Digital Commons Network^™

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 …

Implementation Of The Process Improvement Toolkit For Hospital Acquired Pressure Injuries, Christina Bearden

Dissertations

Problem: Approximately 2.5 million people within the United States receiving inpatient medical care will develop a pressure injury each year (Padula & Demarmente, 2018). Pressure injuries (PI) are a multifactorial complication that can often be avoided with general prophylactic measures. Despite this, inpatient settings around the United States continue to see a rise in PIs.

Method: The quality improvement initiative utilized a descriptive, observational design. The turn team toolkit was implemented and monitored over a two-month period. Patient descriptors and quantitative data were collected through a retrospective chart review. The primary data collected was on pressure injury rates and staff …

Implementation Of Skin-To-Skin Immediately Post C-Section: A Pilot Study, Miah Vernor

Dissertations

Skin-to-skin contact during the golden hour is a practice that has numerous health benefits following the delivery of a newborn. These benefits include a healthy transition to extrauterine state, initiation of breastfeeding, thermoregulation, and more. However, the mode of delivery affects how often this practice is done. Parents who deliver vaginally are routinely offered the opportunity to perform skin-to-skin immediately after delivery whereas birth parents who deliver by cesarean section are not always offered this same benefit due to various reasons. A quality improvement project was conducted on an 18-bed labor and delivery unit at a Midwest hospital. This project …

Implementation Of Skin-To-Skin Contact Immediately Post Cesarean Birth: A Quality Improvement Project, Sophia Cooke

Dissertations

Problem: Skin-to-skin contact implemented within the first hour of a newborn’s life improves health outcomes for both mother and infant. One of these health outcomes includes exclusive breastfeeding. The purpose of this quality improve project was to implement an infant securement device within the operating room after cesarean section births to decrease the time to initiate skin-to-skin contact and increase exclusive breastmilk feeding rates at discharge.

Methods: This study utilized a descriptive, observational design and was guided by the Plan-Do-Study-Act framework. A pre-test, post-test design was utilized to compared retrospective and prospective data. The retrospective data was collected to assess …

Disambiguation Of Aerococcus Urinae Species Diversity, Brian Ian Choi

Dissertations

Aerococcus urinae is an uncommon inhabitant of the human urogenital tract. The Gram-positive bacterium has been implicated in a wide range of urinary tract diseases that, if left untreated or undiagnosed, can progress to severe disease such as infective endocarditis. Comparative analysis of 115 A. urinae isolates from infection episodes of urinary tract infection, bacteremia, infective endocarditis, urgency urinary incontinence, stress urinary incontinence, interstitial cystitis / painful bladder syndrome, and asymptomatic individuals reveal substantial diversity with respect to predicted virulence factors, metabolism, and observed biofilm behavior. Through whole genome sequencing analysis, these strains can be reorganized into six new taxonomic …

The Impact Of Trauma In Urban Communities On Educators And How They Prevail, Angelique Brown

Dissertations

This research was an exploration of the impact of community trauma in urban communities. The focal participants were educators who have worked 10 or more years in the profession and in a school building. The study surveyed 20 educators using open-ended questions to understand their experiences with trauma, strategies for coping, and the effects on their personal and professional lives. Community trauma, including gun violence, mass and school shootings, homelessness, educational neglect, was common among participants. Notably, traumatic events such as the deaths of Michael Brown, George Floyd, and Trayvon Martin, and the COVID-19 pandemic, had significant emotional personal and …

Factors Influencing Outcomes Of Undergraduate Nursing Student's Education, Patricia Jenkins Barnard

Dissertations

In 2021, approximately 509,000 undergraduate nursing students graduated from baccalaureate nursing educational programs. These new registered nurses (RNs) faced the same adversities as prior generations, including feeling unprepared to practice nursing, personal expectations did not match the reality of the situation, and working in an unwelcoming environment exacerbated by COVID-19 changes. During the time of COVID-19 changes in classroom delivery and settings brought these issues to the forefront (Dewart, 2020; IOM, 2010; NLN, 2015). There is a lack of information about nursing education modalities and their efficacy. Preliminary review documented that there was no clear evidence of which teaching modalities …

