Digital Commons Network^™

Recognizing Barriers In The Elderly Population And Increasing Access To Case Management Services, Loveleena Alex

Doctor of Nursing Practice Projects

Abstract

Implementing case management can lead to fewer hospitalizations in the elderly population. Barriers influencing the number of hospitalizations include low socioeconomic status, transportation needs, health literacy, financial strain, multiple comorbidities, underserved populations, medication availability, availability of community resources, and access to primary care. A review of the available literature revealed that by addressing these barriers in a primary care setting and implementing case management, the number of hospitalizations can be decreased and the quality of life in the elderly population can be improved. This quality improvement project implemented a screening and referral process for chronic care management in the …

Implementation Of Web-Based Patient Education In Newly Transplanted Kidney Recipients, Tabo Mwikisa-Kelly

Doctoral Projects

Kidney transplantation is the preferred treatment for patients suffering from kidney failure. It is a complex process that is intended to improve one’s quality of life by adhering to a lifelong treatment plan of immunosuppressant therapy. Therefore, it is essential for patients or their caregivers to have adequate knowledge to care for themselves following post-transplant, which can contribute to better patient outcomes. In a metropolitan Bay area hospital in Northern California, the current state of practice involves educating newly transplanted kidney recipients through face-to-face interactions with the patient and handing out a transplant booklet during their initial transplant hospital stay. …

An Evaluation Of A Structural Competency Training For School Nurses, Rachel J. Torres

Doctoral Projects

The aim of this quality improvement project was to use structural competency as a tool to highlight the broad social, political, and economic structures that influence health and subsequent inequities and disparities. A one group, pre-and post-design quality improvement project was used to determine whether the Structural Competency Working Group curriculum influenced school nurses’ thought processes regarding the factors that influence health outcomes. The curriculum was adapted to a 1.5-hour training and delivered to a group of school nurses from a highly populated and socially, economically, and culturally diverse urban county in northern California. The results showed that after the …

How Provider Education On Identification And Referral Of Eligible Patients To A Care Management Program Affects Readmission Rates: An Evidence-Based Project, Kosisochi Agube

Doctor of Nursing Practice Projects

Hospital readmissions cost the U.S. healthcare system approximately $17.4 billion each year. Minimizing hospitalizations among Medicare beneficiaries is therefore a high priority. This study aimed to evaluate how identifying patients at high risk of hospital readmission—i.e., patients with complex health needs, such as those with chronic conditions—and referring them to a transitional care program impacts readmission rates in a primary care clinic. The PI hypothesized that identifying high-risk individuals and enrolling them in a care management program to improve their health would lessen their need for inpatient and other high-cost healthcare services.

The PICOT question for this project is as …

A Psychometric Validation Of The Provider Responses, Treatment, And Care For Trafficked People Instrument, Shaneke O. Pryce

Theses & Dissertations

Background

Human trafficking (HT) is often referred to as modern-day slavery, where force, fraud, or coercion is used to lure an individual into a life of labor or sexual exploitation. Although trafficked persons commonly interface with the healthcare setting, they are often unidentified and returned to the trafficked population. Previous studies have shown that while in captivity, trafficked persons have accessed medical care on various occasions, seeking treatments ranging from minor ailments to more severe ones at emergency departments, primary care clinics, and specialized clinics for sexual and reproductive health (Chisolm-Straker et al., 2016; Lederer &Wetzel, 2014). The inability to …

Contraceptive Decision-Making Through The Lens Of Social Determinants Of Health Among Female Sex Workers: A Qualitative Descriptive Study, Jessica L. Zemlak, Kamila A. Alexander, Deborah Wilson, Susan G. Sherman

College of Nursing Faculty Research and Publications

Aims

The aim of the study was to examine how female sex worker's motivations, desires, intentions and behaviours towards childbearing and childbearing avoidance inform their contraceptive decision-making. We explored the influence of social determinants of health in the domains of social context (sexual partners and experiences of violence), healthcare access, economic instability on the contraceptive decision-making process.

