Digital Commons Network^™

Impact Of A Transplant Nurse Navigator In The Dialysis Setting, Judith D. Pozzerle

Electronic Theses and Dissertations

Patients with kidney disease have better patient outcomes and quality of life with a kidney transplant. However, the transplant process is complicated with inherent inequalities and biases and patients frequently fail to initiate a referral for transplant evaluation. The Centers for Medicare and Medicaid have now placed financial incentives to improve the number of patients transplanted. The only way to increase the number of patients transplanted is to start with a referral for evaluation. Studies have been done highlighting the barriers, but there is a lack of studies implementing strategies to improve these numbers. Utilizing Kotter’s change theory and describing …

An Exploration Of The Experiences Of Perinatal Depression And Anxiety Among Pregnant And Parenting Adolescents In The Tampa Bay Area Of Florida, Olajumoke Adetoun Ojeleye

USF Tampa Graduate Theses and Dissertations

Perinatal depression (PND) and perinatal anxiety (PNA) are increasing among pregnant and parenting adolescents (PPAs), with PNA often underrecognized. This leads to significant socioeconomic costs and adverse maternal consequences if untreated. Hence, this dissertation explores the experiences of PND and PNA among PPAs, focusing on their knowledge gaps, perception, mental health needs, care preferences, and access to PMH care. The research employs a qualitative design (free-listing and in-depth interviews) to gather participant insights. Key findings reveal that many PPAs possess limited knowledge about PNA when compared to PND. Lack of support from partners, family, and peers emerged as the topmost …

Expediting Toxicological Evidence Collection In Patients Presenting To The Emergency Department With Report Of Drug Facilitated Sexual Assault (Dfsa): A Quality Improvement Project, Adelene Egan

DNP Projects

Title: Expediting Toxicological Evidence Collection in Drug-Facilitated Sexual Assault: A Quality Improvement Project

Background/Significance: Drug-facilitated sexual assault (DFSA) involves substance use to incapacitate victims, with rapid drug metabolism necessitating prompt evidence collection. Delays in blood collection reduce toxicology detection rates, compromising legal outcomes. In one New York ED, DFSA kits (Part B) were routinely collected after biological evidence (Part A), creating a critical gap.

Purpose: To improve compliance with evidence-based prioritization of blood collection (Part B before Part A) for DFSA cases through a structured QI initiative.

Methods: The project synthesized evidence from a systematic review of …

Integrated Mental Health Care In Specialty Clinics For Children With A Diagnosis Of Asthma Or Diabetes: A Mixed Methods Study, Joan P. Totka, Maria Peña, Joshua A. Steinberg, Peter M. Wolfgram

College of Nursing Faculty Research and Publications

Introduction

Using patient-reported outcome measures (PROM) in a shared-space mental health-integrated specialty clinic, we explored the feasibility, acceptance, and experience of youth with asthma and diabetes, their families, and the healthcare team.

Method

Using mixed methods, we examined feasibility, acceptability, and experience of PROM inclusion in caring for youth with asthma (n = 7) and diabetes (n = 11), their families (n = 18), and healthcare providers (n= 13). Completion and receipt of PROM (feasibility), postvisit surveys (acceptance), and structured interviews (experience) between June 2019 and February 2020.

Results

Targeted PROM met feasibility goals (80%) …

Staff Education To Increase Substance Use Screening And Treatment For Adolescents In An Outpatient Primary Care Mental Health Facility, Surekha Gorantla

Walden Dissertations and Doctoral Studies

This quality improvement staff education DNP project addressed the practice issue relating to adolescent substance abuse in the project mental health facility. The facility does not have a uniform process for addressing this problem. Follow-up care for adolescents treated in the clinic is a challenge because each provider uses a screening tool of their preference, creating inconsistencies in care and missed care opportunities. Therefore, identifying, reducing, and preventing the negative consequences related to adolescent substance abuse in this clinical setting is vital and needs to be prioritized. I developed and implemented a staff education program using screening, brief intervention, and …

Nurse Educators’ Experiences With Medical Cannabis Education, Rachel Ann Parmelee

