its prevention (Hennekens, 2020). However, according to Hennekens (2020), CVD remains the number one cause of death in America and most developed countries worldwide. The lack of perception and knowledge of actual CVD risk in the young adult population may be contributing to this deadly disease. This project evaluated the effectiveness of education on CVD risk perception and modifiable health behaviors of college students.

Purpose

This project’s purpose was to assess college students' perception of their …

Evaluating The Use Of The Braden Scale For Predicting Pressure Sore Risk© In Residents Of A Short-Term Rehabilitation Facility, Amelia Simmons

All Dissertations

Background: Pressure injuries are significant health issues and one of the biggest challenges organizations face on a day-to-day basis. Aside from the high cost of treatment, pressure injuries also have a great impact on patients’ lives and on the provider’s ability to render appropriate care to patients The keys to preventing the development of pressure ulcers is to identify at-risk individuals as soon as possible so that measures can be implemented.

Objective: To evaluate use of the Braden Scale© on admission and weekly for three weeks in residents admitted to a short-term rehabilitation facility for two months immediately following a …

Implementation Of An Evidence-Based Hospital Acquired Pressure Injury Strategy In The Intensive Care Unit, Tonya C.W. Brigman

Student Scholarly Projects

Practice Problem: Hospital-acquired pressure injuries (HAPI) are a significant concern in healthcare with the most vulnerable group being the adult patients in ICUs leading to increased morbidity, longer hospital stays, and higher healthcare costs.

PICOT: In adult ICU patients (P) does the implementation of daily chlorhexidine gluconate (CHG) baths with post bath barrier cream combined with intentional turning every 2-hours (I) compared to standard skin care practices and nonintentional turning (C) reduce the incidence of hospital-acquired pressure injuries (HAPI) (O) within 10-weeks (T)?

Evidence: The project was based on the analysis of the literature published in the …

Feasibility Of Individualized Toolkits To Reduce Childhood Obesity In A Pediatric Primary Care Setting, Molly Sexe

DNP Projects

Background: Childhood obesity rates continue to rise, leading to comorbid conditions presenting in adolescence and adulthood (Durbin, 2018). Individualized toolkits focusing on various health habits have been identified as an effective intervention in pediatric primary care practices (Byrne et al., 2018; Henderson, 2021; Mead et al., 2017; Smith et al., 2021 & Wright et al., 2018). This project assessed barriers of the current obesity prevention program at a pediatric primary care clinic, Operation Get FIT. This project identified steps to revising Operation Get FIT to tailor it more to the needs and goals of the participating clinic, the providers, and …

Knowledge And Attitudes Toward Baby-Led Weaning In Primary Care, Taylor Schreiner

DNP Projects

Objective

Adequate nutrition is critical for an infant’s growth and development. Around the age of six months, most infants can begin the process of being introduced to table foods. The debate is about what method is safest for the infant, spoon-led feeding or baby-led weaning (BLW).

Methods

This project explored the beliefs, attitudes, and knowledge of both parents of infants and primary care providers (PCP) on baby-led weaning. Data were obtained through the use of pre-and post-surveys following the implementation of specific education for parents and PCPs.

Results

The findings from parents who participated would suggest that most parents who …

Online Diabetes Program Improving Nurses' Competency In School-Age Diabetes Care, Kristina Donovan

Doctor of Nursing Practice Scholarly Projects

Background: Diabetes affects over 280,000 children under 20 in the US, requiring specialized knowledge and skills for management. In a large urban school district with 54,000 students, 159 have diabetes, cared for by 158 school nurses. These nurses often struggle with the complexities of diabetes care and lack standardized training, leading to potential suboptimal care. An online diabetes education program was implemented to improve their competency, knowledge and skills, and confidence in managing diabetes in school-age children.

