Digital Commons Network^™

Advance Care Planning Protocols And Hospitalization, Rehospitalization, And Emergency Department Use In Home Health, Sharon Bigger

Electronic Theses and Dissertations

Aim. The aim of this study was to examine the relationship of advance care planning protocols with hospitalization, rehospitalization, and emergency department use rates in U. S. home health agencies (HHA).

Background. Since 2003, CMS has required HHAs to report on quality outcomes such as hospitalization, rehospitalization, and emergency department use rates, made publicly available online. Advance care planning (ACP) is a conversation about beliefs, goals, values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on ACP have taken place outside of HHAs among populations with serious …

Nursing Toolkit For Care Of The Pediatric Patient With Suicidal Ideation, Christine Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nevada’s pediatric suicide rate is one of the highest in the country. Many patients require inpatient stabilization, either in an emergency department setting or on a pediatric unit, until they are ready for discharge to home or a subsequent behavioral health facility. In many instances, patients are assigned to nurses who have had no formal training on caring for pediatric patients with suicidal ideation. Providing care for these patients can increase nurses’ emotional stressors. Purpose: The purpose of this DNP project was to increase the knowledge of pediatric nurses in Nevada using a nursing toolkit containing information to aid in …

Opioid Overdose Prevention And Naloxone Training Among College Students, Mackenzie Thode

DNP Projects

Background: Opioid abuse is a serious national crisis affecting both public health and economic welfare across the United States. In Tennessee, more than 1,800 overdose deaths were reported in 2018, with nearly 20% of those deaths occurring in Davidson County alone. The number of overdose deaths in Nashville has steadily risen amidst the COVID-19 pandemic by approximately 32% since 2019 to a total of 619 fatal overdoses in 2020, making it the city’s deadliest year on record. Review of evidence: Research shows that intranasal (IN) naloxone training is an effective approach to combating the opioid overdose crisis and can be …

Relationship Of Undergraduate Nursing Students' Emotional Intelligence And Other Factors To Ati-Nclex-Rn Comprehensive Predictor Examination Performance, Sarah Y. Jimenez

Nursing Theses and Dissertations

Background/Problem: Nursing schools prepare nursing students to provide competent and safe nursing care and to pass NCLEX-RN for professional licensure. The ATI-NCLEX-RN Comprehensive Predictor Examination from Assessment Technologies Institute (ATI) has been used to predict the likelihood of passing NCLEX-RN on the first attempt. Emotional intelligence (EI), critical thinking (CT), and resilience contribute to academic performance and may influence test performance.

Purpose: The purpose of this study was to determine significant predictors of ATI-NCLEX-RN Comprehensive Predictor Examination test performance among the variables of EI, CT, and resilience among undergraduate senior nursing students.

Hypothesis: There will be an association between …

Integrating The Concept Of Trauma Into An Undergraduate Nursing Curriculum, Jacey Walker

DNP Projects

Adverse childhood experiences, or ACEs, are early childhood traumas such as abuse, neglect or household dysfunction that can cause chronic physical and mental health problems across the lifespan. Approximately 61% of the adults in the United States have experienced ACEs. The prevalence of ACEs among nurses is at least comparable to population prevalence, and rates may be higher in subpopulations of individuals who work in helping professions. The stressful and highly interpersonal nature of nursing work may exacerbate and compound the health impacts of a nurse’s underlying ACEs, affecting not only the nurse’s health, but also his or her work …

From Bunks And Bars To Sidewalks And Skies: Support For Reentry From Incarceration, Ashley Ann Steen

Theses and Graduate Projects

Currently, there are over 2.3 million inmates in the prison system throughout the United States (Bureau of Justice Statistics, 2018). Over 10,000 ex-prisoners are released from America's state and federal prisons every week and studies show that approximately two-thirds will likely be rearrested within three years of release (Bureau of Justice Statistics, 2018). This scholarly project will explore the literature on why inmates face such a high rate of recidivism. It will further explore the current programming that is provided to inmates prior to release back to the community and offer a questionnaire to utilize in all reentry programs to …

Best Practices To Prevent Or Delay Diabetes In Adults With Prediabetes, Aminata Cham

