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Predictors Of Nonadherence To Radiation Therapy Schedules Among Head And Neck Cancer Patients, Jennifer Lynn Miller

USF Tampa Graduate Theses and Dissertations

Nonadherence to radiation therapy schedules is a documented problem among head and neck cancer patients. This retrospective dissertation study examined whether demographics, clinical characteristics, or physical and psychological symptoms were related to nonadherence in head and neck cancer patients. The electronic medical records of 262 head and neck cancer patients at a southeastern U.S. cancer center were reviewed to determine whether nonadherence was related to symptom scores and other patient and clinical-related factors. Nonadherent patients were more likely to be female, be admitted to the cancer center as inpatients during treatment and receive outpatient IV fluids during treatment. Nonadherent patients …

Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd

Doctor of Nursing Practice Final Manuscripts

Background and Evidence Problem: As the population ages, there is an increase in the incidents of falls. Falls are the predominant cause of both nonfatal and fatal injuries among adults aged 65 years and older (Bergen et al., 2016). Extensive research has been conducted in fall prevention in hospitals, skilled nursing, and rehabilitation units. End-of-life care in a hospice setting presents a greater challenge in risk identification and prevention of falls. A local hospice had 457 falls between July 2018 to mid-March 2019 with a lack of consistent, detailed, fall education and documentation.

Evidence-Based Practice Intervention: Utilizing the American Geriatrics …

Transforming Clinical Care Through Sexual Wellness Education For Community College Students, Chelsea Ovanek

Doctor of Nursing Practice Final Manuscripts

Abstract

Title: Transforming Clinical Care Through Sexual Wellness Education for Community College Students

Statement of the Problem: Unintended pregnancy remains a serious public health challenge throughout the world (World Health Organization [WHO], 2018). College-aged students continue to be a vulnerable population for this health issue, with estimates that 1 in 5 women will give birth before age twenty and 80% of those pregnancies unintended (Guttmacher Institute, 2019). Despite the statistics, approximately 40% of college students have received formal education on unintended pregnancy, sexually transmitted infections (STIs), or effective contraception use (Diedrich, Klein, & Peipert, 2017). According to the World Health …

A Quality Improvement Pilot To Reduce Caregiver Burden In Caregivers Of Hematopoietic Stem Cell Transplant (Hsct) Patients In A Hsct Program In The Northwest, Jody Acheson

Doctor of Nursing Practice Projects

Background: Hematopoietic stem cell transplant (HSCT) is an intensive and complex treatment for certain blood cancers. Caregivers are required for patients receiving this treatment. Caregivers frequently experience caregiver burden. Providing an intervention to alleviate caregiver burden can positively impact patient and caregiver health outcomes.

Project Design: The following was the project design: 1) review the literature to understand the best practices to prevent caregiver burden for caregivers of patients undergoing HSCT, 2) development a pilot quality improvement program based on the evidence, 3) implementation of the pilot, and 4) obtaining feedback from facilitators and participants to optimize intervention for ongoing …

Mental Healthcare For Youth With Type 1 Diabetes: A Call For Integrated Screening, Prevention And Intervention, Kirsten Nelson

Nursing Capstones

Adverse mental health outcomes comprise the leading complication of type 1 diabetes(TID)in children and adolescents(Cameron & Northam, 2012). Comorbid mental health conditions lead to decreased adherence, worsening glycemic control, increased family conflict, poor self-image, and decreased quality of life(QOL). Evidence shows20-50% of youth with TID sought mental healthcare over a five year period yet less than 4% received any form of care during that time(Cameron & Northam, 2012; Jaser, 2010). This literature review was based on review of a case involvinga10 year old male “Benji” whose mother brought him to clinic requesting a second opinion after seeking mental healthcare for …

Excoriation Disorder, Karalynn Johnson

Nursing Capstones

No abstract provided.

Unaddressed Challenges For The “Most Honest And Ethical Profession:” A Pilot Study Of Web-Based Learning Strategies To Prevent Moral Distress, Kelly Straight

Doctor of Nursing Practice (DNP) Projects

Background: Nurses and nurse practitioners (NPs) face greater responsibility to address the ethical challenges that present during the course of patient care, due to advances in medical technology and pharmaceutical innovation, and because of widening disparities within the U.S. healthcare system. These ethical questions, which arise during the course of routine patient care, are increasing in both number and complexity in nearly every patient care setting. Even with codified ethical standards, unresolved and/or ongoing ethical questions and dilemmas pose further issues such as the development of moral distress. This pilot project was designed to help NPs and other healthcare workers …

A Pilot Of Prenatal Transitional Care Services In The Urgent Care Setting, Alexandra Huddleston, Gloria Pryzgoda, Tiffany Hazel

Doctor of Nursing Practice Projects

Established prenatal care leads to better outcomes and reduced healthcare expenditures. Inadequate prenatal care is associated with numerous risks. Many women face a variety of barriers that contribute to inadequate prenatal care. The purpose of this project was to create and pilot a new transitional care protocol to improve the referral rate of pregnant patients to establish prenatal care at a midwestern physician services (MPS) women’s health care clinic after a MPS express care visit. An extensive literature review was conducted, and a streamlined referral process linking pregnant patients to obstetric care was created to address identified barriers. The referral …

Addressing Hypertension Health Literacy In Black Individuals Who English Is Their Second Language, Uche Olateru

Doctor of Nursing Practice Projects

Hypertension is a primary preventable risk factor for cardiovascular disease. Despite advances in preventive and treatment measures, related to blood pressure control, the prevalence of hypertension in the United States remains high among Black People of immigrant and non immigrant communities. Healthcare is increasingly complex, and health literacy problems have increased due to demands by healthcare stakeholders for patients to assume a more independent role in taking charge of their health. A quality improvement project was conducted in a Faith based community to improve the knowledge of participants about hypertension. The objective of this project was to enhance lifestyle management …

Guide Lines Vol. Ii, Issue 3 - May 2020, College Of Health And Human Services

GUIDE Lines

Periodic Newsletter of the Governors State University - University of Illinois, Chicago - Disparities Education Cancer research training and education project (The GUIDE Project).

Willingess To Use Telehealth For Diabetes Management In The Rural Healthcare Setting, Andrew Kim

Doctoral Projects

Diabetes is a disease that has far reaching physically and financially consequences. This disease has shown to increase morbidity and mortality, along with increasing overall healthcare costs. Optimal management of diabetes may require a multidisciplinary approach across the span of multiple encounters with the diabetic patient. Considering the nature of diabetes, integration of telehealth has the opportunity to improve diabetes management by improving healthcare outcomes, along with potential cost savings. However, the use of novel technology like telehealth is only as useful if patients are willing to use it. Thus, this survey aimed to determining whether patients within a rural …

Implementing A Practice Strategy In Primary Care Using An Assessment Tool To Screen For Depression, Donna Snow

Doctoral Projects

Increased efforts are being made to move individuals with co-morbid medical and psychiatric diagnoses toward integrated care. Lack of consistent screening in primary care has caused missed opportunities to identify depression during a routine healthcare provider visit. This project sought to implement a practice strategy in primary care using an assessment tool to screen for depression. Interviews were used to ask patients to answer two questions related to the frequency of depressed mood in the last two weeks. The project was seeking to show by screening patients in primary care for depression, the number of referrals to behavioral health would …

Creating Health Membership In A Health Commons, Melinda Dively-White

Theses and Graduate Projects

Persons living in the margins may be separated or isolated because of poverty, disability, gender, and ethnicity. Isolation, along with exposure to at-risk environments and barriers to accessing health care, contributes to adverse health outcomes. Nurses must be open to learning essential transcultural skills to work with persons living in the margins to provide culturally appropriate care that addresses health inequities. Students in a Doctor of Nursing Practice program at Augsburg University developed an innovative approach to care for people living in the margins. The Health Commons, a nursing-led drop-in center in Rochester, MN, and grounded in Newman's (1999) Health …

Nurses’ Reported Use Of Therapeutic Interventions Surrounding A Stillbirth Event, Sonya Woo

Nursing | Senior Theses

Psychological alterations and therapeutic interventions utilized for mothers who have suffered a stillbirth have been assessed and addressed in prior literature. This researcher reviewed ten articles highlighting the depression, grief, guilt, stress and concerns that can arise and interventions that were initiated within weeks immediately following stillbirth, during the time of a subsequent pregnancy, and a few years after having a subsequent child. An increased utilization of healthcare and health care provider presence have shown to positively influence the psychological effects of stillbirth. This researcher looked into the frequency and variety of which these interventions are being implemented in a …

Learning To Leave: Filipino Families And The Making Of The Global Filipino Nurse, Yasmin Y. Ortiga

Research Collection School of Social Sciences

This chapter investigates how this process of reconfiguring the “social” plays out in the context of the Philippines’ labor export system and pervasive culture of emigration. Focusing on the case of Filipino nursing graduates seeking to work overseas, this chapter discusses how the success of the Philippines’ labor-brokering process relies on individuals who can take on the responsibility of transforming themselves, mainly through education and training, into desirable workers for future employers. While the migration literature had largely framed emigration as an individual aspiration and project, this chapter demonstrates how families subsidize the Philippine state’s labor export system by taking …

A Proposal To Implement Assertive Community Treatment Into A Primary Care Shelter Clinic, Julie Churcher-Fields

Theses and Graduate Projects

Individuals who are experiencing homelessness and severe mental illness have a difficult time accessing healthcare systems. Without mental health treatment and stable housing, individuals develop multiple needs that must be addressed during an individual visit. Without treatment for mental health symptoms, individuals may experience a negative impact on their quality of life and the ability to get basic needs met. Community organizations have an obligation to provide integrated care with a goal to improve overall health for this population. As nurse leaders there is an opportunity to be advocates and implement innovative ideas to improve care. In a large adult …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

Reducing Readmissions In The Heart Failure Population, Yvette Castellanos

MSN Capstone Projects

This paper will explore the importance of preventing acute hospital readmissions in the heart failure adult population. Prevention of re-hospitalization is aimed at improving patient care and outcomes as well as reducing the financial stress caused by readmissions. Recurrent hospitalizations are expensive and unnecessarily overutilize resources (Donzé, Lipsitz, Bates, & Schnipper, 2013). Research shows that improving transitions of care during hospitalization and developing specific heart failure interventions healthcare providers can assist in reducing readmissions. For this project the Plan Do Check Act (PDCA) tool combined with the lean methodology. The PDCA cycle consist of planning, to identify the problems, do …

Moral Distress: Unaddressed Challenges For The “Most Honest And Ethical Profession”, Kelly Straight

DNP Qualifying Manuscripts

Nurses and nurse practitioners (NPs) face greater responsibility to address the ethical challenges that present during the course of patient care, due to advances in medical technology and pharmaceutical innovation, and despite widening disparities within the U.S. healthcare system. These ethical questions, which arise during the course of routine patient care, are increasing in both number and complexity in nearly every patient care setting. Unresolved and/or ongoing ethical questions and conflicts encountered in patient care pose further issues such as the development of moral distress. The literature demonstrates that moral distress contributes to dissatisfaction, disengagement, and burnout which negatively affects …

Emergency Department Homeless And At Risk Homeless Screening Benchmark Study, Emily Mulder

MSN Capstone Projects

Individuals experiencing homelessness drastically overutilize emergency department (ED) services compared to non-homeless individuals (Ku et al., 2014). Many unhoused individuals have serious medical and psychosocial needs, which are chronic in nature, and become exacerbated due to poor management while living on the streets (Ku et al., 2014). The health needs of such individuals would be best managed through primary care continuity. However, care coordination becomes complex when a patient does not have a physical address or knowledge of available community resources (Mitchell, León, Byrne, Lin, & Bharel, 2017). By understanding the unique barriers that homeless and at risk homeless patients …

Nurse Residency Program: A Critical Care Benchmark Project, Dana Wagner

MSN Capstone Projects

Nursing school is arguably one of the most challenging degree plans in existence. The level of professionalism and intelligence of newly graduated nurses (GNs) is exceptional, and the expectation is that they will excel in whatever field of nursing they choose. That said, navigating the theory-practice gap between school and a GN’s first job can be extremely intense, especially in specialty areas such as critical care. According to Belvins (2016), both The Joint Commission and the Institute of Medicine recognize that many GNs are not prepared for fast-paced, high-acuity healthcare environments. The recommendation is the implementation of additional education and …

Early Initiation Of Palliative Care, Ann R. Phillips

MSN Capstone Projects

The overall aim of this project, based upon the best available evidence, clinical experience of oncology nurses, and patient preferences for information about palliative care, is to propose the creation and initiation of a protocol which empowers oncology/palliative care nurses to be able to initiate early discussions about palliative care for patients with advanced stage cancer (III-IV) diagnoses.

By having frank conversations surrounding palliative care early on in the treatment process, patients are better able to make informed decisions about treatment, depending on the trajectory their disease takes. Such conversations provide patients with a clearer picture of what is likely …

“Save My Baby”: The Lived Experience Of Hospitalized Pregnant Women With A Threat Of Preterm Birth, Dua' Yousef Al-Maharma, Inaam A. Khalaf, Fathieh Abu-Moghli, Sajeda Alhamory

The Qualitative Report

Activity restriction in hospital to prevent preterm birth (PTB) is widely used as the first step of treatment. It is associated with adverse physiological and psychological effects on maternal and fetal health that might persist years after birth. A sample of 10 pregnant women who were hospitalized for being at risk for PTB were purposively recruited to describe their lived experience via semi-structured in-depth interview. Five themes were identified, the maternal role establishment and suspending responsibilities, the women's perception of fear of uncertainty and finding support, dissatisfaction of care, the change of routine life and family relationships, and the cultural …

Predictors Of Barriers To Participation In Clinical Research In Adults Living In The Southeastern United States, Jennifer Scanlon

DNP Projects

Research is the necessary foundation for health care advancement and understanding. Significant challenges exist, however, with recruiting and engaging underrepresented populations in clinical research. The purpose of the scholarly project was to determine how stakeholder race, trust, and level of education influence participation barriers in clinical research. The project utilized secondary, cross sectional survey data that were collected between 2014 and 2016 through the former Mid-South Clinical Data Research Network (CDRN), currently known as the STAR-CRN. Descriptive statistics and spearman rank correlations were performed between level of education, level of trust, and each attitude statement for each racial category. A …

The Influence Of End Of Life Education On Stress, Anxiety, And Attitude Of The Healthcare Profession Student, Chiquesha Davis

DNP Final Reports

Providing comfort and support to the dying patient is a significant part of the dying process. When soothing a patient, who is dying, the goal is to prevent or relieve suffering as much as possible. Respecting the patient's health and quality of life goals and decisions is essential. Healthcare profession students can experience multiple levels of anxiety, stress, and a negative attitude while taking care of the dying patient. The implementation of a successful intervention is at the cornerstone of helping reduce stress, anxiety, and attitude change in healthcare profession students. The application can also have a positive impact on …

Shared Decision Making And Decisional Conflict In Women With Postpartum Depression, Leslie Binford, Elizabeth Morse, David Phillippi, Emily Pardy

DNP Projects

Despite well documented adverse outcomes related to untreated postpartum depression, many women face difficulty accessing care. A woman’s experience of conflict related to appraising treatment options that align with both her needs and her values can contribute to delays or barriers to seeking and accessing effective treatment. Shared decision making is the cornerstone of a collaborative patient-provider relationship and has been shown to decrease patient’s experience of decisional conflict. This cross-sectional web-based survey examined the relationship between shared decision making and decisional conflict for postpartum women experiencing depressive symptoms at an urban counseling center in Nashville, TN. Data were collected …

Increasing Knowledge And Self-Efficacy In Nurses Orienting To Cardiovascular Surgery Using A New Periop 202 Program, David Reinhart

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

The operating room theater can be intimidating for new nurses, thus leading to a shortage of nurses who are comfortable working in this environment. Evidence supports that 50% of perioperative nurses in 2017 were between the age of 50 and 59. Additionally, no formal didactic courses are being offered in undergraduate programs and the challenging environment related directly to the future shortage of perioperative nurses. This negatively impacts the number of trained perioperative cardiovascular nurses. The project proposed a new didactic educational Perioperative (Periop) 202 program that aimed to increase nurses’ self-efficacy to function on the cardiovascular operating room (CVOR) …

A Comparison Of Attitudes Toward The Lesbian, Gay, Bisexual, And Transgender Populations, Jacqueline Floyd

DNP Projects

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience a multitude of health disparities and barriers to access care, including lack of knowledgeable health care providers and experiences of discrimination and victimization in health care settings. As future health care professionals, health professions students need preparation to deliver culturally competent, equitable care to members of the LGBT community. Because the attitudes of health care professionals are important determinants in achieving patient-centered care, the purpose of the study was to explore attitudes toward the LGBT population and influencing factors of attitudes among nursing, mental health counseling, physical therapy (PT), occupational therapy (OT), …

Reproductive Health Needs Among Women In Treatment For Substance Use Disorder, Jaanki Bhakta, Elizabeth Morse, David Phillippi

DNP Projects

Integrated care models for substance use disorder (SUD) and reproductive health care have been proposed as a strategy to increase access to reproductive health care for women in treatment for SUD. This cross-sectional, survey-based study measured how women of childbearing age in residential treatment report their demand for and access to reproductive health care, their pregnancy intention, contraceptive utilization and preference for integrating reproductive health care with their current SUD treatment milieu. Eighty-five percent of the women interviewed (N=108) expressed a desire to prevent pregnancy in the next year, although only one-third (33.6%) were using a form of contraception at …

Knowledge And Attitudes Toward Renal Transplantation In Individuals Undergoing Transplant Evaluation, Cassandra Bruns, Jeannie Giese, David Phillippi, Deonna Moore, Elizabeth Hall

DNP Projects

Background: The underutilization of kidney transplant as the preferred treatment for end-stage renal disease is influenced by a lack of knowledge, poor attitudes toward transplantation, and various socio-demographic characteristics amongst the patient population. Negative attitudes toward renal transplant disengages the patient from the evaluation process and often hinders their likelihood of receiving a transplant. Purpose: The purpose of this scholarly project was to determine if patients undergoing transplant evaluation had more positive attitudes and greater levels of knowledge about renal transplantation after attending a standardized educational session. Project Design: This project was a cross-sectional study that utilized a pre-test/post-test design …