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Examining Provider Perspectives On Implementation Of An Integrated Primary And Behavioral Health Care Model In The Outpatient Setting: A Qualitative Study, Holly Gray

DNP Projects

AIM The purpose of this qualitative descriptive research study was to identify and describe primary and mental health provider perspectives, including attitudes and knowledge related to integration of primary and behavioral health care in the outpatient setting. One objective of this project was to gather information from providers in both primary and behavioral health settings to ascertain how they perceive the idea of integrated care. Another objective of this project was to gather information about provider perception of current practice protocols for treatment of patients with comorbid physical and mental health issues, perceived facilitators and barriers to integrated care, and …

Psychological Well-Being Among Breast Cancer Survivors: Factors That Influence Transition From Primary Treatment To Early Survivorship, Celestine G. Gochett

Theses and Dissertations--Nursing

Eudaimonic psychological well-being (PWB) refers to a lifelong process of purposeful engagement in goal-driven tasks or activities resulting in positive psychological functioning. These activities reflect autonomy, purpose in life, self-acceptance, personal growth, positive relations with others, and environmental mastery. While more women are surviving breast cancer, they face a multitude of late and long term physiopsychosocial challenges that result from being diagnosed and treated. Protective health effects associated with the experience of PWB can potentially mitigate ill-being and benefit overall health of breast cancer survivors (BCS). Adequate preparation by healthcare teams to transition them from primary treatment to early survivorship …

Explore The Relationship Among Lung Cancer Stigma, Social Support, And Psychosocial Distress, Lisa Maggio

Theses and Dissertations--Nursing

There is longstanding causal relationship between cigarette smoking and lung cancer. Smoke-free policies and anti-smoking campaigns have been linked to the decline in smoking acceptance and contribute to the unintended consequence of stigmatizing smokers. Lung cancer is viewed as a self-inflicted disease and patients’ feel judged in a manner different from other cancers affecting social interactions between family, friends, and healthcare professionals. Lung cancer stigma contributes to depression, anxiety, poor self-esteem, guilt, shame, blame, threatens a person’s social identity, and limits social support that deeply affects patients and their support persons.

This dissertation contains a review of the literature related …

The Impact Of Nursing A Significant Other In The Course Of Employment, Tania Arnold

Theses: Doctorates and Masters

This thesis describes the experiences of nurses and midwives working in metropolitan hospitals who cared for a significant other in their role of employment.

The absence of research directly related to this topic guided the exploration of individuals’ experiences to establish base line knowledge relating to this phenomenon.

This study used descriptive research to provide information relating to the personal and professional effects on nurses who were required to, chose to or had no choice but to care for a significant other in their role of employment. An on-line survey gathered demographic, Likert scale responses to evaluate impact on care, …

Outcomes Associated With Blood Component Transfusion In Adult Trauma Patients, Allison R. Jones

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate outcomes associated with blood component (BC) transfusion in adult trauma patients. Specific aims were to: 1) explore the relationship between traumatic injury, hemorrhage, and BC transfusion, focusing on consequences of the component storage lesion through presentation of a conceptual model; 2) systematically review research literature comparing outcomes of massively transfused major trauma patients based on ratios of BCs received; 3) evaluating the relationship between type of blood transfusion trauma patients received (whole blood versus BCs) and mortality likelihood after controlling for demographic and clinical variables; 4) evaluating the relationship between volume and …

A Comparative Evaluation Of The Learner Centered Grading Debriefing Method In Nursing Education, Marisa J. Belote

USF Tampa Graduate Theses and Dissertations

The nursing discipline lacks a consensus on a best practice method for debriefing students following simulation-based training. A recognized, standardized method does not exist and various methods are utilized within the domain. The similarities between aviation and healthcare are well documented. Training members of both disciplines require standardization and methods of best practice. The aviation industry through the Federal Aviation Administration has found Learner Centered Grading (LCG) to be a successful educational format. The utilization of the LCG Debriefing method in simulation-based training is the standardized debriefing format for a technologically dynamic industry.

