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Empowering Patients With Central Venous Catheters: Utilizing Evidence-Based Video-Assisted Education To Reduce Central Line-Associated Bloodstream Infections, Pritam C. Steiner

Master's Projects and Capstones

An evidence-based Central Venous Catheter (CVC) dressing change video was created to enhance patient independence, and to increase resource efficiency among nursing staff in an inpatient pediatric setting in which Central Line-Associated Bloodstream Infection (CLABSI) rates were rising. Pediatric oncology patients confer the highest risk of developing CLABSIs due to long-term CVC access, neutropenic effects of treatment regimens, and constant fluctuations between inpatient, outpatient clinic, and homecare settings. Use of video-assisted education is anticipated to standardize and improve patient care, decrease healthcare costs, and increase nurse productivity, and is widely supported by research. Qualitative data collection was conducted by surveying …

Reducing Clabsi In The Nicu With Iv Tubing Competency, Tessa A. Toscano Ms

Master's Projects and Capstones

Central line-associated bloodstream infection (CLABSI) is a significant problem in a Level IV neonatal intensive care unit (NICU) on the West Coast of California. A clinical nurse leader (CNL) student joined a team consisting of the unit’s nursing manager, nursing educator, clinical nurse specialist (CNS), and CNS student. Literature review highlighted the association between the development of CLABSI and the practice of changing central line intravenous (IV) tubing. Five interviews of nurses and 15 observations of nurses performing IV tubing change revealed practice variations within six major steps of the procedure. The team revised the IV tubing change policy to …

Family Centered Care In Icu Settings, Victoria Kingsinger

Honors Theses

More than 5 million patients are admitted each year to Intensive Care Units (ICUs) in the US, and approximately 55,000 critically ill patients are cared for each day. ICU patients are a diverse population that has a need for an increased level of care. These patients often require ventilatory or cardiovascular support, invasive monitoring, and intense nursing and physician observation (Society of Critical Care Medicine, 2015). There are five primary admitting diagnoses for adults, which include respiratory failure, postoperative management, ischemic heart disorders, and sepsis. The mean age of patients is rising, particularly due to the baby boom generation, and …

Patients' Perception Of The Use Of Motivational Interviewing For Childhood Obesity Treatment: A Qualitative Study, Penelope L. Neal Dr.

Electronic Theses and Dissertations

The purpose of this qualitative interpretive descriptive study was to better understand children’s perceptions of the use of motivational interviewing (MI) as a communication style for childhood obesity treatment. Childhood obesity in the United States has reached epidemic proportions and much research effort has been dedicated to reversing this trend. One approach that has demonstrated positive outcomes in the clinical setting is MI. Leading organizations in pediatric healthcare now recommend MI as a communication style to be used for childhood obesity-related behavior change. Although empiric studies have demonstrated improvement in outcomes when this communication style is used with patients and …

Nurses’ Perceptions Of Best Practices To Assess Pediatric Patients And Educate Their Families Experiencing Effects Of Cancer Chemotherapy: “Chemo Brain” A Pilot Study, Jennifer A. Tapping

Senior Theses

With more advanced and more aggressive chemotherapy cancer treatment leading to higher survival rates, complications with quality of life are becoming more prominent. Of these complications, delayed cognitive processing, commonly known as “chemo brain,” is becoming a topic of interest. Cognitive changes are some of the most common as well as the most challenging complications associated with central nervous system (CNS) directed treatment, such as chemotherapy. The term “chemo brain” is often used to describe self-reported or observed cognitive processing delays in patients who receive chemotherapy as a form of cancer treatment (Raffa, 2009). Although these cognitive delays have the …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Knowledge, Intake, And Willingness To Consume Fruits And Vegetables Of Children Located In A Food Desert Versus A Non-Food Desert, Brittany A. Pierce

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The United States Department of Agriculture (USDA) defines a food desert as “urban neighborhoods and rural towns without ready access to fresh, healthy, and affordable foods” (“Food Deserts”, 2014). The purpose of this study was to determine the differences between knowledge, intake, and willingness to consume fruits and vegetables between students going to school in a food desert and students not going to school in a food desert. This study was conducted by showing students picture cards to determine knowledge of fruits and vegetables, surveying students to determine intake of fruits and vegetables, and food sampling to determine wiliness to …

The Rates Of Mothers Who Continually Breastfeed After Implemented Breastfeeding Teaching, Katherine L. Moore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Many mothers are unaware of the benefits of breastfeeding. This lack of knowledge leads to an inability to weigh the advantages and disadvantages of the potential source of nutrition their infant will receive during his or her first months of life. Many mothers never even attempt to breastfeed their infant. Even among the mothers who do initially choose to breastfeed, the majority deviate to other forms of feeding early in the postpartum period. Despite the fact that most major medical organizations encourage exclusive breastfeeding through the first six months of an infant’s life, the CDC report for 2013 claims the …

Safe Sleep Education And Staff Compliance, Shayla M. Hadley

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this project was to evaluate compliance with the teaching and documentation of safe sleep practices within a pediatric unit. The objective was to increase the percentage of the charts of patients one year of age and younger that have documented safe sleep teaching at the level of compliance with the department policy. This change in compliance was measured by determining the percentage of patient charts having documented safe sleep teaching at the level of compliance prior to the implementation of mandatory staff education as compared to the percentage of charts with documented safe sleep teaching at the …

Quality Of Life In Adolescents With Cancer, Molly Ryan

Honors Theses

There is no current universally accepted definition for quality of life (QOL). One source defined the concept of QOL as how an individual measures the goodness of different aspects of their life. These assessments include one’s emotional reactions to life events, disposition, sense of fulfillment, and satisfaction with personal relationships and work (Theofilou, 2013). Another definition encompasses the person’s level of functioning and overall satisfaction and well-being of their life (Lavdaniti & Tsitsis, 2015). QOL can be influenced by many factors, including physical health and certain disease processes. One disease in particular that can significantly affect one’s QOL is cancer. …

Quality Of Life In Adolescents With Cancer, Alexis Guastella

Honors Theses

There is no current universally accepted definition for quality of life (QOL). One source defined the concept of QOL as how an individual measures the goodness of different aspects of their life. These assessments include one’s emotional reactions to life events, disposition, sense of fulfillment, and satisfaction with personal relationships and work (Theofilou, 2013). Another definition encompasses the person’s level of functioning and overall satisfaction and well-being of their life (Lavdaniti & Tsitsis, 2015). QOL can be influenced by many factors, including physical health and certain disease processes. One disease in particular that can significantly affect one’s QOL is cancer. …

Youth Homelessness: The Impact Of Supportive Relationships On Recovery, Sara Gasior

Electronic Thesis and Dissertation Repository

Abstract

AIM: To test a model based on Peplau’s theory of Interpersonal Relations, which examines the influence of a network of service providers, perceptions of social supports and perceptions of family relations on a homeless youth’s perceptions of recovery.

BACKGROUND: Homeless youth comprise an extremely disenfranchised group and have been recognized as one of the fastest growing sub-groups within the homeless population. Homeless youth face impaired access to health and social services. They are often left unsupported and lack social and familial support or relationships with service providers. Homeless youth left unsupported frequently sink into a cycle of homelessness that …

Health-Related Quality Of Life In Children With Cancer, Tha'er Ghandi Almomani

Theses and Dissertations (ETD)

Health-related quality of life is an important phenomenon to measure in children undergoing treatment for cancer. However, the effects of different treatment modalities and cancer related factors over the duration of treatment have not been explored. To assess the effects of different child-, cancer-, and treatment-related factors, we analyzed a large sample of children undergoing curative treatment for 5 different childhood cancer diagnoses. These diagnostic groups were Hodgkin Lymphoma (HL), Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML), Osteosarcoma (OS), and Melanoma. We analyzed a sample of 710 patients across the five diagnostic groups over four time-points in treatment. These …

Reducing Antipyretic Use For Low-Grade Fevers In Otherwise Healthy Children, Tricia A. Templet

Doctor of Nursing Practice Final Manuscripts

Fever phobia is persistent in the pediatric population, as fever is a common complaint for advice calls, sick visits, and urgent care/emergency department utilization. Fever phobia among parents and healthcare providers is evidenced by the quest to return a child to normothermia. Fevers under 38.5ºC (101.3ºF) are considered benign in healthy children, usually requiring no pharmaceutical intervention. Research consistently demonstrates pediatric nurses inappropriately medicate patients for low-grade fevers. The purpose of this evidence-based practice project was to identify knowledge of the benefits and myths of fever in otherwise healthy children and to decrease the use of antipyretics for low-grade fevers …

Wecan Implementation For Parents Of At-Risk Hispanic Adolescents In Middle School, Shannon Leigh Devita

Doctor of Nursing Practice Final Manuscripts

Abstract

CDC-reported childhood obesity rates have tripled in the past three years. Among children in grades five, seven and nine, 30% are overweight or obese, with Hispanic students more likely to be overweight than White students. This evidence-based project examined the effectiveness of NHLBI’s WeCan! for at-risk middle-school-age Hispanic children and parents. The program was implemented at school in two weekly sessions, and its effectiveness was evaluated using the WeCan! survey. The program resulted in improved knowledge, behaviors, and attitudes related energy balance, portion size, healthy foods, physical activity, and screen time and may be useful in other school settings.

Emergency Protocol Program For High School Athletes, Casandra B. Moyer

Doctor of Nursing Practice Final Manuscripts

This evidence-based project (EBP) involved development and implementation of an emergency protocol (EP) education program for high school athletes and coaches at a southern California high school. A Doctor of Nursing Practice student, collaborating with health care and athletic personnel, conducted an assessment of the high school’s EPs for management of asthma, anaphylaxis, diabetes, and heat illness. Then, an EP and educational program were created; coaches and athletes were educated on the protocol during a coaches’ meeting and practice times, respectively. All participants completed pre- and post-tests, and mean knowledge scores were compared. The overall knowledge score increased by 10% …

Evaluating Physical Therapy For Adolescent Patients With Low Back Pain, Kelly Denise Gonzales

Doctor of Nursing Practice Final Manuscripts

Background: Low back pain is a condition affecting many people worldwide. The age of onset is variable, affecting all patient populations from childhood throughout the lifespan. Aims/Purpose: The efficacy of physical therapy for adolescent patients with back pain seen in a pediatric orthopedic clinic was evaluated through comparison of pre and post-intervention pain scores. Patient compliance with physical therapy was monitored and evaluated against outcomes.

Design: A six-month retrospective chart review of adolescent patients with a diagnosis of low back pain. Patients with a diagnosis of low back pain were referred for physical therapy and provided with a home exercise …

Family And Child Development Education For Harrisonburg Adolescents, Mollie M. Moran, Jennifer E. Corser, Julia M. Glauber

Senior Honors Projects, 2010-2019

The pregnancy rate among 15- to 17-year-old women in Harrisonburg is double Virginia's state rate (Townsend, 2008). While meeting administers and guidance counselors of Harrisonburg High School we learned that Harrisonburg High School views this issue as one that cannot be addressed by teaching abstinence in their public school. They have found that because of cultural beliefs, abstinence is not an effective tool for preventing teenage pregnancy. Instead, HHS teaches their students about safe sexual practices and how to have a healthy pregnancy in the event they were to become pregnant. The high school offers a class called “Child and …

Effects Of Multimodal Fever Education On Parents Of Febrile Children, Teresa S. Parkhouse

Evidence-Based Practice Project Reports

Insufficient knowledge regarding the physiology and appropriate management of fever in children often contributes to an increased parental anxiety, inappropriate antipyretic use, and overutilization of medical resources (Chang, Liu, & Huang, 2013; Crocetti, Moghbeli, & Serwint, 2001; Schmitt, 1980). Parental concerns regarding childhood fever can lead to an overuse of health care resources as febrile illness in children accounts for approximately 20% of emergency department visits, 30% of office visits, and over 50% of after-hour phone calls to private physicians (Zomorrodi & Attia, 2008). Research shows that multidimensional educational interventions are most effective in improving parental management of fever (Young …

Improving Vaccination Compliance Among Amish Children In Knox County, Ohio, Laura J. Segraves

Doctor of Nursing Practice Scholarly Projects

Abstract

Children living in Amish communities in Ohio are under-immunized and under-immunized communities are reservoirs for preventable childhood diseases. A recent measles outbreak in central Ohio involved 9 counties and 377 cases of this vaccine-preventable disease. There were 5 hospitalizations related to this measles outbreak in Knox County. Vaccine-preventable illnesses contribute to pediatric morbidity and mortality and are cost prohibitive to individuals and society.

The purpose of this study was to identify real and perceived barriers to immunizations among Amish parents in Knox County, Ohio. The information obtained in this study will be disseminated to the Knox County Health Department …

Exploring Holistic Comfort In Children Who Experience A Clinical Venipuncture Procedure, April Athena Bice

Doctoral Dissertations

Children often experience the uncomfortable effects of invasive procedures as a part of primary health supervision and during times of illness. Inadequate procedural comfort management can lead to numerous lasting harmful effects including distrust of healthcare providers, future intensified pain responses, negative cognitive and emotional experiences, and psychosocial health problems (Czarnecki et al. 2011). Holistic comfort has been well documented in adult literature but little research exists on the understanding of holistic procedural comfort from the child’s perspective. The purpose of this study was to explore perspectives of children age 4 to 7 years and their caregivers regarding procedural holistic …

Pediatric Nurse Practitioner Home Visitation Is Associated With A Decrease In Home Care And Healthcare Utilization Errors In High Risk Infants, Rupalee Patel

Doctoral Projects

The Santa Clara Valley Health and Hospital System’s (SCVHHS) Babies Reaching Improved Development and Growth in their Environment (BRIDGE) program was developed in 2011 to optimize high risk infants' care transition from Neonatal Intensive Care Unit (NICU) to home. In addition to hospital discharge teaching and public health nursing efforts, NICU infants need further in home support given their medical vulnerability after discharge. The objectives of the SCVHHS BRIDGE program are to provide caregiver interventions to minimize home care errors after NICU discharge and to optimize health care access and utilization across the transition of care. SCVHHS NICU infants at …

Identifying Factors In Medication Non-Adherence In Teens Diagnosed With Juvenile Arthritis: A Pilot Study, Susan Viola Senzaki

Doctoral Projects

Purpose: The purpose of this study was to identify factors that correlate with medication non-adherence in teens diagnosed with juvenile arthritis. Background: The impact of medication non-adherence often begins in childhood where children depend and learn from their care-givers how to manage their health. Children with chronic disorders are among those at risk for a higher medication non-adherence. Juvenile arthritis (JA) is a chronic childhood disorder where often medication non-adherence is an issue. Methodology: This was a mixed-method qualitative and quantitative pilot study. Teens between the ages of 11 – 17 years, with juvenile arthritis were asked to volunteer in …

Outcome Analysis And Quality Improvement For Inter-Hospital Transfers Of Pediatric, Carma Lynn Tobiassen

Doctoral Projects

Pediatric patients who initially present to a community hospital setting can be adequately cared for the majority of the time, in the emergency department (ED), on the pediatric ward (PEDS), and the post anesthesia care unit (PACU). When a pediatric patient is in need of specialized care or is decompensating and becomes critically ill, initial medical stabilization is required and the identification of a critical care bed and admitting physician are needed in a timely manner. Inter-hospital transfers (IHT) of pediatric patients are frequent occurrences, as more and more areas are consolidating their resources and Pediatric Intensive Care beds are …

Developing A Patient Care Standard For Adolescents Based On A Nursing Needs Assessment, Kathryn Blake

Doctoral Projects

Mental health patients often suffer from chronic medical conditions and psychiatric comorbidities requiring frequent emergency, primary care, and acute care visits (Douzenis et al., 2012). Caring for psychiatric patients in acute care hospitals has become an increasing burden on healthcare systems with processes in place to care for acute and critical care patients. Healthcare leaders, providers, emergency departments, and medical/surgical hospitals are straining to provide care for complex patients with acute medical conditions and complex mental health needs (Reiss-Brennan, Briot, Savitz, Cannon, & Staheli, 2010). Caring for children and adolescents with medical and psychiatric problems creates the need for a …

Attention Deficit Hyperactivity Disorder And Mindfulness Practice In Children And Adolescents: A Comprehensive Review Of Evidence-Based Research, Donna Nikander

Doctoral Projects

Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental illness in the United States among male and female children and adolescents between the ages of 3 and 17. The emerging fields of neurobiology and neuroimaging have proposed a relationship between mindfulness meditation therapies—initially referred to as mindfulness-based stress reduction (MBSR) and now simply known as mindfulness—and improvements in attention and self-regulation, two major problem areas for ADHD sufferers. Furthermore, recent studies suggest that mindfulness therapies may be effective in reducing symptoms of ADHD in children and adolescents. The purpose of this paper is to review, analyze and synthesize the …

The Effects Of An Evidence-Based Food Allergy Management Plan To Keep Children With Food Allergies Safe At School, Scarlet R. Spain

Evidence-Based Practice Project Reports

The prevalence of food allergies in children has increased 18% between 1997 and 2007 (CDC, 2013). Furthermore, 84% of food allergic children will experience a reaction at school (Powers, Bergren, & Finnegan, 2007). An exposure in a sensitive child may progress quickly into potentially life threatening symptoms and death if not treated. The purpose of this evidence based practice (EBP) project was to determine if implementation of a food allergy management policy in a school setting reduced overall incidence rates of food allergy reactions in school children and to examine compliance to policy guidelines. The project encompassed implementation of a …

Family-Centered Pediatric Radiation Therapy: A Nurse-Led Quality Improvement Collaboration Model, Elizabeth A. Austin

Doctoral Projects

Problem: Parents of children diagnosed with cancer face a number of physical, emotional, and social hurdles in the race for a cure. Family schedules shift dramatically to accommodate daily radiation therapy treatment appointments. Ambulatory procedure unit nursing staff attempt to teach and interpret the process without the benefit of a family-centered intradepartmental structured communication process to promote safe care with these families.

Methods: Implementation of a structured family-centered interprofessional standard work model to promote interdepartmental collaboration. The project implemented a structured family-centered interview and standard work algorithms to improve the radiation therapy family experience.

Results: A structured, streamlined, interdepartmental interview, …

Parental Responses To Outcomes Of Developmental Screening Among Children: A Pilot Study, Ashley Elaine Manus

Chancellor’s Honors Program Projects

No abstract provided.

Coping Mechanisms Of Children With Atopic Dermatitis, Whitney A. St. Mary

Honors Theses

This was a qualitative study that explored the lived experience of parents who had children with atopic dermatitis, otherwise known as eczema. The study had seven volunteer participants and the objective of this study was to determine any coping mechanisms used to overcome the negative aspects of atopic dermatitis. Volunteers were obtained from the Oak Grove Family Clinic. Phone interviews were then conducted and the participants were asked a series of eight questions. After the interviews concluded the researcher then transcribed the interviews and determined common themes from parents’ responses. All of the parents discussed how using unscented lotion, preventing …