Digital Commons Network^™

The Effect Of Transfer Of Care Protocol On The Rehospitalization Rates In Psychiatric Patients, Fernando Guillen Msn, Cnp, Pmhnp-Bc

Student Scholarly Projects

Practice Problem: The problem involved the transition of psychiatric care from long psychiatric hospitalizations to community-based psychiatric treatment which has developed into shorter inpatient psychiatric hospitalizations, which in turn has developed into a significantly higher number of individuals being readmitted within one year of inpatient discharge.

PICOT: In adult patients undergoing inpatient acute psychiatric care (P), how does the use of a transfer of care protocol (I), compared to current transfer of care practice (C), affect the rate of readmission within 30 days for inpatient acute psychiatric care (O), in 10 weeks?

Evidence: The evidence from an extensive literature review …

Supporting Children Impacted By Parental Addiction: A Toolkit For Kinship Caregivers, Nicole Mueller, Jaimee Kudrle

Nursing DNP Projects

Kinship caregiving has become increasingly common in the United States, specifically due to parental substance use disorder. These kinship caregivers (KC) have unique needs that are largely unmet. Often, there is no comprehensive resource for KCs specific to their community. KC’s greatest needs are financial, legal, and mental health assistance, as well as educational information about care of children for the kinship caregivers. The objective of this project was to develop a KC resource toolkit to meet priority needs within the community. The project design utilized an EBP framework and followed a community-based participatory research approach. Project leads worked with …

Screening For Social Determinants Of Health In A Comprehensive Pediatric Sickle Cell Disease Clinic, Marie Turner

Dissertations

Problem: Social determinants of health (SDOH) affect health outcomes across the lifespan. The American Academy of Pediatrics recommends routine screening for SDOH. Poverty is a SDOH affecting health outcomes in children, especially in children with a chronic disease such as sickle cell disease (SCD). Children with sickle cell disease have a high burden of SDOH. This project sought to describe the SDOH barriers experienced by pediatric patients with SCD.

Methods: A descriptive survey/observational design, using a convenience sample of pediatric patients ages 0-19 years old in a comprehensive SCD clinic at a large, urban, Midwestern academic medical center was utilized …

Evaluating Mindfulness On Loneliness In An Older Adult Population, Jessica Tieskoetter

Dissertations

Problem: Loneliness is a widespread public health concern and has negatively impacted mortality and health outcomes among older adults. This quality improvement project’s purpose was to evaluate mindfulness on loneliness and quality of life among adults aged 65 years and older, participating in a weekly befriending socialization program.

Methods: A descriptive cohort design was utilized to assess loneliness pre-and post-implementation of a mindfulness telephone line over three months. A convenience sample of 22 older adults enrolled in a befriending socialization program was used. The Iowa Model of Evidence-Based Practice framework was applied to guide the implementation of a practice change …

Palliative Care Screening For Persons Living With Dementia In A Nursing Home, Shanika S. Pruitt

Dissertations

Problem: Dementia is rapidly increasing as the people of the world mature and life expectancy increases. As the world ages and the prevalence of dementia increases, nursing home placement will and is the most sought place for care of this population. Dementia is under recognized as a terminal illness and palliative care is underutilized for nursing home residents with advanced symptoms of dementia.

Methods: This quality improvement (QI) initiative utilized a prospective, descriptive design. The Palliative Care Screening for the Elderly tool was administered to a purposive sample of persons living with dementia residing in the nursing home. Qualitative data …

The Haunted House Experience: Developing A Home Health Assessment Training Utilizing An Interprofessional, Interinstitutional Virtual Simulation, Angel Holland Dpt, Edd, Pamela Degravelles Phd, Rn, Debbie Knight Pharmd, Karen Dickinson Md, Kathryn Neill Pharmd, Duston Morris Phd, Wendy Ward Phd

Faculty Research ​and Publications

To meet the interprofessional education needs of students during the COVID-19 pandemic, universities transitioned to virtual options. For many universities, this transition was challenging and time-consuming. The Arkansas Interprofessional Education Consortium (ARIPEC) combined resources to create a novel learning experience for students with a focus on the skill of home assessment. An interinstitutional, interprofessional faculty project team was developed to create a learning experience, with each institution responsible for a portion of the virtual simulation development. This paper describes the process for creation and implementation of an interprofessional, interinstitutional virtual learning experience to support the growth of healthcare students across …

