Digital Commons Network^™

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …

Burnout, Self-Efficacy, And Resilience In Haitian Nurses: A Cross-Sectional Study, Marie Therese Georges

Loma Linda University Electronic Theses, Dissertations & Projects

Though nursing burnout is a global problem, research on nurse burnout in Haiti is scarce. Haitian nurses operate in a resource-poor work environment in the context of multiple personal and social challenges. This study assessed burnout (emotional exhaustion, depersonalization, and personal accomplishment) and identified its influencing factors among a sample of Haitian nurses. A cross-sectional survey in French and Haitian Creole was conducted in five Haitian hospitals using forward and back translated scales measuring burnout (i.e., emotional exhaustion, depersonalization, personal accomplishment), self-efficacy, nursing work environment, resilience, and demographic factors. Haitian nurses (N = 179) self-reported moderate emotional exhaustion (M = …

Effectiveness Of Home Health Care In Reducing Return To Hospital: Evidence From A Multi-Hospital Study In The Us, Danielle M. Siclovan, James Bang, Olga Yakusheva, Morris Hamilton, Kathleen L. Bobay, Linda L. Costa, Ronda G. Hughes, Jane M. Miles, Sarah J. Bahr, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background

Home health care, a commonly used bridge strategy for transitioning from hospital to home-based care, is expected to contribute to readmission avoidance efforts. However, in studies using disease-specific samples, evidence about the effectiveness of home health care in reducing readmissions is mixed.

Objective

To examine the effectiveness of home health care in reducing return to hospital across a diverse sample of patients discharged home following acute care hospitalization.

Research design

Secondary analysis of a multi-site dataset from a study of discharge readiness assessment and post-discharge return to hospital, comparing matched samples of patients referred and not referred for home …

Prevention Of Shaken Baby Syndrome Among High-Risk Neonates: Program Implementation And Evaluation, Rebecca Tortolano

College of Science and Health Theses and Dissertations

Abstract Background: Studies suggest that the implementation of high-quality education and support services for caregivers may reduce the incidence of unplanned harm to infants and young children under high-stress circumstances. Purpose: This study evaluates the usefulness of the Period of PURPLE Crying program in a high-acuity NICU at The University of Chicago Comer Children’s Hospital based on six measurable objectives. Methods: The study utilized a Likert-style pretest-posttest survey design to evaluate how the Period of PURPLE Crying program was perceived by NICU nurses. Nurses were educated on the program content during an in-service aimed to teach participants how to utilize …

Caregiving Stress And Self-Rated Health During The Covid-19 Pandemic: The Mediating Role Of Resourcefulness, Elliane Irani, Atsadaporn Niyomyart, Jaclene A. Zauszniewski

Faculty Scholarship

Family caregivers faced unprecedented circumstances and experienced increased levels of stress during the COVID-19 pandemic. Resourcefulness can minimize the effect of stress on health outcomes. The purpose of this study was to examine the associations between caregiving stress during the pandemic, resourcefulness, and self-rated health and assess the mediating effect of resourcefulness. A convenience sample of 70 family caregivers of adults with chronic and/or disabling conditions was recruited using social media groups and professional networking platforms. Data were collected using an online survey and analyzed using linear regression. Mediation analysis was conducted using the PROCESS macro. Higher levels of caregiving …

Commencement Program 2021 (School Of Nursing), Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

2 | 2021 Events of Commencement

4 | University Administration

5 | Significance of Academic Regalia

6 | University History Highlights

8 | Criteria for Institutional Awards

10 | Loma Linda University Health and Loma Linda University Honorees

23 | The Program, The School Honorees, and The Speaker

25 | Candidates for Degrees

40 | Nurse's Pledge

Providing Palliative And Hospice Care To Children, Adolescents And Young Adults With Cancer, Kimberly A. Pyke-Grimm, Beth Fisher, Amy Haskamp, Cynthia J. Bell, Amy Rose Newman

College of Nursing Faculty Research and Publications

Objectives

To describe palliative, concurrent, and hospice care in pediatric oncology in the United States (US), we present a clinical scenario illustrating palliative and hospice care, including eligibility for concurrent care, insurance coverage and billing, barriers to accessing quality pediatric palliative and hospice care, and implications for oncology nursing practice.

