Digital Commons Network^™

Measuring The Effectiveness Of Antidepressant Treatment By Implementing Beck's Depression Inventory (Bdi), Azeem Anjum

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project integrates a structured periodic depression evaluation follow-up protocol for patients diagnosed with Major Depressive Disorder who have been prescribed antidepressant(s) at an outpatient mental health clinic. The purpose of this DNP project is to standardize the method of treatment progression monitoring to improve the timeliness of change detection and subsequent treatment adjustments using the Beck Depression Inventory (BDI) Scale.

Background: According to the World Health Organization (WHO), MDD is one of the most common mental health conditions affecting approximately 280 million people globally and 17.5 million adults in the United States. (WHO, 2021). The economic …

Are You In Control Of Your Diabetes? Providing 1:1 Diabetic Self-Management Education To Adults With Type Ii Diabetes Mellitus In An Outpatient Clinic In An Underserved Community, Joe Gonzales

Doctor of Nursing Practice Final Manuscripts

Non-insulin-dependent diabetes mellitus (DM) is a complicated multisystem disease that accounts for over 20% of health care spending in the United States (Hildebrand et al., 2019). Uncontrolled DM can lead to heart disease, stroke, blindness, amputations, and peripheral artery disease. The literature supports the use of practice guidelines to improve patient outcomes with diabetes self-management education (DSME) and pharmacological interventions.

The purpose of this evidence-based project was to improve hemoglobin A1c (HgbA1c) levels by introducing the 2021 American Diabetes Association (ADA) Standards of Care guideline to improve diabetes self-management in a largely underserved adult Latino community. The intervention included a …

Improving Patient Self-Efficacy, Readiness, And Completion Of Advance Care Planning Documents Using Prepare Documents And Advance Care Planning Group Referral, Marie Vassiliadis

Doctor of Nursing Practice Final Manuscripts

Advance Care Planning (ACP) is an ongoing discussion about medical decision making between a provider, patient, and support person. ACP can also include legal documentation in the form of an advance directive (AD). Nationally, only 36.7% of adults complete any form of AD for end-of-life care. Recently, ACP has become an important quality metric that many organizations are prioritizing. The purpose of this evidence-based project is to improve ACP readiness, self-efficacy, and documentation among patients at an internal medicine clinic using the PREPARE program and referral to an ACP group meeting. PREPARE for Your Care is an online program aimed …

Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante

Doctor of Nursing Practice Final Manuscripts

Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. In the United States, DS occurs in one out of every 700 births. Children with DS have an increased risk of developing serious health conditions. In the military health system, children with DS face many barriers such as frequent relocations and poor access to specialty care. Primary care providers (PCPs) do not consistently follow published guidelines for health supervision.

Purpose: This project aims to improve the care for pediatric patients with DS in the military health system by increasing the knowledge and confidence of PCPs.

Methodology: An educational program …

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

The Future Of Cognitive Dysfunction In Elderly Patients: A Clinical Perspective With Recommendations, Laura Taylor

Doctor of Nursing Practice Final Manuscripts

Background: The U.S. Census Bureau projects the number of Americans age 65 years and older will more than double between 2010 and 2050. The geriatric patient population will likely require the use of surgical services at a higher rate than ever before. To best care for the elderly undergoing procedures with anesthesia, it is imperative to follow the most up to date evidence to avoid post-operative complications, and more specifically post-operative cognitive dysfunction.

Purpose: The purpose of this DNP evidence-based practice project is to identify patients that are at high risk for post-operative cognitive dysfunction prior to undergoing anesthesia. Post-operative …

Improve Hypertensive Patients’ Compliance Postgraduation From The Virtual Care Team Program, Marcie Santillan

Doctor of Nursing Practice Final Manuscripts

Background: Virtual Care Team (VCT) began their program approximately 15 months ago to assist their most vulnerable patients with chronic and uncontrolled conditions such as hypertension, diabetes mellitus, and nicotine use disorder. The program follows the patients for a year to help them manage their chronic conditions and comply with chronic management. When the Virtual Care Team followed up a few months after the graduation with some recent graduates, it was found that a small number of patients returned to their pre-Virtual Care Team habits.

EBP Purpose: The purpose of the project is to follow up on those …

Improving Nursing Student Retention: Early Identification Of Determinants Causing Attrition In Nursing Academic Programs, Tennille Gifford

Doctor of Nursing Practice Final Manuscripts

Introduction: Student success in higher education is a vital focus for the health of a community and the improvement of an individual’s life. It is equally detrimental if a student leaves an educational program without a degree. The purpose of this project was to improve the early identification of students at risk of attrition in a nursing program by using an electronic dashboard interfaced with a self-reporting student survey to identify determinants that are statistically significant factors for student attrition. Background: The current accreditation benchmark for nursing program completion is 70% for Bachelor of Science in Nursing degrees. Concordia St. …

Utilization Of Telemedicine For Follow Up Appointments In Radiation Oncology, Priya Patel

Doctor of Nursing Practice Final Manuscripts

Access to healthcare remains a problem for patients in the United States, especially those who live in remote areas, are immobile, immunocompromised, or are experiencing financial strain. These barriers can lead to missed appointments, putting financial strain on healthcare institutions, and contributing to productivity loss and underutilization of clinic resources. During the COVID-19 pandemic there was a rapid increase in the use telemedicine. Patients were surveyed on the quality of their telemedicine visit at the UCSD Health Moores Cancer Center Radiation Oncology department. The majority of patients would schedule telemedicine appointments in the future, which can reduce the burden on …

Mantram For Mamas: A Pilot Study For Postpartum Women, Ritamarie Smedile

Dissertations

Objective: This pilot study launched an online Mantram Repetition Program (oMRP) using a virtual health portal that aimed to explore online portal accessibility, oMRP acceptance, and overall interface satisfaction among a sample of postpartum women.

Background: Postpartum depression remains one of the most common and severe childbirth complications, affecting more than 13% of women during the first three months after childbirth. Cognitive or behavioral talk therapy sessions and medication are the most frequently recommended treatments to alleviate symptoms. Although effective, women tend not to enroll or adhere to these modalities, suggesting they need alternative treatment plans. A possible alternative, mirroring …

The Lived Experience Of Patients With Clostridioides Difficile, Andrea Scherschel

Dissertations

Background: Clostridioides difficile (C. difficile) is the most common healthcare-acquired gastrointestinal infection in the United States. While there is a plethora of information on the treatment and diagnosis of C. difficile infection (CDI) in the literature, there is a paucity of research findings describing the lived experience of a person with the disease.

Objective: This study described the lived experience of patients who have had one or more CDIs.

Lines of Inquiry: There were two lines of inquiry for this study: (1) Describe the lived experience of having a CDI, and (2) determine if photo-elicitation as a research modality enhanced …

Anxiety And Agitation In Adult Patients Admitted To An Emergency Room During The Covid-19 Pandemic, Doris L. Asombrado

Dissertations

Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through …

A Pilot Project For Tuberculosis Education In College Students, Sarah Williams

Doctor of Nursing Practice Final Manuscripts

Background: San Diego’s Tuberculosis (TB) incidence is more than double the national rate. The majority of cases of active TB are due to the progression of latent TB infection (LTBI).

Objectives: This evidence-based practice (EBP) project aimed to increase knowledge, awareness, and improve attitudes and practices regarding TB among college students.

Participants: Twenty Community College Students in San Diego participated in the project.

Methods: Students attended an in-person educational session. A pre-post knowledge, attitudes and practices (KAP) questionnaire measured the impact.

Results: The intervention improved knowledge and attitudes. The average post-intervention TB knowledge score was 95.8% compared to 57% …

Decreasing Weight Bias Among Aprns, Aprn Students, And Rn Nursing Students Through Educational Seminars, Apryl Cutler

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to systematically review research-based evidence and best practice guidelines brought forth by other researchers, experts and organizations. The goal was to implement an enlightening and educational intervention via seminar to Pre-licensure RN students, APRN students and APRNs on the topics of the non-controllable causes of obesity, weight bias in healthcare and patient-centered approaches to ultimately improve the delivery and quality of care provided to patients living with obesity.

Background: The prevalence of overweight and obesity has been steadily increasing over the past three decades with up …

Educating And Improving Collegiate Athlete Sunscreen Use, Julia Pederson

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to prospectively evaluate the ability to alter the behavior of young adults by providing sunscreen education and thereby reduce their risk of skin cancer from sun exposure. Twenty-three collegiate athletes ages 18 to 21 years old who were on the university softball team were enrolled. These student athletes were then educated about the impact of daily sun protection and risk factors. The goal was to observe an increase in sunscreen use and increase sun exposure awareness.

Background: Skin cancer is the most frequently diagnosed cancer in …

Nurse Practitioner's Perspectives On Human Trafficking In The Emergency Department; A Narrative Inquiry, Ann Gerhart

Dissertations

Background: Human trafficking (HT) is a global and domestic concern that impacts individuals, families, and communities. Over the last ten years, HT has become a significant public health concern intersecting with the health care community in various settings. HT abuse and oppression have both short- and long-term health consequences. Approximately 50 to 88% of trafficked individuals visit a health care provider, and 63% of those visits are evaluated in the emergency department (ED). Nurse practitioners (NPs) working in the ED interact with HT individuals but have not been represented in recent research scholarship.

Purpose: The purpose of this qualitative …

Social Determinants Of Health And Health Confidence, Laura Truman

Dissertations

Purpose/Aims: The purpose of this study was to investigate the relationship among social determinants of health (SDOH), select sociodemographics, and health confidence level in adults receiving care at an urgent care center.

Background/Rationale: To improve overall health and reduce health inequities during a global pandemic and unprecedented rates of inflation, the relevancy and urgency of identifying how patient-level SDOH impact health confidence level are even greater. Extant research indicates a relationship between the number of unmet social needs and low health confidence. Low health confidence predicts poor involvement in self-care and is associated with an increased use of costly health …

Practical Solutions To The Invasion Of Lionfish In Utila, Honduras: Science, Education, Food, And Jewelry, Carolyn Corley

Undergraduate Honors Theses

Lionfish (Pterois sp.) are invasive species capable of devastating coral reef ecosystems due to their lack of predators, large appetites, generalist diet, high fecundity, and rapid spawning rates. As lionfish have expanded their distribution across the Caribbean, many conservation groups have taken it upon themselves to systematically remove these predators from environments where they are threatening native species. However, few have involved the community the way I observed while interning with the Whale Shark and Oceanic Research Center in Utila, Honduras. Protecting coral reefs is extremely important, especially in small communities like Utila, where the majority of people’s …

Algorithmic Bias: Causes And Effects On Marginalized Communities, Katrina M. Baha

Undergraduate Honors Theses

Individuals from marginalized backgrounds face different healthcare outcomes due to algorithmic bias in the technological healthcare industry. Algorithmic biases, which are the biases that arise from the set of steps used to solve or analyze a problem, are evident when people from marginalized communities use healthcare technology. For example, many pulse oximeters, which are the medical devices used to measure oxygen saturation in the blood, are not able to accurately read people who have darker skin tones. Thus, people with darker skin tones are not able to receive proper health care due to their pulse oximetry data being inaccurate. This …

Audacious Corazón: A Nuanced Art Of Care, Dianne Bermudez Torres

Dissertations

Historically, the concept of care in higher education has focused on academic achievements, neglecting the significance of building meaningful relationships between faculty and students that engage both affective and cognitive dimensions (Noddings, 1994). Teaching with the heart, or corazón, embodies care in teaching. Employed in this study was a mixed-methods, exploratory case study approach that explored the intricate art of care and how faculty foster bilingual authorization credential teacher candidates to evolve into culturally responsive educators. Pearson et al.’s (2021) cariño pedagogy serves as a model that empowers faculty’s humanizing agency. Additionally, the study also reflected on the concept of …

Resistencia Indocumentada: Exploring The Lived Experiences Of Higher Education Undocumented Students In The San Diego-Tijuana Border Region, Adan Escobedo Sanchez

Dissertations

Undocumented students face myriad obstacles while attending higher education institutions that would deter them from completing their academic journeys. Furthermore, they are placed with a dual narrative that labels them as either dangerous or exceptional. This study explored the lived experiences of undocumented students in college in the San Diego-Tijuana border region to consider what factors have led to resilience and resistance in their academic journey. By understanding these factors, the research aimed to tackle the dual narrative that burdens undocumented students from the illegality as a master status they possess.

This study used narrative inquiry and a literature review …

Racism Without Race: The Racialization Of Middle Eastern And North African Students At U.S. Colleges, Hannah Mesouani

Dissertations

Although a growing body of literature covers the experiences of international students at U.S. colleges, the stories of those who do not fit into the U.S. racial schema remain untold. This study examined how Middle Eastern and North African (MENA) students understood their racial identities given the United States’ tense history with Islam and the MENA world. Using foundational texts on critical race theory, current scholarship on Arab Americans and foreign-born students, and facets of the Ethnic Identity Scale (EIS), this study examined the experiences of MENA students who study amid a national backdrop of xenophobia and racialized Islamophobia. This …

Talking Back To The Elpac: Resilient Resistance And (Re)Imagining Through Ypart, Zulema Reynoso

Dissertations

Policies that label and track students based on language and race dismiss the voices and lived experiences of English learners (ELs) through forced fits and ideologies that devalue multiple languaging and ways of knowing. This qualitative study explores how an educator and 20 seventh-grade bi/multilingual Latinx students labeled long-term English learners (LTELs) reimagined how language is perceived, taught, and assessed across traditional schooling contexts and language policy landscapes. Drawing from LatCrit theory, Latina/Chicana feminisms, and dimensions of youth participatory action research (YPAR), this study centered both LTELs as jóvenes educados (dignified youth) and a conceptualized taller (studio space) to affirm …

Queering Healthcare Equity: Exploring How Two Community Health Centers That Specialize In Lgbtq Healthcare Frame Cultural Competence, Tommy Royston

Dissertations

Despite increased advocacy and funding, significant inequities in healthcare access, quality of care, and health outcomes have continued to persist for lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) communities. Intersecting marginalized identities such as race, gender, and disability compound health inequities faced by LGBTQ folx. These inequities are not random; rather, they result from deeply embedded homophobia, transphobia, ableism, and racism that pervade the U.S. healthcare system. An exploratory comparative case study was completed using qualitative data collection methods (i.e., key informant interviews, focus groups, and document analysis) to investigate how two California-based Federally Qualified Health Centers (FQHCs) that specialize in …

Equalizing Postsecondary Transition For At-Promise Youth Receiving Special Education Services: A Chance To Succeed, Karla R. Sanchez

Dissertations

Postsecondary transition can be difficult for At-Promise Youth Receiving Special Education Services (APYRSES). Special educators supporting postsecondary transition often manifest traditional and institutionalized forms of oppressive education while dismissing collective values and beliefs.

This qualitative case study examined the beliefs and attitudes shared by three special education teachers after being introduced to a justice-focused, humanizing intervention to facilitate postsecondary transition for APYRSES. The conceptualized intervention was grounded in liberatory educational frameworks and drew from critical, culturally affirming, sustaining, and humanizing theories that foster cultural reciprocity, self-determination skills, and antiracist social–emotional justice learning to afford opportunities for APYRSES to succeed. The …

Analysis Of One Secondary School's Support Systems For Aspiring First-Generation Latinx College Students: A Case Study, Tiffany Cunningham

Dissertations

U.S. Census Bureau Report (2020c) showed Hispanic students constituted 18.5% of the U.S. population, 36% attended higher education and only 14% completed postsecondary education. Research has shown Hispanic, specifically Latinx, students faced barriers in accessing higher education’s hidden curriculum, compounded by deficit beliefs about their language, culture, and lack of family involvement (Kiyama, 2018; C. Martinez & Mendoza, 2020). Additionally, first-generation college students require college readiness skills, including specialized knowledge about college and measurable and immeasurable skills shown to support student success in college (Chlup et al., 2018; Duncheon, 2021; Morley et al., 2021). Despite secondary school supports like college …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

Vista: May 11, 2023, University Of San Diego

USD Vista (1965-)

No abstract provided.

First-Generation Latina Testimonios: Navigating A Predominantly White Institution And Achieving Academic Success, Nancy Correa

M.A. in Higher Education Leadership: Action Research Projects

The purpose of my research was to understand the experiences of Latina first-generation college students at the University of San Diego, a predominantly White institution. Six Latinas participated in a series of group platicas to share testimonios with one another and build community. One research question that guided this study was: “How can the self-efficacy, sense of belonging, and academic achievement of first-generation Latina students be enhanced in a predominantly White institution?” Findings suggested participants’ negative experiences with faculty and White classmates impacted their sense of belonging and academic self-efficacy. Most participants worried how they will continue to finance college …

Vista: May 4, 2023, University Of San Diego

USD Vista (1965-)

No abstract provided.