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Implementation Of Skin-To-Skin Contact Immediately Post Cesarean Birth: A Quality Improvement Project, Sophia Cooke

Dissertations

Problem: Skin-to-skin contact implemented within the first hour of a newborn’s life improves health outcomes for both mother and infant. One of these health outcomes includes exclusive breastfeeding. The purpose of this quality improve project was to implement an infant securement device within the operating room after cesarean section births to decrease the time to initiate skin-to-skin contact and increase exclusive breastmilk feeding rates at discharge.

Methods: This study utilized a descriptive, observational design and was guided by the Plan-Do-Study-Act framework. A pre-test, post-test design was utilized to compared retrospective and prospective data. The retrospective data was collected to assess …

Nursing Staff Education On Enhanced Recovery After Surgery Related To Nurse-Patient Pain Communication, Kathleen Ranne

Walden Dissertations and Doctoral Studies

Perioperative pain is a significant challenge in terms of care of surgical patients which requires effective communication by nurses to improve patient outcomes and satisfaction. The communication component of the Enhanced Recovery after Surgery protocol is a foundation for improved patient outcomes and pain management. The problem that was identified in this Doctor of Nursing Practice project was lack of staff education during the perioperative period related to nurse-patient communications regarding pain management. Using the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this DNP project was to plan, implement, and evaluate a staff education …

Increasing Stroke Symptom Awareness In The Hispanic Community, Karina Barabash

DNP Projects

Ethnic and racial minorities are at higher risk for many health conditions including coronary artery disease and stroke (Mital et al., 2021). The Hispanic population specifically faces more risk factors, less knowledge of stroke symptoms, and higher probability of death and disability post stroke (Eisenstein et al., 2018). Unless this gap is addressed, ethnic and racial minority patients will continue to experience higher rates of death and disability from stroke, compared to non-Hispanic White patients. Therefore, the purpose of this project was to provide clinic-based stroke education in Spanish to Hispanic community members. The goal was to increase awareness of …

Mhealth Intervention For Elevated Blood Pressure Among College Students: Single-Arm Intervention Study, Dieu-My T. Tran, Catherine E. Dingley, Roger Bonilla

Nursing Faculty Research

Background: Current evidence reveals a growing pattern of hypertension among young adults, significantly increasing their risk for cardiovascular disease later in life. Young adults, particularly those of college age, often develop risk factors related to lifestyle choices in diet, exercise, and alcohol consumption. Developing useful interventions that can assist with screening and possible behavioral modifications that are suitable and appealing to college-aged young adults could help with early identification and intervention for hypertension. Recent studies indicate mobile health (mHealth) apps are acceptable and effective for communication and message delivery among this population.

Objective: The purpose of this study was to …

Promoting Healthy Habits Among Children In A Residential Facility., Tiffany Jones

Doctor of Nursing Practice Papers

Background: Childhood obesity has been a significant public health concern in the United States. The prevalence of obesity among children and adolescents has increased over the past few decades. There are serious implications for immediate and long-term health. It poses serious health risks and economic challenges.

Setting: This quality improvement project will take place at a residential psychiatric treatment facility and therapeutic foster care program for children and adolescents with mental health or behavioral issues. This facility is in the suburbs of Louisville, Kentucky.

Purpose: The purpose of this project is to boost physical activity and improve knowledge about nutrition …

Improving Pressure Injury Nurse Awareness And Decision-Making In The Cardiac Intensive Care Unit: A Quality Improvement Project., Sarah G. Moreno

Doctor of Nursing Practice Papers

Abstract

Background/Significance: Hospitalized patients with pressure injuries have 5 times greater death compared to a patient without a pressure injury. A needs assessment identified the problem of pressure injuries in the CVICU with the goal to improve nurse awareness and decision-making to decrease pressure injuries in the CVICU.

Purpose: The purpose of this project was to increase nurse awareness of pressure injury prevention via an education workshop and evidence-based pressure injury decision tree in the Cardiovascular ICU.