Design

We conducted a qualitative descriptive study informed by Miller's Theory of Childbearing Motivations, Desires and Intentions through the lens of social determinants of health.

Methods

Participants were recruited from a parent study, EMERALD, in July–September, 2020. Data were collected from 22 female …

Communication Assessment Tools For Emergency Department Nurses Who Interact With Individuals With Intellectual And Developmental Disabilities, Holly Hunt

Doctor of Nursing Practice Scholarly Projects

Abstract/Executive Summary

Problem Statement: Communication is an essential part of every nurse-patient interaction. During the best of times the patient and nurse can clearly understand each other and engage in successful interaction with positive patient outcomes. Individuals with intellectual and developmental disabilities (IDD) often use nontraditional ways of communicating that can complicate the ideal nurse-patient interaction. When a patient presents with a different method of communicating, the nurse must possess tools available to facilitate a successful interaction. Identifying such a tool or if one cannot be found building a sample tool is vital for positive patient outcomes for individuals with …

Formalized Diabetes Self-Management Education In A Safety-Net Clinic, Emanpreet Kaur

Masters Projects

Diabetes is a complex and chronic illness requiring continuous medical care with multifactorial risk reduction strategies (American Diabetes Association [ADA], 2021). More than 37 million Americans are suffering from diabetes and 90% of them have Diabetes Mellitus Type 2 (DMT2) (Centers for Disease Control and Prevention, 2021). The purpose of this article is to review the background, an organizational assessment, a literature review, and the results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included 16 patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, Body …

Patient Experience In An Interprofessional Collaborative Practice For Underserved Patients With Heart Failure, Connie White-Williams, Maria R. Shirey, Reid Eagleson, Wei Su, Terri Poe, Brittany Fitts, Vera Bittner

Patient Experience Journal

Heart failure is a complex chronic condition that results in multiple patient visits throughout the care continuum. Patient experience has associations with clinical outcomes. The purpose of this study was to examine patient experience among the underserved in a specialized interprofessional collaborative practice heart failure clinic. This prospective study utilized both qualitative and quantitative data to describe the patient experience within an interprofessional collaborative practice. Data were collected from patient experience surveys in 1128 patients seen in the Heart Failure Transitional Care Services for Adults (HRTSA) clinic between January 1, 2018, and December 31, 2021. Interprofessional collaborative practice surveys were …

Animal-Assisted Green Care Farming For Patients With Traumatic Brain Injury, Alex Sargsyan

Epsilon Sigma at-Large Research Conference

Animal-Assisted Green Care Farming for Patients with Traumatic Brain Injury

Purpose

To examine the effects of Animal Assisted Therapies with Farm Animals (AATF) with domesticated ducks on depression and anxiety.

Aim

The proposed study will use single-group time series design and collect survey data to explore the changes in anxiety and depression in patients exposed to AATF. The study will be guided by the Self-Efficacy Theory. The study will involve 30 patients with TBI living in The Crumley House Rehabilitation Center in Limestone, TN.

Hypothesis. Engaging in AATF with domesticated ducks will be associated with decrease in anxiety and depression. …

Barriers To Screening For Diabetic Retinopathy: A Scoping Review, Amy Cooper Rn, Bsn, Lajerica Bates Rn, Bsn, Julie Bridges Rn, Bsn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

More than 34 million people in the United States have diabetes. Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of vision loss. Risk factors for diabetic retinopathy include Type 1 and Type 2 Diabetes, hypertension, smoking, and being African American or Hispanic/Latino. This scoping review seeks to analyze the current research on ways to increase vision screenings, thus reducing cases of diabetic retinopathy in adults.