Methods: An asynchronous online competency-based diabetes education program to improve nurses’ competency to care for school-age children with diabetes was implemented in an …

Traditional Art Dance Therapy To Reduce Stress Levels Of Elementary School Students, Shinta Restu Wibawa, Christantie Effendy, Heny Suseani Pangastuti, Ami Novianti Subagya, Eryono Budi Wijoyo, Aisya Puteri Andari, Dwi Apriliana, Qurrota Aini Zahrotu Sholikhah

Jurnal Keperawatan Indonesia

COVID-19 pandemic has accelerated the development of new learning systems that are more student-centered. Unfortunately, elementary school students experienced stress and difficulties in adapting from face-to-face to online learning system. Online learning environment lacks in accommodating outdoor activities which are important for children. Several techniques can be applied to reduce stress, including dancing. This research aimed to examine the effectiveness of Traditional Art dance Therapy (TATA) for elementary school students in reducing stress. In this quasi-experimental research, one-group pretest-posttest design without control group was applied, involving 84 students at one elementary school in Yogyakarta , Indonesia. Students’ levels of stress …

Examining The Relationship Between Shift Work And Diabetes Mellitus Among Nurses: An Evidence-Based Case Report, Angga Arifianto, Indah Suci Widyahening, Levina Chandra Khoe, M. Ikhsan Mokoagow

Occupational and Environmental Medicine Journal of Indonesia

Background : Work shifts could cause numerous health problems, such as sleep disorders, weight gain disorders, and unhealthy food intake consumption, leading to obesity and changes in blood glucose levels, that eventually lead to diabetes mellitus. This evidence-based case report aims to provide an evidence of association between shift work and the risk of diabetes mellitus among nurses.

Methods : We performed a literature searching from Pubmed, Embase, Cochrane, Scopus, and Google Scholar in September 2023 using keywords ‘shift work’ AND ‘diabetes’ AND ‘nurse’. We included studies that assessed the association between shift work and diabetes among nurses using observational …

Alternative Therapies Of The Banjar People For Children With Fevers, Esme Anggeriyane, Hamzah Hamzah, Nurhikmah Nurhikmah

Jurnal Keperawatan Indonesia

Fevers often occur in children under five years of age due to the immature formation of their immune systems. Such fevers signify that something unusual is happening in the body, often due to illness. Parents conduct various management techniques, such as medical or traditional treatments, based on their beliefs. Banjar society has a health culture known as bapidara, which is used to treat children with fevers presumably attributable to supernatural disturbances. This exploratory research aimed to discover what alternative therapies the Banjar people use to treat children with fevers. This qualitative study used a transcendental phenomenological design. Data collection was …

Self-Efficacy In Salt Consumption Among Patients Undergoing Hemodialysis, Desy Listyaningrum, Melyza Perdana, Anita Kustanti

Jurnal Keperawatan Indonesia

Salt consumption restriction has many advantages in patients on hemodialysis (HD), but it is also very challenging for them. Self-efficacy is a crucial aspect of successful disease management. Factors related to self-efficacy have been evaluated in many countries. However, the different demographic characteristics in Indonesia may show different significant results. Understanding this problem may contribute to the development of nursing interventions and the patients’ self-management ability while undergoing HD. Hence, the present study aimed to determine the factors associated with self-efficacy for restricting salt consumption among HD patients. Altogether, 98 HD patients participated in this cross-sectional study. The Self-efficacy for …

Barriers To Implementation Of Practice Guidelines In Heart Failure, Mary Geisenhof

DNP Projects

In 2022, the most recent guidelines for care of the patient with heart failure (HF) were released by the American Heart Association (AHA), the American College of Cardiology (ACC), and the Heart Failure Society of America (HFSA). In summary, this group did not recommend fluid restriction for patients with heart failure, unless they are in the end stages of heart failure, and only if fluid restriction may be beneficial (Heidenreich et al., 2022). Despite this recommendation, some providers and nurses continue to restrict fluids. The aim of this DNP project, therefore, was to analyze barriers to implementation of best practices …

Student Nurse Experiences Of Retention Strategies And The Perceived Contribution To Academic Progress, Jessica Dugas

Walden Dissertations and Doctoral Studies

There is a worldwide nursing shortage that has been heightened by the COVID-19 pandemic. Several factors have contributed to the worsening shortage, including high attrition rates in nursing programs. Retention strategies have been suggested to support nursing students during their education to have success and graduate. The purpose of this descriptive qualitative study was to explore how nursing students experience retention strategies and their perceived contributions to academic progress. Bandura’s social cognitive theory was the theoretical framework used to guide the study. Data were collected from one-on-one interviews with 12 nursing students recruited using purposeful and snowball sampling. Data were …

Educating Nurses On The Components Of A Healthy Work Environment, Kathryn L. Scott

Doctoral Dissertations and Projects

It is essential to look at the entire picture to ensure patient care is offered in the highest quality manner possible. One must look at patient satisfaction, quality outcomes, and job satisfaction experienced by the nursing staff providing care to accomplish this goal. Research has shown that nurse burnout has increased exponentially as of late. Some blame the COVID-19 pandemic; others look at the generation of nurses graduating from nursing school and starting in the field, comparing the baby boomer nurse to the Gen Z nurse. Many factors are involved, and with the recent addition of paying particular attention to …

Provider Implementation Of Probiotics As An Adjuvant Treatment Modality For Patients With Anxiety And Or Depression In A Primary Care Setting, Sarah Dedmon

Doctoral Dissertations and Projects

The prevalence of anxiety and depression among Americans is growing rapidly. Patients are seeking out traditional treatments as offered by their primary care providers, but also frequently look toward integrative or complementary methods of managing their symptoms. The use of dietary supplements is at an all-time high, yet the U.S. Food and Drug Administration does not regulate these substances for potency and purity or evaluate them using quality standards as it does pharmaceuticals. Most providers lack education regarding the physiological interaction their patients may experience when using these substances and are naïve to their place in primary care medicine. The …

Toward Concurrent Identification Of Human Activities With A Single Unifying Neural Network Classification: First Step, Andrew Smith, Musa Azeem, Chrisogonas O. Odhiambo, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Hanim E. Diktas, Spencer Upton, Corby K. Martin, Brett Froeliger, Cynthia F. Corbett, Homayoun Valafar

Publications

The characterization of human behavior in real-world contexts is critical for developing a comprehensive model of human health. Recent technological advancements have enabled wearables and sensors to passively and unobtrusively record and presumably quantify human behavior. Better understanding human activities in unobtrusive and passive ways is an indispensable tool in understanding the relationship between behavioral determinants of health and diseases. Adult individuals (N = 60) emulated the behaviors of smoking, exercising, eating, and medication (pill) taking in a laboratory setting while equipped with smartwatches that captured accelerometer data. The collected data underwent expert annotation and was used to train a …

Wiping Out Central Line Associated-Bloodstream Infections: Cleaning High Touch Surfaces In The Picu, Emily Heth

Dissertations

Problem: Central line-associated bloodstream infections (CLABSIs) are a significant, preventable healthcare-related complication of hospital admission and medical management of critically ill and medically complex patients. CLABSIs result in significant adverse outcomes such as increased morbidity and mortality, prolonged length of stay (LOS) in the intensive care unit (ICU) and in the hospital, increased cost of treatment, and increased rates of readmission. Direct and indirect contact within the patient’s hospital environment are potential means of transmission for microorganisms, increasing the inherent risk of acquiring a CLABSI.

Method: For this quality improvement (QI) project, a pre-post design was utilized to evaluate the …

Implementation Of The Process Improvement Toolkit For Hospital Acquired Pressure Injuries, Christina Bearden

Dissertations

Problem: Approximately 2.5 million people within the United States receiving inpatient medical care will develop a pressure injury each year (Padula & Demarmente, 2018). Pressure injuries (PI) are a multifactorial complication that can often be avoided with general prophylactic measures. Despite this, inpatient settings around the United States continue to see a rise in PIs.

Method: The quality improvement initiative utilized a descriptive, observational design. The turn team toolkit was implemented and monitored over a two-month period. Patient descriptors and quantitative data were collected through a retrospective chart review. The primary data collected was on pressure injury rates and staff …

Implementation Of Skin-To-Skin Immediately Post C-Section: A Pilot Study, Miah Vernor

Dissertations

Skin-to-skin contact during the golden hour is a practice that has numerous health benefits following the delivery of a newborn. These benefits include a healthy transition to extrauterine state, initiation of breastfeeding, thermoregulation, and more. However, the mode of delivery affects how often this practice is done. Parents who deliver vaginally are routinely offered the opportunity to perform skin-to-skin immediately after delivery whereas birth parents who deliver by cesarean section are not always offered this same benefit due to various reasons. A quality improvement project was conducted on an 18-bed labor and delivery unit at a Midwest hospital. This project …