Nursing DNP Projects

Abstract

Diabetes mellitus is a common disease prevalent in 10.5% of the US population about 34.2 million people and a disproportionate percentage of people of color. An EBP project for people with prediabetes was conducted in a faith-based based setting after institutional review board approval. The purpose of the project was to increase fruits and vegetable intake and increase physical activity in adults with prediabetes. The Chronic Care Model was used to guide the design and implementation of the project. The project was a modified version of the National Diabetes Prevention Program (NDPP) in a series of four 2-hour sessions …

Implementation Of A Perioperative Pathway For Individuals With Or At High Risk For Obstructive Sleep Apnea, Kimberly Claude

Doctor of Nursing Practice Scholarly Projects

Background At the Veterans Affairs Boston, pre-operative screening for obstructive sleep apnea using the STOP-Bang questionnaire and referral to pulmonary service for those who fail screening is not reliably completed. For patients identified as having OSA or at high risk for OSA, advice on how to reduce postoperative risk may not be adequately communicated through the perioperative process. The project aim is to construct and implement a perioperative pathway to ensure surgical patients with OSA or suspected OSA receive evidence-based care throughout the perioperative period.

Methods The intervention for this quality improvement project was an evidence-based perioperative pathway which includes …

Impact Of The Covid-19 Pandemic On Chhs Students, Macey Seal

Honors Theses

The 2020 COVID-19 pandemic has impacted students in various ways. Students around the world / in the U.S have been impacted in financial, emotional, mental, and physical ways as COVID-19 continues to change the way the world is navigated. The purpose of this thesis is to explore the feelings and vulnerabilities of students at the College of Health and Human Services (CHHS) building during the 2020 Pandemic. In order to succeed in school, students need to feel financially stable, physically stable and mentally stable. While many students have struggled with this balance in the past, the effect of COVID-19 has …

Impact Of The Covid-19 Pandemic On Chhs Students, Linnea Wood

Honors Theses

The 2020 COVID-19 pandemic has impacted students in various ways. Students around the world / in the U.S have been impacted in financial, emotional, mental, and physical ways as COVID-19 continues to change the way the world is navigated. The purpose of this thesis is to explore the feelings and vulnerabilities of students at the College of Health and Human Services (CHHS) building during the 2020 Pandemic. In order to succeed in school, students need to feel financially stable, physically stable and mentally stable. While many students have struggled with this balance in the past, the effect of COVID-19 has …

Exploring The Lived Experience Of Adolescent Caregivers, Abbigale Laurentius

Honors Theses

In today’s society, the population is aging, and any member of the family could find themselves in the role as an informal caregiver. Adolescents between the ages of 12 and 18 years old may have these caregiving responsibilities, and it is imperative that healthcare professionals recognize and support this change of roles. A literature review revealed a general lack of research from within the last five years regarding adolescent caregivers. Those studies that were analyzed in the review presented themes of depression, anxiety, lack of education, and insufficient social supports for the adolescent. An unfolding case study was then designed …

Goals-Of-Care & End-Of-Life Quality In Relapsed High-Risk Leukemia: Silent Conversations, Lacy Jo Graham

Doctor of Nursing Practice Scholarly Project

BACKGROUND: The distorted association of “end of life (EOL)” with “goals of care (GOC)” has “silenced” crucial goals discussions in patients with relapsed high-risk leukemia, which raises concerns for the provision of care that is inconsistent with patient’s values and preferences.

AIM: The two main goals of this study were to quantify hematologists rate of participation in a GOC pathway initiative during two separate months, then explore their definition and barriers to having/documenting GOC discussions.

DESIGN: Mixed-methods, explanatory sequential design (follow-up explanations variant).

SAMPLE: Quan: Hematology inpatient admissions during the months of October 2020 and January …

Mindfulness Training In Mitigating Implicit Bias: Improving Cultural Competency For Nurses Caring For Lgbt Individuals, Daniel Terrell, Msn, Rn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Equitable care remains a goal of the United States healthcare system, with cultural competency training used as one intervention to mitigate disparities. Cultural competency education is primarily based on racial and ethnic differences, often omitting other marginalized groups. Implicit bias consequences are not addressed in such training programs despite the association with health outcome disparities. Research related to implicit bias has demonstrated the ability to promote malleability in implicit associations.

