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Hypertension And Treatment Modalities: What Does The Current Evidence Say?, Luis R. Tellez

Cohort XII

Background/Problem Statement: The significantly elevated rates of cardiovascular (CV) disease observed among individuals with mental health conditions might stem from suboptimal handling of cardiovascular risk factors. In this project, I sought to address one aspect of cardiovascular risk: hypertension in patients 18-74 years of age, marked with a blood pressure >140/90 mmHg in a psychiatric inpatient setting. A tenday review of patient care revealed that hypertension management provided to patients under our service was inadequate and might be improved by adopting and implementing more consistent and systematic protocols for medication administration.

Aims/Methods: At the onset of my project, I undertook …

Addressing Social Determinants Of Health In Medication-Assisted Treatment Programs, Audrey Hunter

The Eleanor Mann School of Nursing DNP Capstone Projects

Introduction: Medication-assisted treatment (MAT) is considered the most effective treatment for patients with opioid use disorder (OUD); however, MAT program retention rates are consistently low across the United States. Addressing social determinants of health (SDOH) through text message could impact MAT retention; therefore, a pilot project at a federally qualified healthcare center (FQHC) was implemented.

Methods: The Protocol for Responding to and Assessing Patients’ Assets, Risk, and Experiences (PRAPARE) SDOH screening tool was implemented for patients undergoing MAT for OUD. Community resource referrals were provided via text message based on the screening results. Retention in treatment was measured by prescriptions …

Modifiers Of The Effects Of Different Dimensions Of Social Support On Cardiac Rehabilitation Adherence., Melissa Amraotkar

Electronic Theses and Dissertations

Introduction: Cardiovascular disease (CVD) is a leading cause of mortality worldwide. Cardiac Rehabilitation (CR) is a Class I, level A indication for treatment and prevention further complications of CVD. The attendance rate for CR in the U.S. is very low, especially among female patients. Dimensions of social support, sex of the support provider, and the quality of primary intimate relationship are associated with health-promoting behavior and may influence CR adherence in patients. Purpose: The purpose of this study was to examine the relationship between dimensions of social support and CR adherence, and whether these relationships were moderated by factors such …

Effects Of Group Visits On Self-Care Management For Veterans With Type 2 Diabetes Mellitus, James Nwaizugbu

Doctoral Projects

Individuals diagnosed with type two diabetes mellitus (DM2) can be overwhelmed by daily choices, leading to self-care neglect. Self-care is vital to DM2 management to avoid chronic complications. This project utilized group visits to increase self-care management and improve outcomes among veterans with poorly controlled DM2.

This evidence-based practice (EBP) project used a single-group quasi-experimental pretest-posttest design to evaluate a self-care management program for US veterans with poorly controlled DM2 who were enrolled a clinic within the Department of Veterans Affairs (VA), Northern California Healthcare System (NCHCS). The study facilitator provided education on DM2, medication, diet, and exercise. Participants (N …

Exploring The Nexus: The Influence Of Acculturation And Stress On Infant Outcomes Among Hispanic And Black/African American Adolescents, Mia I. Moreno

2024 Spring Honors Capstone Projects - Archive

Numerous studies on acculturation and acculturative stress exist; however, findings are inconsistent and overlook an exploration of differences between Hispanic and Black/African American (B/AA) adolescents’ acculturation, stress, and birth outcomes. Despite societal and cultural challenges for both minorities, Hispanic women typically have positive birth outcomes comparable to White women, but B/AA women show an increased risk for negative birth outcomes. Further, minority and adolescent childbearing women frequently receive fewer prenatal care (PNC) visits than recommended which may impact birth outcomes. Therefore, my study sought to compare Hispanic and B/AA women’s birth outcomes assessing acculturation and stress and examine the relationship …

Effects Of Nonpharmacological And Pharmacological Interventions On The Management Of Polycystic Ovarian Syndrome, Ellington Fagg

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Polycystic ovarian syndrome, commonly known as PCOS, is a metabolic endocrine disorder that affects many women of childbearing age. Although PCOS is a rather common disease, there is a general lack of knowledge on how to approach treatment for different types of women.

Purpose: The purpose of this literature review is to investigate both nonpharmacological and pharmacological treatment interventions that can be used to manage both the symptoms and underlying conditions associated with PCOS.