Methods: A MeSH search was conducted to identify pressure injury interventions and nurse awareness of pressure injuries which resulted in 17 …

Evidence-Based Diabetes Exercise Intervention, Laura Smith

Nurse Residency

Type 2 diabetes mellitus is a chronic, noninfectious disease that affects a large population of adults in the world. Typically, it is associated with obesity, a sedentary lifestyle, and the consumption of undesirable meals (Nakrani et al., 2020/2023). Even with various treatments available for type 2 diabetes, most patients find it challenging to maintain a steady blood glucose level.

Exploring Maternal Perspectives On Human Milk Banks In Pakistan And Identifying Barriers And Enablers For Establishment, Hina Baba Jan, Naghma Rizvi, Kiran Mubeen, Marina Baig

Journal of Asian Midwives (JAM)

Background: Low-and middle-income countries including Pakistan still have low breastfeeding rates and infant feeding remains a concern. Human milk banks (HMBs) play a crucial role in neonatal and infant health by providing safe, pasteurized donor human milk to infants who do not have access to their mother's own milk, particularly preterm and low-birth-weight infants. The perception regarding the concept and use of HMBs has yet to be explored in several contexts, especially in the low-and middle-income countries including Pakistan.
Aim: To explore the perceptions of mothers regarding human milk banks in Pakistan, focusing on the barriers and enablers to …

Balancing Life After Spousal Loss: A Cross-Sectional Study Investigating The Mental Well-Being And Life Satisfaction Of Martyrs’ Wives, Mehreen Aslam, Ambreen Tharani, Yasmin Parpio, Rafat Jan

Journal of Asian Midwives (JAM)

Background: The wives who have lost their spouses in conflict zones are known as martyrs’ wives. After sacrificing the martyrs’ lives, their wives not only face the traumatic experience of losing their loved ones, but this loss may substantially affect their physical, socioeconomic, and emotional health. It may serve as a "vulnerability factor," raising the risk of depression.
Objective: To assess the levels of life satisfaction and mental well-being within the wives of martyrs residing in Karachi, Pakistan.
Methodology: A descriptive cross-sectional study was conducted to assess the mental well-being and life satisfaction of martyrs’ wives living in Karachi Pakistan. …

The Effectiveness Of Nurse Assistants Training Programme On Safe Motherhood: A Study On Bhutanese Nurse Assistants, Jureerat Kijsomporn, Nualyai Pitsachart, Phayong Thepaksorn, Ling Shing Wong, Vinodhkumar Ramalingam, Voon Wan Niu

Journal of Asian Midwives (JAM)

Background: This study aims to investigate the ability of nurse assistants in midwifery care in Bhutan to apply their knowledge and skills after attending the training programme.
Methods: A qualitative methodology was utilized in this study, in-depth interviews using a semi-structured interview guide questionnaire with five nurse assistants, three district health officers, and two medical doctors from hospitals. The interviews (n=10) were conducted on-site at basic health units in URA and Tang, Bhutan.
Results: The data analysis of their perceptions yielded three major categories: (1) Confirmability, the Quality of knowledge and skills of the program; (2) Credibility, Effectiveness, and comprehensiveness …

Determinants Of Underutilization Of Maternal Health Services In Anc Clinics In Lmics: A Narrative Review, Jonathan Johnson, Rubeka Mansha, Abeer Musaddique

Journal of Asian Midwives (JAM)

Background: Antenatal care (ANC) is critical for achieving Sustainable Development Goals (SDG) 3.1 and 3.2, aiming to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030, and to decrease neonatal and under-5 mortality rates. Despite its importance, approximately 830 women die daily from preventable pregnancy and childbirth causes, predominantly in low-resource settings.
Methods: The study conducted a comprehensive literature search from January 1, 2009, to December 30, 2020, focusing on delayed initiation of ANC in low- and middle-income countries (LMICs). The search used multiple databases and included observational research and Demographic …

