Digital Commons Network^™

Resilience In Black Mental Health Counselors, Ericka Cables

Dissertations

Though resilience is a commonly studied variable in different disciplines, there is relatively little research on occupational settings. Researchers take various perspectives in defining resilience as a trait, process, and an outcome. Regardless of how it is defined, it is a vital protective factor for Black mental health counselors who may be significantly impacted by similar experiences, such as racism and racial discrimination, as the Black clients they serve. This dissertation study consisted of two studies utilizing the same data set. In the first study, psychometric properties of a new quantitative instrument, the Race-Based Resilience Scale (RBRS), was constructed to …

Cortisol Administration Normalizes Aberrant Functional Connectivity In Women With Depression, Adam C. Runyan

Dissertations

Previous resting-state functional connectivity (rsFC) research has identified aberrant connectivity in several large brain networks in depression, including the default mode (DMN), frontoparietal (FPN), and salience networks (SN). Connectivity of these networks is also related to depressive symptom severity and is affected by cortisol levels. To our knowledge, this is the first study to investigate the effects of acute cortisol administration on rsFC of DMN, FPN, and SN in individuals varying in depression history and severity. We collected resting-state fMRI scans for 74 women with and without a history of depressive disorder after administration of cortisol and placebo using a …

Implementing Recova® To Adjust Estimated Dry Weight In An Outpatient Hemodialysis Clinic, Ayomide Aruwajoye

Dissertations

Problem: The purpose of this project is to implement the Recova® tool to adjust estimated dry weight supporting interdisciplinary team management of fluid overload in dialysis patients. Fluid overload can lead to high rates of morbidity and mortality. A total sample of 26 hemodialysis patients in an outpatient clinic located in a metropolitan city in a midwestern state was included in the project. Data collected shows there was poor knowledge familiarity with how fluid should be managed in patients suffering from chronic kidney disease. The nurses utilized the Recova tool for a period of 8 weeks to help aid in …

Factors Influencing The Adoption Of Smart-Home Appliances: Users' Perspectives, Prakash Shahi

Dissertations

Smart appliances will be a significant part of the annual $300 billion smart-home market by 2025. Their use is expected to grow at a compounded annual growth rate of 31% for the foreseeable future. Currently, 12-16% of households use smart-home products in the U.S., including thermostats, TVs, refrigerators, coffee machines, garage door openers, and vision-equipped doorbells. Smart appliances provide significant benefits to us over traditional appliances. Smart appliances simplify our lives by automating various tasks in our homes and allowing us to monitor and control them remotely from our offices, grocery stores, and wherever we may be.

Despite the usefulness …

Maintaining Yoga Practice For Diabetes Control And Prevention, Gina K. Alexander

Dissertations

Type 2 diabetes mellitus affects millions of individuals, representing a vast burden of disease for the national health care system. Yoga practice has demonstrated potential for diabetes control and prevention, yet few yoga-based studies explore factors affecting maintenance of yoga practice over time.

The purpose of this study was to explore factors influencing the maintenance of yoga practice over time, to clarify the relationship between the social environment and yoga practice, and to examine the influence of a yoga intervention over time on the physical activity of adults with or at risk for type 2 diabetes.

The Lived Experience Of Parents Of Children With Special Healthcare Needs On Public And Private Insurance: A Phenomenological Study, Regine P. Reaves

Dissertations

Due to recent advances in medical technology, the number of children with special healthcare needs (CSHCN) is steadily growing in the United States. CSHCN comprise more than 40% of overall healthcare costs nationwide, even though this group is only comprised of 16% of the U.S. child population. There are significant differences between private and public health plans in terms of cost, adequacy, and parent satisfaction. As an added benefit, some public and private health insurance plans offer nursing care coordination (or nursing case management) services. The purpose of this study was to understand the experiences of parents of CSHCN enrolled …

The Impact Of Emotional Intelligence On The Leadership Of Chief Human Resources Officers In The California Community Colleges System, Tonya Davis

Dissertations

Purpose: The purpose of this phenomenological study was to describe the perceptions of chief human resources officers (CHROs) in the California Community Colleges System regarding the impact of emotional intelligence (EI) on their leadership in four areas: self- awareness, self-management, social awareness, and relationship management.

Methodology: This qualitative phenomenological study described the lived experiences of CHROs as those experiences relate to the impact of EI on their leadership. A random sample was selected from the target population of 24 CHROs located in the Central and Southern Regions of California. The instrumentation used in the study was semistructured interview questions adapted …

Adolescent Depression: Experiences And Meanings Of Being Parented And Parenting, Terri Jean Farmer

Dissertations

Major depression affects up to 40% of U.S. adolescents in mild to severe forms, compromising emotional, academic, and relational functioning, including that of interacting with parents. The purpose of this study was to explore the parent-adolescent relationship during an episode of depression in order to elucidate the adolescent experience of being parented and the parental experience as it contributes to the context of the adolescent. Research questions included: 1) What are the depressed adolescent's meanings and experiences of being parented? 2) How do the meanings and experiences of parenting contribute to the context of the lifeworld of the depressed adolescent? …

The Lived Experiences Of Minority Nursing Students: Perceived Barriers To Success, Strategies For Success, And The Role Of Grit, Sherry Ann Koenigsman

Dissertations

The education and graduation of minority nursing students is needed to meet the healthcare needs of the people of the United States. However, more minority nursing students are lost to attrition than are white students. The purpose of this study was to seek to understand, from the perspective of the minority nursing students themselves, what barriers they face, their strategies for success, and the role grit plays in their nursing school journey.

Predicting The Nclex-Rn Pass Rate At An Associate Degree Nursing Program, Dawne Devoe Olbrych

Dissertations

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) firsttime pass rate for an associate degree in nursing (ADN) program was below the national mean, presenting a problem for graduates who failed the NCLEX-RN and could not enter the workforce as registered nurses. Knowles's assumptions of adult learning, Ebbinghaus's forgetting curve, and Zull's neuroscience research served as the theoretical frameworks for this study. The purpose of this study was to identify which academic and time-lapse variables predict the graduate's first-time passage for the NCLEX-RN. Archived academic records and NCLEX-RN results for all 786 graduates from one ADN program who took …

An Examination Of The Influence Of Select Non-Cognitive Variables On The Intention Of Minority Baccalaureate Nursing Students To Complete A Baccalaureate Nursing Program, Dena B. Evans

Dissertations

On college and university campuses nationwide, understanding the phenomenon of student retention has become an institutional imperative. The loss of any student is costly to a college or university, resulting in considerable financial loss (Siedman, 2005). For some programs of study, such as nursing, retention is paramount, not only for the institution but for the communities which are served by its graduates. Moreover, retaining minority nursing students is of particular importance because it holds the key to the resolution of a long-standing absence of minority representation in the nursing profession, the nursing shortage and the elimination of health disparities among …

Evaluating Sbirt In A Behavioral Health Urgent Care, Christina L. Williams

Dissertations

Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU …

Multi-Method Approach To Examining Psychosocial Responses And Reactions To Covid-19 In The Us And China, Fan Li

Dissertations

Objective

The purpose is to examine health care providers’ psychosocial responses to COVID-19 in China and the US via exploring relationships among psychological responses and describing experiences of working at the epicenter during the pandemic.

Methods

In manuscript one, a cross-sectional study was conducted in nurse and physician volunteers who provided direct care to COVID-19 patients in Wuhan (volunteers) and those with no COVID-19 contact outside of Wuhan (non-volunteers). A path analysis theoretical model was developed to illustrate the relationships among psychosocial variables and was separately applied to volunteer and non-volunteer groups.

In manuscript two, a cross-sectional study was conducted …

Transition Needs, Challenges, Satisfaction, And Support Strategies Of Newly Hired Nurses In The Clinical Setting, Ric-An Artemio S. Gadin

Dissertations

With a looming shortage of nurses in the global scenario, there is a deep concern to address the transitioning of newly hired nurses to become skilled nurses who can deliver essential health services without compromising the safety and effectiveness of patient care. There is an urgent need to effectively prepare these new nurses for the transition to bedside clinical practice. This prompted the researcher to identify the transition needs, challenges, satisfaction, and support strategies of newly hired nurses in the clinical setting. This study utilized a descriptive method of research using a validated self-constructed survey questionnaire to elicit responses from …

Increasing Rooming-In Rates On A Mother Baby Unit, Scotti Manes

Dissertations

Problem: For new postpartum mothers, rooming-in has much evidence-based benefit; yet it is not widely accepted. Recent trends show the standard of care has changed to have newborns cared for in the nursery during parts of the postpartum period. Healthcare providers have unintentionally lacked providing ample education to new mothers regarding the benefits of rooming-in for mothers and newborns.

