Digital Commons Network^™

Exploring Restorative Justice, Suspensions, And Expulsions With African American Males, Dorothy L. Mosby

Dissertations

Zero tolerance programs led to unequal consequences for African American males because the programs targeted behaviors African American students were more likely to receive discipline for, which resulted in an increase of disciplinary situations for the students. With the disproportionate suspensions and expulsions of African American male students in public schools, Illinois Senate Bill 100 addressed the discipline issues to reduce the number of long-term suspensions and expulsions. In the 2016–2017 school year, the state of Illinois implemented Senate Bill 100. The bill reconstructed the procedures on how school administrators suspended and expelled students; Restorative Justice was a technique used …

Barriers To Mental Health Treatment In Patients Referred By Primary Care, Rebecca Palmer

Dissertations

Problem: Limited access to mental health treatment is one of many potential barriers to treating mental illness in the United States. Where resources are readily available, reportedly high no-show rates for established mental health appointments suggests further investigation is necessary to identify frequent barriers within that population. This was a quality improvement project to identify common themes in patient-reported barriers to care.

Methods: A 4-question phone survey was offered to individuals that did not appear at their mental health appointment. Data was analyzed to identify the most commonly reported barriers to mental health treatment. Additional data collected includes reported history …

Referrals To An Opioid Overdose Program With Ems Involvement: Comparing Treatment Outcomes, Courtney Haas

Dissertations

Problem. The rising rates of opioid overdose deaths continue to be a significant public health concern. Innovative programs utilizing a Recovery Coach in the Emergency Department (ED) have demonstrated initial success. However, there is limited evidence to support their effectiveness for improving treatment or recovery outcomes for people living with opioid use disorder. The purpose of this study was to evaluate whether the method of arrival to the ED for an opioid overdose affects engagement and retention in an opioid overdose project in a midwestern metropolitan area, which utilizes a Recovery Coach in the ED. Methods: Utilizing the Plan-Do-Study-Act framework, …

Nitrous Oxide Use For Minor But Painful Pediatric Procedures, Samantha Kremer

Dissertations

Problem: Nitrous oxide (N₂O) is used for mild to moderate pain control and anxiolysis. Registered nurses (RN) as providers of N₂O administration may decrease the number of missed opportunities for pain control or anxiolysis. The purpose of this quality improvement initiative was to evaluate the type of procedures and rate of N₂O administration by providers, and cost difference between them.

Method: A descriptive, cohort-design for pediatric patients in the Imaging and Sedation Department between October through November of 2017 and 2018. Data was compared between physicians in 2017 and either a physician or RN …

Race-Based Trauma Care Training For Veteran’S Health Administration Nurse Practitioners, Vanessa Loyd

Dissertations

Abstract

Problem: Trauma informed care has become a priority for persons exposed to psychological, physiological, emotional consequences as a result of traumatic experiences. Veterans are from different cultures, including gender, race, religion, sexual orientation and other social groups. The Veterans Health Administration (VHA) is responsible for the health of this culturally diverse patient population. Healthcare providers without any prior military experience may experience difficulty obtaining an accurate history and physical exam due to the military’s cross-cultural environment. The project aim was to increase confidence and competence in race-based trauma care by incorporating training into a new acute care fellowship …

Adult-Geriatric Acute Care Nurse Practitioner Fellowship For The Veterans Health Administration, Karen Scaglione

Dissertations

Problem: Nurse practitioner (NP) fellowship programs assist the novice NP in transitioning from a traditional nursing role to advanced practice. The Veteran’s Health Administration (VHA) utilizes a NP primary care fellowship program. An acute care fellowship may assist with role transition, confidence and competence for acute care NPs. The purpose of this evidence-based pilot project was to develop a transition to practice acute care fellowship program at a Midwestern VHA hospital.

Methods: A prospective, descriptive design utilizing a convenience sample of senior adult-geriatric nurse practitioner (AGNP) students during a pilot study of an acute care fellowship program. Outcome measures …

Management And Support Of Uninsured Patients With Diabetes Type Ii Within A Nurse Managed Clinic, Emma Spencer

Dissertations

The purpose of the project was to improve the quality of care for the uninsured, Type II Diabetics residing in a Midwestern urban underserved community. Community Health in Partnership Services (CHIPS) was a nurse-managed clinic, located in that area, that sought to lessen the burden of being uninsured. An annual fee of $35.00 allowed an uninsured community member access to a variety of different health care providers including specialists. In order to utilize this health care team efficiently, it was necessary to implement nurse-led care coordination for patients diagnosed with Type II Diabetes. This quality improvement project followed the Plan …

A Vaccine Administration Training Program To Increase Adolescent Vaccination Rates, Claire Jensen

Dissertations

Abstract

Immunizations have been proven to control life-threatening diseases. Often Registered Nurses (RNs) administer vaccines but are unsure how to discuss vaccines with vaccine hesitant patients. Missouri’s adolescent vaccination rates are below its neighboring states. This initiative’s purpose was to increase adolescent vaccine administrations at a Missouri County Health Department (MCHD).

