Digital Commons Network^™

Implementing A Tai Chi Exercise Program To Prevent Falls In Long-Term Care, Angela F. Miles

Dissertations

Falls can be a frequent occurrence in older adults residing in long-term care facilities. At the project site there was no systematic process to impact falls, so an evidence-based solution was sought. The purpose of this quality improvement project was to determine if the translation of Li et al.'s research utilizing Tai Ji Quan: Moving for Better Balance (TJQMBB) exercise in conjunction with the current fall risk assessment would impact fall rates among older adults over a 12-week period in an urban Georgia long term care facility. Betty Neuman's systems theory and Kurt Lewin's change model provided the scientific underpinnings …

Perspectives Of An Automotive Technician And Automotive Technician Educator: An Autoethnography, Christopher E. Reynolds Sr.

Dissertations

The purpose of this study was to explore automotive technician and automotive technician educator’s obstacles and expectations they faced during their educational and occupational endeavors. Constructivism and social constructivism were used as theoretical frameworks. Autoethnography was the selected qualitative research method. Using an interpretive process, several convergent topics were identified: education encouraging professional interests, professional obstacles, challenging normalcies, training and educating automotive technicians, the drive for professional certification, bridging the gap between industry and education, experience, patience, and exposure.

Several methods are recommended to help future automotive technicians and automotive technician educators overcome obstacles they might face, which include the …

An Analysis Of Teachers’ Viewpoints From Public, Private, And Charter Schools On Effective Lesson Planning And Instruction, Samone Smith

Dissertations

This dissertation explores the perspectives of elementary school educators in St. Louis, Missouri, regarding impactful lesson planning and instruction across public, charter, and private school settings. Drawing on existing literature and empirical data, the study seeks to unveil the approaches and perceptions teachers hold towards lesson planning, shedding light on essential characteristics for effective teaching. The introductory chapter sets the stage by presenting the significance and purpose of the study, framing research questions, and outlining the methodology. The following chapters explore the theories, review the literature, and analyze collected data to help us understand lesson planning practices in modern education. …

Depression Screenings In Older Adult Primary Care Patients: A Pilot Study, Karissa A. Rodriguez

Dissertations

Depression is a profound problem among people of all ages, but it is especially prevalent in older adults aged 65 and older. Identification and diagnosis of depression are obtained through screenings.

This project aimed to increase the frequency of depression screenings at all primary care office visits and analyze the agreement between the depression screening tools, the Patient Health Questionnaire (PHQ-9) or the Geriatric Depression Scale (GDS-15), when assessing depression in older adult primary care patients ages 65 and older. Theoretical Framework: The Plan-Do-Study-Act (PDSA) cycle is a problem-solving model used to create change and adapt to a project's needs. …

The Development And Testing Of An Instrument To Measure Perceptions Of Body Art Among Nurse Educators And Nursing Students, Deana M. Nunes

Dissertations

Increasing diversity in the nursing workforce is a national priority to better care for a diverse patient population and minimize healthcare disparities. Nurse educators teach students to practice with compassion and respect, recognizing the dignity, worth, individual choice, and unique attributes of all patients. Perceptions of nursing professionalism are heavily influenced by appearance. Many nursing programs restrict visible body art in their dress code policies based on long-held notions and negative stereotypes of individuals with body art. Shouldn't nursing students who choose to have body art receive the same respect and lack of judgment? A better understanding of nurse educators' …

A Case Study Of Educational Context Influencing High School English Teachers’ Knowledge, Perceptions, And Uses Of Technology, Alicia Curles

Dissertations

One-to-one programs are being implemented in schools and districts to improve and increase students’ learning opportunities. This qualitative case study aimed to examine high school English teachers’ perceptions, knowledge, and contextual uses of one-to-one technology devices in a unique context after the COVID-19 pandemic. The study consists of a single case study in a large South Georgia district that is a combination of rural, urban, suburban, and island communities. This research study was guided by Brianza et al.’s (2022) extension of the technology, pedagogy, and content knowledge framework, XTPACK, and was informed by a social constructivist approach. Qualitative data from …

Exploring Students' Perceptions And Experiences Of Faculty Caring In The Undergraduate Classroom In A Traditional Baccalaureate Nursing Program: A Qualitative Descriptive Study, Sheila M. Garilli

Dissertations

Academic nurse educators' use of caring attributes in the classroom could impact students' educational journey. Educators are leaders who should model caring behaviors toward their students. This role modeling will empower students to demonstrate these caring behaviors toward their patients. A literature review discovered a gap surrounding the study of faculty caring in the classroom. This research study explored students' perceptions and experiences of faculty caring in the undergraduate classroom in two traditional baccalaureate nursing programs. This study utilized a qualitative descriptive method with purposeful sampling and in-person recruitment at two universities in a Northeastern state in the United States. …

A Culturally Informed Mentorship Model For Historically Underrepresented Ethnic Minority Advanced Practice Registered Nursing Students, Lonnie P. Herring

Dissertations

Ethnic minority students pursuing advanced practice nursing degrees often face unique challenges that hinder their academic success and persistence, such as limited mentorship opportunities that address their cultural considerations. A lack of culturally informed mentorship (CIM) may contribute to feelings of isolation, lower self-efficacy, and reduced retention rates among ethnic minority advanced practice registered nursing (APRN) students. Through cultural competency, CIM programs are emerging as a promising approach to address these challenges and support the needs of historically underrepresented ethnic minority (HUEM) students. The underrepresentation of HUEM APRN students in graduate nursing education and advanced nursing practice is a persistent …

The Implementation Of A Care And Communication Bundle For End-Of-Life Patients, Brendalee Carty Obiorah

Dissertations

Research studies have noted an improvement in end-of-life (EOL) patient's quality of life (QOL) from hospice. However, little research has been conducted to explore how the involvement of hospice care affects those in an assisted living facility (ALF). The purpose of this quantitative, pre and post-test quasi experimental design DPI project was to see to what degree a relationship exists between the care and communication bundle (independent variable) implementation and QOL (dependent variable) for 20 EOL patients on hospice in an ALF in Central Georgia. Jean Watson theory of caring and the theoretical domains framework (TDF) guided this project. The …

Perceptions Of Graduate Nurse Practitioner Faculty On The Use Of Simulation In Lieu Of Traditional Clinical Hours, Virginia Strong

Dissertations

Simulation in undergraduate nursing curriculum has been identified as an effective and safe substitution for the traditional clinical experience; however, graduate nurse education programs could not substitute clinical hours with simulation-based education. These clinical hours required NP students to provide direct face-to-face patient care. Simulation had wide variability in the number of hours utilized within each specialty. NONPF discussed the use of simulation, as it pertains to the curriculum of the NP student on more than one occasion and concluded its impact on NP education was a potential alternative to traditional clinical experiences. Studies indicated that graduate nursing students enjoy …

Power And Control In Medicine And Nursing - Could Intrinsic Gender Beliefs Impact Interprofessional Education In Pre-Professional Programs?, Catherine Christine Delant

Dissertations

Examination of the power dynamics at work in perpetuating health care hierarchy-related interprofessional collaboration barriers is needed to rationally develop strategies for teaching collaborative skills to health care providers. A mixed-methods study employing critical realist grounded theory examined the implicit beliefs, assumptions and power hierarchies related to gendered perceptions of the professions of nursing and medicine by students of those professions.

The Lived Experience Of Registered Nurses And Registered Midwives In St. Kitts And Nevis, Raiden Gaul

Dissertations

At the beginning of the 20th century, St. Kitts and Nevis had one of the highest infant mortality rates in the Caribbean. However, unlike some Caribbean nations with similar historical and socioeconomic factors that continue to suffer from significant health disparities, St. Kitts and Nevis implemented strategic health reforms that have led to dramatic improvements in maternal and neonatal health outcomes. One of the strategic reforms designed to address these poor health outcomes was to mandate that all registered nurses in St. Kitts and Nevis pursue certification in the post-basic midwifery program. The purpose of this study was to examine …

How Does Vr Affect Motivation, Engagement, Performance And Student Interest In High School Science?, Ann Marie Carrier

Dissertations

This study investigates the impact of virtual reality (VR) on high school science students' motivation, engagement, performance, and interest in STEM disciplines. Building on Huang et al. (2021), this research replicates and extends their findings, focusing on how different levels of VR immersion influence learning outcomes. The study aligns with the Next Generation Science Standards (NGSS) and the Georgia Standards of Excellence (GSE). Utilizing a quasi-experimental design, 123 high school students experienced varying levels of immersive VR via the Titans of Space Plus app on Meta Quest 2 headsets and desktop computers. Study population included 55% males, 45% minorities, and …

The Impact Of Hourly Safety Rounding On Pediatric Fall Rates, Natalie Doskal-Poe

Dissertations

The Impact of Hourly Safety Rounding on Pediatric Fall Rates

Abstract

Problem: Falls are a common adverse event in the inpatient pediatric setting and are a significant risk to patient safety. Environmental factors, such as unclear pathways, bed rails down, beds in high position, and call lights out of reach, are considered avoidable causes of patient falls. The site’s fall data in a 12-month period from January 2023 to January 2024 showed (n=9) patient falls occurred with (n=5, 55.6%) due to environmental factors. The purpose of this Quality Improvement (QI) pilot project was to assess the …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