Decreasing Overall Breast Cancer Risk Through Assessment, Treatment, And Prevention Of Vitamin D Deficiency In The Adult Population, Rachel Jamison

Doctor of Nursing Practice Scholarly Project

The primary objective of this study is to examine the effectiveness of an educational initiative aimed at enhancing nurse practitioners' understanding and recognition of vitamin D deficiency. The purpose of this program is to equip them with the skills to screen, diagnose, and manage this condition to mitigate the overall risk of breast cancer in patients. Vitamin D deficiency is a prevalent global health issue that affects over one billion people, and it can manifest at any stage of life without showing any symptoms, making it challenging for healthcare providers to detect. However, even mild or prolonged deficiencies can lead …

Role Of Hospital Leadership In Pandemic Preparedness: Experience At A Tertiary Hospital In Kenya During The Covid-19 Pandemic, Lucy Wangari, William Macharia, Benjamin Wachira, Jemimah Kimeu, Boniface Mativa, Lukoye Atwoli

Emergency Medicine, East Africa

Introduction Pandemic preparedness refers to being ready for, responding to and recovering from public health crises, and is integral for health security. Hospital leadership is a critical building block of an effective healthcare system, providing policy, accountability and stewardship in a health crisis.

Objectives and methods We aimed to describe the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi, a private not-for-profit tertiary healthcare facility, following the COVID-19 pandemic. We reviewed over 200 hospital documents archived in the COVID-19 repository including those received from the Kenya Ministry of Health, emails, memos, bulletins, meeting minutes, …

Implementation And Evaluation Of A Neonatal Resucitation Program Protocol In Stand-Alone Emergency Department, Hannah Collins Walden

Doctor of Nursing Practice Scholarly Projects

Problem statement: Within nursing there are some skills that hold a significant amount of risk. This includes neonatal resuscitation within stand-alone emergency departments. Due to the low frequency of opportunities to practice neonatal resuscitation, nurses must utilize alternative methods to maintain current evidence-based practice. Purpose: The purpose of this project was to evaluate the effectiveness of a protocol incorporating Neonatal Resuscitation Program (NRP) preparedness and simulation to increase stand-alone emergency department nurses’ perceived clinical competence to performing neonatal resuscitation. Methods: The development and implementation of a protocol that defines and incorporates NRP roles, provides a maintenance checklist for …

Implementing The 5a’S Of Obesity Management In Primary Care, Holly H. Rowell

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The prevalence of obesity continues to increase globally, with greater prevalence in the southern United States, resulting in higher costs to the healthcare system and greater risks for the development of other chronic diseases. Purpose: Determine if implementing the 5A’s of Obesity Management among primary care providers in a rural, low-income healthcare setting will increase the diagnosis of obesity and result in a subsequent decrease in weight among patients who are obese. Methods: An educational session was held to familiarize providers with the 5A’s of Obesity Management and the importance of obtaining and documenting proper height …

Impact Of Hydrogen Peroxide Wipes Disinfecting Clostridioides Difficle On High-Touch Surfaces, Tyler Wolf Ramirez

Doctor of Nursing Practice Scholarly Projects

Clostridioides difficile is the leading cause of nosocomial diarrheas worldwide (Centers for Disease Prevention and Control [CDC], 2022). 15% of all hospitalized patients in the United States develop antibiotic-associated diarrhea (AAD), with 15-25% of cases caused by C. difficile (CDC, 2022). C. difficile costs the United States Healthcare system $5.4-6.3 billion annually (Balsells et al., 2019). The project’s purpose was to see if implementing hydrogen peroxide (H2O2) wipes using an interprofessional team leads to the following expected outcome(s): reduction in hospital-acquired C. difficile infections and comparable disinfection rates to sodium hypochlorite. An interprofessional team consisting of the primary lead, Clinical …