Data Sources

Peer-reviewed articles, clinical practice guidelines, professional organizations, and expert clinical opinion examining pediatric oncology, palliative care, and hospice care.

Conclusion

Understanding the goals of palliative and hospice care and the differences between them is important in providing holistic, goal-directed care.

Implications for Nursing Practice

Oncology nurses play …

Learning Objectives Of Cultural Immersion Programs: A Scoping Review, Kate Buchanan, Marrianne Velandia, Marina Weckend, Sara Bayes

Research outputs 2014 to 2021

Background: Cultural immersion as a learning activity provides students with the opportunity to experience diversity and develop cultural safety. Both, ‘Study Abroad Programs’ and ‘Internationalisation at Home’ (IaH) aim to provide a cultural immersion experience for students. However, explicit learning objectives are essential for quality pedagogy and for students to develop cultural safety from their learning experience.

Objective: To identify the learning objectives of study abroad and Internationalisation at Home (IaH) programs in higher education health profession programs.

Design: A scoping review was undertaken according to recommendations by the Joanna Briggs Institute (Peters et al., 2020) and PRISMA guidelines.

Data …

Exploring Canadian Children's Social Media Use, Digital Literacy, And Quality Of Life: Pilot Cross-Sectional Survey Study, Lorie Donelle Phd, Rn, Fcan, Danica Facca, Shauna Burke, Bradley Hiebert, Emma Bender, Stephen Ling

Publications

BACKGROUND: Understanding social media use and digital literacy among young Canadian children is an increasing area of concern, given the importance of digital inclusion for full and informed participation in evolving educational, civic, corporate, social, and economic spaces. OBJECTIVE: The aim of this study was to explore internet and social media knowledge as well as social media use among Canadian children aged between 6 and 10 years. METHODS: We conducted interview surveys with 42 children aged between 6 and 10 years who participated in an after-school health promotion program in an urban community in Southwestern Ontario to understand their digital …

Life Course In Hearts: Enhancing Telehealth Resilience And Mindfulness Intervention In Older Adults Experiencing Abuse And Trauma-A Conceptualization, Mary Dioise Ramos

Faculty Articles

Advances in research and evidence-based practice improve the prevention and treatment of diseases, but the marginalized seems to be left behind. The purpose of this paper is to conceptualize a telehealth intervention aimed to improve the health and health span of older adults. More particularly, we articulate the conceptual framework underlying our intervention, Telehealth Resilience Mindfulness (TRM) Intervention, which will be delivered via text messaging (for those who have phones or smartphones), video conferencing such as Zoom (for those with internet connectivity), or in-person (when it is practical) to older adults to enhance HEARTS (health, experiences of abuse and trauma, …

Obesity Prevention Toolkit To Combat Weight Gain Related To Sedentary Behavior And Dietary Habits In College Students: An Evidence-Based Project, Maria Amos, Martha Fuller

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Forty percent of the US population ages 20-39 are categorized as obese,

their BMI is over 30, and 35% of college age students are obese or overweight. Issues related to obesity cost the US $147 billion annually. Between 40%-50% of college students are reported to be inactive. Inactivity can lead to increased morbidity and mortality related to increased risks of cardiovascular disease, diabetes, hypertension, musculoskeletal issues, and depression. Providing dietary and physical activity education and access to nutritional information promotes behavior change in young adults.

Aims of Service Change: This evidence-based project proposal aims to provide a toolkit …

Code Blue: Do You Know What To Do? Increasing Nurse Confidence And Readiness Through In-Situ Mock Code Simulation, Katelyn Nusser

Master's Projects and Capstones

An underprepared nurse is the most dangerous threat to patient survival in the intense and frightening environment of a code blue situation. With basic life support certification required on merely a biannual basis, it cannot be expected that nurses maintain the skills and knowledge without routine application. This quality improvement project proposed the following PICOT question: for medical-surgical nurses, how does in-situ mock code blue training between BLS recertification periods affect nurse readiness and confidence in a code blue situation? Mock code simulations were conducted over a three-week period with an emphasis on hands-on practice as well as teamwork and …

Utilizing Tracer Methodology To Evaluate The Effectiveness Of A Hospital Antimicrobial Stewardship Program, Christine Smyth

Doctor of Nursing Practice (DNP) Projects

Antimicrobial resistant organisms are a growing threat in the United States and globally. It has become the expectation that healthcare institutions, including hospitals, contribute resources to create and maintain antimicrobial stewardship programs to decrease antimicrobial resistance, improve patient outcomes, and decrease the spread of multi-drug resistant organisms. The methods utilized to evaluate antimicrobial stewardship at hospitals often only evaluate outcome measures and fail to capture knowledge of the hospital antimicrobial stewardship program among prescribers, clinical pharmacists, and nurses, as well potential barriers to antimicrobial stewardship among healthcare providers. The purpose of this Doctor of Nursing project is to implement and …

Family Caregivers’ Experiences And Changes In Caregiving Tasks During The Covid-19 Pandemic, Elliane Irani, Atsadaporn Niyomyart, Ronald L. Hickman

Faculty Scholarship

The purpose of this descriptive study was to describe family caregivers’ experiences and changes in caregiving tasks and approaches during the COVID-19 pandemic. Using web-based strategies, 69 family caregivers of adults with chronic or disabling conditions were recruited and completed an online survey about positive and negative caregiving experiences, and ways in which caregiving has changed. Data were analyzed using descriptive statistics (structured questions) and conventional content analysis (open-ended responses). Participants reported concerns about their loved one’s physical and mental health, the limited access to other caregiving sources, and the limited opportunities to maintain personal well-being. Caregiving tasks completed more …

Using Mindfulness To Decrease Stress In College Students, Saska Pavlovic

Evidence-Based Practice Project Reports

The prevalence of stress is increasing in colleges, where students are experiencing anxiety at an alarming rate, with anxiety being the topic most discussed in university counseling centers. The purpose of this evidence-based practice project was to determine the effect of mindfulness exercises on college students’ perceived stress. The Stetler Model guided the project development and implementation. The literature search revealed that best practice included mindfulness exercises through a combination of face-to-face instruction and remote online audio meditation for a duration of eight weeks. For this project, 56 undergraduate students (health care-leadership, health-science, and nursing majors) enrolled in a health …

Culturally Appropriate Health Education: Translation Of A Parturient Pain Relief Options Pamphlet Into French And Spanish, Francis Minor, Austin Cook

Doctor of Nursing Practice Projects

The rise of immigration worldwide introduces a diverse, multicultural population of patients seeking healthcare in the United States. Barriers to communication, both spoken language and culturally associated communication norms, limit immigrant women’s ability to seek, gain access, and follow through with perinatal care. In order to provide safe, effective, and culturally sensitive care, recognition of language and cultural differences of all individuals must be considered when providing patients with educational materials (Perera et al., 2012; Plumbaum et al., 2014). The aim of this project was to translate an existing pain relief options pamphlet into French and Spanish in order to …

Care Of The Healthcare Provider, Kari Hullinger, Emily Moscardelli

Doctor of Nursing Practice Projects

Evidence has shown a strong correlation between a healthy provider and the positive care that the provider can promote to others. Many evidence-based health promotion programs have been implemented throughout many health systems. These programs have shown improvement of the providers’ overall health. And in return, these providers are able to better care for their patients. Detailed reports have shown many health consequences that healthcare providers have acquired due to long hours, intense training, lack of time, lack of sleep, and the concept of always putting their patients first. A health system in Springfield, Illinois was examined to determine if …