This quality improvement initiative had an observational, cross-sectional, descriptive design. RNs employed at three MCHD clinics attended an adolescent vaccine administration training program (VAT) and completed pre-/post-tests regarding the Advisory Council on Immunization Practices recommendations. Medical record reviews from March 1-April 30, 2018 and March 1-April 30, 2019 compared …

Evaluating The Delivery Of Diabetes-Related Care Among The Asian Population, Lyly Bui

Dissertations

Purpose: This project evaluated current practices for Type 2 diabetes mellitus (T2DM) screening and management among Asian Americans (AAs) presenting to a primary care clinic and determined whether these practices adhered to the American Diabetes Association (ADA)’s 2018 guidelines.

Methods: A retrospective chart review was performed to extract data from clinical case records of AAs who visited the Vietnamese Health Center (VHC) between November 1, 2017 and November 1, 2018. Descriptive statistics were utilized to analyze the data.

Results: Of 173 charts reviewed, 76.3% of AAs had no previous T2DM diagnosis and 23.7% had a previous diagnosis. Among those without …

Decreasing Opioid Overprescription Following Outpatient Gynecology Surgery, Monica Kistler

Dissertations

Problem: Opioid abuse may be a result of overprescribing opioids. There are no opioid prescribing recommendations for minor gynecologic surgery. As a result, there is a wide variation in prescribing practices at a privately-owned surgery center where excessive opioid prescription occurs.

Methods: A quality improvement initiative with a descriptive, cohort design. A retrospective review of medical records and telephone surveys over three months resulted in the development of a series of posters describing prescription data for three procedures: hysteroscopy dilation and curettage (HDC), uterine ablation (UA), and laparoscopy (LAP). The trends and changes in opioid prescription practices were displayed throughout …

Depression In Hiv-Positive Individuals Living In A Residential Housing Community, Danielle Njeri

Dissertations

Problem: Depression is the most prevalent psychiatric disorder among individuals living with HIV. Depression rates are three times greater than those found in the general population . Undiagnosed and untreated depression can have a negative effect on the management of HIV infection, resulting in increased mortality and a poorer quality of life. The purpose of this quality improvement initiative was to assess the incidence of depression in HIV-positive individuals living in a residential community.

Methods: A prospective, descriptive, cohort design. Convenience sample of HIV-positive adult residents living in an HIV residential community. The nine-question patient health questionnaire (PHQ-9) …

Screening For Sexually Transmitted Infections In Adolescents, Millicent Palacios

Dissertations

Abstract

Problem Adolescents are contracting sexually transmitted infections (STIs) with half of all new STIs occurring in those aged 15-24 years old. The American Academy of Pediatrics, recommended all sexually active adolescents be screened for STIs. Incorporation of a sexual behavior assessment may assist providers with identifying STI risk.

Methods A descriptive design comparing three cohorts of adolescents presenting for a well-exam. The cohorts analyzed were: urine screening on all adolescents, urine screening for only those reporting sexual activity, and a self-administered sexual history questionnaire tool, based on the HEEADSSS psychosocial assessments.

Results The majority (97%), of all three cohorts …

Implementation Of The Integrated Palliative Outcome Scale (Ipos) Into Palliative Care Practice, Lisa A. Pezold

Dissertations

Abstract

Problem: The Visiting Nurse Association of Greater St. Louis (VNA) has a grant-funded, palliative care program called Advanced Illness Management (AIM). The Integrated Palliative Outcome Scale (IPOS) is a tool for providers to identify symptoms. The VNA implemented the IPOS in 2017. A previous quality improvement project revealed that IPOS symptoms were addressed less than 95% of the time leaving patients to suffer from burdensome symptoms, thereby reducing their quality of life.

Methods: Providers were educated on the importance of addressing all symptoms with pharmacologic or nonpharmacologic interventions and the impact the interventions have on the AIM program, grant …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

This Is My Story: Using Patient Personalization Posters To Improve Nurses' Caring Behaviors, Kelly S. Johnson

Dissertations

The critical care environment renders patients unable to share the kind of personal information that illuminates their story outside of the intensive care unit. Therefore, learning about the individuality of this patient population and building caring relationships with them is more difficult than with a fully communicative patient. The aim of this project was to investigate the relationship between the patients' and families' perceptions of caring behaviors and the use of the "This is My Story" poster for critically ill adults. A two-group comparison was done between patients in a surgical intensive care unit who received the "This is My …

Perceived Teaching Style And Academic Growth In An International School Setting, Jamie Elizabeth Martin

Dissertations

The presence of international schools has grown significantly around the world to accommodate a growing need for academic instruction that differs from that provided in local schools and to meet the rapid demands of globalization. As demands for international schools increase, demands for student performance are also increasing.

This quantitative correlational study seeks to determine if correlations exist between teaching style and student academic growth in mathematics within an international school setting. The study also determines if a dominant teaching style exists and if correlations between teacher grade level and teaching style can be made among international teachers who teach …

Teaching English Learners: A Study Of Procedures And Perceptions Of Missouri Program Directors And Mainstream Classroom Teachers, Merica Schoen Clinkenbeard

Dissertations

Professional development for mainstream classroom teachers to meet the influx of diverse learners is not adequately met by most school districts (Quintero & Hanson, 2017). The purpose of this mixed-methods study was to gain information from English learner program directors about English learner program practices and professional development specific to the needs of English learners in Missouri school districts. Mainstream classroom teachers from different-sized schools with high- and lowincidence of English learner students were interviewed to gather the perceived level of understanding of best practices for the implementation of research-based strategies. The Missouri Professional Learning Guidelines for Student Success guided …

Evaluation Of A Brief Online Alcohol Intervention For College Students: The Role Of Race-Specific Normative Feedback, Racial/Ethnic Identity, And Readiness To Change, Jacob Scharer

Dissertations

Brief online interventions are effective for reducing alcohol use among college students. However, some research has suggested that these interventions may be less effective for African American students. This study evaluated the acceptability and efficacy of a widely available brief online alcohol intervention in a sample of African American and Caucasian college students through a randomized controlled trial. The aims of this study were to determine if providing race-specific normative feedback impacted treatment efficacy for African American students, and if this effect was moderated by racial/ethnic identity and readiness to change. Participants were 310 heavy drinking African American and Caucasian …

An Examination Of Death Anxiety, Psychological Depression, And Adult Attachment Patterns Among Saudi Students In The Usa, Siham Ahmed Alswayel

Dissertations

This study was designed to investigate the relationships between death anxiety, psochological depression, and adult attachment patterns within Saudi students in U.S. universities. The sample of 684 participants was obtained via the Saudi Arabian Cultural Mission (SACM) in the United States. Death anxiety was measured by the ASDA survey, psychological depression was measured by the CESD-R survey, and adult attachment patterns were measured by the RQ survey. All data were self-reported via an online form. There was a significant relationship between death anxiety and adult attachment patterns. Death anxiety and psychological depression were positively correlated. Among the entire sample, adult …

The Importance Of Leadership Motivational Activities In Encouraging International Students To Return To Their Tier 1 Universities, Eric Hall

Dissertations

Abstract

The problem is international students are not returning to their undergraduate Tier 1 institutions during a period when quality student enrollment is essential, and there is scant research on academic advising strategies that can be used to combat international student attrition at these universities (O’Keefe, 2013). Studies have often lumped all international students together and made efforts to attract more international students, but the reasons why international students chose research universities, and returned, were not being investigated in this manner (Hegarty, 2014).

The purpose of this proposed study was to gain an understanding of the decision-making and reasoning processes …

Meeting The Needs Of Graduate International Students In A Mid-South University: A Descriptive Phenomenology Study, Ifeyinwa Onyeke-Onwelumadu

Dissertations

NAFSA’s economic analysis indicates that international students and their families created or supported 340,000 jobs and contributed $26.8 billion to the U.S. economy during the 2013-2014 academic year (NAFSA, 2014). The analysis for reveals that for every seven international students enrolled, three U.S. jobs are created or supported by spending. These occur in the following sectors: higher education, accommodation, dining, retail, transportation, telecommunications, and health insurance. By the 2017-2018 academic year, the US witnessed further significant contribution of international students to the US economy, contributing $39 billion from living expenses, tuition, and fees. Also, the contributions of international students created …

Innovative Teaching Practices To Accelerate Student Learning In The Areas Of Literacy And Science, Michelle Simmons, Paris Bouchard

Dissertations

The researchers of this joint dissertation aspired to create and implement innovative instructional practices that would accelerate student learning. Both researchers believed in the importance of experimenting with structures and processes that lead to instructional impact. They were both passionate about developing an instructional model that would accelerate student learning by focusing on student transfer of skills. They sought to answer the question, Can learning be accelerated when teachers are supported and encouraged to create and implement instructional practices grounded in research? One researcher studied a practice that would potentially increase students’ ability to think critically and problem solve using …

Party Blight In Rural Missouri: Causes And Consequences Of Local Organizational Decline, Joseph Anthony

Dissertations

Political parties are fundamental institutions to representative democracies, and they have been an integral part of the American political fabric since the early 1800s. Changes in the political landscape have pressed social scientists to engage in a now long-running academic debate as to whether political parties are in a state of reform and adaptation in the modern campaign environment, or if they are in an overall state of decline. While there has been considerable attention given to national and state party organizations, very little is known about how local party organizations are faring in the modern campaign environment. This dissertation …

Examining Burnout In Direct Care Personnel In An Intermediate Care Facility For The Mentally Retarded, Amanda Alisa Teal Townsend

Dissertations

The purpose of this descriptive, cross-sectional study was to examine burnout in direct care personnel in an Intermediate Care Facility for the Mentally Retarded (ICF/MR). Burnout exacts high personal costs from direct care personnel working in Intellectual Disabilities (ID) Services (Hastings, Horne & Mitchell, 2004). There are also organizational costs from employee turnover, decreases in productivity, and potential harm to clients. The conceptual framework guiding this descriptive correlational study was a middle range theory of caregiver stress based on Roy's adaptation model (Tsai, 2003).

The Determinants Of A Health-Promoting Lifestyle In Older Adults, Patricia A. Stockert

Dissertations

Health promotion for the older adult is of critical concern for nursing. Health promotion activities may help this group maintain their health, experience optimal functional capacity, remain independent, and lower medical costs. Limited and conflicting information on health promotion activities and factors that influence these behaviors is available in this population. The purpose of this study was to identify determinants of a health-promoting lifestyle in an older adult population by examining components of the Health Promotion Model. The study also used structural equation modeling to examine the psychometric properties of the Health Promoting Lifestyle Profile II (HPLPII) in older adults. …

Transforming Professional Development For Today's Educational Environment, Amy L. Geurkink-Coats, Richard A. Regina

Dissertations

Professional development is vital to education. It provides an opportunity for continued growth and learning for educators throughout their career. While teachers earn credentials and certification through a university, professional development is intended to hone skills and help teachers evolve in an ever-changing landscape. The changing landscape may involve technology, generational needs, or broader societal interests. This research is an analysis of the implementation of transformational professional development in one large suburban Midwestern school district and one large Midwestern high school in another district. It analyzes data regarding professional development and examines literature that studies teacher participation, attitudes, and transfer …

A Grounded Theory Study Exploring Lesbian Patient Self-Disclosure Of Sexual Orientation In Acute Care, Margaret Ruth Neese

Dissertations

The purpose of this study was to develop a grounded substantive theory to describe the process involved in lesbian self-disclosure of sexual orientation in acute care settings. Philosophical Underpinning: The philosophical underpinning was grounded theory as described by Strauss and Corbin (1998).

Factors Related To Mexican-American Workers' Use Of Hearing Protection, Madeleine J. Kerr

Dissertations

Significant numbers of Mexican Americans work in jobs where they are exposed to harmful noise, therefore they are vulnerable to noise-induced hearing loss. Use of hearing protection is often the only way to prevent exposure to loud noise, yet there is no knowledge of how to promote its use among Mexican American workers. This study builds on a program of research by Lusk in which the determinants of health-protective behavior are identified in order to design effective safety programs. This study was based on a theoretical model adapted from the Health Promotion Model (Pender, 1987).

"We Are Strong Women": A Focused Ethnography Of The Reproductive Lives Of Women In Belize, Carrie S. Klima

Dissertations

Belize is a small country in Central America with a unique heritage. The cultural pluralism found in Belize provides an opportunity to explore the cultures of the Maya, Mestizo and the Caribbean. Women in Belize share this cultural heritage as well as the reproductive health issues common to women throughout the developing world. The experiences of unintended pregnancy, contraceptive use and abortion were explored with women using a feminist ethnographic framework. Key informants, participant observations, secondary data sources and individual interviews provided rich sources of data to examine the impact of culture in Belize upon the reproductive lives of women.

How Are Districts Using The Local Control Funding Formula To Close The Achievement Gap, Jacob Briggs

Dissertations

Purpose: The purpose of this mixed methods study was to identify and describe the impact of the Local Control Funding Formula (LCFF) within Kern County, Monterey County, San Luis Obispo County and Santa Barbara County in narrowing the achievement gap in underachieving populations identified as English Language Learners (ELL) and low socioeconomic status (low SES). Additionally, the purpose of this mixed methods study was to identify strategies implemented by districts who had the highest percentage of change in narrowing the achievement gap.

Methodology: A mixed-method study was conducted in two parts. First, a quantitative analysis was conducted by comparing the …