Menstrual Hygiene Amongst School Girls: Still A Messy Business, Naghma Rizvi, Saleema A. Gulzar, Tazeen S. Ali, Syeda Aleena Fazal, Alishah Aziz Gulzar, Yasmin Parpio, Rimsha Hirani

Journal of Asian Midwives (JAM)

Background: Menstruation has become a taboo topic among adolescent females, affecting their reproductive health, particularly in more traditional South Asian nations such as Pakistan. The study highlights the societal silence surrounds menstruation, which leads to detrimental practices and attitudes among school-age females. The study reveals the sociocultural, psychological, and educational challenges that teenagers encounter. The presence of myths and misconceptions adds to unsanitary habits, which undermine education and reproductive health.
Methodology: A descriptive cross-sectional study was conducted in urban Karachi. The participants were 850 unmarried school-going female adolescents aged 13 to 19. The data were collected using a pre-coded questionnaire. …

Use Of Social Media For Receiving Professional Support In Enhancing Mothers’ Lactation Self-Efficacy, Mehtab Lalwani, Zohra Kurji, Salma Rattani, Zahra Shaheen, Hussain Maqbool Ahmed Khuwaja, Shabina Ariff

Journal of Asian Midwives (JAM)

Background: Insufficient support for breastfeeding and limited exclusive breastfeeding rates emphasize the need for high-impact approaches to enhance maternal confidence in lactation. Social media has emerged as a promising platform for professional support and information dissemination in this context. This review aims to examine the role of social media in providing professional lactation support to mothers in enhancing their lactation self-efficacy.
Method: Employing PRISMA guidelines, the review sought relevant literature on professional assistance in enhancing breastfeeding self-efficacy. Major databases, including PubMed, CINAHL, Google Scholar, and Science Direct, were meticulously queried using targeted keywords. Every selected article underwent screening for English …

Enhancing Maternal And Fetal Well-Being: Exploring The Determinants Of Preconception Care, Mahak Mehdi Hashim Mehdi Hashim, Nurmeen Anwar Ali

Journal of Asian Midwives (JAM)

Preconception care is the delivery of biomedical, behavioral, and social health interventions to women and couples of reproductive ages. The significance of care is emphasized by the World Health Organization (WHO), as it greatly affects the quality of life of the mother and child. However, the uptake of pre-conception care services in Low and Middle-income countries (LMIC) such as Pakistan is low due to several factors. This discussion paper will identify some of the contextual factors related to the quality of health care services, acceptability due to cultural value beliefs, and affordability that largely influence the utilization of preconception care …

Nutric: Enhancing Surgical Intensive Care Unit Patient Nutrition Consultations, Misty Armstrong

Doctor of Nursing Practice Projects

Background: Daily nutritional screenings in the critical care population can identify patients in need of nutritional modifications during hospital admission. Inadequate nutritional assessments of critically ill patients lead to poor outcomes. Daily nutritional assessments result in the early identification of patients at risk for nutritional compromise compared to weekly assessments.

Purpose: The purpose of this project was to incorporate a daily nutritional assessment using the Nutrition Risk in the Critically Ill (NUTRIC) scores for patients in a surgical intensive care unit to identify patients in need of a referral to a registered dietician.

Methods: The method for this project used …

Improving Early Detection And Treatment Of Chlamydia By Implementing A Routine Chlamydia Screening And Testing In Females Between The Ages Of 18–24, Isabelle Vikumitsi

Doctor of Nursing Practice Projects

Background: Chlamydia Trachomatis is the most frequently reported bacterial sexually transmitted infection in the United States. One in 20 sexually active females between the ages of 15 and 24 have chlamydia. Most people with the infection are asymptomatic and do not seek treatment. Chlamydial infections in women, especially if untreated, increase the risk of infertility and ectopic pregnancy, leading to higher medical costs.

Purpose: The project aimed to implement early screening for chlamydial infections in the young adult population to increase early detection of the disease.