Methods: For this quality improvement (QI) project, a descriptive observational study design was used to identify if implementing standardized rooming-in education for patients influences rooming-in rates or the rates of exclusive breastfeeding at discharge. Thirteen staff nurses were identified as “champions” …

Visualizing Depressive Symptom Improvement: Implementing The 17-Item Hamilton Depression Rating Scale, Briana Raterman

Dissertations

Visualizing Depressive Symptom Improvement: Implementing the 17-Item Hamilton Depression Rating Scale

Abstract

Problem

Depression, a mental health diagnosis, has affected about 18.5% of adults (Villarroel & Terlizzi, 2020). Ketamine, a medication initially used as an anesthetic, has improved depressive symptoms in individuals struggling with treatment-resistant depression.

Method

This quality improvement (QI) project used the 17-item Hamilton Depression Rating Scale questionnaire to assess depressive symptom changes in patients receiving intramuscular ketamine for treatment-resistant depression. The questionnaire was administered to patients pre-and post-intramuscular ketamine administration. The data was collected on injections one, three, and six on each participant’s set schedule of injections …

An Evaluation Of A Multidisciplinary Implementation Of Evidence Based Practice In Prediabetes, Emily Sisco

Dissertations

Abstract

Problem Over 70% of prediabetic patients progress to full diabetes. There are over 80 million American adults who are diabetic. Diabetes is the costliest chronic disease that often leads to many other health issues.

Methods This QI project utilized a descriptive observational design. Quantitative data was collected via retrospective chart review. Primary data collected was documentation of a patient visit to the registered dietician and the hemoglobin A1c (HbA1c) of patients who followed up in the office after the referral.

Results Eight patients followed up to the office for a second visit (n=8). Four patients did see the registered …

Bee Brains: Dissecting Pollinator Behavior And The Importance Of Plasticity In The Face Of Changing Environments, Rachel Brant

Dissertations

All organisms face environmental variability, and much of contemporary biological research aims to understand the mechanisms allowing organisms to adapt and survive in the face of change. Animals residing in urban habitats face particularly high levels of unpredictability and environmental fluctuation due to changes based upon human desire. Though urban areas are considered relatively novel habitats, numerous species have adapted to city life, mediated through behavioral and physiological plasticity. Native bee species show particularly high species richness and abundance in urban settings, but the mechanisms driving this pattern are poorly understood. In this dissertation, I explore how bees employ plasticity …

Adverse Childhood Experiences (Aces) Education Implementation For Graduate Nursing Students, Courtney Kovachevich

Dissertations

Chronic conditions are a leading cause of death and disability in the United States (U.S.). Adverse Childhood Experiences (ACEs) are risk factors for chronic conditions and death; however, screening and assessment of ACEs do not occur in primary care settings. A barrier to screening is a lack of knowledge and education during providers’ didactic courses. To address this barrier, a standardized education tool was implemented into a midwestern public graduate nursing Doctor of Nursing Practice (DNP) curriculum. The design was a Quality Improvement (QI) project with a descriptive cohort design and purposive sample. The inclusion criteria were students in the …

Reducing Pediatric Morbidity Through Development Of A Clinical Practice Guideline, Deanna Kroh

Dissertations

Peripheral intravenous therapy is a commonly utilized treatment modality for the care of acutely ill pediatric patients. Two risk factors include infiltration and extravasation injuries. These injuries, peripheral intravenous infiltration or extravasation injuries (PIVIEs), can vary in their clinical manifestations from minor discomfort to harm as severe as loss of limb or disfigurement. Clinicians caring for patients at risk of developing PIVIEs need to be able to act quickly to reduce potential morbidity. The purpose of this project was to create a clinical practice guideline (CPG) that would guide staff intervention if a PIVIE occurs, with the ultimate goal of …

Implementation Of An Evaluation Of Davita Clabsi Protocol To Reduce Bloodstream Infections In Acute Hemodialysis Patients, Emmy Le

Dissertations

Abstract

Problem: Central line-associated bloodstream infection (CLABSI) is the primary cause of morbidity and mortality in End-Stage Renal Disease (ESRD) patients on hemodialysis. It is associated with severe medical conditions, prolonged hospitalization, and financial burden. Despite its convenience and simple operation, central venous catheter (CVC) account for 70% of all CLABSI occurrence and increase the risk for septicemia and death.

Methods: This quality improvement (QI) project utilized a descriptive observational pilot design to identify the effect of DaVita CLABSI Protocol on CLABSI occurrence rate. Quantitative data was collected retrospectively and prospectively via electronic medical record (EMR) review before and …

Family Mentorship Program In The Pediatric Organ Transplant Population, Kristin Rich

Dissertations

Abstract

Problem: At a comprehensive pediatric medical center in the Midwest, there are currently no structured support programs for pediatric transplant patients and their families A regulated and structured family mentor/support program for transplant patients and their families can provide the outlet they require to feel supported by peers who have also gone through the same journey of pediatric solid organ transplantation. Methods: A descriptive program evaluation design utilizing the Stetler model to evaluate data regarding the family mentor/support programs in the diabetic and sickle cell departments at a Midwestern children’s hospital. The purpose was to gather meaningful data for …

Education To Improve Long-Acting Injectable Antipsychotic Use, Travis Donald Wolfangel

Dissertations

Purpose: Long-acting injectable (LAI) antipsychotics are underutilized as an evidence-based treatment for schizophrenia and schizoaffective disorder. The purpose of this quality improvement project was to determine if a web-based LAI education module changed advance practice prescribers’ knowledge, attitudes, and practice behaviors regarding LAI antipsychotics one month after receiving LAI education at a community-based mental health organization.

Methods: This QI project was an observational pre- post-educational design. The 20-item Knowledge, Attitudes, and Practices (KAP) questionnaire was used to assess advanced practice providers’ knowledge retention, attitude changes, and practice modifications regarding LAI antipsychotics and prospective patient chart reviews were performed. …

An Evaluation Of Mindstrong™ Implementation With Graduate Nursing Students, Angela B. Sabblut

Dissertations

Problem: Nursing graduate students are at increased risk of greater stress, anxiety, and depression (Hoying, 2020; Melnyk et al., 2020). Cognitive Behavioral Therapy is the gold standard in the treatment of anxiety and depression (Hoying et al., 2020; Melnyk et al., 2015; Melnyk et al., 2020). MINDSTRONG™, a CBT-based training program, has been proven in many studies to be effective in helping individuals prevent or cope with these issues (The Ohio State University College of Nursing, 2020).

Methods: This Quality Improvement (QI) project was a descriptive-observational, pre-post design. Sample and setting were nursing graduate students from a Midwestern, middle-sized urban, …

Evaluation Of An Education Program Implementation For Adults With Stage 4 And 5 Chronic Kidney Disease, Dana Marie Carter

Dissertations

Abstract

Problem: Patients with long-term medical conditions represent a significant public health issue. Therefore, patients diagnosed with a chronic illness must have a high level of health literacy (HL) to manage their condition effectively. This Quality Improvement (QI) project evaluated the impact of an existing education-based program for stage 4 and 5 chronic kidney disease (CKD) patients and its effect on laboratory values compared before and after an NP-led education program that included vascular access, and modality choices.

Methods: A retrospective chart review was completed on 20 patients with an inclusive diagnosis of CKD stage 4 or 5 from …

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …

The Impact Of Music Education On Middle School Students’ Attendance Rates And Academic Achievement On Math And English Language Arts, Irene Wang Shi

Dissertations

In recent years, students’ standardized test scores have become one of the major measurements for students’ learning. However, music as a non-tested subject is often viewed as a lesser valued subject compared to core subjects. The purpose of this study was to investigate the impact music programs have on student academic achievement and attendance rate. The data was collected from one middle school of a large school district located in the northeast of Missouri. The study population includes sixth, seventh, and eighth-grade students who enrolled in the 2017-2018, 2018-2019, and 2020-2021 school years. The population was divided into students who …

The Impact Of The Phq-8 On Referrals To Psychotherapy Services For Oncology Patients, Sarah Beckmann

Dissertations

Abstract

Problem: Nearly seven million individuals will be struggling with both cancer and depression by 2040. Patients with cancer face a multitude of challenges. These challenges can impact a patient’s mental health and ability to cope with a cancer diagnosis. Currently, there is a large treatment gap among patients who are coping with both cancer and depression. Healthcare providers are neglecting to use evidence-based screening tools to assess patients for depression upon admission to inpatient treatment.

Methods: This quality improvement project took place at a large metropolitan comprehensive cancer center in the Midwest. A descriptive observational design was utilized. Prescreen-post …

Implementation Of A Critical Event Debriefing Tool In The Pediatric Intensive Care Unit, Tara Fiala

Dissertations

Problem: Working in the Pediatric Intensive Care Unit (PICU), staff encounter critical patient events without warning. Debriefing after adverse patient events has been shown to give staff the opportunity to process these events in an open, honest, and judgement-free environment. Debriefing has been recognized as a tool for detecting medical errors, improving team communication, providing emotional support, and analyzing team performance.

Methods: A descriptive, observational pilot study was used to implement the DISCERN tool into a large, midwestern, urban PICU. The aim of the quality improvement project was to achieve a debriefing tool completion rate of 20% over a one-month …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …