Prediabetic Screening Tool In Primary Care, Ashley Koon

Dissertations

Prediabetic Screening Tool in Primary Care

Problem: Diabetes mellitus is a chronic health condition that affects millions of individuals each year. In addition, it is known as the seventh leading cause of death. While guidelines recommend using evidence-based screening tools, many primary care practices do not implement them. Therefore, potentially resulting in delayed identification and implementation of primary and secondary prevention strategies.

Methods: This quality improvement (QI) pilot project utilized a descriptive, observational study design. The American Diabetes Association Risk Tool (ADART) was administered to a convenience sample of patients aged 18 to 44 years old without a previous diagnosis …

Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project, Lauren E. Woll

Dissertations

Abstract

Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased …

Implementation Of An Educational Teach-Back Program For Patients With Hypertension, Lakesha Hill

Dissertations

Implementation of an Educational Teach-back Program for Patients with Hypertension

Abstract

Problem: To improve health literacy and provide adequate health care to patients and their family, clear and effective dialogue is essential. The teach-back method is a technique utilized to confirm a patient’s level of understanding of care instructions done by relaying patient directions, and then confirming the patient understands by asking the patient to reiterate those directions. The purpose of this quality improvement project was to assess the effectiveness of using the teach-back method by health care professionals with their patients who have a diagnosis of hypertension or high …

Implementation Of A Situation, Background, Assessment, Recommendation (Sbar) Patient Handoff Tool In The Electronic Medical Record (Emr), Kristen L. Chandler

Dissertations

Abstract

Purpose and Problem: Handoffs that are poorly conducted are implicated in 80% of preventable adverse events in healthcare facilities. Within a Pediatric Rehabilitation Facility in Maryland Heights, Missouri it was observed that nurse handoffs were not conducted and lacked the use of a standardized evidence-based tool, resulting in nurse dissatisfaction with the handoff process and miscommunication. Recognized by the World Health Organization, The Joint Commission, and Agency for Healthcare Research and Quality, the Situation, Background, Assessment, Recommendation (SBAR) evidence-based tool is effective in improving handoff communication, improving nurse satisfaction, reducing adverse events, and promoting patient safety. The purpose of …

Improving Postpartum Depression Screening Practices In The Postpartum Setting, Courtney Lynn Cole

Dissertations

Abstract

Problem: Postpartum Depression (PPD) is frequently undetected in women due to barriers that limit effective recognition and diagnosis. Depression screenings and treatment referrals improve outcomes in the immediate postpartum period. Follow-up methods for positive depression screens are often missed by postpartum care teams.

Methods: A descriptive, observational design was used for this quality improvement project. A formalized depression screening protocol was created to help guide nursing staff on a Postpartum Unit when detecting a positive depression screen. Convenience sampling was utilized and the sample included patients aged 18-45. Data collected throughout this quality improvement project included Edinburgh Postnatal Depression …

Implementation Of A Structured Discharge Checklist For Children Admitted To The Hospital With Acute Asthma, Nicholas Fleming

Dissertations

Abstract

Problem: The transition process from a hospital setting to home is critical for pediatric patients and their families. However, there is no standardized process to ensure asthma discharge orders and asthma action plans are printed at the time of discharge

Methods: This observational quality improvement project utilized a pre-and-postimplementation of the Kamishibai Card (K-Card) process for pediatric discharge checklist compliance in an inpatient pediatric general medicine unit. This project used a sample of all children aged 2 years to 21 years with an asthma diagnosis admitted to the inpatient general medicine pediatric unit. This project included an …

Impact Of A Standardized Handoff Tool Between Gastroenterology And Pacu Nurses’ Communication And Satisfaction, Matthew Kahmann

Dissertations

Impact of a Standardized Handoff Tool between Gastroenterology and PACU Nurses’ Communication and Satisfaction

Abstract

Problem: Patient handoff between nurses is a critical moment where it is imperative that complete and accurate information is exchanged. Handoff of patient information can be complex, and the use of unstructured, non-standardized handoffs could result in poor communication leading to the omission of pertinent information and a decrease in patient safety and staff satisfaction. Several studies have found the use of standardized handoff tools improve communication, decrease omission of critical information, and improve staff satisfaction. While the use of standardized handoff tools is best …

Attention-Deficit Hyperactivity Disorder: Improving Outcomes Through Early Identification, Tina Lusk

Dissertations

Problem: Failure to identify and treat attention-deficit hyperactivity disorder (ADHD) is associated with academic underachievement, social difficulties, negative physical and mental health effects. Evidence suggests approximately 3% of a broad-based population sample and roughly 13% of an at-risk population are undiagnosed despite significant symptomology (Downey & Zun, 2018; Madsen et al., 2018; Okumura et al., 2019). The United States (U.S.) has no structured screening system for ADHD. Consequently, children receive no referral for diagnosis or treatment to mitigate its effects.

Methods: The Institute for Healthcare Improvement (IHI) Model for Evidence-Based Practice using the Plan Do Study Act (PDSA) cycle guided …

Evaluation Of A Substance Abuse Screening Tool In The Pediatric Emergency Room, Jody Sims

Dissertations

Abstract

Background: Substance abuse among adolescents is one of the most serious social health problems in the United States. The prevalence of alcohol use in adolescents is as high as 80%, while opioid overdose deaths among adolescents have risen by greater than 50% in the last 10 years. Alcohol, tobacco, and other substance use has also increased among youth and is not being properly evaluated in the pediatric hospital setting. The purpose of this project was to evaluate the use of a substance abuse screening tool with SBIRT trained staff in the pediatric emergency room setting.

Methods: The CRAFFT substance …

Improving Pediatric Asthma Outcomes Through Pictorial Asthma Action Plans, Julia Donovan

Dissertations

Problem: Asthma is the leading chronic disease of children and the leading cause of childhood emergency department (ED) visits, hospitalizations, and missed school days. Asthma action plans (AAPs), including photographs or pictures of asthma medications, symptoms, triggers, and devices, have improved parents’ understanding of their child’s asthma and have increased their comfort level in caring for their child.

Methods: An interventional pre-post study with a mixed-method research design, at a large, urban, primary care pediatric clinic with two locations, evaluated the effectiveness of a pictorial AAP on a child’s asthma control. A pictorial AAP was provided, and a childhood asthma …

(Post)Modern Asymmetry: Calibrating The Adult Education Philosophy And Practices Of Faculty Teaching Interdisciplinary Studies In The Community College, Jeremy Dennis

Dissertations

In adult education, the term interdisciplinarity is often treated as an agent for transforming teaching, learning, and research. This appreciation of the concept proliferates despite the fact that its actualization often supports competing interpretations and practices. Many adult educators are unaware of the distinctions made among instrumental, conceptual, and critical interdisciplinarity and the philosophical traditions employed to legitimate their different trajectories. To address these concerns and others, scholars such as Lattuca (2001) have advanced a postmodern conceptualization of interdisciplinarity and introduced a supporting theoretical framework to clarify its character and modes of operation. However, she omitted community college faculty from …

Determinants Of Spiritual Well-Being In Adults Newly Diagnosed With Heart Failure: Primary Palliative Care Applied, Valerie Joy Smith

Dissertations

Guided by Roy's Adaptation Model (Roy, 2009) and using a descriptive, correlational, comparative design, sociodemographic characteristics (age, gender, race, marital status, income), coping, primary palliative care (PPC, spiritual needs, social support, decision-making [DM] engagement, psychological support, PPC information and education provision, goals of care discussion, and care coordination across settings and times), spiritual well-being (SWB), and advance directive (AD) completion in response to living with a HF diagnosis within the previous 12 months were described and the potential relationships and differences between the variables explored.

Spirituality, Religiosity, And Perceived Ability To Provide Spiritual Care In Nursing Students, Shannon O'Connell-Persaud

Dissertations

The objective of this study was to explore nursing students' spirituality, religiosity, and perceived ability to provide spiritual care.

The Impact Of Collaboration, Problem Solving, And Creativity On Computer Programming Education For Middle School Girls, Amanda Meek

Dissertations

Despite high scores and abilities, girls lose interest in science and math throughout middle school. According to the Bureau of Labor Statistics, jobs in the computer science research field will grow 19% by 2026; however, only 18% of the bachelor’s degrees in computer science are earned by women in the United States (ComputerScience.org, 2021). New technology and inventions are being created without the benefit of more diverse perspectives and input from females. There is a need to engage girls and maintain their interest throughout middle school and beyond. Additional research needs to be conducted about the impact and best practices …

Exploring The Lived Experience And Meaning Of Resilience For Nurses: A Descriptive Phenomenological Inquiry, London Draper Lowe

Dissertations

Using descriptive phenomenological investigation, this study shed light on the phenomenon of resilience for nurses in high acuity clinical settings. The purpose of this study was to explore, understand, and describe experiences of resilience by nurses in the clinical setting who demonstrate characteristics of resilience and investigate the meaning these experiences held for them. Another purpose for this study was to increase the knowledge base that nurses and nurse educators have regarding resilience including what factors contribute to the emergence and maintenance of resilience.

The Impact Of Offense Type, Race, And Disclosure On Perceptions Of Employability: Can Bias Towards Hiring A Person With A Criminal History Be Mitigated?, Rheanna Lee Standridge

Dissertations

Individuals with a prior criminal history experience many barriers in the reintegration process, including their ability to gain stable employment. Finding employment for this population is especially important in reducing potential of recidivism. However, research has demonstrated that returning residents experience negative attitudes from employers which are exacerbated by pre-existing stereotypes. Because returning residents are often stereotyped, research suggests that the fear of finding employment is confounded by how they disclose their criminal history to hiring managers. Further, previous research suggests that hiring decisions are impacted by not only offender status, but also by their offense type and race. Although …

Effectiveness Of Simulation-Based Case Studies In Undergraduate Nursing Students, Kesha T. Becnel

Dissertations

An ever-changing healthcare landscape requires today's nurses to have a solid foundation in knowledge and clinical judgment to provide safe care to patients. Nurse educators must implement teaching strategies that help develop the knowledge and clinical judgment that nursing students will need upon graduation and entry into healthcare. Simulation-based experiences have been shown to help develop clinical judgment when used as part of a clinical practicum. However, few studies have examined the effectiveness of simulation-based experiences as a classroom teaching strategy.

Development And Psychometric Performance Of The Family Willingness For Caregiving Scale (Fwcs), Cindy A. Wilk

Dissertations

Family members and close friends of ICU patients receiving mechanical ventilation often sit helpless at the bedside. Participation in care of their loved one may improve adaptation to the stressful situation and better prepare them for caregiving after discharge. The primary aim of this study was to develop and test the psychometric properties of the Family Willingness for Caregiving Scale (FWCS). The impetus for scale development was the lack of a valid instrument to measure caregiver willingness of family members for the ICU patient. The Facilitated Sensemaking Model (FSM) and adapted Psychosocial Assessment Model (PAM) provided the theoretical foundation for …

Debriefing For Meaningful Learning: Fostering Development Of Clinical Reasoning Through Simulation, Kristina Thomas Dreifuerst

Dissertations

There is a critical need for faculty, a shortage of clinical sites, and an emphasis on quality and safety initiatives that drive increasing use of simulation in nursing education. Debriefing is an essential component of simulation, yet faculty are not consistently prepared to facilitate it such that meaningful learning, demonstrated through clinical reasoning, occurs from the experience. The purpose of this exploratory, quasi-experimental, pre-test-post-test study was to discover the effect of the use of a simulation teaching strategy, Debriefing for Meaningful Learning (DML), on the development of clinical reasoning in nursing students.

Family Dining: Food And Drink In The Sopranos – A Gastrocritical Approach, Lisa Davies

Dissertations

This thesis uses gastrocriticism to explore food and drink in the 86 episodes of the long-form narrative HBO television series The Sopranos. Gastrocriticism is an emerging branch of literary criticism that draws on scholarship from a range of disciplines such as sociology, anthropology and cultural studies. A deeper understanding of the series was gained by using a structured framework of enquiry to explore narrative, setting, characterisation and genre through the lens of food and foodways. The Sopranos is a story of an Italian-American crime family and food is abundant in the series and bound up with the identity of …

Student Engagement And The Impact Of Successful Completion In A Virtual Alternative Program, Nicole Almiria Davis

Dissertations

The focus of this study was to examine the correlation between student engagement and successful completion of online alternative courses during the summer session from June 2022 through July 2022. The research questions focused on the difference in engagement levels between students who completed the course and those who did not complete the course. The study was motivated by the growing importance of alternative online programming in education. This study also aimed to fill gaps in existing research that failed to directly connect student engagement to the success of online programs. The findings provide valuable insights for school leaders, teachers, …

Moving Forward With Music To Promote Student Growth: A Mixed Methods Study With 9th-Grade Algebra 1 Students, Willie Mae Dean

Dissertations

The purpose of this mixed methods study was to investigate what effect music had on student achievement and student behavior during independent practice time for 9th-grade Algebra 1 students. Benchmark assessments from the participating district, a focus group of six students, and four in-person teacher interviews provided the data for this study. The beginning-of-year Galileo Algebra 1 benchmark assessment was used as a baseline for the study. Algebra 1 teachers were asked to participate in one of three ways, to play teacher-selected music, to allow students to listen to their own music, or allow no music to be played during …

Trust, Levels Of Functioning, And The Plc Process In A Midwest Middle School: A Case Study, Nancy Fuchs

Dissertations

This dissertation investigated the connections between professional learning communities (PLCs), trust, and targeted interventions to promote increased functioning within adult groups. In contemporary education environments, collaborative efforts and shared decision-making became integral to achieving organizational goals. However, adult groups faced challenges such as communication breakdowns, conflicts, and lack of cohesion, impeding collective efficacy.

The study critically analyzed the theoretical foundations of PLCs and the potential to foster professional growth and collaboration. PLCs were characterized by ongoing learning, reflective dialogue, and a shared commitment to improvement. By providing a structured framework, PLCs offered opportunities for individuals to engage in meaningful interactions, …

Psychological Needs Satisfaction In Teaching: A Mixed Methods Analysis On The Impact Of Evaluation Systems On Teacher Intrinsic Motivational Outcomes Using Self-Determination Theory, Matt Gaglio

Dissertations

The purpose of this study is to examine the relationships between psychological need satisfaction, motivational regulators, and intrinsic motivational outcomes regarding teacher evaluation systems related to the self-determination theory. The study consisted of 144 participants from two school districts and 18 school buildings. Confirmatory factor analysis and structural equation modeling showed that psychological need satisfaction positively predicted autonomous motivation and in turn, positively predicted enjoyment and pressure, while also negatively predicting value. Psychological need satisfaction also negatively predicted controlled motivation with autonomy and competence, but positively predicted relatedness. Controlled motivation positively predicted enjoyment, but negatively predicted pressure and value. Twenty …

Hippocampal Volume And The Detection Of Mild Cognitive Impairment In An Older Adult Population: Assessing Performance On Cognitive Screeners Administered In-Person And Electronically, Kristen Fabrizi

Dissertations

The present study investigated how performance on in-person and electronic neuropsychological assessment measures predicted subcortical hippocampal volume and cognitive decline consistent with mild cognitive impairment. It was hypothesized that the Montreal Cognitive Assessment would display better predictive strength than the Cogstate Brief Battery when evaluating subcortical hippocampal volume measured via structural magnetic resonance imaging. It was further hypothesized that the Montreal Cognitive Assessment would be more sensitive to predicting group membership to the diagnostic classification of mild cognitive impairment compared to the Cogstate Brief Battery. The sample included 445 older adult participants selected from the Alzheimer’s Disease Neuroimaging Initiative 3. …

Foster Parent Knowledge And The Need For Information - Sharing Technology, Amy Lynne Averbuch

Dissertations

In 2023, the United States child welfare system suffers from disorganization, role ambiguity, and deficient transparency. With 12 contempt of court strikes for the system’s Director in 2022, it is clear why child welfare actors are unable to successfully perform. Foster parents, a key stakeholder in the proper care of children, report being unable to successfully perform because they are raising children with significant needs and trauma while having to locate and navigate child welfare system laws, policies, and procedures on their own. The purpose of this research project was to 1 ) identify whether foster parents know who is …

Does Convenience Come With A Price? The Impact Of Remote Testimony On Expert Credibility And Decision-Making, Ashley Jones

Dissertations

Legal cases involving expert testimony, especially by forensic mental health professionals, is increasingly relying on remote testimony to reduce associated costs and increase availability of such services. There is some evidence to show that expert testimony delivered via videoconference (VC) is comparable to expert testimony delivered in person; however, the most compelling evidence for this claim is unpublished. Other evidence across disciplines showed relative comparability between VC and in-person modalities across various types of outcomes. Based on both unpublished and published findings, this study tested the hypothesis that minimal differences in measures of expert credibility, efficacy, and weight assigned to …

Social Spaces, Places, And Substance Use In Shaping Queer Identities, Alessandra Milagros Early

Dissertations

Research has suggested that queer people may be more likely than their cisgender heterosexual counterparts to use substances. Largely, these higher rates are commonly explained through frameworks of victimization or (ab)use that render substance use as a form of coping or inherently problematic. While some queer people do use substances to cope, the social spaces, places, and contexts in which use often occurs are often obscured or ignored. More recently, contemporary queer criminologists have explored queer substance use and have considered how it is intimately linked to social space, place, identity formation, and community building. This dissertation draws from queer …

Baccalaureate Nursing Students' Experiences With Online Case-Based Learning (Cbl) During The Covid-19 Pandemic, Jessica Verplaetse

Dissertations

In spring 2020, in-person learning for nursing students was canceled in response to the Covid-19 pandemic. All courses, including clinical courses, abruptly transitioned to online formats. A significant gap in the literature exists regarding baccalaureate (BSN) nursing students' experiences with online learning during this timeframe. The purpose of this basic qualitative study was to explore BSN students' experiences with online learning during the spring 2020 semester.

Online Education: Benefits And Challenges For Refugee Students, Roza Badritdinova

Dissertations

ABSTRACT

Currently, only 3% of refugees are pursuing higher education opportunities compared to the 37% higher education participation rate globally. There is an urgent need for quality academic work to leave behind the endless descriptive accounts of refugee life and move toward identifying effective strategies and successful solutions that could facilitate the integration of refugees into higher education. Technology has proffered some hope in providing access to public education for marginalized populations. This study looked specifically at how one online education organization attempts to address refugee education and multiple barriers that prevent the majority of the world’s university-age refugee youth …