Digital Commons Network^™

A Strategic Plan To Thread Genomics Competencies Into Undergraduate Curriculum, Holly Mathis

Dissertations

Problem: Genomics in undergraduate nursing education has experienced slow adoption in the United States. Various approaches have been proposed but do not address barriers to successful implementation.

Methods: A strategic plan was developed to increase the amount of genetics and genomic content in the curriculum of an undergraduate nursing program. A gap analysis was performed on the curriculum revealing a paucity of content. A SWOT analysis informed the strategic plan, which included a faculty education program using the ANA/ISONG’s Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines and Outcome Indicators (2^nd ed.) (2009) as a foundation.

Results: Faculty …

Utilizing Wellness Champions As A Faith-Based Initiative For Mental Health Promotion, Tracy M. Webster Cooley

Dissertations

Abstract

Purpose: This program evaluation project evaluated the effectiveness of mental health training and support provided to wellness champions affiliated with a behavioral health organization. This project sought to gain a better understanding of how clergy and laypersons acting as wellness champions in predominately African-American faith-based organizations perceive they create an atmosphere to decrease stigma and increase mental health promotion and wellness when receiving education and training on mental health.

Methods: A descriptive project using a program evaluation design to evaluate the effectiveness of the training of 122 wellness champions from faith-based organizations received from a behavioral health organization …

Evaluation Of Sleep Hygiene Checklist For Delirium In An Intensive Care Unit, Ying Wei

Dissertations

Abstract

Problem: Delirium is a severe complication brought on by sleep deprivation that could increase mortality and prolong intensive care unit (ICU) stays in critically ill patients. This project aimed to develop and implement a sleep hygiene checklist to decrease the incidence of delirium in a Medical Intensive Care Unit (MICU).

Methods: This study used a pre-post design to compare the incidence of delirium pre-and post-implementation of the sleep hygiene checklist. Forty-four patients and thirty-six patients were recruited for the pre-and post-intervention groups, respectively.

Results: The result of this study demonstrated use of a sleep hygiene checklist could decrease the …

The Effects Of High Dose Intravenous Vitamin C In Cancer Patients, Bankole Aluko

Dissertations

Problem: Currently used standard treatments (Chemotherapy, radiation) in cancer patients are generally accompanied with side effects, which may include pain, nausea, vomiting, fatigue, and chemotherapy-induced peripheral neuropathy (CIPN) during and after completion of treatments. High dose IV C may improve the anti-cancer action of chemotherapeutic agents by reducing side effects of fatigue, pain, nausea and vomiting and boosting immune cell functioning, and inhibiting angiogenesis (Mikirova, Casciari, & Hunninghake, 2019).The purpose of this quality improvement project was to explore whether high dose intravenous vitamin C (IV C) prevented major side effects that frequently occur with standard treatments in cancer patients and …

Impact Of The Hester Davis Fall Risk Scale On Inpatient Falls, Amelia Payne

Dissertations

Problem: During a three month period in 2018, a rural acute care facility experienced a fall rate of 3.4 falls per 1,000 patient days. The aim of this clinical scholarship project was to implement the Hester Davis Fall Risk Scale (HDFRS) for adult inpatients in a rural acute care facility.

Methods: Utilizing the Find, Organize, Clarify, Understand, Select- Plan, Do, Study, Act (FOCUS-PDSA) model, the HDFRS was implemented and evaluated using a pre and post design to determine its impact on falls per 1,000 patient days and falls with injury per 1,000 patient days. The method of evaluation was a …

Evaluation Of A Type 2 Diabetes Mellitus Care Coordination Program, Carrie Smith

Dissertations

Abstract

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing Diabetes Care Coordination (DCC) program at an urban clinic for clients with no health insurance in the Midwest. Diabetes related indicators of those enrolled in the DCC program and client reported barriers were documented over a 19 month period.