Walden Dissertations and Doctoral Studies

Medical cannabis is legal in more than half of the United States, and the National Council of State Boards of Nursing has provided guidelines indicating that nurses need to know about medical cannabis. However, most nurses report a lack of knowledge and education but believe that cannabis has therapeutic potential. The problem addressed in this study was the limited research on nurse educators’ experiences with medical cannabis education and its meaning for nursing education. The purpose of this hermeneutic phenomenological qualitative study, supported by an emergent framework, patterns of knowing, was to explore nurse educators’ experiences with medical cannabis education …

Preventing And Managing Delirium In The Pediatric Cardiac Icu, Jordan Aragon, Anya Hirsch, Keara Hughes, Ella Melnyk, Megan Sally, Anna Tisdale

2024

No abstract provided.

Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp

Mindfulness Studies Theses

This study presents research about the nature and prevalence of adverse childhood experiences (ACEs), the mental and physical impacts to individuals exposed to ACEs, and incorporating mindfulness practices into therapeutic approaches to treating them, particularly Mindfulness-Based Narrative Therapy (MBNT). It is important because ACEs have become a global crisis, with the potential for interfering with psychological and physical development, early mortality, and other harmful life outcomes. This thesis provides critical information for mindfulness teachers and practitioners, therapists, educators, regulators, parents, and individuals subjected to ACEs.

The methodology includes extensive literature searches for narrative therapy and mindfulness-based interventions (MBIs) in peer-reviewed …

Impact Of Hospital Virtual Dementia Tour® On Caregivers’ Knowledge And Attitudes Towards People With Dementia, Sarah Cope

Regis University Student Publications (comprehensive collection)

The incidence of dementia, associated with poor health outcomes, is rapidly rising. In review of the literature, dementia education is broadly recommended to impact staff knowledge and patient outcomes. This Doctoral project sought to answer the project question: in healthcare workers who care for hospitalized patients with dementia and behavioral disturbance, will the dementia-centered education initiative, the Hospital Virtual Dementia Tour® (HVDT), improve the care team's knowledge and attitudes in caring for people with dementia, particularly behavioral dysregulation, as measured by scores on pre-post Dementia Attitudes Scale (DAS) Assessment?

A quality improvement quantitative pretest posttest pilot study implementing the Hospital …

Optimizing Advance Care Planning: Leveraging An Electronic Medical Record Prompt To Impact Advance Directive Documentation, Annette L. Meares

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Advance Directives (ADs) support patient-centered care by documenting preferences for future medical treatment. While the Centers for Medicare & Medicaid Services (CMS) incentivizes AD documentation through billing codes, national adoption remains low.

Local Problem: A rural Northern Illinois primary care practice had electronic referral capabilities for ACP; however, referrals remained low and inconsistent during Medicare Annual Wellness Visits (AWVs), limiting opportunities for AD completion.

Methods: This quality improvement project targeted Medicare AWV patients without ADs documented in the electronic medical record (EMR). During a 10-week pre-intervention period, baseline data were collected. In the subsequent 10-week intervention phase, an …

Case Management For End-Stage Renal Disease Patients, Jamie L. Andrews

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Social determinants of health (SDOH) and health literacy directly impact adults with end-stage renal disease (ESRD) on hemodialysis (National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2022; Ulrich, 2020). Adults with ESRD account for 1.5 million hospital admissions and 500,000 re-admissions within 30 days annually (NIDDK, 2022). Case management is essential in reducing re-admissions for adult ESRD patients, requiring abilities to identify factors affecting adult ESRD patients appropriately.

Methods: Therefore, an evidence-based practice (EBP) project using the IOWA Model framework was implemented to increase the knowledge base in identifying care and resources for ESRD patients for telephonic …

Burnout Among Nurses In The United States, Faheem Ohri

Social Work Dissertations - Archive

Burnout is an exhausted state of the body, mind, and emotions, characterized by feelings of “depersonalization and reduced personal accomplishment” resulting from prolonged and continuous occupational stress. Burnout among nurses in the United States (U.S.) is a growing concern with significant implications for healthcare professionals and patient outcomes. Nurse burnout compromises patient safety and workforce stability, but pre-pandemic national correlates remain understudied. This dissertation examined employment settings and demographic correlates of burnout among U.S. nurses using the National Sample Survey of Registered Nurses (NSSRN) secondary datasets. Compared inpatient burnout odds pre-/post-pandemic using national twin surveys. Jackknife complex survey logistic regression …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Racial Health Disparities Among Pregnant Women Of Color In New York City: Biological And Systemic Impacts, Kaylin Peña

Pitzer Senior Theses

Racial Health Disparities Among Pregnant Women of Color in New York City: Biological and Systemic Impacts

Abstract

This thesis aims to explore how racial health disparities, underrepresentation in gynecology, and socioeconomic barriers contribute to adverse pregnancy outcomes among women of color in New York City. Through an interdisciplinary approach that combines resources from medical anthropology and human biology, this research will examine the biological implications of chronic stress, specifically HPA axis dysregulation, and its role in maternal health outcomes. With the idea of intersectionality, as conceptualized by Kimberlé Crenshaw, the study analyzes the various effects of systemic inequities and social …

Educating Nurses On Culturally Competent Intimate Partner Violence Care, Nicole Lee

Nursing | Senior Theses

Purpose

The purpose of this research proposal is to examine the impact of mandatory training for labor and delivery nurses on culturally sensitive care for pregnant women who have experienced intimate partner violence. It aims to address gaps in provider training by evaluating improvement in screening rates, enhanced confidence, and effective interventions.

Methods

This study will recruit nurses from different labor and delivery units from different hospitals. This study will use a pre-test and post-test design to assess the effectiveness of the training. The evaluation will measure the changes in knowledge, confidence, and screening practices before and after training.

Results …

The Impact Of Structured Weekend Group Therapy On Restraints, Seclusion And Length Of Stay On Inpatient Psychiatric Units, Victoria Grau

West Chester University Doctoral Projects

Group therapy is an essential part of inpatient psychiatric treatment, with documented positive effects including better medication compliance, lower readmission rate, and improved self- esteem. Patients who are admitted for an inpatient psychiatric stay have a small window of time in which behavioral health staff can work with them. Group therapy can help patients develop a plan for these issues and provide a foundation for successful discharge and symptom management. The project site is a mid-size teaching hospital in an urban community with higher rates of mental health diagnoses than the national average. Group therapy was conducted initially Monday – …

A Quality Improvement Project To Enhance Chronic-Condition And Self-Care Knowledge In Adolescents With Spina Bifida, Ann Paris

DNP Scholarly Projects

Background: Spina Bifida is the most common central nervous system disorder in the United States (CDC, 2024). Even with early surgical repair, patients may have chronic, disabling, multisystem needs (Phillips et al., 2017). Adequate care of Spina Bifida requires a multidisciplinary approach. As such, patients with spina bifida require multiple specialty providers, clinic appointments, care-tasks, and interventions (CDC, 2024, Phillips, et al., 2017). Synthesizing information from multiple care providers can be daunting, especially for adolescents as they grow more autonomous in their care, and especially as they enter the age of pediatric-to-adult transition (Psihogios et al., 2015).

Purpose: …

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

Multidisciplinary Approach To Reduce The Heart Failure Readmission Rate, Nisha Thekkedam

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States, 6.7 million adults have been diagnosed with heart failure (HF), a number projected to rise to 8.5 million by 2030. National data indicate a 30-day readmission rate of 18.2% among HF patients from 2010 to 2017. In Texas, around 12% of the Medicare population in Texas, and specifically 11% of the Medicare population in North Texas County, have been treated for HF. A North Texas hospital reports an 18-20% HF readmission rate over the past several years. Purpose: This EBP project included the implementation of a care bundle using the Dutch Heart Failure …

Reducing Caregiver Burden For The Caregivers Of Heart Failure Patients, Joyce W. Kimani