Methods: A pre-post design was used for this project to compare chlamydia diagnosis rates …

Examining Risk Factors For Early-Onset Breast Cancer, Jennifer Grace Taylor

Theses and Dissertations

Introduction: There have been great advancements in screening and in the identifying of risk factors associated with breast cancer, however, there is a lack of information of these factors in women with breast cancer occurring under the age of 45, known as early-onset breast cancer (EOBC). EOBC is often found at later stages, negatively impacting young women’s careers, family planning, and mental health. Additionally, because of the health disparities that exist within the U.S. health care system, women belonging to racial and ethnic groups, specifically young Black women, tend to have poorer outcomes and higher mortality rates of EOBC …

Examining Risk Factors For Early-Onset Breast Cancer, Jennifer Grace Taylor

Theses and Dissertations

Introduction: There have been great advancements in screening and in the identifying of risk factors associated with breast cancer, however, there is a lack of information of these factors in women with breast cancer occurring under the age of 45, known as early-onset breast cancer (EOBC). EOBC is often found at later stages, negatively impacting young women’s careers, family planning, and mental health. Additionally, because of the health disparities that exist within the U.S. health care system, women belonging to racial and ethnic groups, specifically young Black women, tend to have poorer outcomes and higher mortality rates of EOBC compared …

A Quality Improvement Project To Reduce Facility-Acquired Pressure Injuries, Carolina Rosario

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Facility-acquired pressure injuries (FAPIs) pose significant risks to patient outcomes and healthcare costs ($500 to $70,000 per PI) in subacute rehabilitation (SAR) facilities. An assessment in a SAR identified a concerning pressure injury (PI) rate of 15.3%, exceeding the national benchmark of 10% for such facilities. This prompted an evidence-based quality improvement (QI) initiative.

Aim of the Project: This project aimed to reduce FAPI rates by 30% or greater among patients 65 and older using a PI prevention bundle called SSKINS (Skin, Surface, Keep moving, Incontinence/moisture, Nutrition/hydration, Self-management).

Review of the Evidence: A comprehensive literature review indicated that PIs …

Correlations Of Physical And Psychological Health In Parents Of Individuals With Autism Spectrum Disorder, Norah L. Johnson, Abir K. Bekhet, Emily Zint, June Wang, Sylvia Peña, Amy V. Van Hecke, Mauricio Garnier-Villarreal, Alexander V. Ng

College of Nursing Faculty Research and Publications

Background: Individuals with autism spectrum disorder (ASD) have social communication difficulties and restricted, repetitive, and/or sensory behaviors or interests. The prevalence of ASD is now 1 in 36 individuals. Parents of individuals with ASD face challenges that can affect their physical and psychological wellbeing.

Objective: With the long-term goal to tailor an exercise program, the purpose of this study was 2-fold: (1) establish the baseline physical and mental health of parents of individuals with ASD and (2) estimate the relationship of physiologic variables with psychological variables of health for parents of individuals with ASD.

Methods: This descriptive, cross-sectional study (N …

A Guide To Understanding Big Data For The Nurse Scientist: A Discursive Paper, Henry Ofori Duah, Samantha J. Boch, Sara Arter, Nichole Nidey, Joshua Lambert

College of Nursing Faculty Research and Publications

Big data refers to extremely large data generated at high volume, velocity, variety, and veracity. The nurse scientist is uniquely positioned to leverage big data to suggest novel hypotheses on patient care and the healthcare system. The purpose of this paper is to provide an introductory guide to understanding the use and capability of big data for nurse scientists. Herein, we discuss the practical, ethical, social, and educational implications of using big data in nursing research. Some practical challenges with the use of big data include data accessibility, data quality, missing data, variable data standards, fragmentation of health data, and …

Optimal Fat-Modified Diet Duration For The Treatment Of Postoperative Chylothorax In Children, Melissa M. Winder, Stephanie Schwartz, Jason R. Buckley, Kristi L. Fogg, Megan Matiasek, Alissa Lyman, Alisa Tortorich, Kathy Holmes, Deborah U. Frank, Mandy Nasworthy, Piyagarnt E. Vichayavilas, Rebecca A. Bertrandt, Cam Kasmai, Jill C. Kuester, Tia T. Raymond, Lawrence E. Greiten, Ron W. Reeder, David K. Bailly

College of Nursing Faculty Research and Publications

Background

Dietary modification is the mainstay of treatment for postoperative cyclothorax in children. However, optimal fat-modified diet (FMD) duration to prevent recurrence is unknown. Our aim was to determine the association between FMD duration and chylothorax recurrence.

