Technology In Nursing Classrooms: A Qualitative Phenomenological Interpretative Study, Ose G. Martinez

Dissertations

Nursing students have to learn how to critically think and pass a licensure examination to practice their profession. Current students seem to be bored by lecture strategies most commonly applied by seasoned nurse educators. A gap in the literature regarding lived experiences of seasoned nursing faculty members applying technological applications when teaching nursing topics. The purpose of this phenomenological interpretative study was to understand the lived experiences of seasoned nursing educators using technology in nursing classrooms. Seventeen seasoned nurse educators participated in semistructured interviews. The interviews were transcribed and analyzed with the NVIVO 11™ software. During the interpretative analysis, eight …

Advance Care Planning In Advanced Heart Failure: A Relational Exploration Of Autonomy, Tieghan Killackey

Dissertations

Advance care planning (ACP) is the process of understanding and sharing personal values and goals to ensure people with serious illnesses receive healthcare and treatment that is consistent with their goals and preferences. With the increasing number of treatment options available to patients living with advanced heart failure (HF), ACP is regarded as a means of preserving individual autonomy throughout the illness trajectory. Despite significant public awareness campaigns, research and interventions developed to increase participation in ACP, this practice remains severely under-utilized by those who are chronically ill. This gap in practice highlights the need for further exploration of how …

The Relationship Between Transformational Leadership And Attachment Theory Among Field Grade Officers In The U.S. Army, Rebecca Ochs

Dissertations

Purpose: The purpose of this quantitative correlational study was to determine what relationship exists between U.S. Army field grade officers’ self-reported scores on the five domains of the Leadership Practices Inventory (LPI) (Kouzes & Posner, 2002) and their self-reported scores on the Experiences in Close Relationships Scale (ECR) (Brennan et al., 1998). Methodology: This study used a correlational approach to collect quantitative data from U.S. Army field grade officers. Using the LPI, a self-report transformational leadership measurement tool developed by Kouzes and Posner (2002), that measures five domains that include: (a) model the way, (b) inspire a shared vision, (c) …

The Perception Of Army Counselors On The Impact Of Emotional Intelligence Training On Army Non-Commissioned Officer Leadership Decision-Making Effectiveness, Geraldine Turituri

Dissertations

Purpose: The purpose of this qualitative phenomenological study was to describe the perception of Army counselors in the Military Family and Life Counselor (MFLC) program about the impact of emotional intelligence (EI) training on Army non-commissioned officer (NCO) leadership decision-making effectiveness in their supervision of the soldiers they are responsible for. This study also researched the perception of these counselors about the benefits and challenges of incorporating EI leadership preparation with traditional Army training for NCOs.

Methodology: This qualitative phenomenological study explored Army counselors’ perceptions about the need for EI training for Army NCOs to perform as effective decision-makers. Since …

Topological Data Analysis Of Convolutional Neural Networks Using Depthwise Separable Convolutions, Eliot Courtois

Dissertations

In this dissertation, we present our contribution to a growing body of work combining the fields of Topological Data Analysis (TDA) and machine learning. The object of our analysis is the Convolutional Neural Network, or CNN, a predictive model with a large number of parameters organized using a grid-like geometry. This geometry is engineered to resemble patches of pixels in an image, and thus CNNs are a conventional choice for an image-classifying model.

CNNs belong to a larger class of neural network models, which, starting at a random initialization state, undergo a gradual fitting (or training) process, often a …

High Resolution Intracavity Laser Absorption Spectroscopy Of Transition Metal-Containing Diatomic Molecules, Kristin Bales

Dissertations

Three transition metal-containing diatomic molecules have been studied using intracavity laser spectroscopy. Many of the transitions were recorded using a Fourier-transform spectrometer for detection, allowing collection at Doppler-limited resolution for the gas phase molecules. Several vibrational bands in two electronic transition systems of tantalum fluoride (TaF) have been analyzed, and new molecular constants provided. Transitions involving six electronic states of tungsten sulfide (WS) have been analyzed, with new and updated constants provided, including a deperturbation analysis of three vibrational bands in two of the states. Finally, a fresh perspective on two electronic states of tungsten oxide (WO) included a deperturbation …

The Crisis Of Missouri’S Polity: How Privileged Interest Groups Influenced The Development Of Missouri’S 2014 Tax Reform Law, William Warren

Dissertations

Increasing wealth inequality has created a public discourse concerning its societal impact and the government’s role in its regulation. Should the government regulate and redistribute wealth through taxes and government programs, or should the market regulate it? To this end, one concern that has not been discussed is to what extent wealthy individuals have manipulated our government institutions to ensure their preference of market regulation of wealth distribution. Scholarly research has been conducted at the national level to determine the networks who are altering our political institutions to enable wealthy, minority interests’ access to our legislative process. Due to our …

Nicu Culture Of Care For Infants With Neonatal Abstinence Syndrome: A Focused Ethnography, Monica M. Nelson

Dissertations

The purpose of this ethnographic study was to describe the culture of care and nonpharmacological nursing interventions performed by NICU nurses for infants with NAS.

Evaluation Of The Efficacy Of A Telehealth Support Forum For Reducing Distress In Informal Caregivers Of Patients With Glioblastoma, Stacey D. Green

Dissertations

Glioblastoma is incurable, deadly, and disabling. Informal caregivers of glioblastoma patients face an unpredictable, laborious, costly, and distressing experience. Supported caregivers have less distress and improved caregiver mastery. Often times, caregivers are unable to attend support groups, increasing risk of adverse events for caregiver and patient. This increased risk highlights a need for increased access to support. The purpose of this project was to determine if distressed caregivers of glioblastoma patients at an academic medical center would report reduced distress after participating in telehealth support forums over a period of four weeks. The health belief model was used to implement …

Daily Sbar Sheet For Pediatric Patients With Central Lines, Jordan M. Enzwiler

Dissertations

Problem: The patient’s daily central line Theraworx baths were not being documented and completed at a mid-Missouri teaching hospital. After completing a retrospective chart review for 2022, 8.35% (n=90) of daily central line Theraworx baths were documented. Daily central line baths decrease central line-associated bloodstream infections (CLABSI), prolonged hospital stays, and costs.

Methods: The quality improvement (QI) project utilized a pilot retrospective and prospective pre-post-design. A retrospective chart review on daily central line Theraworx baths was conducted on patients two years and older within the pediatric service line who had a central line. A situation, background, assessment, and recommendation (SBAR) …

Vaccine Hesitancy, Provider Time, And Decision To Vaccinate, Kenneth Shackelford

Dissertations

Problem: To date, there is a significant gap in the literature involving studies evaluating the time healthcare providers spend educating vaccine-hesitant caregivers about the necessity for their child’s immunizations. Due to alarming resurgence rates of vaccine-preventable diseases in children, this project aimed to answer the following question: In vaccine-hesitant caregivers of newborns through six months of age, what is the effect of provider discussion time on vaccine administration (item) at well-child visits during the child’s first six months of life?

Methods: Using a descriptive observation design, pre-collected data on provider discussion time and vaccine administration was evaluated retrospectively from …

Implementation Of A Vestibular Disorder Screening Tool In An Urgent Care, Kathleen A. Probst

Dissertations

Implementation of a Vestibular Disorder Screening Tool in an Urgent Care

Kathleen A. Probst

M.S.N., University of Missouri-Columbia, 2007

B.S.N., University of Missouri-Columbia, 2004

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice

August 2023

Advisory Committee

Susan Dean-Baar, PhD, RN, CENP, FAAN

Chairperson

Jennifer Vines, DNP, MSN, RN

Troy Dinkel, MD

Copyright, Kathleen A. Probst, 2023

Abstract

Problem: Vestibular disorders disrupt everyday living and can cause reduced quality of life. Guidelines developed to screen for vestibular disorders are not efficient to use …

Intimate Partner Violence Screening In The Emergency Department, Rebecca Stuerman

Dissertations

Problem: Intimate partner violence [IPV] is a public health concern that affects one in three women worldwide. IPV can be addressed through identification and early intervention with minimal risk to the patient. The emergency department is an important setting for screening given the frequency with which people who experience abuse may present with IPV-related injuries and other related concerns (depression, suicidality, etc.). Successfully implementing a validated tool for screening and providing early access to resources and referrals may help to mitigate the longterm negative impacts of IPV. The need for increased staff education was a major barrier to screening for …

Evaluation Of Simulation On Medication Errors In The Pediatric Intensive Care Unit, Carrie Clark

Dissertations

Problem: Medical errors are the third leading cause of death in the United States, the most common medical error being medication error. Pediatric patients are at an increased risk of medication error due to medication dosage calculation and the use of frequent high hazardous drugs.

Methods: The quality improvement (QI) project implemented the use of descriptive observational design using retro and prospective data. The data was collected over a 4-week and 4-week period by gathering data via safety and environmental management survey (SEMS).

Results: The data gathered consisted of an increase in medication errors of 150%. The data collected yielded …

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 …

Acute Agitation Intervention Tool For Reduction Of Polypharmacy, Brooks J. Propst

Dissertations

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included …

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 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 …

Effect Of Confusion Assessment Scores On Identifying Delirium In Intensive Care Patients, Kayla Jacobs

Dissertations

Delirium in intensive care unit (ICU) patients can lead to increased length of stay in the hospital, increased risk of complications, increased polypharmacy, family distress and increased rate of mortality (Vasilevskis et al., 2018). Research has shown that addressing modifiable risk factors can improve survival rate by up to 15%, and routine screening for delirium in ICU patients leads to decreased patient anxiety, reduced in-hospital mortality, early recognition, and treatment of delirium (Krewulak et al., 2021 ; Vasilevskis et al., 2018). This quality improvement project used evidence-based intervention to increase accurate documentation of the confusion assessment method in the ICU …

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 …

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.

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 …

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 …

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 …

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. …