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Family members and friends of heart failure patients serve as informal caregivers for many heart failure patients, helping with the management of day-to-day heart failure care. Many caregivers of heart failure patients experience stressors associated with caregiving, including social, psychological, financial, emotional, and physical stress. Reducing caregiver burden is important in improving both patient and caregiver well-being. Healthcare systems can improve caregiver outcomes and encourage the long-term sustainability of informal caregivers by addressing caregiver needs through focused support strategies. The Agency for Healthcare Research and Quality framework was used to develop an evidence-based guideline that healthcare professionals can follow in …

Navigating “Being Seen”: Experiences Of Older Adult Arab Immigrants And Family Caregivers Accessing Health Care Services In Ontario, Selma Tobah, Lorie Donelle Phd, Rn, Fcan, Jodi Hall, Lloy Wylie, Sandra Regan

Publications

Immigrants to Canada face unique barriers to accessing health care including communication barriers, socioeconomic limitations, and a lack of health care system navigation knowledge. Arabs in particular face mainstream negative attitudes, propagated through political discourses as well as entertainment media. We sought to understand how older adult Arab immigrants and family caregivers accessed and experienced health care in Ontario. We conducted a critical constructivist grounded theory, using Charmaz’s approach to grounded theory. A critical constructivist grounded theory method asks not only “what” social processes are happening and “how” but also “why” and “who” benefits. Both older adult immigrant Arabs and …

Harnessing Team Science In Dementia Research: Insights From The Alzheimer’S Disease Research Group In South Carolina, Sayema Akter, Eric Mishio Bawa, Nicholas Riccardi, Daniel A. Amoatika, Margaret C. Miller Ms, Ph.D., Otis L. Owens Mph, Ph.D., Caps, Lorie Donelle Phd, Rn, Fcan, E Angela Murphy, Daping Fan, Melissa Moss, Mihyun Lim Waugh, Sue E. Levkoff Scd, Msw, Sm, Freda Allyson Hucek, Jean Neils-Strunjas Ph.D, Ccc-Slp, Swann Arp Adams Ph.D., Ms, Face, Roger Newman-Norlund, Sarah Newman-Norlund Ph.D., James Hardin Ph.D., John Absher, Bankole A. Olatosi Ph.D., Xiaoming Li Ph.D., Lumi Bakos Ph.D., Quentin Mccollum, Chris Rorden, Leonardo Bonilha, Daniela B. Friedman

Publications

Alzheimer's disease and related dementias (ADRD) are complex and rapidly growing public health challenges that require integrative, collaborative approaches. To meet this need, the Alzheimer's Disease Research Center (ADRC) of South Carolina, a state-funded partnership across multiple institutions, has embraced a team science model that brings together expertise from four key disciplines: neuroimaging-neurology, health sciences, molecular biology, and engineering. This paper highlights the work at the University of South Carolina (USC) and how each discipline contributes uniquely yet collaboratively within a recurring loop model framework. Extending from USC's Cancer Prevention and Control Program, the framework guides scientific growth through four …

Addressing Barriers In The Primary Prevention Of Hypertension In Black People, Makalah Pierre Rn Bsn

Honors Undergraduate Theses

Hypertension is a significant health concern among minority groups, and the black population is most at risk (Abrahamowicz et al., 2023). The black population experience higher prevalence rates of hypertension compared to other racial groups and are more likely to experience hypertension-related problems, including cardiovascular disease (CVD) and chronic kidney disease (CKD).  This literature review explores various nursing interventions aimed at preventing hypertension within this population. In this review, the term “black people or persons” is a broad term used to describe both African Americans and people of Afro-Caribbean decent. This includes various backgrounds such as Haitian, Jamaican, or otherwise …

The Effectiveness Of Trauma-Informed Care Education On The Self-Efficacy Of Pediatric Nurses: An Integrative Literature Review, Mackenzi N. King