Methods

Between September 2020 and November 2021, a search was conducted using PubMed, EBSCOhost, Medline, and CINAHL to identify articles using keywords such as diabetic retinopathy and ophthalmology. This …

Spiritual Care Within The Field Of Healthcare, Summer Sirrine

Honors Theses

This thesis can be interpreted as a fundamental and comprehensive resource that addresses major discussion points of spiritual care (SC) within the healthcare setting. It begins with definition of SC, information surrounding its value within healthcare, the qualifications necessary to practice it, simple yet effective tools and questions to perform SC, as well as acknowledgment of notable barriers and complications, and how those can be dealt with. SC correlates with not only the patient’s physical and mental health, but how it may impact medical practice, depending on how much an individual’s spirituality, religion, etc. affects their life. Healthcare providers should …

Palliative Care In The Neonatal Population, Raegan Miller

MSN Capstone Projects

In more than 90% of cases of neonate deaths, terminal comfort care was provided in a Neonatal Intensive Care Unit (NICU) (Soni et al., 2011). Palliative care teams are increasing, but not enough organizations have embraced the need for better palliative care guidelines. Nor do many organizations know when, how, or if palliative care should even be introduced. These events lead to comfort care measures being underutilized in the NICU for most newborn infants with life-limiting and life-threatening conditions. Neonatal palliative care is discussed more than in years past, but little research has been dedicated to how early palliative care …

Culturally Sensitive Emergency Care For Sexual And Gender Minority Youth, Kaysi Goodall

DNP Projects

There is substantial evidence of disparities in access to healthcare and health outcomes affecting sexual and gender minority youth (SGMY). However, evidence of SGMY cultural sensitivity training for pediatric emergency health professionals is limited. This quality improvement research project in an urban pediatric emergency department (PED) used a cross-sectional, pre-test post-test design to improve health professionals’ knowledge, attitudinal awareness, and clinical preparedness in caring for this population. It was informed by the Institute for Healthcare Improvement’s Model for Improvement and completed in four Plan-Do-Study-Act (PDSA) cycles. Evidence-based pedagogical strategies were utilized for a 60-minute staff training session, including introducing foundational …

The Introduction Of A Family Advisory Council In A Neonatal Icu, Jennifer Streelman

MSN Capstone Projects

Having a baby can be a beautiful thing, but sometimes it’s not all sunshine and roses. Birth sometimes does not go smoothly, and sometimes it happens way too soon. The babies that need help at birth all end up in the neonatal ICU requiring differing levels of care. This is never what anyone plans, and therefore can cause lots of stress to new parents trying to navigate not only being new parents, but suddenly thrust into a world of medical uncertainty. Creating an environment that focuses on family centered care is vital to healthy role transition. The presence of a …

Extended Outreach Process: Heart Failure Care Management Program, Amy Crofts

MSN Student Capstones

No abstract provided.

A Structured Life Review Intervention To Improve Life Satisfaction In Home Health Service Patients: A Feasibility Study, Leah Graf

University Scholar Projects

Two million older adults in the U.S. suffer with depression. Adults who live with the difficulties of depression concurrently experience dissatisfaction with life. Life review is a systematic recollection of past events. Dr. Robert Butler postulated that, as the elderly and those with terminal illness approach the end of their lives, there is a resurgence of life experiences in the conscience (1963). A successful life review conducted by an active listener assists the individual to process unresolved conflicts and attain ego-integrity in the final stage of life. Home health services have become an increasingly accepted option for managing chronic illnesses …

A Pilot Program To Address Nurse Leader Moral Distress Secondary To The Performance Evaluation Of Underperforming Personnel, Lisa Krening

Doctor of Nursing Practice Projects

Problem Description: First defined in 1984, as a nurse knowing the correct course of action but perceiving barriers that constrain the action, moral distress has evolved to include challenging situations associated with moral uncertainty, moral conflict, and ethical or moral dilemmas (Campbell et al., 2016; Fourie, 2015, 2016; Jameton, 1984). While the bulk of the moral distress literature has highlighted the challenges of direct care nurses, nurse leaders also grapple with ethical dilemmas that often lead to moral distress (Edmonson, 2010; Ganz et al., 2015; Prestia et al., 2017). Additionally, research indicates that nurse leaders lack experience in navigating ethical …

Depression Screening In Hematology/ Oncology Outpatient Clinic, Nikki Marshall Msn, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Oncology patients have multiple factors that can lead to depression, such as treatments, end-of-life decisions, stressors from home, pain, financial responsibilities, and transportation needs. If depression goes unaddressed, it can diminish the quality of life in oncology patients.

