Digital Commons Network^™

Implementing An Antibiotic Stewardship Program Using The Mitigate Toolkit In An Urgent Care Setting, Christina Ross

DNP and Student Works

Antibiotic resistance is one of the utmost hazards to public and global health. On average, 2.8 million annual antibiotic-resistant infections in the U.S. and more than 35,000 deaths resulted in 2019. Increased resistance rates are related to worse clinical outcomes and healthcare costs - an increase in adverse reactions such as allergic reactions and Clostridium difficile infections results. The creation of Urgent Care (UC) clinics across the U. S. has increased access to healthcare but exceeded the national average of antibiotic prescriptions to maintain patient satisfaction. Developing an Antibiotic Stewardship Program (ASP) in a UC setting will reduce inappropriate antibiotic …

Compounding Stress: A Mixed Methods Study On The Psychological Experience Of Miscarriage Amid The Covid-19 Pandemic, Madeline Fernandez, Alison Swift, Christyn Dolbier, Kaitlin Guard Banasiewicz

Individual Articles

Background: Experiencing a miscarriage can have profound psychological implications, and the added strain of the COVID-19 pandemic may have compounded these effects. This study aimed to explore the psychological experiences, assess the levels of psychological distress (depression, anxiety, and post-traumatic stress disorder), and examine the relationships of personal significance of miscarriage and perceived stress with psychological distress of women in North Carolina who suffered a miscarriage of a desired pregnancy between March 30, 2020, and February 24, 2021, of the COVID-19 pandemic, at 14 to 31 months after the loss. Methods: We conducted a cross-sectional mixed-methods study using a convergent …

Implementing Profiling To Boost Vaccination Uptake Among Nurses And Nursing Students: A Machine Learning Approach, Nursing Impact Project, Marco Tomietto, Giancarlo Cicolini, Kristina Mikkonen, Michelle Croston

Sigma Foundation for Nursing Research Grant Reports

This project aims to identify the underlying patterns of nurses' and nursing students' vaccination hesitancy at the international level. The project also aims to compare countries to support the design of tailored vaccination campaigns in healthcare organizations, to improve vaccination uptake and patient safety.

Using Evidenced-Based Practice To Increase Knowledge And Awareness Of Sexually Transmitted Infections, Amanda M. Brickey

Dissertations

The purpose of this quality improvement (QI) project is to increase the knowledge and intent to change practice through education on the importance in assessing sexual health history in patients at a federally qualified health center (FQHC) in Western Washington State by providing continuing education to primary care providers.

Reducing Heart Failure 30-Day Hospital Readmissino Rates Through A Post Discharge Educational Program, Yadira Pagano

DNP and Student Works

Congestive heart failure is a complex and debilitating condition affecting millions of people nationwide resulting in frequent admissions to the hospital and decreasing patient's quality of life and costing thousands of dollars not only to patients by to the healthcare system. The proposed quality improvement project is aimed at reducing Heart Failure 30-day hospital readmission rates by implementing a post-discharge educational program. The program consists of weekly contact with heart failure patients recently discharged from the hospital to reinforce discharge education topics.

Neonatal Intensive Care Nurses' Perceptions Of Nurse Leader Behaviors And Their Impact On The Workplace Environment, Meggan R. Mcculley

Dissertations

Nursing leadership is a crucial component in today's healthcare organizations as nurses make up the largest profession in healthcare overall. Nurse leaders have the ability to affect the environment of the nurses' workplace in both positive and negative ways, thus impacting their Quality of Nurse Work Life (QNWL). QNWL is an indicator of nurse satisfaction within their workplace, and the ability of the nurse to make meaningful contributions to their home units and the organization. The purpose of this qualitative, interpretative phenomenological analysis (IPA) study was to describe what it meant to experience nursing leadership from the perspective of Level …

Settler Colonial Determinants Of Indigenous Health: Relationship Between Indigenous Women's Level Of Allostatic Load And High Blood Pressure During Pregnancy; A Secondary Analysis Of The Strong Heart Study, Nicole A. Thomas

Dissertations

There is a dearth of comprehensive literature relevant to the relationship between settler colonialism and health outcomes of Indigenous peoples residing in the United States (U.S.). Critical analysis of settler colonial determinants of Indigenous health will help to further shape discourse, research priorities, and policy relevant to Indigenous population health and disease distribution. This thesis will bring awareness to settler colonialism, propose relationships between settler colonialism and health outcomes, and identify specific settler colonial determinants of Indigenous health to help guide development and use of nursing theory. This dissertation argues that the structure of settler colonialism threatens and implicates the …

Certified Registered Nurse Anesthetists' (Crna) Perceived Ease And Usefulness Of Video Laryngoscopes For Endotracheal Intubation Of Surgical Patients With Difficult Airways, Uwe G. Klemm

Dissertations

Anesthesia providers frequently encounter patients with difficult airways. The inability to effectively ventilate and oxygenate a patient due to failed endotracheal intubation increases patient morbidity and mortality (Detsky et al., 2019; Joffe et al., 2019). Video laryngoscopes appear to provide benefits by improving airway visualization and first-attempt endotracheal intubation success and decreasing the rate of failed endotracheal intubation attempts (Lewis et al., 2017; Pieters et al., 2017; Vargas et al., 2021). This research study examined the perceived usefulness and ease of use of video laryngoscope technology by CRNAs for initial endotracheal intubation when confronted with a difficult airway. The study …

Caring Behaviors Of Nursing Students And Their Attitudes Toward Older Adults, Jacquelyn D. Lambert-Davis

Dissertations

Caring is an emotion. It is a feeling of compassion and an understanding of the difficulties of others. Research indicates that caring behaviors and attitudes are an important part of the knowledge base for nursing students. Caring behaviors and attitudes are an important part of the knowledge base for nursing students in order to provide competent care for older adults. This descriptive cross-sectional study reports findings of caring attitudes and behaviors of nursing students using the Caring Dimensions Inventory (CDI). The purpose of this study was to examine the self reported attitudes and caring behaviors of nursing students toward older …

Development And Evaluation Of A Nurse Practitioner Directed Early Palliative Care Initiative And Its Impact On Goal-Concordant Care At A Cancer Center, Ashley V. Weinmann

Dissertations

Seriously ill patients often experience discordant care. Delivering high-quality healthcare requires effective communication to support goal-concordant care.

Pancreatic cancer has a 5-year survival rate of 12% with a high symptom burden. Pancreatic cancer patients often have unmet needs that lead to increased psychological, spiritual, social, and physical needs. Early integration of palliative care can provide high-quality communication and goal-concordant care. A retrospective analysis of MDACC's pancreatic patients found that 34% were referred to palliative care.

Instructor Characteristics That Increase Self-Efficacy In Nursing Students, Kaycee J. Jacobson

Dissertations

With the current nursing shortage, finding ways to increase nursing retention in graduate nurses can help ease the shortage. Self-efficacy is a factor that contributes to an individual's well-being and can affect their professional accomplishments. The purpose of this study, guided by Bandura's theory of self-efficacy, was to identify instructor characteristics that may impact student perceived self-efficacy in the clinical setting. Bandura identified self-efficacy as a factor that contributes to an individual's well-being as a whole and can affect their professional accomplishments. A sample of 19 nursing students who were enrolled in a clinical course were recruited and completed the …

Depression Screening In Children And Adolescents On Epilepsy Monotherapy Using The Modified Phq-9, Barbara Peters

Group: Samford University Moffett & Sanders School of Nursing

The purpose of this project is to implement depression screening in 11-17-year-old patients on one anti-epileptic drug (AED) in a pediatric neurology practice using the Patient Health Questionnaire-9 Modified for Teens or PHQ-9M and evaluate the outcomes, especially those related to symptoms of depression and specific AEDs.

Enhancing Teamwork By Interprofessional Simulation, Pamela Thomas, Marilyn Ostendorf, Katelyn Russell, Sein Weir, Beth Schnarr, Carly Andrews

General Submissions: Presentations (Oral and Poster)

An interprofessional education (IPE) event was held among students in three disciplines from USI's College of Nursing and Health Professions integrating Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) in a simulated cardiopulmonary arrest scenario. Faculty from Nursing, Occupational Therapy Assistant (OTA), and Respiratory Therapy (RT) planned the IPE which included the date, time, equipment, scenario, pre- and post-briefing. The event was designed to reinforce experiential learning utilizing TeamSTEPPS education as the guiding framework. TeamSTEPPS education promotes collaboration using effective communication, leadership skills, situation monitoring, and mutual support during a simulated patient event to better prepare students …

Evaluating The Health Literacy Practices Of A Primary Care Health System Serving A Diabetic Population At High Risk For Low Health Literacy, Alana D. Norris-Bermudez

Dissertations

Health literacy (HL) is a powerful determinant of patient health outcomes, yet a minority of the U.S. population possesses proficient health literacy. Healthy People 2030 positions HL prominently among the new overarching goals as follows, "Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all" (The Office of Disease Prevention and Health Promotion, 2023). HL comprises two interlinked components: personal HL and organizational HL, (Office of Disease Prevention and Health Promotion, n.d.). Implementing HL practices within healthcare system facilities such as hospitals, FQHCs, and/or primary care practices to support universal HL precautions …

Examining Content And Construct Validity Of The Nyu Langone Health Nursing Education And Competency Algorithm (Ne-Ca), Vincenza Counglin, Alice Nash

Sigma Foundation for Nursing Research Grant Reports

The purpose of this research study is to explore if the NYULH NE-CA is a reliable and valid process for identifying nursing education and competency in the acute care setting.

Wellness Promotion Quality Improvement Project, Jacqueline K. Cantor

Dissertations

The purpose of this capstone project was to bring evidence-based wellness promotion through physical activity (PA) using the World Health Organization (WHO) (2020) guidelines to Psychiatric Mental Health Advanced Practice Nurses (PMH-APRNs) to improve mental health care and provider self-care. The guiding PICOT question was "For PMH-APRNs in community-based mental health practices, will the consistent implementation of the evidence-based intervention of a wellness prescription promoting physical activity based on WHO's (2020) PA Guidelines, compared to no consistent use in current practice, increase the promotion/prescription of PA to their mental health patients and increase the PMH-APRNs' own physical activity over eight …

A Non-Weight Centered Approach To Modifying Eating Attitudes In Polycystic Ovarian Syndrome, Jo'quishia A. Lethermon

Dissertations

Polycystic Ovarian Syndrome (PCOS) is an anovulatory disorder characterized by insulin resistance and endocrine dysfunction. Infertility and abnormal weight gain in women of childbearing age are often a result of PCOS, impacting quality of life and posing potential long-term health sequelae. Prescribing weight loss has been adopted by clinicians as an effective intervention to improve insulin resistance. For some patients, this practice has led to the negative effects of weight cycling and disordered eating attitudes which can result in long term adverse cardiometabolic outcomes. A quasi-experimental pre-and-post-test study was conducted to evaluate how a non-weight centered program influences eating attitudes …

Influence Of Social Media On Mothers' Decision-Making Regarding Vaccinations, Wendy M. Patterson

Dissertations

This study involved determining why mothers hesitate to vaccinate their children and where they get their information about vaccinations. This descriptive qualitative study guided by the health belief model explored the influence social media has on mothers' perceived barriers to vaccinating their children. A descriptive qualitative approach was used, and one-on-one audio interviews were conducted via Zoom or in person with 19 participants. Participants were mothers 19 or older, had children between zero and 18, made medical decisions for their children who resided in their household, and sought information about vaccinations via healthcare providers, social media platforms, friends, or family. …

Evaluating Effective Communication Of Baccalaureate Nursing Students, Christine N. Brockway

Dissertations

The purpose of this mixed methods study was to determine how communication evaluation by clinical faculty compared in a clinical setting versus a simulation setting for Bachelor of Science in Nursing (BSN) students. Fifty (50) BSN students from three different schools of nursing were scored using the Interprofessional Situation, Background, Assessment, Recommendation Nurse to Physician Rubric in both clinical and simulation settings by seven nursing faculty. Scoring for each student occurred in both settings during one semester. Following the evaluation, students and faculty were asked to participate in a focus group to discuss their experience. Results from this study showed …

The Effect Of Guideline Education On Anticoagulatin Management And Professional Collaboration In Ecmo Patients, Luis E. Farfan

Dissertations

This project aims to assist nurses and advanced practice nurses in preventing thrombosis and bleeding during ECMO treatment. It suggests following established anticoagulation guidelines, providing comprehensive education, and promoting teamwork among healthcare professionals. This approach can enhance patient outcomes by increasing knowledge and collaboration, ultimately leading to optimal administration of unfractionated heparin. Over approximately 20 weeks, the project was undertaken to enhance knowledge pertinent to anticoagulation management in patients undergoing Extracorporeal Membrane Oxygenation (ECMO). This initiative involved facilitating educational sessions tailored for nurses and Advanced Practice Providers (APPs) and focused on improving collaborative processes between these healthcare professionals.

Exploring Moral Distress In Icu Nurse Practitioners: A Descriptive Phenomenological Study, Steven L. Bocchese

Dissertations

Nurse Practitioners (NPs) working in the intensive care environment experience clinical and operational anxiety, such as moral distress. Moral distress occurs when an individual knows the ethically correct action but cannot take it due to internal or external constraints or violation of their professional core values. Historically, nurses have experienced moral distress at higher levels than other healthcare professionals, especially those in intensive care units (ICUs). This phenomenological study aimed to describe the lived experience of moral distress in ICU NPs, specifically emphasizing its effect on their personal and professional lives. Research on moral distress has demonstrated that individuals who …

Concept-Based Debriefing And Concept Mastery: A Pilot Study Linking Debriefing To Nursing Concept Mastery, Crystel L. Farina

Dissertations

Increases in patient acuity and comorbidities in acute care settings require students to possess a greater depth and breadth of knowledge compared to decades ago. Additionally, there is an urgency to adapt nursing education to meet current healthcare trends. Simulation is a pedagogical strategy to enhance critical thinking and clinical decision-making in nursing education. Simulation scenarios are a psychologically safe environment where nursing students may practice patient care and learn from their mistakes (Rudolph et al., 2014). The debriefing following the simulation scenario provides opportunities for self-reflection on actions taken during the simulation scenario. Currently, five debriefing methods support students' …

Development And Evaluation Of A Teamstepps® Program Among Cardiac Procedural Unit Staff In A Mid-Atlantic Community Hospital To Improve Teamwork And Patient Safety, Dawn K. Mutchko

Dissertations

Communication and teamwork between members of the non-provider patient care team in the cardiac procedural unit were observed to be unbalanced and at times ineffective. Team members additionally expressed concerns regarding efficiency and accuracy in patient handoff, specifically between units. The goal of this study was to improve teamwork and communication among the staff of the cardiac catheterization and electrophysiology lab. Participation in this initial, single-unit phase would include the non-physician staff of that unit.

Effects Of Mindfulness-Based Interventions On Psychological Distress In Healthcare Workers: An Integrative Review, Michelle Kober, Yu-Ping Chang

Creating Healthy Work Environments (CHWE)

The use of mindfulness-based interventions have been shown to improve mental health symptoms related to the unique stressors experienced in the healthcare worker population. Creative and innovative support measures are needed in order to enhance participation and commitment to these types of programs so we may foster healthier work environments.

A Comparison Of Emotional Intelligence And Resilience Between Bachelor's Degree And Associate Degree Nursing Students, Natalie Board

Dissertations

Emotional intelligence and resilience are essential proficiencies critical for nurses to deliver safe and quality patient care. In the healthcare industry, nurses are exposed to numerous complex circumstances in demanding and high-stress environments. The quality of patient care a nurse can deliver depends on one's capacity to handle certain situations effectively. Emotional intelligence and resilience were potentially important variables in improving clinical practices and patient outcomes (Cleary et al., 2018). With the nursing shortage in the US, all nurses became necessary and required on the front lines of patient care during this time of dire need, regardless of their levels …

Addressing Barriers To Medication Adherence: An Evidence-Based Screening Instrument Validation Study, Donna Washburn

Dissertations

Adherence to a prescribed medication regimen is often critical to successful disease management. Cancer diagnoses often further complicate control of the comorbid diseases. Older cancer patients with multiple comorbidities receiving chemotherapy treatment are at increased risk for adverse health outcomes from uncontrolled disease when nonadherent to their medication regimen. The intent of this pilot study was to test the validity of an evidence-based screening instrument designed to identify patients at risk for medication nonadherence and uncontrolled illness. The W-BMA (Washburn-Barrier to Medication Adherence) screening criteria were applied to retrospective data of cancer patients with multiple co-morbidities. SPSS was used to …

Distance Caregiving A Parent With Advanced Cancer, Polly M. Mazenec

Dissertations

Distance caregiving, which is the experience of providing instrumental and/or emotional support to an ill loved one who lives a long distance from the caregiver, is a recent caregiving phenomenon. Although much is known about caregiving a family member with cancer, there has been almost no research describing the experience of caregiving from a distance and intervention studies are non-existent. The purpose of this study was to investigate the effect of distance on caregiver reaction (benefit and burden) and to explore predictors of caregiver psychological well-being (depression, anxiety, and distress) in distance caregivers of parents with advanced cancer. A conceptual …

Psychosocial Determinants Of Suicidal Ideation Among Thai Women, Raya T. Albataineh

Dissertations

According to a Thai Public Health Ministry spokesman, more than 300 Thai individuals commit complete suicide per month, making Thailand the nation with the third-most suicides in the world. Despite the high rates of suicidal ideation in Thai adult women, the predictors associated with suicidal ideation rates are still unknown. Thus, the purpose of this study was to examine those predictors, specifically the extent to which quality of life, intimate partner violence, social support, employment status, partnership status, and parenthood status predict suicidal ideation in this population.

Relationships Among Self-Care Behaviors And Professional Quality Of Life In Oncology Nurses, Susan M. Politsky

Dissertations

Oncology nurses distinguish themselves as providing strength and support for their patients who are receiving treatments to combat the diagnoses of cancer. Nurses are affected by the act of their honest caring and the compassion they provide to their patients. This caring and compassion can unintentionally lead to positive or negative outcomes for the nurse. Caring for oneself is often not a priority of oncology nurses. Introducing and incorporating self-care behaviors may have a direct impact on the well-being of oncology nurses. The purpose of this study was to explore the relationships among the components of self-care behaviors and the …

Expediting Stroke Transfers: Improving Door-In Door-Out Times In A Community Hospital Emergency Department, Susan E. Maynard

Dissertations

Patients with acute ischemic stroke are at high risk for death and disability without rapid treatment. Thrombectomy is a time-sensitive procedure that can restore blood flow to the brain.