The Influence Of Misconceptions On Pedagogical Choices Of Secondary Science Teachers: An Embedded Case Study, Tracey Beyer

Dissertations

This case study, using phenomenography within science disciplines, examines how educators' experiences with misconceptions affect teaching methods in high school physics, chemistry, and biology. Based on constructivist and interpretive theories it highlights that personal experiences shape learning and involve continuously reconstructing knowledge. The shared misconceptions of 13 educators across science disciplines reveal how those experiences influenced both their content knowledge and instructional practices. The findings indicate that educators who openly acknowledge and learn from their past experiences with misconceptions are better equipped to recognize and address gaps in understanding, an asset to furthering student learning. This research highlights the importance …

The Impacts Of Authentic Learning On Student Outcomes, Evan Sheppard, Cameron Conner

Dissertations

This dissertation explores the evolving American education system, emphasizing the role of authentic learning in bridging the gap between schooling and employment, especially in the context of the modern post-pandemic student. Authentic learning, characterized by hands-on activities and real-world applications, is posited as a solution to the skilled labor shortage impacting the economy. This study delves into the history and current practices of authentic learning, examining various programs and strategies implemented in educational settings. Utilizing a phenomenological approach, qualitative data was collected through interviews with recent high school graduates to assess the impact of authentic learning on their post-secondary trajectories. …

The Investigation Of Collaboration Among First-Year Bachelor Of Science Nursing Students, Christie Marie Cavallo

Dissertations

Despite the benefits of collaboration, first-year nursing students prefer not to work together. It was important to find out why nursing students do not want to collaborate. The purpose of this study was to discover first-year nursing students' and faculty's perceptions of how instructor-created opportunities for collaboration contributed to first year nursing students' collaboration. Using Wenger's communities of practice (CoPs) model as a lens, the data were explored using a qualitative explanatory case study approach. This study consisted of individual interviews of 12 first-year nursing students and nursing faculty. Inclusion criteria included students enrolled in or faculty teaching first year …

Development And Evaluation Of A Nurse Practitioner-Directed Mindfulness Initiative Among Patients Diagnosed With Generalized Anxiety Disorder In An Outpatient Psychiatric Practice, Keilah B. Ford

Dissertations

This quality improvement project presents the impact of mindfulness intervention, such as guided meditation on anxiety levels in adult patients in a psychiatric outpatient practice.

Identifying Delirium In Hospitalized Patients Using Nursing Delirium Screening Scale, Christina S. Arockiam

Dissertations

Delirium is a sudden brain dysfunction that can affect the mental status of hospitalized adult patients. At the project site, there was no consistent screening tool for delirium, so an evidence-based solution was sought. The purpose of this quality improvement project was to determine if the translation of Heinrich et al.'s research regarding Gaudreau et al.'s Nursing Delirium Screening Scale (Nu-DESC) would impact the identification of delirium and subsequent provider notification within 30 minutes among adult patients in an acute care hospital in urban California over eight weeks. Virginia Henderson's need theory and the Iowa Model Revised: Evidence-based practice to …

Empowering Female Voices In The Ela Classroom, Jacqueline Gurliaccio Vance

Dissertations

This study aims to understand how women’s voices can be empowered in a high school English Language Arts (ELA) class. Through the use of female authors and female protagonists in the classroom texts, this study seeks to understand if implementing female-driven texts enhances female students’ literary experiences, empowers the personal identities of female students, and shapes female students’ perspectives of themselves and their peers. This case study includes female students in twelfth grade AP Literature class.

Describing Nursing Care Of Severely Obese Patients In Critical Access Hospitals Using Total Quality Management Theory: A Qualitative Study, Amy M. Blankenship

Dissertations

The purpose of this study was to explore nurses' perceptions and experiences regarding caring for severely obese patients and factors that affect quality care of these patients in Critical Access Hospitals (CAHS).

Interdisciplinary Medication Reconciliation Approach For Arabic-Speaking Patients, Rebecca Rodman

Dissertations

Abstract

Problem: Limited English Proficiency (LEP), which includes Arabic speakers, presents challenges in healthcare and can impact medication reconciliation and adherence. Interdisciplinary collaboration involving patients and interpreters is crucial for improving medication reconciliation and adherence. This project aimed to examine the impact of an interdisciplinary medication reconciliation approach on medication adherence with Arabic-speaking patients ages 18-99 over three months.

Methods: This quality improvement (QI) pilot project utilized a descriptive cohort design. A translated validated Morisky, Green, and Levine (MGL) adherence survey consisting of four questions was administered pre- and post-implementation to a convenience sample of Arabic-speaking patients 18 years …

Implementation Of Chlorhexidine Gluconate Dressings And The Effect On Bloodstream Infections In Extracorporeal Membrane Oxygenation Patients At A Pediatric Hospital, Kaitlin Vernier

Dissertations

Extracorporeal membrane oxygenation (ECMO) is an advanced lifesaving therapy used for patients with significant cardiorespiratory failure not responding to conventional therapies. The most common and life-threatening complications associated with ECMO are blood stream infections (BSIs). In addition to increased mortality, BSI's increase patient length of stay and cost. Chlorhexidine Gluconate (CHG) is known to be a significant factor in BSI reduction. The purpose of this quality improvement project is to assess the utilization of CHG-impregnated dressings on the incidence of BSI rates in pediatric ECMO patients. The setting was a 40-bed pediatric intensive care unit (PICU) and a 30-bed cardiac …

Wiping Out Central Line Associated-Bloodstream Infections: Cleaning High Touch Surfaces In The Picu, Emily Heth

Dissertations

Problem: Central line-associated bloodstream infections (CLABSIs) are a significant, preventable healthcare-related complication of hospital admission and medical management of critically ill and medically complex patients. CLABSIs result in significant adverse outcomes such as increased morbidity and mortality, prolonged length of stay (LOS) in the intensive care unit (ICU) and in the hospital, increased cost of treatment, and increased rates of readmission. Direct and indirect contact within the patient’s hospital environment are potential means of transmission for microorganisms, increasing the inherent risk of acquiring a CLABSI.

Method: For this quality improvement (QI) project, a pre-post design was utilized to evaluate the …

Improving Hypertension For Veterans Utilizing Measure Properly, Assessment Of Pharmacology, Alternative Therapy Interest, Routine Outreach, Partner With The Veteran Protocol (Maarp): A Pilot Study, Alyssa S. Dudley

Dissertations

The purpose of this quality improvement (QI) project was to create a hypertension control protocol for the patient aligned care teams (PACT) to follow when a Veteran presents to the primary care clinic (PCC) with uncontrolled hypertension. Despite past interventions, uncontrolled hypertension was still problematic in the Department of Veteran Affairs (VA) Healthcare System. Past and present research suggested that the Veteran population was at higher risk of developing hypertension than those of the civilian population. In hopes to reduce uncontrolled hypertension in the VA's PCCs, the Measure Properly, Assessment of Pharmacology, Alternative Medication Interests, Routine Outreach, and Partner with …

Implementation Of A Standardized Nursing Handoff In A Pediatric Intensive Care Unit, Tori Keeven

Dissertations

Handoff communication is critical in healthcare and is associated with patient safety outcomes. Various tools and interventions are available to improve handoff communication as inadequate communication contributes to medical errors, patient adverse events, and increased mortality. The implementation of a standardized handoff tool has been shown to be effective. Findings revealed a significant 60% reduction in reported patient harm events, despite the study's limited sample size and lack of statistical significance (p = .614). Challenges such as low utilization (18.62%) were attributed to concerns about tool organization, spatial constraints, and staff resistance to change. Recommendations include refining the tool to …

Improving Identification Of Complicated Alcohol Withdrawal Syndrome Using The Prediction Of Alcohol Withdrawal Severity Scale, Kristin Hagopian

Dissertations

Problem: Individuals who drink alcohol excessively are at great risk for alcohol withdrawal syndrome (AWS) when hospitalized. Symptoms and their severity differ for everyone, and research shows that the identification and treatment of AWS is challenging and often inadequate. Mild AWS is often overtreated, while moderate to severe AWS is often underdiagnosed and undertreated, placing individuals at risk for longer hospital stays, more time needed in critical care units, and a variety of unintended consequences.

Methods: This evidence-based practice project had a pre-post intervention design in which the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) was implemented to promptly identify …

Implementation Of Home Blood Pressure Monitoring, Sarah Gutzke

Dissertations

Approximately 48.1% of adults in the United States have high blood pressure. Providers may encourage patients to monitor and log their blood pressure at home. Still, patients often fail to bring this information to appointments, leading to reliance on less comprehensive in-office measurements. This quality improvement project aimed to increase adherence to home blood pressure logs using a Blood Pressure Toolkit. A descriptive, observational design was utilized to record patient adherence of taking home blood pressure measurements and increase the number of patients who brought their blood pressure logs to their healthcare provider visits over two months. A convenience sample …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …