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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 …

Self-Care Practices In Doctoral Nursing Students And Effects On Educational Experience, Megan Lutman

Dissertations

Problem: Doctoral nursing students are often faced with stressors on top of their schooling, one of which is continuing to work while pursuing their education. This in combination with normal life stressors can be challenging. The purpose of this project was to survey doctoral nursing students on what their current self-care practices.

Methods: An exploratory needs assessment project was created to gather data from Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students in an urban, mid-sized, Midwestern, public university to identify current self-care practices, barriers to self-care, preference of self-care practices, and the impact these …

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 …

Extubation Readiness Test In A Pediatric Cardiac Intensive Care Unit, Mary K. Holyoke

Dissertations

Extubation Readiness Test in a Pediatric Cardiac Intensive Care Unit

Abstract

Problem: The lack of standard extubation readiness tests (ERTs), that are practiced in pediatric ICUs to monitor extubation readiness, clinicians have the difficult task of weighing the risk versus benefit of extubation. ERTs can aid clinicians in deciphering patients ready to be successfully extubated and have shown to decrease length of mechanical ventilation and decrease extubation failures.

Methods: The quality improvement (QI) project utilized a descriptive observational design to assess the effects of the implementation of an ERT in a pediatric cardiac ICU. This project used a convenience sample …

Self-Care, Resilience, Self-Compassion, And Burnout In Doctoral Nursing Students: An Exploratory Needs Assessment, Logan Justice

Dissertations

Abstract

Problem: In the United States, one in three nurses experience symptoms of burnout, and doctoral nursing students are additionally challenged to juggle multiple school, work, and life demands (Reith, 2018; Woo et al., 2020). The purpose of this project was to explore the current self-care practices of doctoral nursing students to understand how self-care relates to resilience and burnout.

Methods: This exploratory needs assessment utilized a convenience sample of Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students at a medium sized midwestern university. An electronic data collection survey was constructed to assess student self-care practices, …

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 …

Physical And Psychological Effects Of Qigong Exercise In Community-Dwelling Older Adults: An Exploratory Study, Pei-Shiun Chang

Dissertations

Older adults need exercise programs that correspond to age-related changes. Qigong exercise, a type of Chinese traditional medicine exercise, is a gentle low-impact exercise and is safe for older adults. Qigong interventions have resulted in improved psychological well-being, muscle strength, flexibility and balance in Asian adults with chronic conditions. However, little data are available on the effects of Qigong exercise on older adults' health in the United States. The purpose of the study was to explore feasibility, adherence, and preliminary efficacy of an 8-week Qigong exercise intervention in community-dwelling older adults in the United States.

(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 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 …

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 …

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.

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 …

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, …

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. …

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 …

Racial Differences In The Strong Black Woman Schema And Its Relationship To Health Behaviors And Perseverance, Raegan Bishop

Dissertations

Black women face a number of poor health outcomes, with 50% of Black women 20 years and older suffering from cardiovascular disease, and a diabetes incidence rate that is almost double that of White women. Health behaviors like physical activity, diet, and stress management can assist in reducing the onset and worsening of these diseases. However, Black women are less likely to engage in these behaviors compared to women of other races. Additionally, even when Black women do engage in positive health behaviors, they see fewer positive results than White women. One potential influencer in the complex relationship that Black …

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.

Sociodemographic And Health-Related Risks For Loneliness And Outcome Differences By Loneliness Status In A Sample Of Older U.S. Adults, Laurie A. Theeke

Dissertations

Loneliness is a prevalent problem for older adults and has been shown to be associated with negative physical, psychological, and social variables. There has been limited research focusing on the relationship of loneliness to health. There is a gap in the literature when it comes to understanding how the problem of loneliness relates to the health of older adults in the United States.

The purpose of this study was to address this gap in the literature through the testing of two models, the first model represented the postulated risks for loneliness and the second model represented the postulated outcomes for …

The Relationships Between And Among Parental Perceptions Of Family-Centered Care, Parental Beliefs, And Parental Stress In The Pediatric Intensive Care Unit, Kelly Keefe-Marcoux

Dissertations

Children hospitalized for critical care require increasingly complex and technical care, which can be very stressful for parents. Awareness of the importance of parents' role while their child is receiving critical care is vital to deliver care within a family-centered philosophy that is mutually beneficial to parents and nurses. This descriptive correlational study examined the relationships between and among parental perception of Family-Centered Care (FCC) nursing practices, parental beliefs regarding their role and their hospitalized child, and parental stress during their child's admission to the Pediatric Intensive Care Unit (PICU). This study utilized the Family-Centered Care theoretical framework to examine …

Evaluating Middle School English Language Learners’ Science And Literacy Proficiency, Yasemin Ozkaya

Dissertations

The academic success and English proficiency of ELL students are receiving more attention as a result of the growing number of ELL students and the demand for accountability and assessment in education. It is widely accepted that ELL students struggle on state standardized tests because they lack the cognitive academic language abilities needed to succeed on extensive subject evaluations (Thakkar, 2013). According to Abedi and Dietel, ELLs' academic performance lags behind that of other segments of population, and the attainment gap reduces only slightly over time (2004).

The NWEA archival data of 6th, 7th, and 8th grade students who attended …

The Association Between Pelvic Floor Dysfunction And Mental Health In Natal Females With A Focus On Native American Populations, Lexxie Gramke

Dissertations

Purpose

Over half of natal females in the United States suffer from pelvic floor dysfunction (PFD). PFD can increase risk of mental health sequelae; however, no studies have been conducted examining the association between mental health and PFD in the Native American (NA) population. This dissertation aims to evaluate the association between PFD, with a focus on overactive bladder (OAB), and mental health in females with specific attention to NAs.

Methodology

A current state of the science review examined the literature for associations between OAB with depression and anxiety in females. Utilizing this literature review, a theoretical model was constructed …

Exploring The Fifth Quarter: An Enquiry Into Offal Eating In Contemporary Irish Food Culture, Its History, And Its Future, Niall Toner

Dissertations

Animal offal and organ meats seem to have all but disappeared from domestic cuisine in Ireland, despite the recent renaissance in the country’s food culture. This thesis has examined the extent and nature of the consumption of these comestibles in contemporary Irish food culture, and the perceived decline in offal’s popularity in Ireland in the past fifty years. It also sought to discover whether offal and organ meats might have a place in the future of our cuisine, and whether the consumption of more offal and organ meats in Ireland might contribute towards a more sustainable food production system, and …

Case Study On Increasing The Amount Of High School El Students College And Career Ready, Octavio Patino

Dissertations

Purpose: The purpose of this qualitative multicase study was to describe the leadership practices of high school principals who work with their staff to close the college and career achievement gap for English language learners (ELLs) based on Anderson and Ackerman Anderson’s (2010) change model (mindset, behavior, culture, and systems).

Methodology: This qualitative multicase study was conducted through interviews with four high school principals of Title I schools in California. I selected qualitative methods because they describe the leadership practices that worked with their staff to close ELLs’ college and career readiness (CCR) gap.

Findings: Close examination of data from …