Methodology: Twenty articles that contained a mix of clinical trials and randomized control trials were reviewed for the evidence that is included in this literature …

The Impact Of Authoritative Parenting Compared To Authoritarian And Permissive Styles On Long-Term Psychological And Behavioral Function Of Offspring., Brooke Washington

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Different parenting styles produce specific traits in offspring that are of direct relation to the chosen parenting style of the household. The goal of this study is to answer the question: What is the impact of authoritative parenting compared to authoritarian and permissive styles on long term psychological and behavioral function of offspring? This systematic review was conducted to collect and analyze studies relating to the long-term psychological and behavioral effects of offspring who were raised in one of the three most common parenting styles practiced: authoritative, authoritarian, and permissive. The authoritative parenting style is classified as establishing a warm, …

Evaluating Effective Communication Of Baccalaureate Nursing Students, Christine Brockway

Dissertations

Brockway, Christine. Evaluating Effective Communication of Baccalaureate Nursing Students. Published Doctor of Philosophy dissertation, University of Northern Colorado, 2024. The purpose of this mixed methods study was to determine how communication evaluation by clinical faculty compared in a clinical setting versus a simulation setting for Bachelor of Science in Nursing (BSN) students. Fifty (50) BSN students from three different schools of nursing were scored using the Interprofessional Situation, Background, Assessment, Recommendation Nurse to Physician Rubric in both clinical and simulation settings by seven nursing faculty. Scoring for each student occurred in both settings during one semester. Following the evaluation, students …

Difference Between The Impact Of Active Social Media Use And Passive Social Media Use On Adolescent Mental Health: An Expanded Literature Review, Lydia Underwood

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: With the first generation of adolescents being raised with seemingly unlimited access to social media, there is a clear need for research to determine the long-term mental health effects of social media use. Social media use can be categorized into two main categories — active use and passive use. Active use refers to a user posting content and engaging in the media they are viewing. Contrastingly, passive use refers to a user consuming social media content, without engaging in it in ways such as liking or commenting. The aim of this extended literature review was to answer the …

Nurses' Perceptions Regarding Supportive Care In The Neonatal Intensive Care Unit, Brandi D. Garrett

Nursing Theses and Dissertations

NICU nurses are the primary supporters of NICU families and their infants, making it vital that nurses understand the impact of a NICU visit on families and how to improve the parental experience. The complex challenges begin at the NICU admission, where families are left bewildered and unprepared for the uncertainty that lies ahead. During the NICU stay, nurses support families by providing encouragement and empowerment as they navigate their new role as NICU parents. In addition, NICU nurses are advocates for supportive initiatives to help NICU families cope with challenges such as being away from their infant and better …

Electronic Health Records: Using Polarity Thinking To Explore The Relationship Between Technology And Nursing Practice, Debra Winckler

Nursing Theses and Dissertations

Building a robust information technology infrastructure has been recognized as integral in addressing national concerns about patient safety, healthcare quality, and healthcare costs. Federal efforts to promote the nationwide adoption and integration of electronic health records (EHRs) include the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which provided over $27 billion in federal incentives to healthcare organizations and providers to incorporate EHRs into healthcare practices. Medicare and Medicaid Electronic Health Record Incentive Programs, initiated in 2011, were enacted to expand EHR functionality, encourage EHR system upgrades, and establish nationwide use of certified EHR technology. Subsequently, …

Evaluation Of An Emergency Department Provider Information Update On The Initiation Of Suboxone With A Community Treatment Program Referral For Opioid Overdose And Opioid Use Disorder, Carmen Brewington

All Dissertations

Over 21 million people in the United States (U.S.) require substance use disorder (SUD) treatment; yet less than 4 million people receive treatment (Bressan & Kening, 2023). According to Thomas et al. (2022), opioid overdose deaths are increasing, and improving access to evidence-based treatment is critical. Hospital emergency departments (EDs) play a lifesaving in the emergency treatment of opioid overdoses; but can also serve as gateways to opioid treatment by healthcare providers for opioid addictions (Reuter et al., 2022). Mortality, after an ED visit for opioid overdose, is high (Thomas et al., 2022). Community resources are limited, thus making it …

Male Infertility: A Retrospective Review Of Laboratory Charts At A Tertiary Teaching Hospital In Nairobi City County, Festus Mulakoli, Doris Machaki, Abednego Ongeso, Maureen Akolo, Ruth Wagathu

School of Nursing & Midwifery, East Africa

Background: Globally, approximately 50 million couples experience one form of infertility, and 10 million cases of subfertility have been reported in sub-Saharan Africa. Infertility is characterized by a lack of clinical conception among couples who live together for more than one year with regular coitus, without the use of contraception. Factors related to fertility vary by sex and geographical region. These factors include age, lifestyle, infectious diseases, and genetic disorders. In African culture, children are considered a simple inheritance and a measure of masculinity, so efforts are needed to address the growing problem of male infertility in this context. …

Cost Benefit Analysis Of Anesthesia Providers Within Gastroenterology Outpatient Practices, Jennifer Buffum Brown

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anesthesia delivery in ambulatory and office-based settings has seen significant growth in the last 25 years. The advances in effective short-acting anesthetic drugs, combined with the rise in demand for minimally invasive surgery, allows for an increase in the number of surgical procedures to be achieved outside the hospital setting. Ambulatory anesthesia promotes patient health by reducing recovery times. It also contributes to sustainability by lowering costs otherwise associated with overnight hospital stays. Patient preferences for minimally invasive outpatient surgery, and faster recovery times have spurred an increased demand for business relationships between modern medical practices and anesthesia providers. Certified …

A 5-Year Longitudinal Structural Equation Model Of Social Isolation And Probable Major Depression Among Participants With Spinal Cord Injury, Chao Li, Susan Newman Phd, Rn, Crrn, Faan, Jillian M. Clark, James S. Krause

Publications

OBJECTIVE: To develop longitudinal structural models of social isolation and probable major depression (PMD) over a 5-year interval among participants with spinal cord injury (SCI). DESIGN: Longitudinal structural equation modeling of self-report assessments collected during two follow-ups (2013 as Time 1, 2018 as Time 2) of a 45-year multicohort longitudinal study. Participants (n = 557) were identified from a specialty hospital in the Southeastern United States and two Midwestern hospitals and were initially enrolled in 1973-1974, 1984-1985, 1993-1994, or 2003-2004. PMD symptomology was measured by the Patient Health Questionnaire-9 (PHQ-9) and was defined by PHQ-9 scores ≥ 10. Social isolation …

Mentorship Program Including Alumni, Nicole Brainin

Doctor of Nursing Practice Projects

The landscape of advanced education in nurse anesthesia presents considerable challenges for Student Registered Nurse Anesthetists (SRNAs), accentuated by demanding clinical hours and the transition from experienced ICU nursing to novice learners. This study explores the implementation of alumni mentorship within Nurse Anesthesia Programs (NAPs) to alleviate these stressors. An initial survey gauged alumni interest in mentorship roles, while a follow-up survey assessed the program's impact on student satisfaction and communication. Findings suggest that engagement and communication frequencies are lower than optimal, while alumni mentorship is perceived positively. Recommendations for enhancing the program include diversified communication channels, structured interactions, and …

Emotional Intelligence And Srna Success Utilizing A Sim Experience, Melody Gassoway, Kaleigh Peters

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) face many challenges in meeting the rigorous demands of their doctoral-level training. Research demonstrates that high levels of emotional intelligence (EI) contribute to SRNAs’ academic and clinical success and improve patient safety and quality of care. Simulation is emerging as an educational tool to enhance the EI skills of students training in highly stressful professions and demonstrates promising benefits for SRNAs, such as improved decision-making, critical thinking, self-awareness, and self-regulation (Moriber & Beauvais, 2017; Dix et al., 2021). This doctoral project aimed to determine the efficacy of a high-fidelity simulation for strengthening the EI skills …

Local Anesthetic Systemic Toxicity: Last Protocol Development, Implementation, And Evaluation For Healthcare Providers, Rachel Vaughn

Doctor of Nursing Practice Projects

LAST is an uncommon but deadly complication of local anesthetic administration. Healthcare facilities benefit from protocol implementation to help streamline best evidence-based practice. The American Society of Regional Anesthesia and Pain Medicine warrants a LAST emergency protocol for any healthcare facility practicing regional anesthesia. Healthcare personnel encountering patients at risk for LAST must understand the symptoms and treatment of LAST to improve response time and patient outcomes. The project implemented a LAST protocol at a rural hospital in Southern Illinois in July 2023. The investigator held an educational service to discuss the new LAST protocol and implementation. The educational service …

Education For Healthcare Professionals On Protocol For Prostate Cancer Screenings On Inmates, Heather Ackerman, Randi Janae Ballard

Doctor of Nursing Practice Projects

Cancer is the leading cause of death for incarcerated individuals, prostate cancer awareness and screening guidelines are essential areas of focus for healthcare professionals (Puglisi et al., 2021). Prostate cancer screenings recommend that males between the age of 55-69 be informed of evidence-based guidelines and offered these screenings as a part of routine health maintenance (USPSTF, 2018). In 2019, the Illinois Department of Corrections (IDOC) was ordered to follow these guidelines for incarcerated individuals (Raba, 2021). As of 2021, the IDOC had yet to implement these screenings for incarcerated individuals within the state facilities. Two separate one-hour educational sessions regarding …

Psychiatric Mental Health Nurse Practitioner Perceptions Of How Providing Patient Care During The Covid-19 Pandemic Affected Their Own Mental Health, Linda Cabage

Electronic Theses and Dissertations

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to …

Telehealth Acceptance And Medical Mistrust Among The Elderly Of Rural Appalachia: A Correlational Study Using The Medical Mistrust Index And Technology Acceptance Model, Victoria Hood-Wells

Electronic Theses and Dissertations

Adults aged 65 years and above have grown substantially over with past decade. However, the chance of developing multiple comorbidities only increases with age. Because elderly residents of rural Appalachia often encounter barriers to healthcare, rural nurses, providers, and policy makers must overcome physical and structural barriers, but also gain a more in-depth understanding of the personal and cultural attitudes impacting the use of new and innovative forms of healthcare delivery. With a slow and variable uptake of telehealth adoption in rural Appalachia, and in the presence of well-documented medical mistrust, this study was designed to better understand the degree …

The Lived Experience Of Nurses In Caring For Patients With Covid-19, Jessica Barre

Electronic Theses and Dissertations

Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Psychological Safety Of Pre-Licensure Nursing Students: A Longitudinal, Qualitative Study, Laura Butler

Student Works

Background: Previous studies have explored the concept of psychological safety among pre-licensure nursing students; however, the literature is notably sparse on personal descriptions of pre-licensure nursing students’ experiences of psychological safety in clinical settings. Individual descriptions of psychological safety will provide added insight and understanding about the elements that shape psychological safety in pre-licensure nursing students.

Objectives: This research aimed to longitudinally explore pre-licensure nursing students' experiences of psychological safety during clinical rotations and how their experiences of psychological safety change over time.

Methods: This study used a longitudinal, qualitative, descriptive approach. Participants were recruited from a …

Perceived Barriers Of Early Mobilization In The Intensive Care Unit, Melissa Sonderman, Emily Miles, Joshua Ferge

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Early mobilization of Intensive Care Unit (ICU) patients can improve patient outcomes but also includes barriers to implementation. Nebraska Medicine has continued to have ongoing quality improvement initiatives like the ABCDEF liberation bundles and early mobilization that have been attempted but have never fully come to fruition. This project surveys Nebraska Medicines ICUs staff to better understand attitudes, knowledge and behavior regarding early mobilization using a validated tool. The aim was to identify barriers, so the organization could better understand the needs of ICU staff for future implementations of early mobility and related assessment tools.

Materials and Methods

A …

Going, Going, Gone: The Influence Of Job And Home Demands And Resources On Emergency Department Nurse Turnover, Jordan Gail Smith

All Dissertations

Nurse turnover, which challenged healthcare organizations even before the pandemic, reached alarming rates across hospitals worldwide during COVID-19. Due to the unprecedented and stressful nature of the pandemic, recent investigations have focused primarily on exploring job demands and nurse turnover intentions. While job demands are critical to understanding turnover, this narrow scope ignores the possible influence of other factors such as job resources and demands and resources external to the work domain. This study utilized archival qualitative data from a longitudinal survey of Emergency Department clinicians to analyze research questions and hypotheses. The first aim of this study was to …

Incorporating Aac Training In Nursing Education Programs To Enhance Understanding Of Caring For Patients With Complex Communication Needs, Tessa Bradley

Honors College Theses

As healthcare professionals, nurses must be able to effectively communicate with their patients to ensure their health, safety, and comfort. However, this can be particularly challenging when it comes to patients with complex communication needs (CCN), where communication breakdowns can lead to sentinel events. Alternative and augmentative communication (AAC) can help those with CCN improve communication across various settings, including in healthcare. Unfortunately, there is a severe lack of training for nurses when it comes to communicating with patients with CCN and the use of AAC. Webb et al. (2024) investigated the effectiveness of a combined synchronous and asynchronous training …

Needs Assessment For Implementation Of A Dedicated Admission And Discharge Nurse Position, Connie Ngo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Patient turnover refers to when patients are admitted, discharged, or transferred to or from a clinical unit or another facility. Rapid patient turnover compels nurses to provide care in an environment where clinical demands exceed nursing care capacity. The excess of clinical demands can lead to rationing of nursing care and culminate in nursing stress and dissatisfaction. These negative effects on the nursing workforce subsequently have undesirable implications for patient and hospital outcomes. Implementation of a dedicated admission and discharge nurse (ADN) position can optimize patient flow, improve nursing satisfaction, and ultimately promote positive patient outcomes. Purpose: The purpose …

Video Monitoring For Fall Prevention, Atongane Taku

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient safety is a vital aspect of healthcare. Falls and fall-related injuries continue to occur in hospitals worldwide and fall prevention is one of the top priorities in providing quality care. Fall assessment tools, bed alarms, patient rounding, patient education, physical restraints, environmental modification, bedside sitters, and remote video monitoring are some of the methods implemented to reduce falls. This project was a quasi-experimental study informed by Kotter and Cohen Model of Change. The initial purpose of this process improvement project was to educate staff on the significance of video monitoring in fall prevention and determine whether the education regarding …

Staff Assist Process In The Emergency Department Setting, Caroline Goodnight Rn, Rasha Burkeba Rn, William Covert Rn

Nurse Residency

In the Emergency Department, how do zone-based response systems compare to department-wide response systems in a staff assist affect overall patient outcomes within a one-year period of time?