Honors Undergraduate Theses

Pediatric nurses often care for patients who have experienced various forms of trauma, including medical traumatic stress, abusive head trauma, child maltreatment, and sex trafficking. Trauma-informed care (TIC) is a clinical approach that acknowledges the psychological and physical effects of trauma, supports the identification of trauma survivors, and seeks to prevent re-traumatization during healthcare encounters. Research has highlighted the need to improve nurses' self-efficacy in delivering TIC effectively. This integrative literature review explores the impact of TIC training on pediatric nurses’ knowledge, confidence, and competence in providing TIC. A comprehensive literature search was conducted using CINAHL Ultimate, APA PsychInfo, and …

Integrating Lifestyle Medicine Into Undergraduate Nursing Education, Lyndsay Wright

DNP Research Projects

Abstract 

Objective: Lifestyle Medicine (LM) effectively addresses the lifestyle-related diseases that contribute most to global morbidity, mortality, and healthcare spending. However, nurses and nursing students struggle with maintaining healthy lifestyles themselves, with LM and health behavior change strategies insufficiently taught in nursing education. Method: A quasi-experimental study with a pre-test and post-test design examined the effects of an LM educational intervention on undergraduate nursing students’ knowledge of LM and intentions for health behavior change. Data were collected using demographic questions, an LM knowledge (LMK) questionnaire, the Lifestyle Medicine Assessment (LMA), and a modified Intention to Change Behavior Scale …

Evaluating The Implementation Of Social Determinants Of Health Screening In An Interdisciplinary Clinic, Taylor M. Adams

DNP Projects

Background: Social Determinants of Health (SDOH), including food, housing, interpersonal violence, and transportation are non-medical problems that can influence health outcomes (World Health Organization, 2020). Low-income minorities and public-payer groups are at considerable higher risk for social needs. Collaboration within the community can improve health outcomes (Sulley et al., 2021). A literature review revealed limited evidence of screening in dental clinic settings. Failure to identify and address SDOH needs in this population can lead to poorer health outcomes.

Purpose: The purpose of this quality improvement project was to implement and evaluate social determinants of health screening and evaluate the …

Understanding Emergency Department Utilization By African Americans For Routine Diabetes Care: Are We Asking The Right Cultural Questions?, Melissa Scollan-Koliopoulos

Nursing Faculty Publications

Introduction: The emergency department is a source of routine care for many African Americans. Afrocentric cultural characteristics may serve as a better proxy than race for understanding preferences for emergency department use over primary care for diabetes management. Methods: A literature review was conducted including key terms related to transitional healthcare, emergency department recidivism, Afrocentric cultural characteristics, racism and health disparities, and diabetes in African Americans. An example of tailoring talking points using Afrocentric cultural characteristics is proposed using Jone’s TRIOS Model, a Afrocentric Self-enhancing and Protective Theory. Results: The literature includes evidence to support a complex explanation for emergency …

Human Trafficking In The Er: Will You Recognize The Signs?, Lauren Neff

Doctor of Nursing Practice Projects

Current data reveals that 88% of human trafficking (HT) victims seek some form of health care while being trafficked. More specifically, 63% seek care in the emergency department setting (McAmis et al., 2022). A recent literature review indicates that regarding human trafficking and healthcare, there is a lack of awareness and knowledge on the issue. Healthcare team members often have little to no education or knowledge of potential signs and symptoms of a victim in a trafficking situation. The purpose of this DNP project was to increase healthcare staff knowledge of human trafficking (HT) and, more specifically, nurses in an …

A Quality Improvement Project Reinforcing Nursing Education On Support Resources For Families In The Icu, Emily Siel

Master's Theses and Capstones

BACKGROUND: The Intensive Care Unit (ICU) is often a source of psychological, physical, social, financial, and spiritual distress for families of patients. Multidisciplinary support resources are available but are often underutilized. Nurses are uniquely positioned to assess needs and integrate resources into care. Therefore, enhancing nurses' ability to guide families to appropriate support resources may alleviate distress and promote holistic well-being for patients and their families.

METHODS: The Plan-Do-Study-Act (PDSA) model was used to guide this project. A pre-intervention survey assessed awareness, utilization, and perception of ownership. Following dissemination of the intervention, a post-survey evaluated improvements in knowledge and integration. …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …