Digital Commons Network^™

Auditing Workplace Aggression And Violence In The Emergency Department, Michelle Parmentier

Dissertations

Abstract

Problem: Emergency Department (ED) staff are not reporting patient and visitor episodes of aggression and violence. The rate of violence per patient visit is unknown.

Methods: An observational, descriptive quality improvement project about Type I and II workplace aggression and violence (WAAV) reporting by ED staff and security consisted of education, an anonymous survey of the previous six months of WAAV, and a monthlong anonymous WAAV audit in a Midwestern ED.

Results: The survey response rate was 59% with 65% never reporting WAAV, 13% reporting all WAAV occurrences, 9% reporting some occurrences, and 13% usually not experiencing WAAV. The …

Evaluation Of A Process Change Using An Updated Sedation Protocol, Rachel Allen

Dissertations

Problem: Pediatric delirium is continuing to increase intensive care environments and for patients who require mechanical ventilation and continuous sedative medications. Delirium is harmful to the patient creating lasting neurologic and mental health issues along with prolonged hospitalization and increased healthcare cost

Method: For this quality improvement (QI) project, a descriptive observational study was used to evaluate the implementation of a sedation protocol for patients who are mechanically ventilated and on continuous sedative medications. This was completed with the use of retrospective chart reviews three months prior to implementation and three months after the new protocol was implemented. Nurses were …

Addressing Perceived Barriers To Screening For Adverse Childhood Experiences In Primary Care, Trenton Conway

Dissertations

Problem: Inconsistent screening for Adverse Childhood Experiences (ACEs) in primary care settings leads to fewer appropriate behavioral health (BH) referrals and may increase risk for and incidence of chronic health conditions.

Methods: This quality improvement (QI) project used a descriptive observational design with prospective and retrospective data collection. The CDC’s ACE screening tool was administered to patients 18 years and older presenting to primary care. Data collection included number of ACE screenings completed and the number of BH referrals made following the screening. In additional, information was collected from medical assistants (MAs) and providers about the ACE screening process.

Results: …

The Mission System: An Electronic Health Record For Medical Treatment In Guatemala, Tawniece M. Curry

Dissertations

Abstract

Problem: The introduction of an electronic health record (EHR) system has become an essential component in monitoring and tracking patient information in most developed countries but are difficult to implement in underdeveloped countries. Guatemala is a country with poor health care and limited resources for patient tracking and monitoring. An organization in Guatemala, Nursing Heart Inc. (NHI), provides care to over 40 underserved rural communities but lacks the ability to monitor and track patient information. In order for NHI to properly monitor and evaluate their programs and track patients’ continuity of care, the introduction of an EHR system is …

Palliative Care Screening For Persons Living With Dementia In A Nursing Home, Shanika S. Pruitt

Dissertations

Problem: Dementia is rapidly increasing as the people of the world mature and life expectancy increases. As the world ages and the prevalence of dementia increases, nursing home placement will and is the most sought place for care of this population. Dementia is under recognized as a terminal illness and palliative care is underutilized for nursing home residents with advanced symptoms of dementia.

Methods: This quality improvement (QI) initiative utilized a prospective, descriptive design. The Palliative Care Screening for the Elderly tool was administered to a purposive sample of persons living with dementia residing in the nursing home. Qualitative data …

Nursing Anxiety Self-Evaluation And Resiliency Methods, Dianne Deck

Dissertations

Abstract

Introduction: Nurses are stressed due to the demands of their job. This study aims to determine whether MICU nurses at a large Midwestern hospital would have reduced stress and anxiety after a 30-day meditation and exercise intervention.

Design and Methods: A quasi-experimental pre-post pilot study design was adopted. The convenience sample consisted of eight Medicine Intensive Care Unit (MICU) nurses in a large Midwestern urban tertiary medical center. Data collected included demographics, pre- post-Beck Anxiety Inventory Scale (BAIS), pre- and post-Single Item Stress Scale (SISS), and weekly diaries on exercise and meditation.

Results: The pre- post-SISS showed statistical significance …

Evaluating Patient Health Questionnaire-9 (Phq-9) Use In Burn Survivors, Chelsey Friend

Dissertations

Problem: A burn injury affects both psychological and physical health, resulting in a greater than 50% major depressive disorder morbidity. The purpose of this quality improvement (QI) project is to evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) in adult burn survivors, with an aim to increase the use of the screening tool.

