Digital Commons Network^™

Documenting The Journey Towards Becoming An Anti-Racist White Educator, Heather Mccord

Dissertations

As a White teacher in public education, I have had the great pleasure of educating students from all over the globe. My career began in a district that served predominantly White students from middle class families. The only Black students I interacted with were those bused in from the city while participating in the desegregation program. There were noticeable biases and beliefs teachers held toward those students. However, since I was early on in my career with little experience, I was unaware of damage being done to these students. Once I began working for an extremely diverse district, in a …

Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton

Dissertations

Abstract

Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.

Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …

A Correctional Study Of Nursing Instructor Use Of Best Practice With Multiple Choice Questions, Diane Droutman

Dissertations

Multiple choice questions are used as evaluations in nursing schools. Nursing instructors and nursing book publishers develop exam questions. The specific problem addressed by the study was how best practice in multiple choice test items, item analysis, and revision of choice test items used by nursing instructors. Using a survey method, this correlational design research looked at the relationship of faculty use of best practice in test item construction, analysis, and revision of multiple choice test item in nursing programs in the United States. Even though a relationship was noted, the statistical effect level was minimal. There was no correlation …

Religious Leadership: Agents Of Social Change, Jacqueline Carter

Dissertations

Historically, churches in the United States acquired respect as institutions that cultivated spiritual maturity and advocated for social equality in Black communities. Religious leaders represent the voice of reason for communities facing complex social problems, then and today. How educational attainment influences religious leaders’ social action strategies and decisions to engage or disengage in social activism is under explored. Additionally, it is unclear what strategies religious leaders use for social advocacy in their communities. Using andragogy and social cognitive theory as theoretical frameworks, the purpose of this phenomenological study was to explore the educational experiences of religious leaders to understand …

Registered Nurses' Perceptions Of Obesity, Elizabeth Pettifor

Dissertations

Obesity has become an epidemic in the United States (U.S.) population. Obesity is a risk factor for many health problems that ultimately lead to death or disability. Nurses in the U.S have a higher-than-average rate of overweight and obesity. The purpose of this exploratory, qualitative case study was to identify and recommend areas for change in the hospital environment to assist bedside nurses in the U.S to have a healthier lifestyle. Social media was used to conduct a purposeful sampling technique and recruit 10 registered nurses working full time at the bedside in the U.S who struggle with obesity. Semi …

Vocational Education: Cna Students’ Perspectives Of Soft Skills In Training And The Workplace, Kimberly S. Mcclendon-Payton

Dissertations

Purpose: The purpose of this quantitative study was to identify CNAs’ perceptions about the most important soft skills used by CNAs in training and the workplace.

Methodology: This quantitative research study identified CNAs’ perceptions of the most important soft skills they used based on the composite model for soft skills. CNAs were selected based on purposeful sampling. Likert scores were collected from the survey responses.

Findings: Examination of the quantitative data from the 35 CNAs revealed that brainstorming is the most important collaboration soft skill in CNA training and the workplace.

Conclusions: Results based on the findings of this study …

The Mother's Lived Experience Of Breastfeeding In The First 4 Weeks Postpartum: A Heideggerian Hermeneutic Phenomenological Analysis, Stacy Rosales

Dissertations

The purpose of this study was to more fully understand, in their own words, the experiences of mothers who began breastfeeding their infant after birth and may or may not have been breasting at four weeks postpartum. A single research question guided this study: What are the lived experiences of breastfeeding mothers during the first four weeks postpartum? Eight mothers who delivered in the past four to six weeks were interviewed. Data were analyzed using a Heideggerian hermeneutic phenomenological approach. This method was chosen because it allowed the researcher to conduct interviews and explore the lived experience of breastfeeding mothers …

The Effect Of Pre-Procedural Opioid Video Education On Pediatric Patients Undergoing Orthopedic Surgery, Amy Pham

Dissertations

Problem The opioid epidemic is a continuing public health threat, growing amongst the pediatric population. Contributing to the issue are their accessibility within the community, and lack of education on safe storage and disposal of opioids.

Methods For this quality improvement (QI) project, a descriptive observational study design was used to identify the opioid storage and disposal habits of patients and their caregivers at home. The participant and caregiver dyads were shown a brief opioid educational video pre-operatively and were followed up with via emailed survey two weeks post-operatively. The survey contained questions pertaining to disposal and storage habits of …

Primary Care Screening For Adverse Childhood Experiences (Aces) In The Adult Population, Carrie Plisco

Dissertations

Problem: Exposure to Adverse Childhood Experiences (ACEs) is associated with chronic diseases in adulthood. Several studies found over 60% of adults have had exposure to one or more ACEs. While guidelines for ACEs screening exist, most primary care practices do not perform screening at this time. This results in a lack of referrals for adults with history of ACEs for proper behavioral health (BH) intervention.

Methods: This quality improvement (QI) initiative utilized a descriptive observational design. The Centers for Disease Control and Prevention (CDC) ACEs screening tool was administered to a convenience sample of adult patients aged 18 years and …

Post-Cesarean Section Pain Management Using Pre-Built Computerized Order Entry Sets, Ashleigh Hunkins

Dissertations

Abstract

Problem

Electronic medical records (EMR) have helped decrease common medication errors. However, prescribing errors are still elevated. Creating pre-built order sets can decrease medication errors for post-cesarean section women.

Methods

This project used an evidence-based practice approach to create new order sets. Women undergoing a cesarean section between January 15, 2021 and April 14, 2021 received the new order sets. A retrospective data review was conducted pre and post-implementation between the dates of October 15, 2021 and April 14, 2021 to view medication errors.

Results

Before implementation of the order sets, there were 239 cesarean deliveries and eight errors …

Pre-Anesthesia Assessment In Children With Down Syndrome: A Head To Toe Guide, Laurel Kinsey

Dissertations

The purpose of this project was to provide and assess an educational intervention for a multidisciplinary interprofessional collaborative sedation team at a children's hospital in Anchorage, Alaska.

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …

Effect Of Purposeful Nurse Rounding On Patient Satisfaction, Jayne Mangi

Dissertations

Problem Delayed nurse response times in an inpatient setting can have a negative impact on patient experience, and is reflected in patient satisfaction surveys such as The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The purpose of this project is to improve HCAHPS scores related to “responsiveness” in an antepartum unit.

Methods A prospective observational study designed to improve HCAHPS scores regarding nurse response time conducted as a retrospective and prospective review of data. Results of HCAHPS scores related to “responsiveness”, and actual nurse response times were examined before and after a nurse education tool was implemented. …

Standardizing Genomic Testing Of Pancreatic Cancer In A Community Oncology Practice, Julie Marie Scott

Dissertations

Problem. Ordering genomic testing for patients with pancreatic cancer can discover germline or somatic mutations that may allow for targeted therapy. There are some difficulties in obtaining genomic tests, such as which test to order, and optimal timing of ordering. In addition, interpreting results and maintaining easy access to the report in the electronic medical record can be difficult. Delays in ordering genomic testing can delay the discovery of an actionable mutation for treatment.

Methods. A descriptive comparison project was developed comparing rates and timing of ordering of genomic testing for patients with pancreatic cancer who established care with a …

Impact Of Aging Information On The Continuing Education Preferences Of Behavioral Health Clinicians, Nicholas Schmidt

Dissertations

The United States population is aging rapidly and the behavioral health workforce is ill-prepared to meet the concurrent rise in demand for services for older adults. Clinicians specializing in working with older adults make up a very small portion of providers and the majority of service provision falls on general practitioners. The discipline of counseling has emphasized multicultural competencies in training and practice but has not specified standards of competence for work with older adults; little is known about the interests and training preferences of Licensed Professional Counselors (LPCs). This study examined the impact of receiving foundational information about aging …

Proactive Text Messaging For Public Health Surveillance During The Covid-19 Pandemic, Daria Kester

Dissertations

Problem

The Department of Public Health (DPH) of a suburban Midwestern county considers surveillance and control of COVID-19 to be sub-optimal, resulting in part from difficulties with completing case and contact interviews.

Methods

To increase the success rate of case investigation, proactive messaging using short message media (SMS) alerts is used in a quality improvement initiative based on the PDSA framework. Participants are sent text message alerts prior to receiving a call from a DPH case investigator. Results are recorded in a statewide database.

Results

Individuals who received text messages prior to receiving a case investigation interview phone call were …

Attitudes Toward Sars-Cov-2 In Frontline Healthcare Workers And First Responders, Michelle Tiffany Arrington

Dissertations

Problem: To date, little evidence exists to understand attitudes of SARS-CoV-2 in frontline healthcare workers (HCW) and first responders (FR), related to best practices in mitigating virus spread. The purpose of this project was to assess attitudes toward COVID-19 in young adults, ages 18-44 years old, who are frontline workers related to their adherence to PPE guidelines, social distancing, hand hygiene, community exposures, and vaccinations.

Methods: A descriptive survey design using five-point Likert scale questions and 26 open-ended questions and was implemented one-year after onset of the pandemic. A purposive sample working in a large, urban, Midwest metropolitan area was …

Educating College Students About Human Papillomavirus, Pamela Bryant

Dissertations

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in the US affecting almost 60% of college women ages 20 to 24 years. At one west coast community college, two thirds of males and half of females were unaware of HPV vaccine recommendation through age 26 years.

This aim of this project is to determine if an evidence-based online educational video about HPV and HPV vaccine would increase knowledge of HPV and intent to receive the vaccine among community college students enrolled in urban and suburban community colleges in Southern California. Measured outcomes of interest included HPV knowledge …

Factors That Affect Adequate Analgesia In African Americans With Cancer Pain, Navdeep Singh

Dissertations

Receiving adequate analgesia has been shown to be problematic for African Americans with cancer pain. The vast majority of studies only simply highlights the existing disparities between African Americans and Caucasians in pain management. There is a lack of research focusing on the etiology of these disparities, specifically on what causes prescriptions for inadequate analgesics, especially for African Americans. The purpose of this study was to characterize the adequacy of analgesia received by African Americans with cancer pain and to elucidate what patient characteristics contributed to receiving adequate analgesia.

What You Speak Shall Come: Examining Spirituality On Retention Of African American Males Attending A Predominantly White Institution Using A Sequential Explanatory Mixed-Methods Design, Carlous Brian Yates

Dissertations

African American males have faced significant challenges at institutions of higher education over the years (Harper, 2013; Griffith et al., 2019). This study aimed to examine the impact of spirituality on the retention of African American males attending a Predominantly White Institution (PWI) through a sequential explanatory mixed-methods design study.

The participants in the study were African American males (N = 47) with age range 18 to 48 years old all attending a mid-sized university located in the mid-western region of the United States during the Fall 2020 and Spring 2021 semesters. The university is considered a Predominantly White Institution …

Nurse Residency Program Use In Alabama Hospitals: Exploring The Decision-Making Strategies Of Hospital Administrators, Miranda M. Smith

Dissertations

Current literature supports the creation and implementation of nurse residency programs to support new graduate nurses as they transition into nursing practice. Additionally, nurse residency programs have been shown to increase nurse satisfaction and retention (Crimlisk et al., 2017; Olson-Sitki et al., 2012). Currently, there are only three nurse residency programs in the state of Alabama. The lack of this important post-licensure resource poses a problem for new graduate nurses who are seeking additional assistance and guidance during the transition to professional practice.

This qualitative study examined the decision-making process of hospital leaders in the implementation of the nurse residency …

The Effect Of Pedagogical Agent Persona On Performance, Self-Efficacy, And Attitudes In Adult Learners In An Online Environment, Justin L. Mathews

Dissertations

Pedagogical agents, virtual avatars that are often included in online training or educational modules, have been studied in a variety of disciplines to determine the extent to which their inclusion in online or multimedia learning environments may influence both cognitive and affective outcomes in learners. The present study examined the effect of a peer-like pedagogical agent providing motivational messaging in an online English language learning environment to determine if the agent will positively affect college students’ performance, self-efficacy, and attitude in comparison to a control group. All participants studied an online, self-paced English grammar module, either with (treatment version) or …

Examining The Psychological Effects Of Adolescent Bullying In Adults, Douglas Caro

Dissertations

Being an adolescent victimized by bullying is not only widespread but all too common in a society that deems it a “normal” rite of passage. However, bullying in schools has received increased attention since school shootings have inundated the media and news headlines the last several years. Some have correlated bullying to the shooters being bullied themselves. Being a victim of bullying has been linked to serious medical and mental health problems, not just in adolescents but across the lifespan. It is common for victims to experience physical problems such as abdominal pain and other gastrointestinal concerns. Mental health problems …

The Impact Of Consumer Smart Device Platforms On Illness Uncertainty And Anxiety In Patients With Atrial Fibrillation, Wing Yan Vien Cheung

Dissertations

Atrial fibrillation (AFib) is a common cardiac arrhythmia associated with increased risk for comorbid health conditions. Advancements in consumer technology have enabled patients to monitor hearth rhythm independently, yet, much remains unknown about patient outcomes related to the use of these smart device platforms (SDP). The aim of this study was to examine the iatrogenic and/or remedial effects of SDP use on patient reported outcomes of illness uncertainty, cardiac anxiety, body vigilance, AFib symptoms, symptom burden, and healthcare utilization. The sample included 130 AFib participants (65 in SDP group) recruited through ResearchMatch, American Heart Association support forum, and other online …

Talk To Me - A Re-Standardization Of Bedside Report, Lisa Randall

Dissertations

The use of bedside shift report provides for an accurate exchange of information between healthcare providers. Bedside shift report has been shown to decrease call light usage, medication errors, patient falls, as well as increase patient and nurse satisfaction. The aim of this project was to re-implement the usage of bedside shift report on two units in a community hospital. The steps involved in this project were a preliminary survey followed by observations of the current process of bedside report. The next step was to educate regarding the importance of bedside report and its benefits. This was followed by another …

Reducing Hospital-Acquired Pressure Injuries Through The Implementation Of The Leaf Patient Monitoring System, Meghan Kelley

Dissertations

A top priority for all hospitals is patient safety. A major component of patient safety classified under this category is prevention of hospital-acquired pressure injuries (HAPIs), which are considered "never-events" by the Joint Commission and align with the World Health Organization as preventable harm. Due to current policies on a particular unit not proving to be effective at reducing HAPIs, the implementation of the FDA-cleared Leaf Patient Monitoring System was proposed. This technology uses a sensor adhered directly to the patient to reduce the trending HAPI rates on the a progressive care unit while assisting nursing in adhering to the …

Diabetic Education To Reduce Readmission Of Patients With Diabetes, Nicoleta F. Buiciuc

Dissertations

Hospital readmissions by patients with diabetes rise due to known risk factors such as lack of a healthy diet, physical activity, aging and obesity (Sonmez, Kambo, Avtanski, Lutsky, & Poretsky, 2017). Diabetes education and management is key to improving self-care behaviors and reducing hospital readmissions within 30 days (Drinic et al. 2017 & Sullivan & Alexander, 2019). Diabetes self-management involves education on healthy diet, exercise, self-monitoring of blood glucose, avoidance of risk factors and complications (Chai et al., 2018). Hospitalization provides an ideal time to identify barriers to improving a diabetes home regimen and promote DSME (Inpatient Diabetes Management, 2016). …

Depression Screening And Management In A Free Primary Care Clinic, Ashley Gagne

Dissertations

Introduction. Depression diagnoses in the United States continue to rise within the primary care setting. At a free primary care clinic in the Southeastern United States, the PHQ-9 screening tool was being used to screen patients for depression, but providers were not regularly addressing positive screenings. Aims. This quality improvement project aimed to evaluate health care staffs' awareness, attitudes and confidence towards depression screening and management and implement best practices in primary care identification and follow up for depression.

Methods. Health care staff at a primary care clinic responded to Revised Depression Attitudes Questionnaire (RDAQ) pre-and post-surveys to measure their …

Analysis Of The Primary Volatile Compositions In The Oort Cloud And Jupiter-Family Comets Towards The Goal Of Understanding Their Origin And Diversity, Mohammad Saki

Dissertations

Knowledge of the initial conditions present in the early solar nebula is required to understand the evolution and its current volatile content. Comets were some of the first objects to accrete in the solar nebula. They are among the most pristine (primitive) remnants of the solar system formation, and their present-day volatile composition likely reflects the composition and conditions where (and when) they formed. Therefore, they are fossils of the solar system formation. High-resolution near-infrared spectroscopy is a valuable tool for sampling the parent volatile (i.e., ices subliming directly from the nucleus) composition of comets via analysis of fluorescence emission …

Novel Low Temperature Properties Of Filled And Unfilled Single Crystal Irsb3, Matthew Cook

Dissertations

The skutterudite family of materials has garnered a lot of attention in the condensed matter community and it persists to be an important system for exploring the fundamental physics of solids. The initial interest into compounds with this common structure was due to their promising thermoelectric properties giving the possibility of efficient energy harvesting. Since, there has been a huge effort to systematically synthesize new filled skutterudite compounds, as nearly every type of strongly correlated behavior has been found within this family. As the field of topological materials has gained momentum, these materials have also been given a renewed interest …