Digital Commons Network^™

Caring With Courage: A Bone Marrow And Hematopoetic Stem Cell Transplant Caregiver Instructional Class And Support Group, Danica J. Dorlette

General Submissions: Clinical Settings Materials

Informal caregiver preparedness plays a crucial role in successful cellular therapy recovery. An interdisciplinary workshop was implemented between 1/2019 and 5/2024 to educate caregivers on symptom management, infection prevention, safe food handling, discharge planning, home safety, and internal and external supportive services. This quality improvement project aimed to increase confidence in caregiver-related tasks.

Veteran Reintegration: A Descriptive, Exploratory Analysis Of The Psychosocial Challenges And Enrichment Of Post-9/11 Members Following Separation From Service, Kirsten M. Verkamp

Dissertations

Reintegration into civilian life after military service is a critical transitional period for post-9/11 veterans, with 47-75% reporting challenges. This study aimed to explore associations between psychosocial challenges and enrichment outcomes among post-9/11 veterans. Given there are 18.4 million American veterans and an estimated 200,000 service members projected to separate annually, it is imperative that researchers, healthcare professionals, and community leaders understand the nuanced nature of reintegration.

Pain Management In The Skilled Nursing Facility And Return To Acute Care, Amy S. Berkhout

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

This program evaluation project aimed to assess the effectiveness of a pain management (PM) initiative and the associated Medicare cost-benefit analysis at a 96-bed skilled nursing facility (SNF) in Arizona. The Centers for Disease Control and Prevention’s Framework for Project Evaluation was used to guide this project. A board-certified PM provider was brought into the SNF to treat pain specific to each patient. Prior to this intervention, patients were being treated for pain by the internal medicine provider on staff. Data were collected at the facility to determine if implementing a designated PM program decreased the number of patients returning …

Culturally Tailored Diet Education In Hispanic Patients With Diabetes, Kelly Chavez

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Type 2 Diabetes Mellitus (DM2) is a medical condition affecting millions of individuals worldwide. Research has shown Hispanic individuals have higher occurrence rates of DM2 than non-Hispanic individuals (Mora & Golden, 2017). Although this condition can be treated with medication, lifestyle modifications such as diet and exercise are also needed for adequate management. With diet modification, patients can significantly improve their hemoglobin A1C (hbA1c) results, improving their DM2 control, and reducing the risk for worsening of disease and complications. Many studies have concluded there is a need to provide culturally tailored dietary education in patients with DM2 to improve management. …

Enhancing Management Of Hospitalized Patients With Opioid Withdrawal, Christine Aliory

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Opioid use disorder (OUD) impacts over 1.2 million people in the United States. This population suffers from multiple comorbidities which can result in the need for hospitalization. Managing opioid withdrawal in hospitalized patients is challenging. Assessment tools like the Clinical Opioid Withdrawal Scale (COWS) help healthcare providers determine appropriate interventions to alleviate withdrawal symptoms for these patients. This quality improvement project aimed to decrease the number of incidents of violent behaviors and/or patients leaving the hospital against medical advice (AMA) during opioid withdrawal and enhance nurses’ ability to perform the COWS assessment. Organizational data from a 402-bed acute care hospital …

Reducing Caregiver Accommodations In Pediatric Eating Disorders Through Psychoeducation, Mackenzie F. Davis

Group: Samford University Moffett & Sanders School of Nursing

Childhood eating disorders (ED) are complex conditions, involving both medical and psychological factors. Caregivers, including parents, grandparents, and legal guardians, play crucial roles in managing ED behaviors beyond the clinical setting. The psychological effects of caring for a person with an ED have been shown to be more significant than caregivers of patients with schizophrenia and depression (Martin et al., 2015). Negative emotions often lead to caregivers providing accommodations for their child’s eating disorder. Accommodations are behaviors or decisions meant to reduce stress or conflict but ultimately promote ED behaviors or dysfunction. Caregiver accommodations have been identified as a barriers …

A Program To Improve Uncontrolled Blood Pressure And Knowledge Deficit, Joseph Kohout

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

This project aimed to evaluate the effect of an educational module on the knowledge and self-efficacy of patients with hypertension. By enhancing patients' understanding and confidence in managing their hypertension, this initiative aimed to improve health outcomes and empower individuals to take proactive roles in their care. The study employed education and awareness campaigns to address insufficient hypertension awareness, self-efficacy, and knowledge. Guided by the Health Belief Model, the project was evaluated by a pre/posttest design on a convenience sample of adults in a family practice clinic. The study examined participants' demographic factors, such as age and gender, alongside their …

Pain: Prevention, Assessment And Management, 4th Edition, Registered Nurses' Association Of Ontario

General Submissions: Clinical Settings Materials

The purpose of this fourth edition guideline is to provide nurses and members of the interprofessional team with evidence-based guidance for the prevention, assessment and management of all types of pain across the lifespan. This BPG is to be used by nurses and members of the interprofessional team across the health care continuum and in all domains of practice caring for persons at risk of or currently experiencing pain. It is also to be used by employers including health service organizations and academic institutions.

Clinical Practice In A Digital Health Environment, Registered Nurses' Association Of Ontario

General Submissions: Clinical Settings Materials

The purpose of this BPG is to foster nurses’ ability to maintain, advance, and strengthen professional practice in the context of a digital health environment. Broadly, this guideline includes information related to:

• the skills and competencies required by clinical nurses to ensure safe, quality, person-centred and compassionate clinical care through therapeutic relationships in a digital health environment;
• the skills and competencies required by nurses to engage in the design, development and evaluation of digital health environments;
• the skills and competencies required by nurse leaders and other leaders in all domains of clinical care, administration, education, research, and policy to support …

Development And Evaluation Of A Multiple Sclerosis-Related Suffering Index, Carolyn A. Wilder, Jennifer Gravesa, Salem O. Dehomb, Amanda L. Goodinga, Elizabeth J. Taylor

Dissertations

Multiple sclerosis (MS) is a chronic, progressive neurological disease characterized by complex physical, psychological, and emotional challenges that profoundly impact patients’ quality of life. Despite advances in symptom management, the multifaceted suffering experienced by individuals with MS remains inadequately measured, understood, and addressed. This study aimed to develop and validate the Wilder Multiple Sclerosis Suffering Index (WMSSI), a novel tool designed to quantitatively measure the unique dimensions of suffering in this population.

Non-Ventilated Prone Positioning In The Covid-19 Population, Marie Delouche, Nishant Varghese, Christi Knapp, Jiangzhen Jenny Li, Michael Guffey, Danielle Guffey, Geraldine B. Jones

General Submissions: Clinical Settings Materials

In the population of confirmed COVID-19 positive patients on a telemetry unit, will proning every 2 hours result in a decreased length of stay for the intervention group (patients that prone) as opposed to the control group (patients that receive standard of care) over a period of 9 months (2021-2022)?

Unveiling Grit: Exploring Student Perseverance In The Bsn Nursing Program, Jennifer Evans, Ashley N. Carter, Susan A. Seibert, Erin Reynolds

General Submissions: Academic Settings and Education-based Materials

Baccalaureate nursing (BSN) programs face declining enrollment and high attrition rates. Investigating factors contributing to student success is essential for developing strategies for improving student retention and academic success.

The Implementation Of Mindfulness-Based Practice For Nurse Leaders, Janelle L. Cooney

DNP and Student Works

Frontline nursing leadership is one of the most demanding positions in the clinical setting. A leader’s negative physical, psychological, emotional, and behavioral issues can directly impact staff and patient satisfaction, quality and safety metrics, and staff retention. The utilization of a mindfulness-based activity has been shown to be successful in a leader’s ability to cope with day-to-day professional stressors.

Determining The Effectiveness Of An Educational Intervention On Self-Management Behaviors Of Adults With Type 2 Diabetes At A Rural Clinic: A Quality Improvement Project, Stacy L. Harvey

Dissertations

Diabetes Mellitus Type 2 (T2DM) has the highest mortality deaths, and these are projected to increase over the years. Living with diabetes can be very stressful to manage because of the complexity and required multidisciplinary approach required for effective health maintenance and lifestyle management. Diabetes self-management education programs are essential for improved glucose control and the goal is to help patients improve their lifestyle choices through knowledge of the disease for effective self-management behaviors in the essential areas of diet, exercise, glucose monitoring, medication and cooperation with the diabetes team.

Mental Health Awareness: Identify, Understand, Respond, Anita Boutwell

Group: Samford University Moffett & Sanders School of Nursing

Mental health awareness in community colleges is emerging as a critical concern with the increase in depression and anxiety among the students they serve. Rural colleges often serve a diverse population, many of whom have socioeconomic challenges, including financial instability and family responsibility. Within the State of Alabama, approximately 24.3% of young adults receiving Medicaid were diagnosed with depression and 61.8% did not receive any mental health care in 2020 (State of Alabama Public Health, 2022). In addition, Alabama’s suicide rate among young adults is ranked 13% above the national rate (Center for Disease Control and Prevention, 2024)

Type 2 Diabetes Mellitus Among Haitian Americans, Balkys Bivins

General Submissions: Community and Population-based Materials

The primary objective of this study was to determine the prevalence of diabetes among Haitian Americans.

A convenience sample was used to collect baseline information, including Hemoglobin A1C (HbA1C) level, age, weight, height, basal metabolic index (BMI), and blood pressure measurements.

Upon approval from the Johns Hopkins Institutional Review Board, the researchers recruited more than 401 Haitian Americans.

[Excerpt From] Johns Hopkins Evidence-Based Practice For Nurses And Healthcare Professionals (5th Ed.), Kim Bissett, Judith Ascenzi, Madeleine Whalen

Sigma Publications: Book Excerpts

Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals has proven to be one of the most foundational books on EBP in nursing and healthcare. Building on the strength of previous versions, the fifth edition is fully revised with an updated Johns Hopkins Evidence-Based Practice model to better serve as a step-by-step how-to manual for EBP projects. The revamped, simplified model features updates to the categories of evidence and appraisal tools, with an emphasis on using suitable pre-appraised evidence.

Let’S Talk: Older Cancer Patients’ Experiences With Symptoms Assessment And Management By Oncology Nurses, Gyasi Moscou-Jackson

General Submissions: Clinical Settings Materials

Purpose: to examine older adult cancer patients’ experiences with nursing symptom management, focusing on reporting, assessment, and management of cancer-related symptoms by oncology nurses.

Ondansetron For Propofol Injection Pain, Tatum B. Edlin, Lauren Barnes

Group: Samford University Moffett & Sanders School of Nursing

Propofol injection pain can be the most distressing part of a patient’s peri-operative experience. The current standard of practice is to use intravenous (IV) lidocaine to blunt the pain on injection caused by propofol; however, this does not guarantee a comfortable, satisfactory induction for the patient...

Ketamine: Pain Management Efficacy In Adolescent Spinal Fusion Surgery, Anna C. Kraus

Group: Samford University Moffett & Sanders School of Nursing

Posterior spinal fusion (PSF) surgery for adolescent idiopathic scoliosis (AIS) is an extensive procedure with a notoriously painful postoperative recovery often necessitating large doses of opioids. While opioids provide potent analgesia for moderate to severe pain, these medications also have adverse effects, including nausea and vomiting, constipation, and an increased risk for hypoventilation. As a result, the addition of multimodal analgesia (MMA) adjuncts to perioperative pain regimens is becoming an increasingly common practice to reduce opioid requirements and consequently minimize opioid-induced side effects for patients undergoing PSF surgery.

Preoperative Non-Pharmacological Anxiolysis For Pediatric Patients, Ashton Rowsey, Mary Beth Greenway

Group: Samford University Moffett & Sanders School of Nursing

The most common medications used for anxiolysis in pediatrics include midazolam, dexmedetomidine, fentanyl, and ketamine. Unfavorable outcomes from pharmacological management of preoperative anxiety consist of respiratory complications, hypotension, drowsiness, and delayed recovery. Based on literature review, nonpharmacological distraction techniques are as beneficial in alleviating preoperative anxiety levels in pediatric patients without the known adverse effects as compared to pharmacologic treatment options. Nonpharmacologic techniques mentioned include maskless induction devices, gamification, preferred cartoons, coloring, use of electronic devices, and animated stories about surgery and anesthesia. Distraction techniques are cost efficient and hold minimal to no adverse effects when utilized in patient care.

Airway Management For Esophagogastroduodenoscopy With Hemorrhage, Peyton C. Thetford Jr., Lisa Herbinger

Group: Samford University Moffett & Sanders School of Nursing

Patients undergoing an esophagogastroduodenoscopy (EGD) require vigilance from the anesthesia provider regarding the status of their airway. These procedures are typically performed utilizing sedation anesthesia and the use of an endoscope inserted orally to inspect the esophagus and the stomach. This creates a scenario where the airway can be compromised by the presence of the endoscope. In patients who have an active gastrointestinal (GI) bleed, the risk of aspiration increases significantly. In this specific case, the patient developed a hemorrhage from an ulcer that was biopsied during the EGD. Multiple hemostatic sprays were used on the hemorrhaging ulcer, but neither …

Vasopressin As A Catecholamine-Sparing Mechanism, Hannah E. Capps

Group: Samford University Moffett & Sanders School of Nursing

Persistent hypotension, or refractory hypotension, is frequently observed as an adverse event intraoperatively. Various conditions, including chronic hypertension, metabolic acidosis, and/or methamphetamine misuse, may lead to catecholamine desensitization. As consequence of catecholamine resistance, hypotension is often unresolved by administration of commonly used vasopressors like phenylephrine, ephedrine, epinephrine, and/or norepinephrine. It is essential that persistent hypotension is treated promptly in effort to avoid end-organ ischemia and subsequent mortality risks. Vasopressin use may spare progressive catecholamine depletion through a separate mechanism of action that increase blood pressure and perfusion to vital organs. During an observed case, a 43-year-old male patient with a …

Radiation: Risk, Exposure And Efficacy Of Protective Measures, Jamie M. Holmes

Group: Samford University Moffett & Sanders School of Nursing

Since x-ray radiography was discovered in 1895, radiology has evolved into a critical component of modern medicine. The rise of minimally invasive surgery (MIS) has increased the need for radiologic imaging to ensure proper instrument placement and anatomical accuracy during procedures. This study evaluates radiation exposure, associated risks, monitoring devices, and the effectiveness of personal protective equipment (PPE) to enhance radiation safety and protective practices in the surgical environment...

Raas Inhibitor-Induced Refractory Hypotension In Anesthetized Patients, Cristina Basulescu Pfister, Amy Snow

Group: Samford University Moffett & Sanders School of Nursing

Refractory hypotension is an increasing perioperative concern most prominently seen in patients on chronic renin-angiotensin-aldosterone system (RAAS) inhibitors. Angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers (ARBs), or a combination of the two therapies are common first-line medications used to treat primary hypertension. Despite the benefit of managing hypertension, such therapies do not come without complications. The principal mechanism of RAAS inhibitors is by inducing vasodilation by decreasing angiotensin II. However, this poses limitations during surgical events managed under general anesthesia...

Care For People With Disabilities: Health Assessment And Promotion Simulation With Disability Content Inclusion For Pre-Licensure Nursing Students, Eda Ozkara San

Sigma Foundation for Nursing Research Grant Reports

Background: Experiential learning activities on care for people with disabilities (PWD) would help nursing students develop the knowledge, skills, and attitudes (KSAs) needed to provide quality care for PWD.

Purpose: The purpose of this study was to evaluate the perceived changes in nursing students’ KSAs related to the care for PWD following participation in health assessment and prevention (HAP) experiential learning activities.

Methods: This was a quasi-experimental, pre- and posttest educational intervention study. Nursing students (n = 160) attended multiple experiential learning activities as a required part of their HAP coursework and completed a pre and posttest survey to assess …

Intimate Partner Violence Screening Education For Nurses In Emergency Department, Martha I. Wydra

Dissertations

This quality improvement project aims to increase nurses' knowledge, confidence, and skills in IPV assessment in the ER using an education program and the PREMIS tool.

Earthing Practice For Mental Health Among Adults In The United States: A Phenomenological Inquiry, Natalie Greenberg

Dissertations

This study aimed to explore the lived experience of adults in the United States who practice earthing for mental health.

Difficult Conversations: Educating Nursing Students On Responding To Child Maltreatment, Angela Karakachian

Sigma Foundation for Nursing Research Grant Reports

Nursing students lack the knowledge and training on child maltreatment. The purpose of this presentation is to discuss the implementation and the impact of an educational intervention to improve student nurses’ comfort and confidence on detecting cases of child maltreatment and caring for suspected victims and their families using low-fidelity simulation.

Perspectives Of Latino Adolescents: Cultural Beliefs And Practices About Health Literacy, Sonique Sailsman

Sigma Foundation for Nursing Research Grant Reports

The purpose of this study is to explore the cultural beliefs and practices of Latino adolescents related to acquisition and utilization of health information. Although there is growing research in health literacy specific to adolescents, limited data is available to illuminate aspects of health literacy in the Latino adolescent population. Available studies focus on testing interventions to improve health literacy but fall short of providing an understanding of how specific cultural groups acquire and use health information. This study aims to seek culturally specific information from Latino adolescents, which can ultimately lead to increasing the healthcare providers understanding of how …