The Use Of A Clinical Pathway To Increase Child Abuse Screenings Of Young Children With Fractures, Stephanie Li Schaller

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Nationally, infants and young children who present to emergency departments with fractures are not being screened adequately for possible physical abuse with a skeletal survey (Paine & Wood, 2018; Shelmerdine et al., 2014; Wood et al., 2019). Without universal screenings, implicit bias along racial and socioeconomic lines becomes a factor in deciding which children with fractures get screened, resulting in either under-or over-utilization of skeletal survey screenings (Kim et al., 2017; Paine & Wood, 2018). When child abuse is not diagnosed correctly, further abusive injuries or death can occur (Ravischandiran et al., 2010). Purpose: This evidence-based practice project …

Unintended Consequences Of The Electronic Health Record And Cognitive Load In Emergency Department Nurses, Carolyn S. Harmon

Theses and Dissertations

Background: The electronic health record (EHR) was rapidly implemented to improve patient safety. However, this rapid and widespread EHR implementation negatively connects to patient safety. Clinician cognitive overload is also thought to be negatively connected to patient safety, especially in the chaotic emergency department (ED) setting. Limited research has been conducted on unintended consequences of the EHR (UC-EHR) and cognitive load (CL) in ED nurses. Understanding the UC-EHR and CL in ED nurses facilitate informed interventions to improve nursing practice and patient safety.

Aims: Guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 framework, the aims of this …

Assessment Of Trauma-Informed Care Knowledge Among Caregivers In An Inpatient Mental Health Unit, Katie Rhea, Loni Conley, Jeremy Williams, Kathryn Wiltfong, Teresa Bigand

2022 Providence Nurse Research Conference

Background: Research suggests exposure to traumatic events is extremely common. Furthermore, risk of developing chronic health conditions or engaging harmful behaviors such as substance use later in life increases with more frequent exposure to traumatic events, especially during childhood. Best evidence recommends delivery of health care using a Trauma Informed Care (TIC) approach to improve outcomes such as anxiety or depression. This care approach guides healthcare providers on interactions with patients centered on the tenets of (1) safety, (2) trustworthiness, (3) peer support, (4) collaboration, (5) empowerment and choice, and (6) cultural, historical, and sex issues. On one inpatient …

Assessing The Contribution Of Immigrants To Canada's Nursing And Health Care Support Occupations: A Multi-Scalar Analysis, Rafael Harun, Margaret Walton-Roberts

Social Work and Urban Studies Faculty Research

Background

The World Health Organization adopted the Global Strategy on Human Resources for Health Workforce 2030 in May 2016. It sets specific milestones for improving health workforce planning in member countries, such as developing a health workforce registry by 2020 and ensuring workforce self-sufficiency by halving dependency on foreign-trained health professionals. Canada falls short in achieving these milestones due to the absence of such a registry and a poor understanding of immigrants in the health workforce, particularly nursing and healthcare support occupations. This paper provides a multiscale (Canada, Ontario, and Ontario’s Local Health Integration Networks) overview of immigrant participation in …

Examining Perceived Stress And Diet Quality Among Low-Income Families Engaged With A Nutrition-Based Food Assistance Program, Kelsey R. Wolfe, Kathryn L. Dambrino, David Phillippi, Laura Gray

DNP Projects

Abstract

Introduction: Evidence suggests poor-quality diets and high levels of stress have negative impacts on health, especially in low-income families in the southern United States. Nutrition-based food assistance programs were developed to meet nutritional needs of food insecure clients. The purpose of this scholarly project was to explore the relationship between perceived stress and diet quality among low-income families engaged with a nutrition-based food assistance program.