Sample: Clients included were 18 years and older, with no insurance, having the diagnosis of Type 2 diabetes mellitus, and were enrolled in the DCC program within the first six months of the program's initiation.

Methods: A retrospective chart review of 24 clients recording diabetes related outcome indicators …

Utilizing High Flow Oxygen Therapy In Infants With Bronchiolitis, Sarah Ulses

Dissertations

Problem Bronchiolitis is the leading diagnosis of hospitalizations for children under one-year. The purpose of this study was to evaluate the effectiveness of supportive high-flow oxygen (HFO) therapy for infant patients requiring more than 2L/min nasal cannula (NC).

Methods An observational, descriptive design with convenience sampling of infants aged one-year or less, hospitalized with bronchiolitis and requiring HFO therapy. Comparisons were done between 2019 when no HFO was allowed on the general unit and in 2020 when HFO was allowed.

Results Of 28 patients (N = 28), 13 (n = 13) were in the 2019 cohort and 15 …

Take 10 Program Effects On Fifth Grade Academic Achievement, Emily Janes

Dissertations

Problem Less than one-fourth of children reach their recommended 60-minutes of daily physical activity. Inactivity can result in poor academic performance; whereas physical activity stimulates brain functions responsible for regulating comprehension and attention, release of brain chemicals to improve learning, and enhances neurogenesis resulting in better cognition. The purpose of this quality improvement project was to evaluate the Take 10 exercise program in a rural, Midwestern elementary school fifth grade classroom.

Methods An observational, descriptive design with a purposeful sample of fifth-grade students in a rural elementary school. Grades in math, science, and reading were examined the semester before (quarter …

Increasing Cms Sepsis Core Measure Adherence Rates Through Virtual Consultation, Angela Cann

Dissertations

Problem: According to the Centers of Disease Control and Prevention (CDC, 2016), it is estimated that sepsis affects around 1.5 million individuals in the United States annually, causing the death of 250,000 individuals and being responsible for one out of three hospital deaths. One-fourth of patients who develop severe sepsis will die during their hospital stay. Delays in sepsis treatment contribute significantly to increased morbidity, mortality, and length of stay in the hospital. The Centers for Medicare and Medicaid (CMS) sepsis bundle guideline adherence rate in the Emergency Department of a Level III Trauma Center was stagnant at 55% through …

Improving Clinician Adherence Rates To Aims Testing On Individuals Taking Long-Term Antipsychotics, Shavaun Johnson

Dissertations

Abstract

Problem: Tardive dyskinesia is a common problem that creates challenges in the lives of those affected by it. The Abnormal Involuntary Movement Scale records the occurrence of tardive dyskinesia in patients receiving neuroleptic medication. With this scale, clinicians can detect tardive dyskinesia and its severity over time. The aim of this study is to learn the current rate of adherence for clinicians at the organization and to create and implement an intervention that will increase that rate in an effort to improve patient outcomes and quality of life.

Methods: This quality improvement project will use a descriptive cohort …

Multidisciplinary Team Approach Effect On Pediatric Severe Asthma, Lila Kertz

Dissertations

Problem. Children with severe asthma are more likely to be non-adherent with their prescribed medications, often related to barriers. A holistic assessment of these patients has been suggested, but is not typically performed in most pediatric asthma clinics. The purpose of this project was to evaluate the effects of severe pediatric asthma clinic services designed to perform holistic assessments and provide comprehensive care.

Methods. An observational, descriptive design was used to evaluate the Severe Asthma Clinic for Kids (SACK) created in 2013 using a retrospective database review. A convenience sample of data collected on all children treated in the clinic …

Intimate Partner Violence Screening In Adolescent And Young Adult Females, Emily Myers

Dissertations

Abstract

Problem Adolescents and young adult females are at risk for experiencing intimate partner violence (IPV). Females aged 16- to 24-years of age experience IPV three times more likely than males. Universal screening for adolescent IPV is considered a gold standard for adolescent anticipatory guidance. The purpose of this quality improvement initiative was to evaluate the impact of an adolescent IPV screening instrument in an urban, Midwestern shelter for pregnant adolescent and young adult females.

Methods An observational, descriptive design. All adolescent and young adult females presenting for intake evaluation were screened for IPV using the Healthy Relationship Quiz over …

Mitigating Suicide Risk Post-Discharge From Inpatient Crisis Stabilization: Safety Planning Intervention, Leighia M. Mcghee

Dissertations

Abstract

Purpose: The purpose of this program evaluation is to evaluate the effectiveness of a newly implemented safety planning intervention (SPI) tool, comparing patient outcomes relating to suicide attempt rates, emergency department (ED) encounter rates, and inpatient rehospitalizations rates pre and post its integration to care in a suburban behavioral health hospital.

Methods: A descriptive cohort design utilizing a retrospective chart review was completed over six months, three months pre, and three months post implementation of the SPI program. A convenience sample of inpatient charts was reviewed to assess the rate of suicide attempts, ED encounters frequencies, and hospitalization rates …

Optimizing The Effectiveness Of Peripheral Intravenous Catheters, Carrie Kollar

Dissertations

Problem Hospitalized adult patients require more than one short peripheral catheter (SPC) to complete the prescribed intravenous (IV) therapy due to catheter failure and the practice of resiting. The purpose of this quality improvement initiative was to increase the rate of SPCs remaining in situ for the entire duration of the IV therapy for hospitalized adult patients.

Methods Application of an engineered securement device (ESD), an educational program pertaining to modifiable risk factors, and changing the practice to removal upon clinical indication were methods utilized to reduce the number of SPC insertions and catheter failures. This study was conducted at …

Compassion Fatigue And The Emergency Department, Alexandra Myers

Dissertations

Problem The emergency department (ED) is a high-stress environment. Nurses exposed to this stress for prolonged periods are subject to compassion fatigue (CF). The purpose of this quality improvement project was to identify and reduce the level of CF in ED nurses by implementing Real Time Transformative Response^© (RTR). RTR^© is a technique that uses combinations of neurofeedback response awareness, biofield therapy intervention, and clearing of unwanted energy.

Method A purposeful sample of ED nurses working at a moderately-sized, suburban, Midwestern hospital ED who were scheduled to work 24-hours or more per week completed a Professional Quality of …

Degree Completion Of Underrepresented Minorities Majoring In Mathematics As A Function Of Undergraduate Student Programs, Marnice Anthony

Dissertations

Abstract

Students with disabilities, minorities, and women are underrepresented in the critical demand courses of study in Science, Technology, Engineering, and Mathematics (STEM) undergraduate college enrollment. Institutions of higher education in the United States of America are challenged with a continuous need for undergraduate students to choose and earn a STEM degree. The 2019 annual report of Women, Minorities, and Persons with Disabilities in Science and Engineering indicated these groups continue to be disproportionately underrepresented relative to the U.S. population. In 2014, the U.S. Department of Education reported that upon graduation students studying mathematics in college have higher employment rates …

The Role Of Professional Nursing In The Origin Of The Newborns' And Mothers' Health Protection Act Of 1996 From A Feminist Perspective, 1981-1996, Jan-Louise Leonard

Dissertations

This social historiography tells the story of the origin of the Newborns' and Mothers' Health Protection Act of 1996. In the 1980s when the federal government reduced allocations to states' Medicaid programs as a cost saving measure, hospitals, initiated early discharge of patients to save costs. Given four million births annually, childbirth is the most frequent reason for hospitalization in the United States. Hospitals discharged Medicaid insured mothers and newborns very early at twenty-four hours for a normal birth and seventy-two hours for a cesarean. Other insurers adopted similar managed care strategies in the early 1990s. By 1995, unionized nurses …

Integrating Nursing Peer Review Into A Unit Shared Governance Model, Mary Jane Brann

Dissertations

Transformational nursing leaders develop environments that empower nurses to achieve nursing excellence. The systems identified by the Magnet Accreditation program, such as shared governance and peer review, help achieve these environments. During the project, a peer review tool based upon the American Nurses Association (ANA) standards of practice was developed. The tool was revised to assist staff nurses with identification of medical record items that exemplified each standard while they were completing the mandatory medical record audits required by the Joint Commission.

A Multi-Hospital Examination Of The Relationship Between Hospital Nursing Resources And Hospital Quality Outcomes, Cheryl A. Patterson

Dissertations

This exploratory study examined the relationship between hospital nursing resources and quality outcomes of hospital care. A portion of Donabedian's model linking structure to outcome was used to frame the study. Structure variables consisted of hospital nursing resources. Outcomes were (1) patient satisfaction (with a: overall hospital stay, and with b: nursing care) and, (2) inpatient (risk-adjusted) mortality. The purpose of this study was to explore at the institutional level these relationships; the hospital being the unit of analysis. Nursing resource data were collected by the investigator from hospitals belonging to the same health care market.

Social Patterns And Pathways Of Hiv Care Among Hiv-Positive Transgender Women, Dana D. Hines

Dissertations

Transgender women have the highest HIV prevalence rates of all gender and sexual minorities, yet are less likely to enter and be retained in HIV care. As a result, they are at high risk for HIV-related morbidity and mortality. This study aimed to describe the illness career of transgender women living with HIV and to describe how interactions with health care providers and important others influenced their illness trajectory.

The Lived Experiences Of Male Partners Of Women Who Have Previously Been Diagnosed With Postpartum Depression, Judy Kaye Smith

Dissertations

This qualitative, descriptive phenomenological study was conducted to determine the actual lived experiences of male partners of women who have previously been diagnosed with postpartum depression. The study also explored the knowledge level of male partners with regard to the phenomenon of postpartum depression. While experiences were varied, three common themes emerged of being vulnerable, being helpless, and coping with two to four sub-themes identified under each one. The seven men who participated demonstrated gaps in the knowledge with regard to the phenomenon of postpartum depression.

Psychometric Properties Of The College Athlete Psychological Screening Tool: Validation Of The Depression And Anxiety Subscales, Joseph C. Case

Dissertations

The aim of the present study was to gain a better understanding of the descriptive psychometric properties of the College Athlete Psychological Screening (CAPS) measure. The CAPS is a newly developed assessment screening measure designed to assess 14 common problem areas for college athletes. For the present investigation, 395 participants completed the 108-item CAPS measure. To establish criterion validity, participants also completed the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The present study had three research questions. Question one discussed the descriptive psychodynamic properties (Cronbach’s alpha, means, and standard deviations) of the 14 CAPS subscales. Question two …

Academic Library Support Of Social Entrepreneurship Programs, Anthony L. Paganelli

Dissertations

The concept of social entrepreneurship was introduced into higher education in the late 1980s. Since then, social entrepreneurship programs have increased at higher educational institutions nationally and globally. This study examines how academic libraries support the growing trend of social entrepreneurship programs and the perceptions of academic library administrators and faculty librarians toward social entrepreneurship programs. Based on the review of literature, little information exists regarding the academic library support of social entrepreneurship programs. This study involved a survey instrument distributed to academic library administrators and faculty librarians from social entrepreneurship program institutions and a follow-up interview. The analysis provided …

A Phenomenology Study Of Possible External And Internal Factors Relating T Women’S Under-Representation In Leadership In Large Chinese Media Organizations In Beijing City, Xiaoxue Xiang

Dissertations

The purpose of this study is to gain a better understanding of possible factors that contribute to the underrepresentation of women in leadership positions in Chinese media through their lived experience. The 10 participants in this study were from large media organizations in Beijing. The results of this study indicate Balancing work and family and Chinese traditional culture can be considered as the external possible factors of the barriers women leaders encountered in Beijing large media organizations; the negative influence of traditional culture on Chinese women, which refers to women’s low self-evaluation and negative self-awareness, can be taken as the …

Training To Develop Academic Advisor Efficacy And Workforce Readiness, Jessica Powers

Dissertations

The competitive workforce views training as an investment in human capital, which is seen as its most valuable asset. In order to meet labor demands of tomorrow, the workforce will depend on higher education to educate workers. This will put academic advisors and the training they receive further in the spotlight, as they play a meaningful role in student success. Training has been shown to increase occupational self-efficacy and impact employee performance, but empirical research is lacking from the advisor perspective to explore their perception of training and occupational self-efficacy. In a study of N = 108 of faculty and …

The Relationship Between Organizational Trauma-Informed Care And Secondary Trauma Symptoms In Staff Members Of Kentucky Domestic Violence Programs, Mary Ellen Foley

Dissertations

This study evaluated secondary traumatic stress (STS) levels in 89 employees from Kentucky’s 15 regional domestic crisis programs to determine whether certain demographic variables predicted STS levels (as measured by the Secondary Traumatic Stress Scale©) and whether employee perception of organizational trauma-informed care practices (as measured by the Ticometer©) reduced levels of STS. Results of a multiple regression analysis indicated that personal trauma history severity did significantly impact STS levels. In this way, the current study rejected the null hypothesis. Results also indicated that the more the employee perceived the organization to adopt and execute trauma-informed care practices, the lower …

Culturally Relevant Pedagogy And First-Generation Latinx Student Sense Of Belonging, Rachel Abel

Dissertations

This qualitative research study assessed the impact of culturally relevant pedagogy on first-generation Latinx student sense of belonging at an emerging Hispanic serving institution (HSI). This study adds to current literature around culturally relevant pedagogy, which focused on the close, meaningful relationships between faculty and students in the classroom (Ladson-Billings, Gay, Wlodkowski, & Ginsberg, Stembridge, et al.). The link to sense of belonging (Hurtado & Carter, 1997) demonstrated the importance of academic and non-academic setting connections that led to other social and academic outcomes, which include student satisfaction, motivation to study, and perseverance in completion of a post-secondary. A transformative …

Student Perceptions Of School And Teachers In The Classroom, Sonji Jones-Manson

Dissertations

Much of the existing education research on student outcomes has focused on gaining a better understanding of student cognition and behavior, considering affect primarily as the role of a mediator or moderator to cognitive or behavioral outcomes. Student satisfaction with school is an affective outcome that is shaped by their relationships with their teachers. Though research on affect as an outcome has increased, it has not been well-understood and often ignored in models of understanding student outcomes. This qualitative study adds to the body of research on student affect as an outcome by collecting data from current high school students …

Clinical Trainees' Experience Of Burnout And Its Relationship To Supervision, Amanda Weaver

Dissertations

Burnout is a phenomenon that has recently gotten a lot of attention in research and media, but there is still a need to understand burnout among clinical trainees. Burnout is characterized by emotional exhaustion, a sense of cynicism, and a reduced sense of personal accomplishment. This qualitative study attempted to understand clinical trainees’ experience of burnout, the factors they believed were contributing factors to their burnout, and how supervision impacted this experience. The participants included six trainees who were enrolled in a clinical or counseling doctorate program, have experienced or are currently experiencing burnout, and had at least six months …

A Mixed-Method Study Analyzing The Impact Of Continuing Education On K-12 Educators, Jennifer Sue Edler

Dissertations

Teachers are consistently developing learners that independently seek to gain knowledge and skills throughout life (Blaschke, 2012). Educators must desire to learn new and improved skills to gain knowledge. The new regulations and qualifications, and standards surrounding a career in education require teachers to become continual learners. Professional development is the practice of teachers continuing to grow in their fields and varies depending on personal preference, personal interests, and professional history, as well as addresses issues present in their district or school (Day, 1999). Educational policies and laws outline the need for high-quality professional development for teachers. However, little evidence …