The Impact Of A Cultural Competence Assessment Tool On Teaching Strategies In The Dnp Curriculum At Southern Illinois University Of Edwardsville, Katarina Dobrosavljevic

Doctor of Nursing Practice Projects

Providing culturally competent and culturally congruent care to patients leads to better outcomes and reduction of poor outcomes due to health disparities. Providing care that is not culturally congruent can contribute to communication barriers, resulting in deficient diagnostic testing, miscommunication about etiologies, treatment plans that are not individualized, and discounting of patient's ideas. Individuals from diverse cultures face health disparities which contribute to inadequate care and poor outcomes. The purpose of this project was to survey former graduates of the Southern Illinois University of Edwardsville (SIUE) family nurse practitioner (FNP) program to assess their level of cultural competence and areas …

Physical Well-Being And Healthy Lifestyle Options, Michael Perkins

Doctor of Nursing Practice Projects

Background

The AANA has identified stress management or wellness as a priority for all CRNA programs. The Health and Wellness Initiative put in place by the AANA in 2004 is a model designed for all SRNA programs and intended to address students’ participation in wellness events in order to combat stressors.

The primary purpose of this project was to gain information about the stress faced by SRNAs enrolled at a Midwestern University and to evaluate strategies that could help students properly deal with stress.

Methods and Evaluation

Fifty-five students participated in the survey, data were compared by year in the …

Caring Calls: A Weekly Phone Call Intervention And The Correlation With Loneliness In Rural Dwelling Adults, Abigail Jumbeck, Jennifer Timm, Mieca Valen, Chris Malone

Nursing DNP Projects

Purpose: This pilot study’s aim was to examine the impact of weekly phone calls from interprofessional students on loneliness in rural dwelling adults.

Design: A pretest and posttest quasi-experimental design was utilized.

Setting: The intervention was based in southeastern Minnesota, although the participants could have lived anywhere. Zoom for Healthcare © was utilized, and students were able to make the phone calls from their homes, therefore, no travel was necessary.

Subjects: The subjects were rural dwelling adults (over the age 18 years old).

Intervention: Interprofessional students made weekly social phone calls to rural dwelling adults over ten weeks.

Measures: The …

Screening For Resilience In Pediatric Primary Care, Kaitlin Phelan, Martha Grant Fuller

Doctor of Nursing Practice Final Manuscripts

Introduction: Adversity in childhood increases risk for physical and mental health problems. Children who undergo adverse events can still flourish, due to the concept of resilience. Literature shows that resilience influences health more than adversity, and screening for resilience may improve practice.

Method: A valid screening tool for resilience, The CD-RISC, was given to children twelve and above during their well visit during February 2021 at a clinic in Oceanside, CA. Scores were categorized into four quartiles. Children responding in the lowest two quartiles received provider follow up.

Results: 97 surveys were scored: 39 scoring in the lowest quartile, 19 …

Professional Quality Of Life Indicators And Turnover Intention In Forensic Nurses, Leigh Anne Meyer

Doctor of Nursing Practice Scholarly Projects

Background/Significance: Significant barriers to forensic nurse workforce development exist, affecting patient access to care. Retention of forensic nurses is a persistent problem. Turn-over of forensic nurses can be attributed to many factors related to professional quality of life, including compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS).

Methods: A convenience sample of forensic nurse program coordinators was used to identify the effect of an educational session on professional quality of life and strategies for reducing stressors within the role on ProQOL-5 and TIS-6 scores using a pre- post-test quasi-experimental survey design. Correlation between professional quality of life indicators …

A Quality Improvement Project To Increase Intimate Partner Violence Screening On College Campuses, Becky Murck

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: Sexual assault on college campuses can be a life-changing event and goes unreported 80% of the time. Women are not screened for intimate partner violence (IPV) regularly when seen in university student health settings. Student health settings on college campuses can fill this gap by routine screening for intimate partner violence.