Methods: A retrospective and observational design was used to analyze previously collected survey responses from clients participating in a nutrition-based food assistance program in Nashville, TN (N = 425). Descriptive statistics and Spearman’s …

Perceptions Of Hazing Among Young Male United States Military Service Members: A Qualitative Analysis, Elizabeth C. Metzger, Jasmin N. Bennett, Cristobal S. Berry-Caban, Elizabeth J. Allan, Christopher J. Guenthner, Bryce M. Meerhaeghe, Brian Borsari, Donna M. Kazemi Phd, Rn, Cne, Fiaan, Lindsay M. Orchowski

Faculty Publications

This study examines hazing among a sample of young male service members in the United States (US) military. Individual semi-structured interviews were conducted with active duty service members (N = 10) aged 18 to 24 at a large Southeastern US Army post to examine their conceptualization of hazing. Thematic analysis revealed three emergent themes: (1) the definition of hazing and hazing behaviors; (2) the ritualistic nature of hazing; and (3) the sexual nature of hazing. Most participants provided their own definition of hazing. One participant had difficulty in differentiating between hazing and bullying, the others had distinct definitions as …

Commencement Program 2022, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2022 Events of Commencement

5 | The Academic Procession

6 | Institutional Administration

7 | Board of Trustees

8 | Significance of Academic Regalia

9 | University History Highlights

11 | Criteria for Institutional Awards

13 | Loma Linda University Health and Loma Linda University Honorees

27 | The Programs, The School Honorees, and The Speakers

• School of Medicine, 28
• School of Pharmacy, 52
• School of Dentistry, 67
• School of Public Health, 92
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication Sciences and Disorders, …

Screening For Childbirth-Related Posttraumatic Stress Disorder Using The City Birth Trauma Scale: A Pilot Project, Meredith Kazato

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project is to identify birthing people with childbirth-related posttraumatic stress disorder (CB-PTSD) symptoms using the City Birth Trauma Scale (CBTS). Once identified, at risk birthing people will receive verbal education about CB-PTSD and a social work consultation, if necessary.

Background: A birth is deemed traumatic, and thus fulfills one of eight criteria of posttraumatic stress disorder (PTSD), when during labor, delivery, and/or immediately postpartum, the birthing person perceives themselves and/or their baby’s life to be in danger and/or are at risk of being critically injured. These events include but are not limited to emergency cesarean …

Improving Vaccination Rates Through Community Partnership, Marissa Marquez

Doctor of Nursing Practice Final Manuscripts

IMPROVING VACCINATION RATES THROUGH COMMUNITY PARTNERSHIP

by

Marissa Marquez, DNP Student, FNP-C, MSN, MBA, RN, BSN

Clinical Mentor: Jill Milton, MSN, FNP-C

Joseph Burkard, DNSc, CRNA, AACN Health Policy Fellow

Purpose: The purpose of the quality improvement project is to improve the vaccination rates and vaccine series completion rates of school age children at Rosa Parks Elementary school through a targeted educational intervention.

Background: Under immunization among school-aged children is an ongoing challenge. Low rates of immunization can cause outbreaks of communicable disease, leading to preventable injury, loss of life, and burden to the healthcare system. Among other …

Screening People Experiencing Homelessness For Adverse Childhood Events (Aces), Priya Vishwanath

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to implement a screening tool identifying patients who have four or more Adverse Childhood Events (ACEs) and connecting them to resources to build protective resilience. Stress during the developmental years can lead to preventable health conditions that are costly and impede quality of life. Nine out of the ten leading causes of death are ACE related illnesses. These are caused by complications of toxic stress syndrome. During a 7-month period, 138 patients were screened; 45% had ACEs of four or more.

A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford

Mindfulness Studies Theses

The Center for Mind-Body Medicine (CMBM), founded by Dr. James Gordon, provides communities with evidence-based Mind-Body Skills Groups (MBSGs) that foster self-care, self-awareness, and self-expression. MBSGs range from 8 to 12-week series on various mind-body practices wherein group members meet, practice, and reflect on the impact of mind-body skills in their lives. Research has demonstrated that participants in MBSGs have positive outcomes. Healthcare professionals (HCPs), especially nurses, gain resiliency from MBSGs. As facilitators of MBSGs, nurses develop essential skills transferable to clinical and educational settings. MBSGs are therapeutic for adult participants with chronic stress. Prior to this thesis, only one …

Early Integration Of Palliative Care With Curative Oncology Treatment For Patients With Advanced Cancer: Implications For Clinical Nursing Practice, Rhea Rughani

Honors Projects

Palliative care, though clinically established to improve health-related quality of life measures for patients with advanced illness, remains underutilized and largely limited to end of life care. This project aims to inform oncology nursing practice through the analysis of literature supporting the early integration of palliative care with standard curative oncology treatment for patients with clinically advanced cancer. Informed by relevant research, clinical practice guidelines, and improved specialty palliative care training, oncology nurses and nurse practitioners are ideally situated to advocate for and initiate early palliative care integration, to holistically improve the standard approach to complex cancer care.