Objectives: This project assessed a mindfulness meditation exercise intervention on nursing awareness in interacting with lesbian, gay, bisexual, and transgender (LGBT) patients. Additionally, an LGBT health education module that …

Adoption Of Evidence-Based Practices In Stroke Transitions Of Care, Sabena Passarello, Rn, Msn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Stroke is a leading cause of mortality in the U.S. Individuals who suffer from stroke or transient ischemic attack are at risk for further cerebrovascular events. Prevention requires thorough diagnostic evaluation and care coordination, particularly from inpatient to outpatient settings. Transition of Care programs are effective methods for developing long-term treatment, establishing follow-up, and preventing further complications.

Aims/Objectives: The project purpose was to integrate evidence-based recommendations into a Transitions of Care program for patients with ischemic stroke or transient ischemic attack. The aims were to evaluate whether implementation of Stroke Transitions of Care improved outpatient follow-up and stroke readmission …

Addressing Social Determinants Of Health In Community-Based Palliative Care, Mary D. Chenge

Doctoral Projects

Background and Objectives: Addressing social determinants of health (SDOH) in the medical community has recently started; however, there is yet to be a standardized format for addressing the social needs of patients. Consequently, a protocol was developed to address SDOH to increase screening rates, social work referrals, and capture depression reimbursement.

Methods: The quality improvement project was implemented using the Plan-Do-Study-Act framework at an urban Community-Based Palliative Care organization in the Midwestern United States. Participants included office staff and 140 patients (two separate sets of 70 randomly selected patients pre/post-implementation). A protocol was developed for screening 11 SDOH using an …

Sickle Cell Disease: Development Of An Acute Pain Management Program In A Hematology/Oncology Practice, Elizabeth Pohl

Doctoral Projects

Background: Patients with sickle cell disease experience can experience acute episodes of severe pain that require prompt pain medication. Treating uncomplicated, acute sickle cell disease pain in the emergency department setting has been shown to be costly and lead to higher rates of hospitalization than similar care in a dedicated outpatient setting.

Objectives: The aim of this article is to outline the program development efforts undertaken to apply current literature findings and evidence-based practice guidelines to create a program development toolkit and business plan for a sickle cell disease acute pain management program in an outpatient hematology practice.

Methods: A …

Improving Adolescent Risk Assessment And Provider Follow-Up In Primary Care, Darby R. Disselkoen

Doctoral Projects

Purpose: The purpose of this quality improvement project was to improve preventive care for adolescent patients by implementing standardized, routine screening for risk-taking behaviors and improving provider response to identified risks using the Rapid Assessment for Adolescent Preventive Services tool and resources for providers to reference during discussions about risk.

Methods: Quality improvement methodology was utilized at a midwestern pediatric primary care office to implement a practice workflow for staff to follow during annual, adolescent wellchild exams beginning at age thirteen.

Results: Analysis of project results demonstrated a significant increase in routine screening for adolescent risk behaviors compared to the …

Diverse Students Collaborating To Address Social Determinants Of Health Using Listening Sessions, Juanita T. Garcia, Leona Vandevusse, Gladys Simandl, Amber N. Johnson, Qiyan Mu, Jennifer Jean Dahlman

College of Nursing Faculty Research and Publications

In this article, a Nursing Workforce Diversity grant-funded project examined the social determinants of health (SDH) including diverse high school and baccalaureate nursing students. All involved students were from educationally and/or economically disadvantaged backgrounds and/or underrepresented minority groups. The purpose of this article is to report the project outcome data and analysis gathered from students' experiences of SDH, using the collaborative method, listening sessions. The project staff and student nurses discussed SDH with high school students, who then identified and prioritized key SDH in their neighborhoods during a series of facilitated listening sessions in their schools. Initial analysis included reviewing, …

School Students’ Perception On Risky Behavior And Their Utilization Of Health Care Services, Muhammad Kamil Che Hasan, Noor Faizah Tutasting Rawi, Mohd Said Nurumal, Siti Hazariah Abdul Hamid

Jurnal Keperawatan Indonesia

The Malaysia Ministry of Health reported adolescents’ low utilization of healthcare services, although they need this ser- vice as a consequence of their involvement in risky behavior. This cross-sectional study aimed to determine adolescents’ perception on risk taking behavior and their utilization of health care services. A modified self-administered questionnaire was used to collect data from 250 secondary school students aged 13 and 14 years in one of the selected schools in Malacca, Malaysia. Data were analyzed using SPSS 20. Fast food consumption, loitering after school, physical fighting, smoking, and non-use of helmets were the most reported risky behaviors among …

Does Religious Belief Affect Attitudes Towards Mental Illness?, Robert B. Conway

Honors College Theses

There has been an increase in recent years in the effort to raise awareness of mental health issues, particularly suicide. However, awareness does not equate to understanding and there has been little in the way of public education. One of the biggest obstacles faced by those suffering from a mental illness is the public stigma associated with it. Given the high percentage of the population in the South who identify as being religious, this study looked at the relationship between religiosity and public stigma towards mental illness. Two hundred forty-two university students drawn from undergraduate biology and nursing classes completed …

Using Quality Improvement (Qi)-Focused Evaluation To Redesign Direct Home- And Community-Based Services During The Covid-19 Public Health Emergency:, Marcia Moriarta, Anthony Cahill, Heidi Fredine

Developmental Disabilities Network Journal

Like many UCEDDs in the Developmental Disabilities (DD) network, the Center for Development and Disability at the University of New Mexico offers direct service programs in home and community settings. Before the start of the COVID-19 pandemic, services were delivered in-person to about 1,000 families across the state including clients with intellectual or developmental disabilities and/or from at-risk communities. In March 2020, due to the spread of COVID-19, a public health emergency was declared in New Mexico and home and community services were stopped throughout the state. This meant direct service programs at the Center had to turn to telehealth …

Research Recruitment: A Case Study On Women With Substance Use Disorder, Kristy J. Cook Phd, Rn, Ibclc, Kim L. Larson Phd, Mph, Rn, Fnap

The Qualitative Report

Women with substance use disorder may evade research participation because of individual and societal factors. Limited information exists on recruitment of women with substance use disorder. The purpose of this study was to delineate recruitment challenges among women with substance use disorder and identify successful recruitment strategies. An exploratory case study was used to examine recruitment of women with substance use disorder. This case study was informed by a pilot study in 2017-2018, where data were generated from 25 direct observations and three key informants from a drug rehabilitation treatment agency. Analysis took an explanation-building approach, which incorporated chronological field …

The Emerging Global Tobacco Treatment Workforce: Characteristics Of Tobacco Treatment Specialists Trained In Council-Accredited Training Programs From 2017 To 2019, Christine E. Sheffer, Abdulmohsen Al-Zalabani, Andrée Aubrey, Rasha Bader, Claribel Beltrez, Susan Bennett, Ellen Carl, Caroline Cranos, Audrey Darville, Jennifer Greyber, Maher Karam-Hage, Feras Hawari, Tresza Hutcheson, Victoria Hynes, Chris Kotsen, Frank Leone, Jamie Mcconaha, Heather Mccary, Crystal Meade, Cara Messick

Nursing Faculty Publications

Tobacco use is projected to kill 1 billion people in the 21st century. Tobacco Use Disorder (TUD) is one of the most common substance use disorders in the world. Evidence-based treatment of TUD is effective, but treatment accessibility remains very low. A dearth of specially trained clinicians is a significant barrier to treatment accessibility, even within systems of care that implement brief intervention models. The treatment of TUD is becoming more complex and tailoring treatment to address new and traditional tobacco products is needed. The Council for Tobacco Treatment Training Programs (Council) is the accrediting body for Tobacco Treatment Specialist …

Analysis Of Healthcare Miscommunication And How To Effectively Improve Communication Outcomes: An Integrative Review, Jill Suzanne Smith

Doctoral Dissertations and Projects

Healthcare workers convey client information regularly to provide essential and safe care. Errors in communication have been linked to a decrease in client satisfaction and an increase in medical errors. Both the Joint Commission and the World Health Organization have recommended using a standard communication tool, SBAR, to increase client satisfaction and decrease medical errors. A review of 52 research articles determined effective SBAR training should be conducted utilizing simulations to improve the healthcare providers’ self-confidence and usage of the SBAR tool. This integrative review also concluded the number and length of SBAR simulation sessions have no consequence on the …

Perceptions Of Migrant And Seasonal Head Start Parents About Childhood Vision Care Utilization, Felicia R. Thomas

Electronic Theses and Dissertations

The benefits of pediatric vision screening for very young children is not a new concept. However, not all children receive this valuable preventative intervention, or they do not receive an evaluation or examination to rule out or treat common visual refractive errors. This Doctor of Nursing Project sought to identify factors that impact a parent’s failure to follow up on recommendations for further evaluation or treatment following their child’s failed vision screening. The project utilized a phenomenological study to assess Migrant and Seasonal Head Start parents’ perceptions about their perceptions of the need for preventative vision screening and care. Three …

Dnp Final Report: Breaking The Cycle: Care Coordination Interventions And Sickle Cell Readmissions, Naphtali Edge

DNP Final Reports

Background

Approximately 100,000 people in the United States are affected by Sickle Cell Disease (SCD). Sickle Cell Disease represents the second highest readmitting diagnosis at Houston Methodist Hospital. The purpose of this study is to determine the impact of implementing care coordination interventions to reduce hospital readmissions of patients with SCD.

PICOT

In adult patients with SCD in the acute care hospital setting, how does care coordination intervention compared to no care coordination intervention affect the readmission rate for patients with SCD over a 3 – 6-month period?

Body of Evidence

Eleven studies were critical appraised and included in the …

Use Of Ecomaps In Qualitative Health Research, Veena Manja, Ananya Nrusimha, Harriet Macmillan, Lisa Schwartz Dr, Susan Jack

The Qualitative Report

Qualitative health research plays a central role in exploring individuals’ experiences and perceptions of wellness, illness, and healthcare services. Visual tools are increasingly used for data elicitation. An ecomap is a visual tool that applies ecosystems theory to human communities and relationships to provide an illustration of the quality of relationships. We describe the use of ecomaps in qualitative health research. Searches across eight databases identified 407 citations. We screened them in duplicate to identify 129 publications that underwent full text review and included 73 in the final synthesis. We classified and summarized data based on iterative comparisons across sources. …

Virtual Home Assistant Use And Perceptions Of Usefulness By Older Adults And Support Person Dyads, Cynthia F. Corbett Phd, Rn, Faan, Elizabeth M. Combs, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Otis L. Owens, Isabel Stringfellow, Thien Nguyen, Catherine R. Van Son

Publications

Aim: Describe virtual home assistant use and usefulness from the perspective of older adults and their support persons. Methods: This was a mixed-methods study with older adults and their support persons (n = 10 dyads). Virtual home assistant (VHA) equipment was installed in participants’ homes, and its use was documented for 60 days. Participants received protocol-guided telephone calls to address their VHA questions or problems. The type and frequency of VHA use were summarized with descriptive statistics. End-of-study interviews about VHA use were conducted with dyad participants. Qualitative content analyses were used to describe the interview findings about the dyad’s …

The Relationship Between Accurate Knowledge On Hiv/Aids Transmission And Adolescent Pregnancy In Ghana: A Further Analyses Of The 2017 Multiple Cluster Indicator Survey, Emmanuel Brenyah Adomako, Kwabena Frimpong-Manso, Petronella Munemo, Henry Ofori Duah, Pascal Agbadi

College of Nursing Faculty Research and Publications

Background

The literature posits that HIV knowledge is associated with precautious sexual behaviour and practice. We hypothesised and investigated the association between knowledge of HIV transmission and adolescent pregnancy in Ghana, given that the relationship between HIV knowledge and adolescent pregnancy has not been extensively studied.

Methods

We did analyses on 5836 cases (weighted as 5121) of 15–24 years old reproductive age women in the female dataset of the 2017 Multiple Cluster Indicator Survey. Adolescent pregnancy was operationalized as reproductive age women between 15-24 years who became pregnant before the age of 18 years. Accurate HIV knowledge was measured by …

"There Is Always Violence": An Exploratory Study Of Phnom Penh, Cambodia, Street-Involved Children, Jarrett D. Davis, Glenn M. Miles, Sean Blackburn, Erika Mosebach-Kornelsen

Dignity: A Journal of Analysis of Exploitation and Violence

As the economic center of Cambodia, Phnom Penh has long been a hotspot for street-involved children and families. While violence is a common facet of life on the street, risk and vulnerability among children is notoriously difficult to measure. Most large-scale surveys tend to sample children within homes and schools, which overlook street-involved children who are commonly unregistered, irregularly attend school, and live outside of houses. This research paper is one of a series of studies on such groups in Southeast Asia. The study conducted 94 semi-structured interviews with street-involved children eight to 18 years of age in Phnom Penh. …