Purpose: This quality improvement project aimed to increase intimate partner violence screening rates with the implementation of an evidence-based intimate partner violence screening tool and healthcare provider training.

Project method: A retrospective chart view was conducted before and after implementing the Humiliation, Rape, Anger, and Kick (HARK) evidenced-based …

Michigan Physician Orders For Scope Of Treatment: Development Of A Nationally Recognized Program, Megan Owens

Doctoral Projects

Background: Advance directives are well intentioned, but fail to promote patient autonomy in emergent situations.

Objective: To develop a sustainable portable medical order program consistent with national standards through an evidence-based toolkit.

Methods: A literature review and policy analysis were conducted to develop toolkit. Interviews were conducted with content experts to validate toolkit.

Results: The final toolkit consisted of five components: educational materials for healthcare providers, a policy brief, strategies for fund development, strategies for quality monitoring, and a cost savings exemplar.

Conclusions: An evidence-based toolkit tailored to state-specific barriers is critical to development of a portable medical order program.

Access To Healthcare For The Hispanic/Latino Population, Rebecca Loritz

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: The U.S. Hispanic/Latino population faces significant barriers to accessing healthcare. The most common barriers Latinos face are language barriers, cost barriers, immigration statuses, insurance coverage barriers, transportation barriers, health literacy and education barriers, as well as lack of access to healthcare providers. These barriers impact not only their ability to access healthcare but also the quality of healthcare they receive.

Purpose: To synthesize the existing literature evaluating that identifies barriers to healthcare.

Methods: CINAHL and PubMed were systematically searched, along with a manual internet search for journal articles that studied access to care issues for the Latino population in …

The Effects Of Telehealth On Patient Satisfaction And Information Recall For Breast Cancer Survivors During Covid-19, Stacey Teicher

Doctoral Projects

The coronavirus (COVID-19) pandemic has changed how cancer survivorship care is delivered. (Al‐Shamsi, 2020). To protect vulnerable breast cancer patients, health care providers are moving towards telecommunication such as telephone, video, and secure messaging (electronic mail) versus in-person visits to connect with their patients (Segelov et al., 2020) during this pandemic. Breast cancer survivorship visits can be safely deferred from in-person visits to telehealth visits (Dietz et al., 2020). This doctoral project examines the impact of transitioning from in-person to telehealth (telephone or video) visits on patient satisfaction and recall of information for breast cancer survivors reviewing their Survivorship …

Mental Health Resources For The Pediatric And Adolescent Populations In The Rural Setting, Devon Shafer, Kyle Aldridge, Amy Lilly

Doctor of Nursing Practice Projects

Cognitive behavioral therapy (CBT) is a mainstay of treatment for problems such as anxiety and depression. However, access to this form of psychotherapy treatment is limited in rural areas, especially in pediatrics. The purpose of this project was to increase access to CBT through the use of smart phone CBT applications for patients at one rural midwest pediatric clinic. An extensive literature review revealed that mobile cognitive behavioral therapy (CBT) applications can be an effective option for adjunct therapy when provider access is limited. Two CBT mobile applications were selected for the project and training was provided to clinic providers. …

Self-Management Of Chronic Low Back Pain In The Hispanic Population: A Feasibility Study, Jasmeen Mohammed

Honors Scholar Theses

This study sought to evaluate the feasibility and acceptability of S-SPINE self-management interventions in the Spanish-speaking Hispanic population. Four focus groups were conducted during the study, with a total of 12 participants. During these virtual meetings, we obtained feedback on the S-SPINE modules and explored the needs and preferences of the Spanish-speaking population regarding lower-back pain self-management. Overall, we found that people prefer digital content in self-management modules and want to communicate better with their providers regarding their chronic pain. In addition, while there are a few support groups and resources online regarding chronic pain for Spanish-speakers, there are not …

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …