Digital Commons Network^™

Power And Control In Medicine And Nursing - Could Intrinsic Gender Beliefs Impact Interprofessional Education In Pre-Professional Programs?, Catherine Christine Delant

Dissertations

Examination of the power dynamics at work in perpetuating health care hierarchy-related interprofessional collaboration barriers is needed to rationally develop strategies for teaching collaborative skills to health care providers. A mixed-methods study employing critical realist grounded theory examined the implicit beliefs, assumptions and power hierarchies related to gendered perceptions of the professions of nursing and medicine by students of those professions.

The Lived Experience Of Registered Nurses And Registered Midwives In St. Kitts And Nevis, Raiden Gaul

Dissertations

At the beginning of the 20th century, St. Kitts and Nevis had one of the highest infant mortality rates in the Caribbean. However, unlike some Caribbean nations with similar historical and socioeconomic factors that continue to suffer from significant health disparities, St. Kitts and Nevis implemented strategic health reforms that have led to dramatic improvements in maternal and neonatal health outcomes. One of the strategic reforms designed to address these poor health outcomes was to mandate that all registered nurses in St. Kitts and Nevis pursue certification in the post-basic midwifery program. The purpose of this study was to examine …

Evaluation Of New Graduate Nursing Orentation Program, Elizabeth Arroyo

Dissertations

When a new graduate nurse enters the hospital for the first time the feeling is intense, and intimidation is at an all-time high. The fact that everyone in the unit knows there is a new nurse is worrisome for often the phrase "nurses eat their young" is a thought that overwhelms so many new nurses. The hospital located in central Florida has a 16-week orientation program that has been in effect for three years, but is facing negative results. The job turnover rates in the hospital from new graduate nurses is 70% in just one year (Lindfors & Junttila, 2014). …

How Does Vr Affect Motivation, Engagement, Performance And Student Interest In High School Science?, Ann Marie Carrier

Dissertations

This study investigates the impact of virtual reality (VR) on high school science students' motivation, engagement, performance, and interest in STEM disciplines. Building on Huang et al. (2021), this research replicates and extends their findings, focusing on how different levels of VR immersion influence learning outcomes. The study aligns with the Next Generation Science Standards (NGSS) and the Georgia Standards of Excellence (GSE). Utilizing a quasi-experimental design, 123 high school students experienced varying levels of immersive VR via the Titans of Space Plus app on Meta Quest 2 headsets and desktop computers. Study population included 55% males, 45% minorities, and …

Special Education Preschool Teachers’ Perspectives, Attitudes, And Self-Efficacy Towards Inclusive Education, Mieke Kramer Tavares

Dissertations

Purpose: The purpose of this study was to investigate the perspectives of special education preschool teachers in California regarding the inclusion of children with disabilities in general education preschool classrooms. Furthermore, the study examined the self-evaluation of these teachers regarding their abilities to support children with disabilities in general education classrooms. Last, the study aimed to identify additional factors that impact the attitudes of teachers towards including children with disabilities in general education preschool classrooms.

Methodology: A mixed methods nonexperimental descriptive, sequential, convergent research design was employed. Data collection tools included surveys (quantitative) and interviews (qualitative). In Phase 1, dependent …

The Impact Of Hourly Safety Rounding On Pediatric Fall Rates, Natalie Doskal-Poe

Dissertations

The Impact of Hourly Safety Rounding on Pediatric Fall Rates

Abstract

Problem: Falls are a common adverse event in the inpatient pediatric setting and are a significant risk to patient safety. Environmental factors, such as unclear pathways, bed rails down, beds in high position, and call lights out of reach, are considered avoidable causes of patient falls. The site’s fall data in a 12-month period from January 2023 to January 2024 showed (n=9) patient falls occurred with (n=5, 55.6%) due to environmental factors. The purpose of this Quality Improvement (QI) pilot project was to assess the …

The Influence Of Misconceptions On Pedagogical Choices Of Secondary Science Teachers: An Embedded Case Study, Tracey Beyer

Dissertations

This case study, using phenomenography within science disciplines, examines how educators' experiences with misconceptions affect teaching methods in high school physics, chemistry, and biology. Based on constructivist and interpretive theories it highlights that personal experiences shape learning and involve continuously reconstructing knowledge. The shared misconceptions of 13 educators across science disciplines reveal how those experiences influenced both their content knowledge and instructional practices. The findings indicate that educators who openly acknowledge and learn from their past experiences with misconceptions are better equipped to recognize and address gaps in understanding, an asset to furthering student learning. This research highlights the importance …

Patient-Generated Health-Data Information Needs In Pediatric Asthma, Victoria L. Tiase

Dissertations

Patient-generated health data (PGHD) are data collected by patients that can be used to screen for health problems or monitor progress toward health goals. These data may be especially useful for those with chronic health conditions such as pediatric asthma, as PGHD reflect the day-to-day status and home behaviors. Without access to PGHD within clinical workflows, clinicians working to personalize care and treat patients at an individual level may have an incomplete picture of those patients. A thorough understanding of information needs and display preferences is required to present PGHD in the clinical documentation without causing information overload. The aims …

Stepparenting And Schooling: Challenges, Reconstitutions, And Outsider Perceptions, Christopher Repa

Dissertations

This study examined the challenges stepparents face in schooling their high-school aged children. An analysis of how stepfamily formation can impact this process was also investigated. The sample included 13 families composed of one biological and one non-biological parent with at least one child between the ages of 14 and 18 who was currently attending high school. Stepparents were asked to share their experiences with other family members, the school, and the community as they related to the education of their stepchildren. The primary research focus was to identify difficulties and successes that stepparents encounter as they engage with schools …

Evaluation Of Reported Level Of Clinical Confidence In Student Nurses Using Deliberate Practice, Leslie Kirkwood

Dissertations

Critical thinking and clinical reasoning, which support confidence in clinical decision-making of nurses, are still being developed during pre-licensure education. Nursing faculty in higher education are tasked with the challenge to increase the level of practice undergraduate nursing students experience during their program. The research question guiding this project was what effect does the use of deliberate practice with medication administration have on medical-surgical nursing II students regarding clinical confidence? The purpose of this quantitative, quasi-experimental study was to determine if the use of deliberate practice with nursing students by implementing weekly medication administration simulations would increase the level of …

Ethical Leadership And Moral Foundations Congruence, Sarah Willey

Dissertations

Research has examined follower perceptions of ethical leadership, but rarely accounts for the (mis)alignment between a follower’s sense of ethics and morality and that of a leader. This research examined the effects of a leader’s expression of each of the five Moral Foundations dimensions on ethical leadership perceptions, moderated by the respondent’s preferences for each of these foundations. To address this question, a policy capturing design was used to manipulate leaders’ high and low levels of each of the five foundations. The results of multilevel analyses indicate that at least for some dimensions of Moral Foundations, a follower’s evaluation of …

The Investigation Of Collaboration Among First-Year Bachelor Of Science Nursing Students, Christie Marie Cavallo

Dissertations

Despite the benefits of collaboration, first-year nursing students prefer not to work together. It was important to find out why nursing students do not want to collaborate. The purpose of this study was to discover first-year nursing students' and faculty's perceptions of how instructor-created opportunities for collaboration contributed to first year nursing students' collaboration. Using Wenger's communities of practice (CoPs) model as a lens, the data were explored using a qualitative explanatory case study approach. This study consisted of individual interviews of 12 first-year nursing students and nursing faculty. Inclusion criteria included students enrolled in or faculty teaching first year …

A Mixed-Methods Study On The Implementation And Perceptions Of Grading For Equity Practices In A Sixth Grade Science Midwest Middle School, Lisa Meacham Stein

Dissertations

Equitable grading practices were a focal point in present-day educational discussions and gained increasing attention in recent years due to concerns regarding fairness, inclusivity, and student success. This research study examined the principles and implementation of equitable grading practices within a sixth-grade science classroom. The researcher synthesized existing literature, examined case studies, and considered the perceptions of students, teachers, and the researcher study in order to contribute to the ongoing discussion on creating more equitable grading systems.

Key areas of focus included the history and development of the education system, the purpose and significance of grades, the examination of traditional …

Development And Evaluation Of A Nurse Practitioner-Directed Mindfulness Initiative Among Patients Diagnosed With Generalized Anxiety Disorder In An Outpatient Psychiatric Practice, Keilah B. Ford

Dissertations

This quality improvement project presents the impact of mindfulness intervention, such as guided meditation on anxiety levels in adult patients in a psychiatric outpatient practice.

Identifying Delirium In Hospitalized Patients Using Nursing Delirium Screening Scale, Christina S. Arockiam

Dissertations

Delirium is a sudden brain dysfunction that can affect the mental status of hospitalized adult patients. At the project site, there was no consistent screening tool for delirium, so an evidence-based solution was sought. The purpose of this quality improvement project was to determine if the translation of Heinrich et al.'s research regarding Gaudreau et al.'s Nursing Delirium Screening Scale (Nu-DESC) would impact the identification of delirium and subsequent provider notification within 30 minutes among adult patients in an acute care hospital in urban California over eight weeks. Virginia Henderson's need theory and the Iowa Model Revised: Evidence-based practice to …

Empowering Female Voices In The Ela Classroom, Jacqueline Gurliaccio Vance

Dissertations

This study aims to understand how women’s voices can be empowered in a high school English Language Arts (ELA) class. Through the use of female authors and female protagonists in the classroom texts, this study seeks to understand if implementing female-driven texts enhances female students’ literary experiences, empowers the personal identities of female students, and shapes female students’ perspectives of themselves and their peers. This case study includes female students in twelfth grade AP Literature class.

Department Of Defense Project Management Team Leaders: Team Dynamics And Teamwork Strategies During Complex Construction Projects, Shane Frey

Dissertations

Purpose: This qualitative multi-case study explored the challenges, strategies, and recommendations that DOD project management team leaders experienced as they made complex decisions leading successful construction projects based on Parker’s (2008) model.

Methodology: A qualitative multi-case study research design described the challenges, strategies, and recommendations Department of Defense project management team leaders used as they made complex decisions leading successful construction projects.

Findings: Close examination of data collected from interviews and artifacts yielded 117 frequencies for DOD project management team leader's team characteristics, and six themes regarding the lived experiences, challenges, strategies, and recommendations. Five key findings and one unexpected …

Interdisciplinary Medication Reconciliation Approach For Arabic-Speaking Patients, Rebecca Rodman

Dissertations

Abstract

Problem: Limited English Proficiency (LEP), which includes Arabic speakers, presents challenges in healthcare and can impact medication reconciliation and adherence. Interdisciplinary collaboration involving patients and interpreters is crucial for improving medication reconciliation and adherence. This project aimed to examine the impact of an interdisciplinary medication reconciliation approach on medication adherence with Arabic-speaking patients ages 18-99 over three months.

Methods: This quality improvement (QI) pilot project utilized a descriptive cohort design. A translated validated Morisky, Green, and Levine (MGL) adherence survey consisting of four questions was administered pre- and post-implementation to a convenience sample of Arabic-speaking patients 18 years …

Implementation Of Chlorhexidine Gluconate Dressings And The Effect On Bloodstream Infections In Extracorporeal Membrane Oxygenation Patients At A Pediatric Hospital, Kaitlin Vernier

Dissertations

Extracorporeal membrane oxygenation (ECMO) is an advanced lifesaving therapy used for patients with significant cardiorespiratory failure not responding to conventional therapies. The most common and life-threatening complications associated with ECMO are blood stream infections (BSIs). In addition to increased mortality, BSI's increase patient length of stay and cost. Chlorhexidine Gluconate (CHG) is known to be a significant factor in BSI reduction. The purpose of this quality improvement project is to assess the utilization of CHG-impregnated dressings on the incidence of BSI rates in pediatric ECMO patients. The setting was a 40-bed pediatric intensive care unit (PICU) and a 30-bed cardiac …

Wiping Out Central Line Associated-Bloodstream Infections: Cleaning High Touch Surfaces In The Picu, Emily Heth

Dissertations

Problem: Central line-associated bloodstream infections (CLABSIs) are a significant, preventable healthcare-related complication of hospital admission and medical management of critically ill and medically complex patients. CLABSIs result in significant adverse outcomes such as increased morbidity and mortality, prolonged length of stay (LOS) in the intensive care unit (ICU) and in the hospital, increased cost of treatment, and increased rates of readmission. Direct and indirect contact within the patient’s hospital environment are potential means of transmission for microorganisms, increasing the inherent risk of acquiring a CLABSI.

Method: For this quality improvement (QI) project, a pre-post design was utilized to evaluate the …

Improving Hypertension For Veterans Utilizing Measure Properly, Assessment Of Pharmacology, Alternative Therapy Interest, Routine Outreach, Partner With The Veteran Protocol (Maarp): A Pilot Study, Alyssa S. Dudley

Dissertations

The purpose of this quality improvement (QI) project was to create a hypertension control protocol for the patient aligned care teams (PACT) to follow when a Veteran presents to the primary care clinic (PCC) with uncontrolled hypertension. Despite past interventions, uncontrolled hypertension was still problematic in the Department of Veteran Affairs (VA) Healthcare System. Past and present research suggested that the Veteran population was at higher risk of developing hypertension than those of the civilian population. In hopes to reduce uncontrolled hypertension in the VA's PCCs, the Measure Properly, Assessment of Pharmacology, Alternative Medication Interests, Routine Outreach, and Partner with …

Implementation Of A Standardized Nursing Handoff In A Pediatric Intensive Care Unit, Tori Keeven

Dissertations

Handoff communication is critical in healthcare and is associated with patient safety outcomes. Various tools and interventions are available to improve handoff communication as inadequate communication contributes to medical errors, patient adverse events, and increased mortality. The implementation of a standardized handoff tool has been shown to be effective. Findings revealed a significant 60% reduction in reported patient harm events, despite the study's limited sample size and lack of statistical significance (p = .614). Challenges such as low utilization (18.62%) were attributed to concerns about tool organization, spatial constraints, and staff resistance to change. Recommendations include refining the tool to …

Improving Identification Of Complicated Alcohol Withdrawal Syndrome Using The Prediction Of Alcohol Withdrawal Severity Scale, Kristin Hagopian

Dissertations

Problem: Individuals who drink alcohol excessively are at great risk for alcohol withdrawal syndrome (AWS) when hospitalized. Symptoms and their severity differ for everyone, and research shows that the identification and treatment of AWS is challenging and often inadequate. Mild AWS is often overtreated, while moderate to severe AWS is often underdiagnosed and undertreated, placing individuals at risk for longer hospital stays, more time needed in critical care units, and a variety of unintended consequences.

Methods: This evidence-based practice project had a pre-post intervention design in which the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) was implemented to promptly identify …

Implementation Of Home Blood Pressure Monitoring, Sarah Gutzke

Dissertations

Approximately 48.1% of adults in the United States have high blood pressure. Providers may encourage patients to monitor and log their blood pressure at home. Still, patients often fail to bring this information to appointments, leading to reliance on less comprehensive in-office measurements. This quality improvement project aimed to increase adherence to home blood pressure logs using a Blood Pressure Toolkit. A descriptive, observational design was utilized to record patient adherence of taking home blood pressure measurements and increase the number of patients who brought their blood pressure logs to their healthcare provider visits over two months. A convenience sample …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

Improving Mental Health Outcomes For Amputees, Zachary Elmore

Dissertations

Problem: depression, anxiety, and other mental health disorders are more commonly diagnosed in the amputee population related to changes in mobility, activities of daily living, and quality of life (Turner et al., 2020.) As the amputation population is projected to reach over 3 million Americans in the next 25 years, additional screening is imperative to identify patients at high-risk for mental health deterioration (Ziegler-Graham et al., 2018).

Methods: this was a project that included screening all patients with the Personal Health Questionnaire for Depression (PHQ-8) meeting the inclusion criteria of being admitted to 7500 Vascular Surgery at Barnes-Jewish …

Restraint Reduction Using The Brøset Violence Checklist, Deanna Kappelmann

Dissertations

Abstract

Problem: Patient aggression, restraint usage and assaults against healthcare workers have numerous negative health outcomes. Patient aggression and restraint usage on inpatient psychiatric units can be identified early with imminent violence predicative tools such as the Brøset Violence Checklist (BVC), where patient de-escalation interventions can subsequently occur.

Methods: This quality improvement project was conducted using a cohort design with a retrospective and prospective chart review. The IHI PDSA model was used for this project. The BVC was administered to male and female patients ages 18 to 64 years old on the adult inpatient psychiatric unit during the implementation period. …

Addressing Daily Compliance Of Central Line Discussions In A Pediatric Cardiac Intensive Care Unit, Caitlin Sherwood

Dissertations

Purpose: The purpose of this project was to determine the impact of targeted education on the consistency of central line discussions during daily, multidisciplinary rounds in a pediatric cardiac intensive care unit.

Method: The Kellogg Logic Model was utilized to guide this project. Education was created and presented to bedside nurses working within the unit regarding the importance of daily central line discussion and the impacts of central line associated blood stream infection on patients. The rate of central line discussion was collected pre- and post-intervention to assess effectiveness of the education.

Findings: This project failed to …

360 Degree Clinical Competence Evaluation For Pediatric Hospitalist Advance Practice Provders, Elizabeth A. Schickler

Dissertations

Problem: Advanced practice provider (APP) peer reviewed clinical competencies is an expected part of professional, organizational, and The Joint Commission (Joint Commission) requirements, however, is not well defined and subject to organizational application and interpretation. Providers favor peer review as a means to improve professional practice. There is a lack of data to support frequency of feedback and method of feedback to support readiness to change practice and comfort giving and receiving feedback.

Methods: The quality improvement project utilized an analytical experimental design.

The Cardin Hospitalist Advanced Practice Provider - Readiness Assessment (CHAPP-RA) tool was implemented to a convenience sample …

Evaluation Of A Smoking Cessation Program In Primary Care, Yolanda Duncan-Watt

Dissertations

Abstract

Problem: The adult tobacco smoking rate exceeds 12.5%. The problem is the insufficient attention given to smoking cessation education in low socioeconomic status(SES) communities. There is a lack of access to and awareness of smoking cessation programs for low-income populations.

Methods: This quality improvement (QI) study will use a descriptive, observational approach. A retrospective medical record review will be conducted to determine the rate of individuals who got the smoking cessation intervention and the rate of those who successfully quit one month after the intervention. Data was collected throughout the spring of 2024, during primary care visits and phone …