The Community Health Worker: Improving Prenatal Health In Rural And Minority Populations, Deirdre A. Martinez

DNP Qualifying Manuscripts

The United States continues to have an unacceptably high rate of preventable deaths among pregnant and new mothers—the highest rate among developed countries. Pregnancy outcomes are especially poor in minority, rural, and medically-underserved populations, with lack of access to healthcare being identified as a primary factor in poor pregnancy outcomes and pregnancy-related deaths. It is imperative that action be taken to reverse this disturbing trend. Introduction of the Community Health Worker (CHW) into the multidisciplinary healthcare team is a solution that results in increased access to healthcare, along with many other positive health outcomes, and is one way in which …

Psychosocial Distress Screening For Patients With Cancer: A Value-Based Approach To The Integration And Delivery Of Holistic Care, Candy Cheung

Doctor of Nursing Practice (DNP) Projects

Background: Patients with cancer (PWC) have a high prevalence of experiencing psychosocial distress as they bear the burden of the disease. Emphasis is needed on psychosocial care, as the COVID-19 pandemic negatively impacts mental health. Psychosocial distress screening is considered a standard practice by the National Comprehensive Cancer Network (NCCN), which recommends using the validated Distress Thermometer (DT) as a screening tool.

Local Problem: The DNP project ambulatory infusion clinic (AIC) site does not have a standardized distress screening tool for staff. There was a lack of awareness of an existing non-validated distress screening and little to no intervention or …

Save The Children® Community Health Worker Program - Prenatal Care, Deirdre A. Martinez

Doctor of Nursing Practice (DNP) Projects

The United States continues to have an unacceptably high rate of preventable deaths among pregnant and new mothers—the highest rate among developed countries. Pregnancy outcomes are especially poor in minority, rural, and medically-underserved populations, with lack of access to healthcare being identified as a primary factor in poor pregnancy outcomes and pregnancy-related deaths. It is imperative that action be taken to reverse this disturbing trend. Introduction of the Community Health Worker (CHW) into the multidisciplinary healthcare team is a solution that results in increased access to healthcare, along with many other positive health outcomes, and is one way in which …

Improving Compliance With Treatments For End-Stage Renal Disease Patients On Hemodialysis, Susan Blakeney

Doctoral Projects

According to Blumrosen et al. (2020), the dialysis population cost expenditure is greater than “seven percent of the Medicare budget at nearly $40 billion a year” even though this population is “less than one percent of the Medicare population” (p. 1436). Additionally, the renal disease population is growing in the United States and internationally which contributes to rising healthcare costs around the globe (Levin, 2018).

The purpose of this Doctor of Nursing Practice (DNP) project was to identify the factors or reasons hemodialysis patients miss treatments or only stay for partial treatment. Hemodialysis patients are required to have treatments three …

Contextual Factors Associated With Organizational Learning In Hospitals: An Instrument Development Study, Bret Lyman, Kylie C. Thorum

Faculty Publications

Aim: Develop a valid, reliable research instrument to measure contextual factors associated with organizational learning in hospitals.

Background: A valid, reliable instrument for measuring contextual factors associated with organizational learning is needed so nurse leaders and researchers can improve healthcare by facilitating and studying organizational learning.

Methods: The Organizational Learning in Hospitals model guided development of the Organizational Learning Instrument-Context. Content validity was refined and evaluated through cognitive interviews and expert reviews. The instrument was distributed to direct care nurses in Magnet® hospitals in the United States. Intraclass correlation coefficients validated the use of multilevel analyses. Construct validity was assessed …

Moral Distress And Ethical Climate In Pediatric Nurses In The Time Of Covid, Katherine Bliss Soriano

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

Moral Distress in an increasing problem in nurses and other healthcare professionals due to the many challenges nurses face in proving care to their patients and families. These challenges can be magnified when the nurse is conflicted and unable to successfully navigate the moral and ethical responsibilities of the profession leading to moral distress. The COVID-19 pandemic has had profound and global widespread consequences including the impact on pediatric nurses. This descriptive correlational study examined the relationship between moral distress and ethical climate among pediatric nurses who cared for patients during the COVID-19 pandemic. This study used Corely’s Theory …

Using The Whole School, Whole Child, Whole Community Approach To Improve An Urban Early Learning Center Students’ Social, Emotional, And Physical Health And Wellness, Joelle Chateauneuf

Doctor of Nursing Practice Scholarly Projects

Background: Integrating school-based health education and models of healthy lifestyles in early childhood provides a foundation for lifelong health learning. Many chronic may be prevented or mitigated through early childhood health education. Early learning centers (ELCs) may be a perfect setting to enable young children to achieve their full potential.