Methods

Retrospective cohort study conducted across 6 pediatric cardiac intensive care units within the United States. Patients aged < 18 years who developed chylothorax within 30 days after cardiac surgery between January 2020 and April 2022 were included. Patients with a Fontan palliation, who died, or were lost to follow-up or within 30 days of resuming a regular diet were excluded. FMD duration was defined as the first day of a FMD when chest tube output was < 10 mL/kg/d without increasing until the resumption of a regular diet. Patients were classified into 3 groups (< 3 weeks, 3-5 weeks, >5 weeks) based on FMD duration.

Results

A total of 105 patients were included: < 3 weeks (n = 61) 3-5 weeks (n = 18), and >5 weeks (n = 26). Demographic, surgical, and hospitalization characteristics were not different across groups. In the >5 weeks group, chest tube duration was longer compared with the < 3 weeks and 3-5 weeks groups (median, 17.5 days [interquartile range, 9-31] vs 10 and 10.5 days; P = .04). …

Lived Experiences, Perceptions, And Caregiving Trajectories Of Family Caregivers Of Youth With Substance Use Disorders (Suds) In Zambia, Ireen Manase Kabembo

Lingnan Theses (MPhil & PhD)

There is unequivocal evidence that family caregivers contribute to healthcare systems worldwide by providing care for persons with chronic illnesses in the home setting. his study explores the lived experiences, perceptions, and caregiving trajectories of 30 family caregivers of youth aged 16-24 diagnosed with Substance Use Disorders (SUDs) in Zambia. Data was collected through in-depth semi-structured interviews, a caregiving timeline, and participant observation and analysed using interpretative phenomenological analysis. Guided by the integrated theoretical framework of positioning theory and the theory of caregiving dynamics, this study offers a new lens for understanding caregiver’s experiences regarding caregiver identity, self-perceptions, interpersonal relationships, …

The Effectiveness Of Pressure Injury Prevention Through Educational Intervention Within The Long-Term Care Setting, Ashley Nunley

Doctor of Nursing Practice Projects

The prevalence of pressure injuries, particularly in older adults, continues to be disturbingly high, especially in those suffering from chronic diseases and frailty, bringing a higher awareness of applied preventive and therapeutic measures (Jaul et al., 2019). In long-term care nurses, will an educational, evidenced-based pressure ulcer prevention program impact health outcomes by increasing nurses’ knowledge, compared to no intervention over four weeks? The Pieper-Zulkowski Pressure Ulcer/Injuries Knowledge Test was used to evaluate the nurse's pressure injury knowledge pre- and post-educational intervention. The paired t-test was used to analyze the pre-and post-test data from the educational intervention. This DNP project …

Increasing Nurses’ Knowledge Of Cultural Preferences Influencing Diabetes Self-Management Among Sierra Leoneans, Winstina Aminata Taylor

Walden Dissertations and Doctoral Studies

The practice problem identified at the project site was the lack of nurses’ knowledge of how cultural preferences influence diabetes self-management practices among African Americans with diabetes mellitus. An educational program focused on the cultural preferences of Sierra Leoneans that influence diabetes self-management practices was provided for 48 nurses who worked in the agency. The doctoral project included concepts from nursing education and cultural competence theories to inform the approach. The project followed the ADDIE model process steps to develop and implement the educational program. The sources of evidence included pre- and posteducation surveys administered to participating nurses to assess …