The aim of this research was to …

Sleep, Depressive Symptoms And Cognition In Older Adults And Caregivers Of Persons With Dementia, Glenna Shemida Brewster

USF Tampa Graduate Theses and Dissertations

Caregivers of persons with dementia, who are often older adults, report sleep disturbance, high rates of depressive symptoms and may be at risk for impaired cognition. This dissertation examined sleep, depressive symptoms, and cognition in older adults and caregivers of persons with dementia. The aims of the review of literature were to understand, in community dwelling adults 60 years and older, the relationships among sleep parameters (sleep onset latency, wake after sleep onset, sleep efficiency, total sleep time, and general sleep complaints), and the domains of cognition (Executive Function, Attention, Episodic Memory, Working Memory, Processing Speed), and global cognition. Based …

Strategies To Prevent The Unintentional Retention Of Foreign Objects In Surgical Patients, Leonard Harichand Ramdas

Walden Dissertations and Doctoral Studies

The Institute of Medicine's report in 2000, To Err Is Human: Building a Safer Health

System, highlighted the seriousness of medical errors in the U.S. health care system. The unintentional retention of foreign objects in surgical patients is one of those errors. At the time of this study, there was no standardized counting policy and process across operating rooms in the United States. The purpose of this project was to develop a best practice educational counting program to help prevent the unintentional retention of foreign objects in surgical patients. The Logic Model was used to guide the design of the …

Caregiver Perceptions Of Healthcare Providers And Environments Related To Children With Autism Spectrum Disorder, Deanna Klettlinger, Lynn Wirfel, Brittany Bielak

Williams Honors College, Honors Research Projects

The healthcare setting can be intimidating for any child. For children with autism spectrum disorder (ASD), in particular, this setting can cause anxiety and elicit disruptive behavior. The reactions of children with ASD to healthcare settings have not been widely studied. This study explores the lived experience of caregivers of children with ASD related to healthcare providers and environments. A qualitative phenomenological approach and methods guide the study. Purposive sampling was utilized at a resource center to identify and recruit participants fulfilling inclusion criteria. Sample size consisted of four female and two male adults. Semi-structured interviews were performed and voice …

The Effect Of An Educational Hunger Cues Intervention On Awareness In Mothers With Infants, Juliana F. Gill, Ellen A. Vierheller

Williams Honors College, Honors Research Projects

Stress to an infant can inhibit the ability to properly feed and gain the nutrients that are essential for efficient growth. Mothers who are unaware of early hunger cues from their infant have the potential to stress the infant if their early hunger cues are not attended to. The purpose of this study was to examine the effect of an educational hunger cues intervention on awareness in mothers with an infant. The following research question will be answered: Will new mothers who complete an educational intervention show increased awareness of hunger cues in their infants, in comparison to before the …

A Comparison Of Empathy In Sophomore And Senior Baccalaureate Nursing Students, Alexandra I. Woods, Stephanie Malachin

Williams Honors College, Honors Research Projects

Empathy is a cognitive process rather than an emotional and is often learned through life. Hildegard Peplau’s theory of interpersonal relations explains the importance of the nurse having a shared experience with the patient. Empathy is a crucial skill for nursing students to develop because it is shown that nurses showing empathy is directly related to improved patient satisfaction. Empathy levels tend to decrease as students progress throughout nursing school. The purpose of this study is to examine the empathy levels in sophomore baccalaureate nursing students compared to senior baccalaureate nursing students. Using a descriptive comparison design and a cross-sectional …

Assertiveness In Nursing Students, Kaitlin F. Amicone, Rachel Miller

Williams Honors College, Honors Research Projects

The problem that this study focused on was that there was minimal evidence on whether or not nursing students become more assertive throughout their academic education. The purpose of this study was to compare the assertiveness scores of sophomore level nursing students and senior level-nursing students. The study was guided by Hildegard Peplau’s theory of interpersonal relations in nursing, which focuses on the therapeutic process between nurses and patients, rather than on internal patient pathology. The descriptive, comparative study used a 15-question survey design and a convenience sample of sophomore and senior level nursing students at a large urban Midwest …

A Systematic Review: Non-Pharmacological Interventions For Chemotherapy-Induced Nausea And Vomiting, Miranda L. Ayers, Olateju F. Olowe

Williams Honors College, Honors Research Projects

Around 70-80% of patients receiving chemotherapy are at risk of chemotherapy-induced nausea and vomiting (CINV), which can interfere with appetite and the ability to perform normal activities for daily living. When CINV is severe, psychological distress, depression, and physiological impairment occur. Patients may also stop chemotherapy treatments, which can lead to untimely deaths. The aim of this systematic review was to identify, describe, and evaluate the evidence about the use and effectiveness of non-pharmacological interventions, compared to no use of non-pharmacological interventions, on self-reported episodes of CINV among the cancer patients. Twenty articles were reviewed on the use of acupressure, …

Induced And Spontaneous Labor Education: Evaluation, Knowledge, And Intent To Discuss Options In Pregnant Women, Kathleen Hartzell, Katherine Bartolotta

Williams Honors College, Honors Research Projects

Labor inductions are increasing worldwide, with rates continuing to rise each year. Currently 30% of labors in the United States result from inductions. The purpose of the study was to examine the effect of an educational intervention about induced and spontaneous labor on knowledge and intent to discuss options with health providers in pregnant women. This study was guided by the health-belief model which explains that people’s beliefs about how a health care decision may affect their lives affect how they make the decisions. This study was conducted using a quantitative and descriptive design with pre and post paper and …

Health Behaviors Of Mandated And Voluntary Students In A Motivational Intervention Program, Donna M. Kazemi Phd, Rn, Cne, Fiaan, Maureen J. Levine, Jacek Dmochowski, K Roger Van Horn, Li Qi

Publications

UNLABELLED: College students engage in many unhealthy behaviors, one of these, heavy alcohol use, is a major global public health problem. OBJECTIVE: This longitudinal study examined whether students' mandated/voluntary status in a program to reduce college drinking was associated with overall health, ethnicity, gender, and personality traits. Both mandated and voluntary groups participated in the Motivational Intervention (MI) program to prevent high risk drinking. METHODS: Freshmen (710 voluntary, 190 mandated, n = 900) between the ages of 18 and 21, received the MI at baseline and again at 2 weeks, with boosters at 3, 6 and 12 months. Participants completed …

African Americans' Culturally Specific Approaches To The Management Of Diabetes, Ida J. Spruill, Gayenell S. Magwood Phd, Rn, Faha, Faan, Lynne S. Nemeth, Tiffany H. Williams

Publications

Spirituality is an important multidimensional cultural resource and coping strategy used by many African Americans for managing chronic diseases such as diabetes. Yet, few studies examine meaning and interpretation of colloquial terms frequently used for coping within the context of a community culture. We designed an interpretive qualitative study to gain a deeper understanding of a colloquial phrase, "I ain't claiming it," used among Project SuGar research participants when discussing diabetes. Thematic analysis revealed two major themes, Acknowledgment and Denial, as coping mechanisms through an active or passive relationship with God. Sub-theme of acknowledgment was presented as front seat driver …

Diversity, Inclusion And Organizational Citizenship Behaviours: A Study Of Nurses In The Irish Healthcare Sector, Deirdre O'Donovan

PhDs

This thesis focuses on inclusion, national culture and Organizational Citizenship Behaviour (OCB) in the Irish healthcare sector. Due to the high number of migrant nurses employed in the sector, the level of understaffing and subsequent requirement for effective performance and behaviours, the Irish healthcare sector was chosen as the primnary focus for the research. In particular, the study draws on in-depth interviews undertaken with 37 nurses and midwives, from four cultures, currently employed in hospitals in Cork. Analysis of the interviews resulted in the identification of a number of findings. One significant finding concerns the identification of a set of …

Sweet Slumber: A Case For Melatonin As A Sleep Aid, Destiny L. Morris

Graduate Research Projects

No abstract provided.

Using Servqualto Identify Gaps In Quality Care For Patients With Cystic Fibrosis: A Hospital-Based Quality Improvement Project, Alisha M. Nadeau

Master's Theses and Capstones

Background: Cystic Fibrosis (CF) Care Centers were established to centralize and integrate the knowledge and skills of pulmonary medicine, nutrition, gastroenterology, nursing, respiratory therapy, social work, and genetics to efficiently provide care for people living with CF. The high quality, specialized care that is given at CF Care Centers has led to the improved length and quality of life for people living with CF.

Aim: The aim of this quality improvement project was to identify any gaps in providing effective, high quality care to patients with CF to reduce the variability in nursing practices and improve their quality …

Be Seen And Heard Being Clean: A Patient-Centered Approach To Hand Hygiene At Concord Hospital, Ashley Pinkham

Master's Theses and Capstones

Background: Regular hand washing is recognized as the most effective means to combat the spread of infectious illness; however hand washing behavior amongst health care workers (HCW’s) is inconsistent. Furthermore, measurement of hand washing behavior is subject to bias.

Aim: This quality improvement project aimed to remove the Hawthorne effect and improve the behavior of HH at Concord Hospital.

Methods: A quasi-experimental, pre-posttest design was used to evaluate HH rates on a 32 bed med-surge unit at Concord Hospital. Baseline data was collected for 30 days by asking patients if they had seen or heard staff cleaning their hands. Using …

Treatment Outcomes For Opiate Addicted Pregnant Women, Jennifer L. Roth Parr

DNP Projects

The problem of opiate addiction is complex enough but compounded when the patient is pregnant. Substance use during pregnancy produces harmful and costly effects to both the mother and the fetus (Veilleux, Colvin, Anderson, York & Hines, 2010). The rate of opiate addiction among pregnant women in the U.S. has been increasing in epidemic numbers since the beginning of the 21st century. This paper looks at research on the origin of the problem, the demographics of the average pregnant opiate addicted patient, the effects on the woman and her unborn child, and available treatment options.

Prenatal Anxiety And Cesarean Delivery In A Clinic Population, Carol A. Kirby

DNP Projects

Although there is an abundance of literature on the topics of prenatal anxiety, stress, depression, etc. during pregnancy, very little research has been conducted on the impact of prenatal anxiety on cesarean delivery and the studies which have been conducted have resulted in conflicting results. This study focused on prenatal anxiety in a clinical population, the characteristics of participants with reported high anxiety, and its association with cesarean deliveries. Prenatal anxiety was defined as Spielberger’s state anxiety and measured with the STAI. Data was collected over all three trimesters of pregnancy and post-delivery. The characteristics of participants who reported high …

Assessment Of Patient Barriers To And Facilitators Of Screening Colonoscopy: Utilizing Patient Perspectives To Formulate Recommendations To Improve Colorectal Cancer Screening Rates, Heather N. Cox

DNP Projects

A pilot study was conducted that utilized focused patient interviews to determine patient barriers to and facilitators of screening colonoscopy. The interviews were transcribed and systematically analyzed to detect recurring patterns and themes related to screening colonoscopy completion or lack thereof. Descriptive statistics were used to summarize additional sample characteristics such as gender, education level, and income level. Among those who had received a screening colonoscopy (44%, 11 of 25), provider recommendation was the most influential factor for procedure completion, followed by the combination of provider plus family member recommendation. Additional findings revealed that due to medical necessity, several patients …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Assessment Of Organizational Readiness: Parent Advisory Councils In A Children's Hospital Within A Hospital, Suzanne R. Springate

DNP Projects

Background: A children’s hospital within a hospital (CHWH) in the Midwest region of the United States established a strategic goal to become the preferred provider for children in the region. Outcomes in patient and family experience had fallen short of established organizational expectations. Recognizing that parent advisors are an essential component of patient and family centered care, the strategic plan called for integrating parents into formal, advisory roles.

Purpose: The purpose of this practice improvement project was to perform an assessment of organizational readiness to incorporate parents into formal advisory roles at this CHWH.

Methods: A cross-sectional survey design was …

Dnp Practice Inquiry Project Report: Depression Screening In Primary Care, Mary Kathleen Stafford

DNP Projects

Depression affects many people worldwide and is a leading cause of disability. National guidelines and recommendations have been created that support screening for depression in the primary care setting, however due to many barriers depression screening is often not performed or documented. This capstone project consists of three manuscripts, which evaluate the lack of depression screening in the primary care setting. The first manuscript is an integrative review of the literature to support depression screening in primary care and to address barriers to depression screening. The second manuscript is a guideline analysis of a national guideline published by the Institute …

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

Stress In Parents Of Children With Type 1 Diabetes, Megan B. Carter

DNP Projects

Pediatric healthcare providers across the country care for many children with complex chronic diseases. Many of these children are not developmentally mature enough to manage their disease process, leaving the parent of the chronically ill child to manage their disease. The parent of the chronically ill child may experience stress related to their child’s illness, termed pediatric parenting stress, and may have difficulty dealing with this stress (Streisand, Kazak, & Tercyak, 2003). The manuscripts in this Practice Inquiry Project further investigate the relationship between pediatric parenting stress and the health of the parent and the chronically ill child. The instruments …

Evaluation Of An Educational Intervention To Improve Nurse Managers' Understanding Of And Self-Assessed Competence With Personnel Budgeting, Sue J. Mcfarlan

DNP Projects

Purpose: The purpose of this paper is to report on the process and outcomes of a DNP practice inquiry project.

Design: The design is a pretest posttest comparative evaluation.

Setting: The University of Kentucky Healthcare Chandler, Samaritan, and KY Children’s hospitals.

Subjects: A voluntary convenience sample of nurse managers was obtained (n=10)

Intervention: The intervention was a 2 hour didactic session and an individualized one-on-one educational session focused on general healthcare finance terms and more specifically on personnel budgeting and productivity metrics

Measures: The pretest and posttest consisted of 20 questions obtained from healthcare finance texts and preparatory materials for …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …