Digital Commons Network^™

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

Digital Contact Tracing During The Sars-Cov-2 Pandemic, Erin Katherine Moran

Dissertations

Problem

Manual contact tracing (MCT) is considered an essential public health intervention for infectious disease control. During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, there was insufficient funding or personnel to reduce transmission effectively. Throughout the pandemic, Missouri remained below the recommended contact tracing response rate (CRR) of 50%. One method used globally to aid in pandemic control was digital contact tracing (DCT); however, Missouri was unable to implement digital contact tracing due to barriers faced, which were not unique.

Methods

DCT was selected as subject of a strategic plan (SP) to augment MCT efforts. Other locales’ successes …

Attitudes Toward Sars-Cov-2 In Frontline Healthcare Workers And First Responders, Michelle Tiffany Arrington

Dissertations

Problem: To date, little evidence exists to understand attitudes of SARS-CoV-2 in frontline healthcare workers (HCW) and first responders (FR), related to best practices in mitigating virus spread. The purpose of this project was to assess attitudes toward COVID-19 in young adults, ages 18-44 years old, who are frontline workers related to their adherence to PPE guidelines, social distancing, hand hygiene, community exposures, and vaccinations.

Methods: A descriptive survey design using five-point Likert scale questions and 26 open-ended questions and was implemented one-year after onset of the pandemic. A purposive sample working in a large, urban, Midwest metropolitan area was …

Mental Health Effects Of The Covid-19 Pandemic On Older Adults, Elizabeth Kerr

Dissertations

Problem: Significant psychological effects such as anxiety, depression, stress, and loneliness are shown to affect the older adult population, aged 65 years and older. The social isolation and disconnectedness related to the COVID-19 pandemic potentially worsens anxious and depressive feelings, increasing the risk for adverse outcomes in the high-risk older adult population. This project aimed to identify older adults at risk for acute, situational mental health issues associated with the pandemic.

Methods: A descriptive study design was used. Telephone interviews were conducted to explore effects of the COVID-19 pandemic on mental health responses in older adults. A convenience sample …

Youth Sports In A Pandemic Age, Robert Bohnert

Dissertations

Abstract

Problem: Youth sporting events is a public health concern as infected youth with coronavirus disease 2019 may unknowingly spread the virus, as many show little to no symptoms (Zimmerman & Nigel, 2020). This project aimed to identify level of adherence to posted Youth Sports Guidelines, which were designed to mitigate the spread of virus at youth sporting events.

Methods: An observational descriptive design was utilized. Two observers tallied guideline violations by participants and spectators at six high-contact (basketball) and six low-contact (swimming) public high school youth sporting events.

Results: A total of 726 youth sport participants and 139 …

The Effects Of Race, Ethnicity, Education, Marital Status, And Family Size On Hysterectomy Rates, Zula Price

Dissertations

Decreasing disparities in hysterectomy rates have been a goal of the United States Department of Health and Human Services as a method of improving women's health. In the United States, hysterectomy rates remain high, particularly among Black women in contrast to other racial and ethnic groups (Qi et al., 2013). This study, using a descriptive research framework, utilized a sample of 1,921 women across the United States who participated in the 2012 National Health and Nutrition Examination Survey (NHANES).

Data were analyzed from the responses of subjects who reported having a hysterectomy in the 2012 NHANES, which is designed to …

Educating College Students About Human Papillomavirus, Pamela Bryant

Dissertations

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in the US affecting almost 60% of college women ages 20 to 24 years. At one west coast community college, two thirds of males and half of females were unaware of HPV vaccine recommendation through age 26 years.

This aim of this project is to determine if an evidence-based online educational video about HPV and HPV vaccine would increase knowledge of HPV and intent to receive the vaccine among community college students enrolled in urban and suburban community colleges in Southern California. Measured outcomes of interest included HPV knowledge …

A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad

Dissertations

Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff's minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging …

A Screening Tool To Identify Patients At High Risk For Perioperative Neuropathy, Carla M. Ibbotson

Dissertations

This project aimed to evaluate anesthesia provider attitudes surrounding the clinical topic of perioperative peripheral nerve injury. Additionally, the project sought to introduce anesthesia providers to a novel risk assessment device that may help identify patients at high risk for perioperative peripheral nerve injury while assessing its potential utility in anesthesia practice.

Factors That Affect Adequate Analgesia In African Americans With Cancer Pain, Navdeep Singh

Dissertations

Receiving adequate analgesia has been shown to be problematic for African Americans with cancer pain. The vast majority of studies only simply highlights the existing disparities between African Americans and Caucasians in pain management. There is a lack of research focusing on the etiology of these disparities, specifically on what causes prescriptions for inadequate analgesics, especially for African Americans. The purpose of this study was to characterize the adequacy of analgesia received by African Americans with cancer pain and to elucidate what patient characteristics contributed to receiving adequate analgesia.

Holistic Blood Pressure Management Plan In Primary Care, Marilyn L. King

Dissertations

The purpose of this Doctor of Nursing (DNP) quality improvement (QI) project was to demonstrate the usefulness of implementing a bilingual educational module for patients with hypertension on improving knowledge, self-efficacy, and self-management at Kids Kare Pediatrics and Family Kare Clinic.

Forty Years After The Larry P. Decision: School Psychologists’ Perceptions Of The Assessment Of African American Students With Specific Learning Disabilities, Shara Cabreros

Dissertations

Purpose: The purpose of this qualitative study was to identify and describe the assessment models school psychologists use to identify African American students with SLDs in three of the K-12 school districts in Riverside County. A second purpose of this study was to determine how school psychologists within three districts of Riverside County perceive the assessment model used in their school district affects the identification of SLDs in African American students. A third purpose of this study was to determine the assessment model school psychologists in three districts in Riverside County believe most accurately identifies SLDs in African American students. …

Clinicians' Use Of Mhealth Applications In Interventions For Substance Use Disorders, James Daniel Bender

Dissertations

The purpose of the study was to examine how clinicians are identifying, evaluating, and utilizing mHealth apps as treatment adjuncts with their clients who have a substance use disorder. A sample of 93 participants (20 males, 72 females, and 1 not listed) completed measures of demographics and inquiries about their use and evaluation of mHealth apps in their practices. Clinicians who work at mental health centers and private practicing clinicians were recruited. The majority of the sample (71%) reported that they had not utilized mHealth apps with their clients who have a substance use disorder diagnosis. Participants who have attended …

What You Speak Shall Come: Examining Spirituality On Retention Of African American Males Attending A Predominantly White Institution Using A Sequential Explanatory Mixed-Methods Design, Carlous Brian Yates

Dissertations

African American males have faced significant challenges at institutions of higher education over the years (Harper, 2013; Griffith et al., 2019). This study aimed to examine the impact of spirituality on the retention of African American males attending a Predominantly White Institution (PWI) through a sequential explanatory mixed-methods design study.

The participants in the study were African American males (N = 47) with age range 18 to 48 years old all attending a mid-sized university located in the mid-western region of the United States during the Fall 2020 and Spring 2021 semesters. The university is considered a Predominantly White Institution …

Examining Treatment Acceptability Of An Eight-Week Mindfulness-Based Stress Reduction Protocol, Blake William Palmer

Dissertations

The goal of this study is to examine whether levels of perceived stress, experiential avoidance, personality traits including openness to experience and agreeableness, and demographic variables will predict the treatment acceptability (indicated by responses on the Treatment Acceptability and Adherence Scale) of an eight-week Mindfulness-Based Stress Reduction (MBSR) program. This study collected data in the Spring of 2019. The final number of participants in the study was 116 (40 females, 76 males, Mage = 36, age range: 22-69 years). Participants completed measures including the Perceived Stress Scale (PSS), Acceptance and Action Questionnaire-II (AAQ-II), the agreeableness and openness to Experience domains …

Development Of A Scale To Measure School Psychologists' Self-Efficacy For Working With Gifted Populations, Brittany Marie Dodds

Dissertations

School psychologists are specialists in educational assessment, consultation, youth mental health, and social-emotional-behavioral development. As a result of their training, school psychologists are positioned to serve students with exceptionalities, including gifted students. However, research indicates that school psychologists' familiarity with gifted issues is lacking and that information regarding school psychologists' self-efficacy for working with this population is nonexistent. Therefore, the aim of the present study was to create a tool to assess school psychologists' self- efficacy for working with gifted populations. The Dodds Inventory of Gifted Self- Efficacy for School Psychologists (DIGS-SP) was developed and administered to 229 practicing school …

High School Principals’ And Assistant Principals’ Perceived Knowledge Of Career And Technical Education, Sara Jo Greene

Dissertations

An employment crisis is ever growing in Kentucky. Business and industry continue to search for reliable skilled employees without success. These representatives have started looking at local high school and technical education centers to help fill these employment gaps. Career and Technical Education (CTE) provides students with a strong foundation to become a well skilled, employable individual who will make a great employee. Although CTE programs are available throughout the state of Kentucky, enrollment is not where it should be. The purpose of this study was to examine the relationship of perceived knowledge of CTE held by Kentucky high school …