Methods: A mixed-methods pre/post-survey design with an educational component was utilized to assess nurse knowledge, confidence, willingness, and barriers to completion of the PHQ-9. Aggregate data were collected to determine PHQ-9 completion rates for patients admitted to and discharged from the unit during the two months …

Evaluation Of An Initiative To Increase Rates Of Exclusive Breastfeeding Among Rural Hispanic Immigrant Women, Naomi E. Pitcock

Dissertations

This project was a retrospective evaluation of the prenatal education component of a multi-component breastfeeding promotion intervention. The educational portion of this program, provided in Spanish using intercultural communication techniques, was designed to increase the number of Hispanic women who choose to initiate breastfeeding, using breast milk exclusively to nourish their newborns. The Hispanic women included in this program were all registered with a local prenatal-care coordination program for low-income women, had routine hospital births (both vaginal and C-section) and elected to participate in the prenatal education class. Data regarding intention to breastfeed and breastfeeding during hospitalization were gathered through …

Untold Perspectives: The Impact Of The Closure Of A Health Institution In A Black Community In North St. Louis County, Patricia Zahn, Kiley Bednar, Andrea Jackson-Jennings, Erica L. Henderson

Dissertations

Based on the literature of social determinants of health, health equity, and anchor institutions, it is evident that hospitals have a role to play in ensuring the health of their community. However, our understanding of the impact of hospital closures is limited, especially when it comes to Black communities. The purpose of this study is to examine the relationship of the closure of the Normandy Osteopathic Hospital to the social determinants of health—specifically access to care and economic stability as it relates to income and wealth generation—for a Black community in one near-North suburb of St. Louis. Ten individuals with …

Self-Compassion And Perceived Readiness For Practice Among Baccalaureate Nursing Students: A Mixed-Methods Study, Laurie A. Walter

Dissertations

There is increasing concern about how nursing students’ psychological health will impact their future nursing practice. The COVID-19 pandemic has enhanced these concerns. Nurse educators are being challenged with preparing nursing students to provide compassionate, patient-centered care despite the stress and psychological challenges of today’s healthcare environment. Self-compassion is a practice of mindfulness, self-kindness, and common humanity which positively influences and predicts psychological health. The purpose of this study was to explore the relationship between self-compassion and perceived readiness for professional practice among undergraduate nursing students.

A convergent mixed-method design utilizing correlational and directed content analyses explored this relationship. The …

Predictors Of Engagement In Nursing Professional Practice: Transforming Organizational Culture In The Post-Covid Healthcare Environment, Jennifer Garnand

Dissertations

Cultivating the shared belief that individuals matter within an organization enhances the empowerment of staff and supports enthusiastic engagement in organizational efforts aimed toward a common mission, vision, and goals (McShane & Von Glinow, 2019). The nursing profession has been plagued by an unprecedented decrease in engagement and diminished job satisfaction, particularly following the prolonged tenure of the COVID-19 pandemic, leading to subsequent attrition amidst a staffing crisis. This quantitative predictive correlational study seeks to determine whether proactive and persevering characteristics, professional identity, and passion of nurses are predictors of engagement in a post-COVID healthcare environment. The research was based …

An Investigation Of Anti-Intellectualism Among Nurses, Jamie Davis-Tubbs

Dissertations

Anti-intellectualism is often offered as an explanation for irrational actions, especially in the grips of uncertainty. The effects of the COVID-19 pandemic have uncovered the consequences of anti-intellectualism within the healthcare system. Nurses, the most identifiability trusted healthcare professionals, have been used to illustrate a healthcare paradox regarding COVID-19. The healthcare paradox presents nurses as highly trained healthcare professionals who do not believe in their own science and reject scientific expertise. Furthermore, nursing anti-intellectualism has been used to spread misinformation during a major health crisis. Yet, we do not know the depth in which anti-intellectualism exists within the nursing profession. …

From The Shadows Of Incarceration To Higher Education: Associated Invisible Identity Development Of College Students With Incarcerated Parents, Andrea Blake

Dissertations

The purpose of this study was to understand the experiences of college students who have experienced parental incarceration and explore how they make meaning of their associated invisible identity in the campus environment at four-year institutions in the U.S. Traditionally socio-historical events and messages about system-impacted individuals, their families, and children have contributed to the invisibility of this population in educational settings. This study employed a narrative inquiry approach. Also, it applied Bronfenbrenner’s (1977, 1979, 1993) ecological model to explore the college experiences of ACIPs while not excluding wider societal and environmental factors that could shape their associated invisible identity …

Secondary School Administrators, Teachers, And Students' Perspectives On Reducing Recidivism In Disciplinary Alternative Education Programs, Chrissell Rhone