Objectives: (1) The purpose of this evidence-based practice (EBP) project is to improve Hematology/ Oncology (HEM/ONC) patient quality, with improved screening (PHQ-9 screening tool) and identification as well as referral for adult patients (18 and older). (2) Assess the knowledge, perception of depression, and confidence level of utilizing the PHQ-9 screening tool in the hem/onc outpatient clinic staff. (3) To increase …

Caring For Children With Mental Health Concerns: The Experience Of Being A School Nurse, Jeannine Kaskoun

Dissertations, Theses, and Capstone Projects

Mental health issues have for years been on the rise among our nation’s schoolchildren, and the COVID-19 pandemic has only served to aggravate what can now be called a crisis. Researchers agree that timely assessment, diagnosis, and treatment of mental health concerns in children are critical to maintaining their growth and development and could potentially aid in decreasing serious mental health events as they move into adulthood. While in an ideal world, each child would have a family medical provider, the fact is that for many children, the school nurse is the child’s sole provider of health care. Many times, …

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Examination Of The Relationship Between Breastfeeding Behaviors And Perinatal Mental Health During The Covid-19 Pandemic, Saher Rehmani, Miriam Kanan

College of Science and Health Theses and Dissertations

Introduction: Perinatal mental health disorders are often overlooked and have been heightened due to the COVID-19 pandemic. Understanding the association between breastfeeding and perinatal mental health is imperative. To date, to our knowledge there are no known studies, that have examined the relationship between perinatal mental health and breastfeeding behaviors among US-based perinatal populations during the COVID-19 pandemic. The purpose of this study was to examine the relationship between maternal mental health and breastfeeding behaviors among US childbearing populations during COVID-19.

Material and Methods: A cross-sectional, internet-based study was performed in the United States mainly in the Chicagoland area between …

Supporting Caregivers Of The Aging Adult: A Program Evaluation, Tanya O'Brien

Student Scholarly Projects

There is an ever-increasing burden on caregivers of individuals with cognitive illness as a result of the increasing number of older adults with dementia and Alzheimer's disease. Currently, St. John's County Florida offers three programs designed to provide support for caregivers of individuals with cognitive illness. This project evaluated the three programs as part of a program evaluation to determine the efficacy of program selection for sustainability. Utilizing the Center for Disease Control's (CDC) Program Evaluation Framework (PEF), a detailed and thorough evaluation review of the Power Tools for Caregivers, Savvy Caregiver, and an original three-model program developed by the …

Toward An Evidence-Based Framework To Guide Health Care Responses For Patients Impacted By Human Trafficking: Evaluation Of The Heal Trafficking Protocol Toolkit, Susie B. Baldwin, Cathy L. Miller, Beth J. Maclin, Sacha Williams, Hanni Stoklosa

Nursing Faculty Publications and Presentations

Trafficked persons seek health care during exploitation, but few health professionals know how to respond appropriately, and few institutions have protocols to guide this response. Currently, no empirically tested framework exists to guide protocol development for human trafficking response protocols in health care settings. Our aim was to empirically evaluate the HEAL Trafficking Protocol Toolkit's usability and effectiveness through cross-sectional survey methodology. We invited users who downloaded the free Toolkit from January 2017 through January 2018 to participate in an electronic survey and conducted descriptive quantitative and qualitative thematic analyses. Survey respondents were professionally and geographically diverse. Eighty-four percent who …

Torn Between The Real Me And The Social Me: Educated Women’S Perspectives Of Surviving Marital Abuse, Mayada A. Daibes, Reema R. Safadi