Examining The Psychological Effects Of Adolescent Bullying In Adults, Douglas Caro

Dissertations

Being an adolescent victimized by bullying is not only widespread but all too common in a society that deems it a “normal” rite of passage. However, bullying in schools has received increased attention since school shootings have inundated the media and news headlines the last several years. Some have correlated bullying to the shooters being bullied themselves. Being a victim of bullying has been linked to serious medical and mental health problems, not just in adolescents but across the lifespan. It is common for victims to experience physical problems such as abdominal pain and other gastrointestinal concerns. Mental health problems …

Postpartum Depression In South Asian American Mothers: An Examination Of Screening Tools And Associated Cultural Factors In Assessment, Heer Panchal

Dissertations

Postpartum depression is a disorder impacting an overwhelming number of women after childbirth with symptoms of depression, anxiety, guilt, and hopelessness. Due to limited research and understanding of postpartum depression in the growing South Asian population in the United States, it is vital to gather data and research on this population to increase understanding of patterns and experiences that occur within the South Asian American population and to incorporate cultural factors into the screening process. The current research’s objectives include discussing the facets of postpartum depression, current tools used to screen for postpartum depression, and helpful interventions to create a …

Nurse Residency Program Use In Alabama Hospitals: Exploring The Decision-Making Strategies Of Hospital Administrators, Miranda M. Smith

Dissertations

Current literature supports the creation and implementation of nurse residency programs to support new graduate nurses as they transition into nursing practice. Additionally, nurse residency programs have been shown to increase nurse satisfaction and retention (Crimlisk et al., 2017; Olson-Sitki et al., 2012). Currently, there are only three nurse residency programs in the state of Alabama. The lack of this important post-licensure resource poses a problem for new graduate nurses who are seeking additional assistance and guidance during the transition to professional practice.

This qualitative study examined the decision-making process of hospital leaders in the implementation of the nurse residency …

Challenges Associated With Treatment Of Borderline Personality Disorder In Older Adults And The Impact On Psychosocial Development, Marisa Victory

Dissertations

The continued growth of the global aging population calls for further expansion and development of the appropriate diagnosis and treatment of older individuals living with borderline personality disorder (BDP), yet there is limited information regarding the impact of the disorder in later adulthood. The pivotal work of Erik Erikson, specifically his psychosocial stages of development, is a widely accepted conceptual framework for understanding human development including into older adulthood. During the late adulthood psychosocial stage of development, people experience a multitude of changes in relationships, work status, family, and what they define as meaningful. These changes can have a negative …

Local Food In Tourism: An Investigation Into Food Offerings At Irish Visitor Attractions—Are We Telling The Right Story?, Kate O Hora

Dissertations

This study’s aim is to investigate food offerings at visitor attractions in Ireland. Recent comments by Fáilte Ireland regarding food at visitor attractions has called on operators to localise their food offerings. A sample of eleven providers of food at visitor sites were invited to participate in qualitative interviews, to conceptualise their experiences with the provision of local food. The results showed that the sector had an overall interest in local food with most of the participants recognising that not enough emphasis was being placed on its promotion. The results of the study reveal that provision of local food provides …

A Study On How Retired U.S. Army First Sergeants Led Their Troops Throughout Turbulent Times In Afghanistan During Operation Enduring Freedom Or Operation Freedom Sentinel, Enrique Ortega

Dissertations

Purpose: The purpose of this qualitative study was to discover and describe behaviors that retired U.S. Army First Sergeants (1SG) applied to lead their troops through turbulent times using the leadership attributes of moral purpose, concern for the collective interest, resilience, and personal temperament during combat operations.

Methodology: This qualitative study used a phenomenological approach to capture data from 10 retired U.S. Army 1SGs in the South Puget Sound area in Washington State who led their companies in Operation Enduring Freedom (OEF) and Operation Freedom Sentinel (OFS). Data were collected from 10 interviews and 71 artifacts of Disabled Americans Veterans …

Does The Input Equal The Outcome For Students With Emotional And Behavioral Disabilities?, Brigid Eileen Bright

Dissertations

Students with emotional and behavioral disabilities experience poor post-secondary outcomes despite the existence of research-based best practices to improve outcomes (Freeman et al., 2019; Mitchel et al., 2019). Research signifies this population as underserved and under-identified (Barnett, 2012). Additionally, funding best practices indicate student outcomes should be considered when allocating resources (Chartrand, 2019). The purpose of this mixed methods study was to consider both inputs and outcomes for graduates with emotional and behavioral disabilities (EBD) and graduates with significant cognitive impairments (SCI) in a rural northwest Arkansas district and the fiscal allocation for both populations. A comparison of quantitative post-secondary …

The Impact Of Consumer Smart Device Platforms On Illness Uncertainty And Anxiety In Patients With Atrial Fibrillation, Wing Yan Vien Cheung

Dissertations

Atrial fibrillation (AFib) is a common cardiac arrhythmia associated with increased risk for comorbid health conditions. Advancements in consumer technology have enabled patients to monitor hearth rhythm independently, yet, much remains unknown about patient outcomes related to the use of these smart device platforms (SDP). The aim of this study was to examine the iatrogenic and/or remedial effects of SDP use on patient reported outcomes of illness uncertainty, cardiac anxiety, body vigilance, AFib symptoms, symptom burden, and healthcare utilization. The sample included 130 AFib participants (65 in SDP group) recruited through ResearchMatch, American Heart Association support forum, and other online …

Social-Emotional Learning: Effects On Teacher Attrition, Retention, And Self-Efficacy, Shawna M. Olney

Dissertations

The rise in teacher attrition rates have been examined since the 1970s (Croasmun et al., 2000). Teachers have reported leaving the profession early due to many factors, including salaries, student discipline, administrative support, parental involvement, working conditions, and lack of professional respect (Cochran-Smith, 2004; Hughes, 2012). Teachers have felt unprepared in dealing with the high demands of teaching, especially in handling student discipline (Thibodeaux et al., 2015). Up to 35% of teachers have reported leaving the profession based on their difficulties with student discipline (Schonert-Reichl, 2017, para. 21; Schonert-Reichl et al., 2017, p. 18). The Collaboration for Academic, Social, and …

Talk To Me - A Re-Standardization Of Bedside Report, Lisa Randall

Dissertations

The use of bedside shift report provides for an accurate exchange of information between healthcare providers. Bedside shift report has been shown to decrease call light usage, medication errors, patient falls, as well as increase patient and nurse satisfaction. The aim of this project was to re-implement the usage of bedside shift report on two units in a community hospital. The steps involved in this project were a preliminary survey followed by observations of the current process of bedside report. The next step was to educate regarding the importance of bedside report and its benefits. This was followed by another …

Depression Screening And Management In A Free Primary Care Clinic, Ashley Gagne

Dissertations

Introduction. Depression diagnoses in the United States continue to rise within the primary care setting. At a free primary care clinic in the Southeastern United States, the PHQ-9 screening tool was being used to screen patients for depression, but providers were not regularly addressing positive screenings. Aims. This quality improvement project aimed to evaluate health care staffs' awareness, attitudes and confidence towards depression screening and management and implement best practices in primary care identification and follow up for depression.

Methods. Health care staff at a primary care clinic responded to Revised Depression Attitudes Questionnaire (RDAQ) pre-and post-surveys to measure their …

Diabetic Education To Reduce Readmission Of Patients With Diabetes, Nicoleta F. Buiciuc

Dissertations

Hospital readmissions by patients with diabetes rise due to known risk factors such as lack of a healthy diet, physical activity, aging and obesity (Sonmez, Kambo, Avtanski, Lutsky, & Poretsky, 2017). Diabetes education and management is key to improving self-care behaviors and reducing hospital readmissions within 30 days (Drinic et al. 2017 & Sullivan & Alexander, 2019). Diabetes self-management involves education on healthy diet, exercise, self-monitoring of blood glucose, avoidance of risk factors and complications (Chai et al., 2018). Hospitalization provides an ideal time to identify barriers to improving a diabetes home regimen and promote DSME (Inpatient Diabetes Management, 2016). …

Reducing Hospital-Acquired Pressure Injuries Through The Implementation Of The Leaf Patient Monitoring System, Meghan Kelley

Dissertations

A top priority for all hospitals is patient safety. A major component of patient safety classified under this category is prevention of hospital-acquired pressure injuries (HAPIs), which are considered "never-events" by the Joint Commission and align with the World Health Organization as preventable harm. Due to current policies on a particular unit not proving to be effective at reducing HAPIs, the implementation of the FDA-cleared Leaf Patient Monitoring System was proposed. This technology uses a sensor adhered directly to the patient to reduce the trending HAPI rates on the a progressive care unit while assisting nursing in adhering to the …