Digital Commons Network^™

Pfas Exposure And Human Health Risk Management - A Policy Review, Callie Sierra Totaro

Master's Projects and Capstones

For centuries, new chemicals and compounds have been invented to improve material longevity or make a product cheaper to produce. Throughout this time, emerging chemicals have often gone through inadequate testing that may not consider all long term environmental and human health effects before they have gone to market in the United States. As a result, thousands of harmful chemicals have ended up in the food supply, water sources, and everyday items of people in the United States with the negative health effects often not being discovered for decades after the start of circulation. By this point, removal and assessment …

A Quality Improvement Project On Anxiety Management Before Ketamine-Assisted Psychotherapy, Kiera Paulo

Doctor of Nursing Practice (DNP) Projects

Background: This Quality Improvement project sought to determine if a brief progressive muscle relaxation (PMR) session could decrease patient anxiety before receiving intramuscular (IM) injections for ketamine-assisted therapy. Problem: The Kerstin Helgason, NP clinic does ketamine-assisted therapy, and many patients express anxiety beforehand, either due to a fear of needles or nerves surrounding the medication treatment. Intervention: This project implemented a brief progressive muscle relaxation therapy for patients with anxiety before receiving their IM injection. Measures: The patient’s anxiety levels were measured before and after the PMR therapy using a five-point Likert scale ranging from none to very severe. Results: …

Community Health Worker Certification Program - Motivational Interview, Advocacy, Communication And Conflict Resolution, Stella Antony

Doctor of Nursing Practice (DNP) Projects

Background: Rural residents have health disparities more than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, health care, health insurance, unhealthy eating habits, poor socioeconomic status, cultural and language barriers, and lack of health literacy. As locals, Community health workers (CHWs) meet these populations and can improve healthy lifestyle changes and advocate for their community.

Local Problem: The population in Fresno and Tulare County in Central Valley, California, is underprivileged, lacks access to proper health care, and has higher rates of health disparities, including chronic …

Mental Health Services: Reaching The Homeless, Gurdeep Mann

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Serious mental illness (SMI) and substance use disorder (SUD) are two common findings among the majority of those experiencing homelessness in the Stanislaus County.

Local Problem: Emergency shelters typically do not provide mental health services on-site, however, a collaboration between First Behavioral Health Urgent Care Center (FBH) and We Care Program Turlock (WCPT) was established to provide mental health services on-site.

Method: The WCPT case manager as part of a Doctor of Nursing Practice (DNP) quality improvement project implemented Assertive Outreach Model interventions to increase utilization of mental health services and established long-term relationships.

Interventions: Frequent contact with …

Improving Health Outcomes For Lgbtq+ Youth Through Provider Education, Marissa Simko

Doctor of Nursing Practice (DNP) Projects

Background and Problem: LGBTQ+ adolescents and young adults (ages 12-25 years) are known to have higher rates of physical and mental health concerns compared to heterosexual and cisgender youth. Within the LGBTQ+ youth community, rates of suicidality, substance misuse, homelessness, and STIs are higher than in the general population. LGBTQ+ youth have greater challenges accessing healthcare and higher rates of healthcare discrimination. This paper presents a quality improvement project focused on improving evidence-based practices in LGBTQ+ healthcare through the development and implementation of a LGBTQ+ youth centered educational workshop for healthcare providers.

Methods: This project was organized in …

Oral Health Literacy: A Tool To Reduce Oral Health Disparities Among Californians, Rubina Bukhari

Master's Projects and Capstones

Oral health is the health of the mouth, cheeks, teeth, and their supporting structure within the oral cavity. It helps in performing day-to-day routine functions such as swallowing, tasting, chewing, talking, and making a wide array of complex facial expressions. Apart from performing everyday functions, oral health is a crucial contributor to the overall state of well-being and good quality of life. It is measured by oral conditions such as tooth decay, gum disease (Periodontal), and oral cancers. Tooth decay and cavity formations are the most prevalent oral health conditions which affect people of all age groups. However, children are …

Introducing Motivational Interviewing Skills To Community Health Workers, Stella Antony

DNP Qualifying Manuscripts

Abstract

Background: Rural population accounts for 15% of the population in the United States of America. Rural residents have a higher risk of health disparities than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, unhealthy eating habits, lack of access to health care, poor socioeconomic status, lack of health insurance, cultural and language barriers, and lack of health literacy. Local Problem: The population in Fresno and Tulare Counties in Central Valley, California is underprivileged, lacks access to proper health care and has higher rates of …

Mental Health Services: Improving Utilization In Homeless Populations, Gurdeep Mann

DNP Qualifying Manuscripts

Emergency shelters provide a unique location to offer easily accessible services for unhoused individuals experiencing mental distress and serious mental illness. Housing First interventions do not improve mental health or social integration. It is important to consider alternative approaches to providing care for homeless individuals. This integrated review was undertaken to evaluate existing evidence of interventions that improve mental health awareness and utilization of mental health services among unhoused populations living in shelters. Assertive outreach is an important strategy that was shown to improve effectiveness of mental health programs in shelters; reconnect individuals with family; and help with psychological integration. …

Decreasing Hospital Acquired Pneumonia In Adult Patients By Patient Care Technicians: Education With A Focus On Oral Care And Tooth Brushing, Amanda Nicole Lee

Master's Projects and Capstones

Hospital acquired pneumonia’s (HAPs) are unfortunate and preventable events quality improvement efforts should focus on. At a Northern California Hospital, there was an unmet HAP rate goal of 2.3 (20 out of 8795 patients) against a target goal of 2. This increase in HAP rates, both non-ventilated and ventilated was a call to action to reduce HAP to the target goal. The quality improvement project specifically aimed to reduce HAP rates on medical-surgical units through an ultra-brief refresher on the hospital validated and endorsed ROUTE bundle. The education focused on oral care completed by the patient care technicians (PCT’s). The …

Impact Of Pcts In The Prevention Of Hap Through A Route Bundle With An Emphasis On Oral Care And Positioning The Patient Out Of Bed And In A Chair, Melissa Ray

Master's Projects and Capstones

Background: Hospital Acquired Pneumonia (HAP) is a leading cause of most hospital-acquired infections among surgery patients who are hospitalized and bed-bound for more than 48hrs. The occurrence of HAP is associated with increased hospital stays and cost of care. However, its occurrence can be reduced by oral care. In this regard, this project aimed to decrease the incidence of HAP on the 3^rd, 4^th, 6^th, and 7^th floors on the Medical Surgical and ICU units of the Northern California Hospital.

Methods: To achieve the aim above, the project utilized methods namely …

The Future Of Universal Basic Income: The Impact Of Organizational Strategies On Alleviating Poverty And Maximizing Outcomes, Anna Mathews

Undergraduate Honors Theses

Universal basic income is gaining traction, with pilot programs being conducted all over the world. These programs are all organized differently, from their sources of funding to their eligibility criteria. This research draws correlations between organizational strategies of UBI programs and the outcomes their recipients experience. Specifically, it analyzes three contemporary UBI programs within the United States: the Stockton Economic Empowerment Demonstration (SEED), Alaska Permanent Fund Dividend (APFD), and the Eastern Band of Cherokee Indians per capita payments (EBCI). The research assesses the physical health, mental health, and economic outcomes of the participants in each case study, in order to …

Community Health Worker Certification Program - Motivational Interview, Advocacy, Communication And Conflict Resolution, Stella Antony

DNP Qualifying Manuscripts

Background: Rural population accounts for 15% of the population in the United States of America. Rural residents have a higher risk of health disparities than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, health care, health insurance, unhealthy eating habits, poor socioeconomic status, cultural and language barriers, and lack of health literacy.

Problem: The population in Fresno and Tulare County in Central Valley, California, is underprivileged, lacks access to proper health care and has higher rates of health disparities. The Save the Children organization’s Community …

Tobacco Policy Reform: Ending The Youth And Young Adult Tobacco Epidemic, Rocio Arjon

Master's Projects and Capstones

Tobacco has been accessible to communities all over the world since 6,000 BC. Overtime, the tobacco industry adapted its products to become more modern and look like technology or taste like common foods and candy. In 1989 the California Department of Public Health organized the California Control Tobacco Program (CTCP) which funds many local jurisdictions in California to provide tobacco education to community members and pass local ordinance to protect the health of their community. This paper is examining the existing policies in Hollister to protect our children and young adults, end the tobacco epidemic, advocate for more comprehensive tobacco …

Save The Children Community Health Worker Program—Project Management, Lauren Loree Burchfield

Doctor of Nursing Practice (DNP) Projects

Background: Community Health Workers (CHWs) are invaluable members of the healthcare system that often have linguistic or cultural connections with the communities they serve and are a potential link to bridging the divide between medically underserved communities to the greater healthcare system.

Local Problem: Save the Children of the Central Valley (STC) employs Early Childhood Coordinators based out of local schools to provide in-home and in-school services to assist families to prepare children for school but do not have formal recognition of CHW training.

Methods: Development of customized education modules for STC, while also complying with nationally accepted CHW competencies …

Using Machine Learning To Analyze Children’S Drawings As Indicators Of Mental Well-Being, Nicholas R. Lawrie

Master's Theses

Human figure drawings are a well-studied diagnostic tool for emotional distress in children. Cleft lip/palate is one of the most common birth defects in the world, and has been shown to negatively impact emotional well-being in childhood which can have negative economic consequences in adulthood. Utilizing a dataset of human figure drawings from children in India and survey data on mental health, this paper will assess the impact of corrective surgery on mental health outcomes, as well as assess the validity of the drawing emotional indicators themselves. The results indicate that while the emotional indicators may not be valid in …

Impacts Of Sea Ice Loss On Polar Bear Diet, Prey Availability, Foraging Behaviors, And Human-Bear Interactions In The Arctic, Jasmin Chen

Master's Projects and Capstones

Anthropogenic-induced climate change has warmed the Arctic 2-3 times faster than the rest of the world, causing sea ice declines that introduce challenges for specialist species, such as polar bears, in adapting to rapid environmental changes. Comparative and quantitative analyses of three Hudson Bay polar bear subpopulations were used to determine the impacts of sea ice loss on polar bear diet, prey availability, foraging behaviors, and human-bear interactions in the Arctic. The study reveal that Hudson Bay polar bears experience the most severe impacts from sea ice declines, resulting in a 30% population decline. Due to their smaller body size, …

Reproductive Health In Rural Guatemala: Finding A Medium Between State And Ngo Policies, Zayra Rivera

Master's Theses

The purpose of this study is to understand and evaluate the manner in which the NGO sector surpasses state led efforts related to improving knowledge about reproductive health within rural areas in Guatemala. This research focuses on using methodologies from four Adolescent Youth Health Programs within the region of Lake Atitlan as well as state run institutions such as schools and health centers.

More specifically, this case study seeks to analyze the current gaps sexual and reproductive health programming in rural indigenous towns in the Sololá department of Guatemala. It compares four private NGO institutions with two public organizations, specifically …

Creating A Pipeline To Increase Diversity In Executive Leadership Positions, Trarina Harris

Doctor of Nursing Practice (DNP) Projects

Background: Minority nurse leader presence at the executive leadership level is suboptimal, with insufficient pathways to increase representation. The lack of diversity in executive leadership threatens efforts to improve patient care and reduce disparities (Jerome Harris, 2021).

Local Problem: Practices to increase the diversity of executive nurse leaders at a pediatric medical center have had very little to no impact. Frontline nurses and nurse executives are not racially or ethnically representative of the increasingly minority patient populations served.

Context: As a commitment to increasing workforce diversity, the medical center developed an executive-level Racial Equity Taskforce, which aligned with the …

Improving Medication Administration Safety In A Correctional Facility With An Electronic Medication Administration System, Rosalinda Salazar

Master's Projects and Capstones

Problem: According to the World Health Organization (2020), medication errors are one of the leading causes of injury and avoidable harm in health care globally.

Context: The county jail houses approximately 700 inmates/patients on a daily basis, and the potential for error when administering medications is high as medications are prepared manually using a paper medication administration record.

Interventions: The jail began using an electronic health record/barcode administration system on October 19, 2020.

Measures: Unusual occurrence reports related to medication errors were reviewed. The time frame included 6 months before electronic implementation, and 6 months after implementation.

Results: Unusual occurrence …

Improving Frequency Of Hand Hygiene Education From Providers To Patients, Nancy Moran, Vanessa Hernandez, Christopher Sutton

Master's Projects and Capstones

Hand hygiene compliance is one of the most simplest forms of preventing infection. This paper focuses on improving the frequency and standardizing hand hygiene education to patients delivered by health care professionals from a primary care clinic. The ambulatory suburban community clinic in Oakland primarily serves the underserved population. The target population are the following providers: Physicians, Physician Assistants, Nurse Practitioners, Registered Nurse, Licensed Practical Nurse, and Medical Assistants. A survey was adapted from evidence-based studies, WHO, and CDC to collect data on current hand hygiene education provided to patients from healthcare professionals. An additional survey was given to patients …

Improving Clinicians’ Access To Patient Education And Va Resource Information, Ella Bermudez

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: In a western US Veterans Administration (VA) hospital system, patient education materials are provider-specific, not standardized, and not located in a central, readily available location.

Context: How does a patient education tool affect the clinicians' delivery of health education in increasing health literacy compared to written information alone in the US veteran population? An integrated literature review was performed using Cochrane, Joanna Briggs Institute (JBI), Scopus, CINAHL, and PubMed databases to address the PICOT question above and determine the impact of patient education tools on health literacy and patient engagement. The literature recommended improving patient education for better …

Needs Assessment: A Food Pharmacy During The Covid-19 Pandemic, Genesis Talavera

Master's Projects and Capstones

Introduction

The needs assessment report discusses the effects of COVID-19 (Coronavirus) pandemic on a low-income Hispanic/Latino population specifically for diabetic patients seeking food pharmacy services at a non-profit clinic in San Mateo County. Nutrition is an essential aspect of diabetes management, which can be challenging to obtain among low-income populations. The COVID-19 pandemic has caused additional challenges among the general population, making it more challenging for the diabetic low-income population. This project was undertaken to identify the effects COVID-19 has on the food pharmacy patients.

Methods

The needs assessment consisted of eleven in-depth interviews done in six week period. A …

Bisphenol-A (Bpa) And Breast Cancer: Utilizing Risk Assessment And Education To Improve Preventative Care, Ashley Catherine Babcock

Doctor of Nursing Practice (DNP) Projects

Breast cancer places a large burden on many communities, causing mortalities, and lasting physical, mental, and financial damage. The majority of cases are not caused by a genetic risk factor, which speaks to the importance of addressing environmental risk factors to reduce disease burden. Bisphenol-A (BPA) is linked to increase risk for and metastasis of breast cancer. BPA is widely used in plastics, exposing a huge portion of the United States population. This project used the model developed for the Green Choices program to trial response to the use of an environmental risk survey and education tool that can be …

Plant-Powered: A Digital Plant-Based Nutrition Intervention For Low-Income Patients With Type Ii Diabetes, Ellen Pelos

Master's Projects and Capstones

Purpose: This project aimed to measure the acceptability and feasibility of plant-based diets among low-income individuals with type II diabetes at the Samaritan House Food Pharmacy and to create a user-centered pilot program to encourage the adoption of a plant-based diet.

Background: Plant-based diets are effective for preventing, treating, and reversing type II diabetes, but there is not much evidence about the acceptability and feasibility of these diets.

Methods: Focus groups were used to gather qualitative data about the acceptability and feasibility of plant-based diets in the target population. The researcher conducted interviews with Food Pharmacy program leaders to learn …

Increasing Utilization Of Motivational Interviewing To Promote Pediatric Oral Health, Ulyses Reamico

Doctor of Nursing Practice (DNP) Projects

Prevalence of early childhood caries (ECC) remains high even in developed countries such as the United States. An interprofessional education (IPE) project between University of San Francisco (USF) School of Nursing and Health Professions and the University of the Pacific (UoP), Arthur A. Dugoni School of Dentistry was initiated four years ago to enhance nurse practitioner (NP) and dental students’ pediatric oral-systemic health assessment and health promotion communication skills. Since then, USF NP students received pediatric oral health assessment training and spent clinical rotations at UoP to provide pediatric oral care alongside dental students. This doctor of nursing (DNP) project …

Art-Based Health Education For Homeless And Marginally Housed Women In San Francisco, Trineca R-N Godfrey

Master's Projects and Capstones

San Francisco currently has the highest rate of unsheltered homeless persons in the United States. Between limited resources and stigma many women included in this most vulnerable population are left with little to no support. Cis women as well as trans and non- binary people are at high risk for negative mental health outcomes due to violence (physical and psychological), stigma, lack of social support, societal marginalization, and the lack of healthcare. Lyon-Martin Health Services and the Women’s Community Clinic, in San Francisco’s Mission Neighborhood, caters to this community through its Outreach Department. Following a staff and outreach client needs …

Dnp Project: Development Of A Nurse-Led Pop-Up Clinic Model In San Diego, Jennifer King

Doctor of Nursing Practice (DNP) Projects

Baccalaureate nursing programs across California (CA) are required by the state board of nursing to provide theory of public health and applied clinical learning to meet the requirements of the state’s public health nurse (PHN) certification. Students in Bachelor of Science in Nursing (BSN) programs are expected to enter the workforce prepared to address population health needs that synthesize community-based assessment and understand epidemiologic approaches to strategize interventions in diverse populations at the local, state and national levels. To adequately prepare nurses for true population health practice, clinical experiences need to be in appropriate settings where they can apply theory …

Implementing Foot Care Program In A Rural Clinic, Maliheh Bakhshi

Doctor of Nursing Practice (DNP) Projects

Abstract

The prevalence of type 2 diabetes mellitus and its complications have increased in the United States (U.S.) in recent years. Patients with diabetes have a higher risk of foot ulcers due to diabetic peripheral arterial disease accelerated by the direct damage to the nerve and blood vessels in lower extremities by high blood sugar. Foot amputations, and frequent hospital admissions due to these and other diabetes complications are also increasing. Healthcare providers’ have a unique opportunity to prevent these complications and hospital admissions, and to promote patient wellness and physical well-being through the provision of timely education and direct …

Defining Young Adulthood, Elena Higley

DNP Qualifying Manuscripts

Young adulthood is a unique developmental period that occurs between the ages of 18 and 25 years, during which there are key developmental tasks that allow the young adult to participate in self-exploration and identity formation. Currently, among various organizations there are differing definitions and age range inclusions for young adulthood, which cause confusion during program development, healthcare service delivery, and research. Young adulthood should be categorized separately from adolescence and adulthood, because young adults have lower rates of healthcare utilization and worse health outcomes related to preventable causes of morbidity and mortality than the surrounding age groups. Young adults …

The Impact Of Cleft Lip/Palate And Clp Surgical Intervention On The Social Integration Of Adolescents In India, Mustafa Zahid

Master's Theses

Cleft Lip/Palate, a congenital orofacial anomaly, carries an incidence rate of approximately 1 in every 1000 births. In addition to the stigma associated with the condition, the varying levels of cleft severity might result in lower life outcomes which could include lower cognitive ability, physical and psychological well-being, social and behavioral outcomes of adolescents. This paper focuses on the social integration element of life outcomes, which is composed of the social inclusion and prosocial behavior of the adolescent. Despite the affordability of restorative surgeries, patients in rural areas of Low and Middle-Income Countries (LMICs) such as India face accessibility and …