The Qualitative Report

The perspectives of educated women on surviving abusive marital relationships have not been adequately explored, thus implying a gap in the literature regarding the role of education in enhancing or mitigating the prevalence of intimate partner violence (IPV). In this context, the question is how do educated women perceive surviving abusive relationships? Interpretative Phenomenological Analysis (IPA), using flexible semi-structured face-to-face interviews, was conducted to understand the experiences of eight highly educated women (master’s, Ph.D.) in abusive marriage. Four superordinate interrelated themes were developed: (a) developing an awareness of self-respect generating role confusion, (b) being torn between traditions and ambitions, (c) …

Interprofessional Collaborative Attitudes: Comparing Social Work Learners To Their Medicine And Nursing Peers, Joseph Bartholomew, Marcia Mount French, Hea-Won Kim

Florida Public Health Review

Interprofessional learning activities in higher education aim to unite healthcare professionals in their future practice, thus reducing duplication and fragmentation of services. This study uses a social learning perspective to examine advanced practice medicine, nursing, and social work learners’ attitudes toward interprofessional education and collaborative practice activities within their university programs. The authors used a cross-sectional design to administer a questionnaire that included the Interprofessional Attitudes Scale (IPAS) to 151 advanced practice health care learners (internal medicine residents, nurse practitioner students, master’s-level social work students). Findings indicated significant differences in three subsections of the IPAS. Social work learners possessed a …

Addressing A Lack Of Education Surrounding Fentanyl Use And Recovery, Nicole Sala, Luciana Gonzalez, Caroline Dorvilien, Teo Keilwitz, Maddy Terhune, Portia Forson

Nursing Leadership in Community Engagement Projects

Nursing Leadership Executive Summary: Addressing a Lack of Education Surrounding Fentanyl Use and Recovery

Our project focused on assisting a nonprofit organization who exists to serve the most vulnerable of families in the Seattle area. They offer a number of programs including a mobile outreach team that seeks to bring resources to families, a program for families which provides the opportunity for new mothers to bond with their newborn, and another program which assists families with medically fragile children to find healthcare resources, and more. Our team was made up of six students from the Lydia Green Nursing Program at …

Navigating Midwifery Solidarity: A Feminist Participatory Action Research Framework, Katherine Buchanan, Elizabeth Newnham, Sadie Geraghty, Lisa Whitehead

Research outputs 2022 to 2026

Background:

A core aspect of midwifery philosophy is the optimisation of normal physiology; however, this has been challenged as a radical idea in the medicalisation of birth. Research has demonstrated the benefits of midwifery in improving outcomes for both mothers and babies. The understanding of midwifery benefits fails to reach wider sociocultural contexts as births becomes more medicalised. Midwifery research requires an action arm, to help translate theory to practice and mobilise midwives in solidarity with women towards action and change.

Aim:

The aim of this article is to describe a Feminist Participatory Action Research (FPAR) by establishing the philosophical …

Engagement In Online Communities By New Mothers In Recovery From Opioid Use Disorder, Nicole M. Mattson, Jennifer M. Ohlendorf

College of Nursing Faculty Research and Publications

Purpose:

The purpose of this study was to examine the role of engagement with online communities by women using medication-assisted treatment (MAT) to manage recovery from opioid use disorder (OUD) during pregnancy and the first year after birth.

Study Design and Methods:

Ten participants were identified through purposive sampling for this secondary data analysis as part of a larger grounded theory study about ways women using MAT for recovery from OUD meet the needs of their mother–infant dyad. Inclusion criteria included: English-speaking, 18 years of age or older, living in the United States, within the first year after birth, using …

Venous Leg Ulcers: An Analysis Of Nursing Knowledge, Shelia Moore-Miller

Electronic Theses and Dissertations

This project evaluated the knowledge level of wound center nursing staff on venous leg ulcer etiology and treatments after an educational intervention. To determine the effectiveness of the educational intervention, participants completed a pretest and posttest evaluation. Venous leg ulcers (VLUs) are chronic lower extremity ulcers affecting older Americans. VLUs are painful and negatively affect activities of daily living. Inadequate VLU treatment can become an infectious process that can ultimately threaten limb existence. A quantitative, quasi-experimental study was conducted over three weeks in a hospital-based wound care center in central Florida. The theoretical framework applied to this project is Lydia …