Problem: In Boston, Massachusetts, there are differences in health experience across population groups. Children of color and lower socioeconomic challenges experience higher rates of chronic conditions.

Available Knowledge: Search of literature showed that school-based healthy lifestyle interventions improve healthy behaviors and can be taught to children as young as preschool. …

Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez

Doctor of Nursing Practice Scholarly Projects

Description of the problem: Obesity is a growing healthcare problem worldwide with extraordinary costs to the individual's health and the healthcare system. Individuals most affected by obesity include socioeconomically disadvantaged individuals, often with limited resources to seek specialized care.

Available knowledge: Various weight-loss interventions exist but access and success rates vary. Weight loss is often modest and additional factors such as social determinants of health, health literacy, and patient motivation are all factors important to the success of an intervention.

Specific Aims: The purpose of this quality improvement project was to improve self-regulatory weight loss behaviors and increase weight loss …

Stakeholder Perspectives On In-Home Passive Remote Monitoring To Support Aging In Place In The Province Of New Brunswick, Canada: Rapid Qualitative Investigation, Emily A. Read, Danie A. Gagnon, Lorie Donelle Phd, Rn, Fcan, Kathleen Ledoux, Grace Warner, Brad Hiebert, Ridhi Sharma

Publications

BACKGROUND: The province of New Brunswick (NB) has one of the oldest populations in Canada, providing an opportunity to develop and test innovative strategies to address the unique health challenges faced by older adults. Passive remote monitoring technology has the potential to support independent living among older adults. Limited research has examined the benefits of and barriers to the adoption of this technology among community-dwelling older adults. OBJECTIVE: This study aimed to explore perceptions of in-home passive remote monitoring technology designed to support aging in place from the perspective of older adults, their family or friend caregivers, social workers, and …

Improving Access To Non-Pharmacologic Integrative Pain Management Modalities In Sickle Cell Disease (Scd) Inpatients, Nicole Lincoln

Doctor of Nursing Practice Scholarly Projects

Background: Evidence suggests that non-pharmacologic therapies complement and work synergistically alongside traditional pharmacologic therapies for chronic pain and have a beneficial impact on the intensity of pain, improved quality of life and functional status. Sickle Cell Patients have complex pain and often feel stigmatized due to pain seeking behaviors. This project evaluates the effect of a clinical initiative stewarded by nurses and managed in the electronic health record. The project aims to improve access to preferred modalities for integrative pain management among hospitalized Sickle Cell Disease (SCD) inpatients.

Methods: The nurses received e-learning and in-person training on the use of …

Transitioning Eating Practices Of Older Adults, Michelle Lajoy Jackson

Dissertations

Purpose: The purpose of this descriptive qualitative study was to explore what factors may have influenced the transition of an individual older adult’s eating practices over a lifespan and the impact participants perceived those factors currently had upon their nutritional health in older adulthood.

Background: The older adult population is recognized as one of the fastest growing populations in the United States. One of many growing concerns for this population is the impact of dietary practices on the morbidity and mortality of this aging population. There is limited research to date that has explored the transitioning of appetite …

Individualized Pain Plans For Pediatric Sickle Cell Patients, Teresa Zingale, Morgan O'Malley, Michael Marx

Doctor of Nursing Practice Projects: College of Nursing

Background: Vaso-occlusive (VOC) pain crisis in sickle cell pediatric patients is a hallmark symptom, and both unpredictable and crippling. There is a lack of evidence as to what is best practice to avoid a VOC pain crisis in pediatric sickle cell patients. Individualized Pain Plans were created and trialed based off the format asthma action plans with goals to improve overall pain management and to prevent or decrease emergency department visits and hospitalizations.

Aims: This is a cross-sectional and quality improvement study designed to evaluate the effectiveness of previously implemented Individualized Sickle Cell Pain Plans in a midwestern children’s hospital. …