Evaluation Of A Clincally-Integrated Community Health Worker Program To Support Adults With Cardiovascular Conditions: Guided By The Prism Framework, Cynthia Orofo

Dissertations

Chronically ill individuals with cardiovascular diseases (CVDs) have been extensively challenged by the complexities of disease management. Cardiovascular disease remains the leading cause of death in the U.S. Although clinically integrated community health worker (cCHW) support interventions have been increasingly implemented to help manage CVDs, a comprehensive analysis of interventions implemented in real-world settings is lacking. The purpose of this study was to observe and evaluate a cCHW support intervention in a real clinical setting serving adults with CVD using an implementation science perspective, guided by the PRISM Framework.

Neonatal Intensive Care Nurses' Perceptions Of Nurse Leader Behaviors And Their Impact On The Workplace Environment, Meggan R. Mcculley

Dissertations

Nursing leadership is a crucial component in today's healthcare organizations as nurses make up the largest profession in healthcare overall. Nurse leaders have the ability to affect the environment of the nurses' workplace in both positive and negative ways, thus impacting their Quality of Nurse Work Life (QNWL). QNWL is an indicator of nurse satisfaction within their workplace, and the ability of the nurse to make meaningful contributions to their home units and the organization. The purpose of this qualitative, interpretative phenomenological analysis (IPA) study was to describe what it meant to experience nursing leadership from the perspective of Level …

Development And Evaluation Of A Nurse Practitioner Directed Early Palliative Care Initiative And Its Impact On Goal-Concordant Care At A Cancer Center, Ashley V. Weinmann

Dissertations

Seriously ill patients often experience discordant care. Delivering high-quality healthcare requires effective communication to support goal-concordant care.

Pancreatic cancer has a 5-year survival rate of 12% with a high symptom burden. Pancreatic cancer patients often have unmet needs that lead to increased psychological, spiritual, social, and physical needs. Early integration of palliative care can provide high-quality communication and goal-concordant care. A retrospective analysis of MDACC's pancreatic patients found that 34% were referred to palliative care.

A Quantitative Analysis Of University Counselors And Student Affairs Personnel's Knowledge And Confidence In Working With Students With Autism Spectrum, Sandra Araiza Salazar

Dissertations

University counselors and student affairs personnel often find themselves unprepared to address the needs of undergraduate students with autism spectrum disorder. Many of these professionals are not receiving the proper training or education to prepare for the unique social, emotional, and academic needs of these neurodiverse students. Due to this trend, many university counselors and student affairs personnel may lack the necessary knowledge and confidence in serving this neurodiverse population. In this first-of-its-kind study, university counselors and student affairs personnel’s knowledge and confidence in working with undergraduate students with autism spectrum was analyzed. A nonrandom sample of university counselors and …

Sensing With Integrity: Responsible Sensor Systems In An Era Of Ai, David Eisenberg

Dissertations

Deep and machine learning now offer immense benefits for consumer choice, decision-making, medicine, mental health and education, smart cities, and intelligent transportation and driver safety. However, as communication and Internet technology further advances, these benefits have the potential to be outweighed by compromises to privacy, personal freedom, consumer trust, and discrimination. While ethical consequences for personal freedom and equity rise from these technological advances, the issue may not be the technology itself but a lack of regulation and policy that allow abuses to occur. A first study examines how emerging sensor-based technologies, limited to only accelerometer and gyroscope data from …

A Non-Weight Centered Approach To Modifying Eating Attitudes In Polycystic Ovarian Syndrome, Jo'quishia A. Lethermon

Dissertations

Polycystic Ovarian Syndrome (PCOS) is an anovulatory disorder characterized by insulin resistance and endocrine dysfunction. Infertility and abnormal weight gain in women of childbearing age are often a result of PCOS, impacting quality of life and posing potential long-term health sequelae. Prescribing weight loss has been adopted by clinicians as an effective intervention to improve insulin resistance. For some patients, this practice has led to the negative effects of weight cycling and disordered eating attitudes which can result in long term adverse cardiometabolic outcomes. A quasi-experimental pre-and-post-test study was conducted to evaluate how a non-weight centered program influences eating attitudes …

Wellness Promotion Quality Improvement Project, Jacqueline K. Cantor

Dissertations

The purpose of this capstone project was to bring evidence-based wellness promotion through physical activity (PA) using the World Health Organization (WHO) (2020) guidelines to Psychiatric Mental Health Advanced Practice Nurses (PMH-APRNs) to improve mental health care and provider self-care. The guiding PICOT question was "For PMH-APRNs in community-based mental health practices, will the consistent implementation of the evidence-based intervention of a wellness prescription promoting physical activity based on WHO's (2020) PA Guidelines, compared to no consistent use in current practice, increase the promotion/prescription of PA to their mental health patients and increase the PMH-APRNs' own physical activity over eight …

The Effect Of Guideline Education On Anticoagulatin Management And Professional Collaboration In Ecmo Patients, Luis E. Farfan

Dissertations

This project aims to assist nurses and advanced practice nurses in preventing thrombosis and bleeding during ECMO treatment. It suggests following established anticoagulation guidelines, providing comprehensive education, and promoting teamwork among healthcare professionals. This approach can enhance patient outcomes by increasing knowledge and collaboration, ultimately leading to optimal administration of unfractionated heparin. Over approximately 20 weeks, the project was undertaken to enhance knowledge pertinent to anticoagulation management in patients undergoing Extracorporeal Membrane Oxygenation (ECMO). This initiative involved facilitating educational sessions tailored for nurses and Advanced Practice Providers (APPs) and focused on improving collaborative processes between these healthcare professionals.

Relationships Among Self-Care Behaviors And Professional Quality Of Life In Oncology Nurses, Susan M. Politsky

Dissertations

Oncology nurses distinguish themselves as providing strength and support for their patients who are receiving treatments to combat the diagnoses of cancer. Nurses are affected by the act of their honest caring and the compassion they provide to their patients. This caring and compassion can unintentionally lead to positive or negative outcomes for the nurse. Caring for oneself is often not a priority of oncology nurses. Introducing and incorporating self-care behaviors may have a direct impact on the well-being of oncology nurses. The purpose of this study was to explore the relationships among the components of self-care behaviors and the …

A Phenomenographical Study Of One School’S Efforts To Improve Student Reading Skills And Parent Literacy Support, Karey L. Williams

Dissertations

Providing early literacy training for children is a vital part of establishing the foundation for the learning they will do for the rest of their lives, so it is important that we do the right work from the start. Unfortunately, too many children are still reading below grade level by third grade, and instead of reading to learn new materials, they are still trying to learn to read. At Van Buren Elementary School, there are many challenges for students and teachers. The school’s Free and Reduced lunch rate is over 86%, the students receiving English to Speakers of Other Languages …

Thoughts, Conflicts, And Feelings Of Ela Teachers’ Experiences During The Covid-19 Pandemic, Matthew Osborn

Dissertations

The COVID-19 pandemic introduced many complications and challenges for educators. There is a need to document and describe teacher experiences during this time to determine common themes that may inform future educational practice. This study utilized narrative inquiry to examine the lived experiences of five secondary ELA teachers during the different phases of the COVID-19 pandemic. Three themes concerning how teachers perceived their students, work demands, and self were identified through several rounds of coding and thematic analysis. The findings and conclusions of this study contribute to developing a shared understanding of what happened in secondary education during the various …

Understanding The Tick Cellular Immunity To Pathogen Infection, Abdulsalam Adegoke

Dissertations

The tick immune response consist of two main components: the cellular and humoral components. The cellular component consists of hemocytes that circulate in the hemolymph-filled body cavity. Tick hemocytes are functional analogs of the mammalian white blood cells and are involved in immune responses including phagocytosis. The Humoral component includes mainly soluble peptides that function as antimicrobial peptides (AMPs) and pattern recognition receptors. Although tick hemocytes partakes in the humoral responses, different tick tissues produce several humoral factors such as AMPs and lectins. We have a deep understanding of the different humoral effectors released across the tick tissues during tick-pathogen …

The Effectiveness Of Curriculum Assessment Literacy Training For Head Start Teachers On Teacher Fidelity Scores And Class Assessment Scores, Netice Rankin, Netice Danyell Rankin

Dissertations

The purpose of this study was threefold, first to assess teachers’ initial knowledge of The Curriculum Fidelity Assessment Tool among Head Start Teachers utilizing the self -assessment. Secondly, the purpose was to assess if an intensive curriculum assessment literacy training made a difference in teacher’s knowledge of the curriculum fidelity Use as measured by The Curriculum Fidelity Assessment Tool for Administrators as reported by ECD Coaches and PI at the pre-test and post-test level. Third, the purpose of this study was to assess if intensive assessment literacy training makes a difference in the variables of interest, namely, curriculum use, classroom …

The Practical Application Of In-Vitro Tissue Digestion As A Means Of Producing Species-Specific Larval Diets And The Impact Of Dietary Protein Composition On Growth And Metabolism In Freshwater Fish, Giovanni Settle Molinari

Dissertations

The heavy reliance on live feeds is currently restricting the growth and sustainability of the aquaculture industry, therefore, the overall goal of this research was to improve the utilization of formulated dry diets at first feeding of larval fish. This was done with a specific focus on the production and provision of the optimal dietary protein form and composition. Chapter 2 aimed to provide an efficient protein source for larval fish by using same-species muscle and endogenous enzymes to produce hydrolysates and by providing a series of diets with increasing molecular weight protein fragments through larval development. Largemouth Bass (Micropterus …

Phenolic Compounds In Date Fruits (Phoenix Dactylifera L.), Muneeba Zubair Alam

Dissertations

This study investigated the phenolic compounds in date fruits, mainly soluble and hydrolyzable compounds, and insoluble melanin. Soluble (27.5–54.0 mg/100 g FW) and hydrolyzable (24.0–78.5 mg/100g FW) phenolic compounds were determined in 18 cultivars using ultra-performance liquid chromatography coupled with mass spectrometry. Phenolic acids were predominant in both fractions while flavonoids were mainly present in the soluble phenolic fraction and the proanthocyanidin B1 and B2 were only present in the hydrolyzable fraction. Four total antioxidant activity assays (total phenolic content, ABTS, FRAP, and DPPH) gave different results for both the soluble and hydrolysable fractions of 26 date fruit cultivars, which …

Exopolysaccharides Of Lactic Acid Bacteria Isolated From Labneh: Characterization, Bioactivities, And Effects On Gut Microbiome And Fermented Milk Rheology, Mohammed Tarique

Dissertations

Exopolysaccharides (EPS), produced by Lactic Acid Bacteria (LAB), are carbohydrate polymers with unique physicochemical properties and various biological activities widely used in food and pharmaceutical industries. This dissertation is aimed to (1) screen 42 new isolates from traditional yogurt-like products (Labneh) for their probiotic nature and identify the LAB strains using 16S rDNA sequencing; (2) optimize the conditions like pH, temperature, time, and quantity of sucrose for the growth of EPS produced by four selected LAB isolates; (3) purify and characterize EPS for the contents and investigate the bioactivities of the partially purified EPS; (4) study the effects of the …

"My Longest Relationship Is With Food": Exploring Eating Related Behaviors Throughout The Gender Identity Journey Of Transgender Males, Angeles Polett Coss

Dissertations

This study sought to explore how transgender adult males have navigated the development of their eating behaviors throughout their gender identity trajectory. While recent research has focused on gender identity development and protective factors of the transgender community, this study explored and examined elements regarding the eating related behaviors of transgender males. Interviews were conducted with six participants within the United States during semi structured virtual sessions; the age range of participants was 19 to 35. Results of this research revealed identity management, Sociopolitical discourse, identity management and inter-relational identity affirmations as inter-multicultural segments that connected with eating related behaviors …

Mathematical Modeling For Dental Decay Prevention In Children And Adolescents, Mahdiyeh Soltaninejad

Dissertations

The high prevalence of dental caries among children and adolescents, especially those from lower socio-economic backgrounds, is a significant nationwide health concern. Early prevention, such as dental sealants and fluoride varnish (FV), is essential, but access to this care remains limited and disparate. In this research, a national dataset is utilized to assess sealants' reach and effectiveness in preventing tooth decay, particularly focusing on 2nd molars that emerge during early adolescence, a current gap in the knowledge base. FV is recommended to be delivered during medical well-child visits to children who are not seeing a dentist. Challenges and facilitators in …

Returning To School After A Pandemic And The Lived Experiences Of Rural High School Mathematics Teachers On Student Success, Joshua Saúl Silva

Dissertations

Purpose: The purpose of this qualitative phenomenological methodology investigation was to examine and describe rural mathematics teachers’ lived experiences on the effects of the COVID-19 global pandemic on freshman students returning to school after being online for 2 years through the lens of Bandura’s theory of self-efficacy and serves as part of a thematic dissertation with each researcher focusing on different educators in the K-12 school system.

Methodology: Through qualitative methodology utilizing one-on-one interviews of nine rural high school freshman mathematics teachers with 5 or more years of experience before, during, and after the COVID-19 global pandemic, data was analyzed …

Glycemic Control In Cardiac Surgery Patients: Revising And Educating Nurses On An Evidence-Based Insulin Infusion Protocol, Joelle D. Hargraves

Dissertations

Glycemic control following cardiac surgery is challenging. Inadequate glycemic control, whether it is hypoglycemia or hyperglycemia, is associated with poor patient outcomes. Recently published studies examining glycemic control in critical illness including cardiac surgery, and clinical practice guidelines from professional organizations support moderate glycemic control (blood glucose [BG] 110 - 180 mg/dl). The problems guiding this evidence-based practice (EBP) change was lack of a current up-to-date evidence-based clinical practice guideline for glycemic control in critical illness and nurses' knowledge deficit.

Simulation In Interprofessional Education: A Case Study With Baccalaureate Nursing Faculty, Sherleena Ann Buchman

Dissertations

Nursing programs across the country are facing the challenge of providing students with optimal clinical skill learning experiences. Faculty members are rising to this challenge in a variety of ways, and current research in nursing education advocates the addition of interprofessional education to the nursing curriculum. History and governing bodies explain how nursing education can achieve this goal but faculty have to implement required and suggested changes. Further research is needed to gain insight into perceptions of the baccalaureate nursing faculty of interprofessional education and how the simulation in interprofessional experience contributes to overall patient safety. Patient safety is a …

Improving Breastfeeding Outcomes: A Pilot Randomized Controlled Trial Of A Self-Efficacy Intervention With Primiparous Mothers, Karen A. Mcqueen

Dissertations

Breastfeeding is recommended as the optimal source of nutrition for newborns for the first 6 months of life and beyond with the addition of complementary foods. While breastfeeding initiation rates have been increasing, duration rates remain a concern as many women prematurely discontinue due to difficulties encountered rather than maternal choice. In addition, there is a sizable gap between rates of exclusive breastfeeding and current recommendations. Targeting modifiable variables that may be amenable to intervention is one strategy to improve breastfeeding outcomes. One such modifiable variable is breastfeeding self-efficacy. Although research has clearly shown that breastfeeding self-efficacy is predictive of …

Some Wounds Don’T Heal: Spirit Assassination Attempts: Tools Of White Supremacy, Karen Louise Douglas

Dissertations

ABSTRACT The purpose of this research was to study the effects of spirit assassination attempts and whether their influence is enduring throughout life and can be linked to my emotional, mental, and physical health. In 1987, the term spirit murdering was coined by Williams to describe the everyday encounters with racism and discrimination, which can evoke a profound sense of powerlessness, hopelessness, and sadness in Black people. I use the term spirit assassination attempts to describe the repeated, intentional words, body language, looks, and actions intended to remind Black people of their societal position intended to destroy hope, joy, and …