Dissertations

This mixed-methods study sought to explore student and staff perspectives on what led students to return to or remain in DAEPs for longer than they were assigned. The researcher reviewed literature related to the history of alternative education programs, placement policies, and alternative school practices. This researcher obtained permission from two schools in a rural county in a southern state. Qualtrics was used to collect all quantitative data. Data was collected using questionnaires and focus groups. The quantitative component of this study was employed so that students could maintain anonymity and honestly respond without feeling pressured or intimidated. Student data …

Evaluating The Effects Of Mindstrong™ In Graduate Nursing Students, Syeda Shah

Dissertations

Abstract

Problem

A high rate of burnout and lack of resiliency is a major problem in nursing graduate students resulting in dropout and mental health issues. MINDSTRONG™ is an evidence-based cognitive behavioral skills-building program with the goal of building resiliency and decreasing burnout through coping skills to improve overall adult health and well-being.

Methods

A descriptive design using quantitative data analysis through pre, and post surveys was used. The surveys evaluated graduate nursing students’ burnout and resiliency after participating in MINDSTRONG™, a cognitive behavioral theory program, implemented by trained facilitators for seven sessions. The sample consisted of all six self-enrolled …

A Study Of Hybrid Cte Programming Vs. Traditional Cte Programming For Students With Ieps At Two Technical High Schools, Esthere K. Scott

Dissertations

The purpose of this paper is to research the postsecondary readiness of students with IEPs at North and South Technical High schools within Special School District of St. Louis County (SSD). The attention is on the description of the readiness outcome of the students in a traditional career in the education program and technical education programs to the students with IEPs in hybrid technical programs. The paper also exploits the concept of inclusivity and diversity in learning and highlights the role of the CTEs in the preparation of the students for the future. However, success is described as either the …

Evaluating Outcome Factors Of Childhood Emotional Neglect: An Exploratory Factor Analysis, Taylor Levitt

Dissertations

Experiencing childhood maltreatment has been shown to have major implications on adult outcomes. Less is known about the outcomes of childhood emotional neglect (CEN). The purpose of this study was to identify factors related to psychological outcomes of CEN within the domains of depression, anxiety, and alexithymia as a precursor to the development of an inventory. One hundred and fifty participant responses on the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Toronto Alexithymia Scale-20 (TAS-20) were collected. Exploratory factor analysis was conducted where nine factors yielded significant results and were titled, “Depressive Symptoms,” “Difficulty Identifying Feelings,” “Usefulness of …

The Role Of Traumatic Experiences In Developing Nocturnal Panic Attacks, Nicole S. Smith

Dissertations

Nocturnal panic attacks refer to panic attacks that occur out of a sleeping state with no obvious cause, resulting in awakening at the peak of a panic attack. Nocturnal panic affects roughly half of patients with panic disorder as well as individuals with other psychological disorders such as PTSD. Prior research has suggested that experiencing a traumatic event may lead to the development of nocturnal panic attacks. The current study sought to expand upon the extant literature related to the role of trauma in nocturnal panic by collecting a comprehensive trauma and panic history in order to establish a timeline …

A Thematic Exploration Of The Liberation Of Identity Through Indigenous Self-Determination: Themes Of Native American And Alaska Native Identity, Martha Fiskeaux

Dissertations

Strong ethnic identity is associated with overall well-being, resilience to change, and higher self-esteem (Kiang et al., 2006; Martinez & Dukes, 1997; Umaña-Taylor, 2003; Yip & Fuligni, 2002) and serves as a protective factor against the stress associated with discrimination (Alvarez & Kimura, 2001; Phinney et al., 1998). Given the historical and systemic barriers faced by the Native American and Alaska Native population, including the history of genocide, colonization, and intergenerational trauma, the development of a strong Indigenous ethnic identity is a necessary area of research focus. Specifically, Native American and Alaska native individuals are 3.5 times more likely to …

The Developmental Pathways And Treatment Approaches For Maladaptive Perfectionism In Undergraduate Student Athletes, Kara Hoff

Dissertations

Developmental and contextual factors may largely contribute to how an undergraduate student athlete develops maladaptive perfectionism (MP) within his or her athletic performance. Being able to understand different possible etiologies of MP will provide enriching clinical information to tailor more in-depth treatment approaches for the student-athlete(s) being impacted by the serious and life-threatening side effects of MP. This literature review provides a comprehensive summary on MP and how it may manifest in the athlete, in addition to how it can mature and intensify throughout one’s athletic career. Treatment approaches for MP in undergraduate student athletes will be discussed in how …

The Impact Of Juvenile Offender Race On Public Perception Of Crime Seriousness, Megan Whitaker

Dissertations

Public perception of crime is an important focus of research, especially when considering juvenile offenders. However, there is very limited research in this area. This study looked at how the public perceives crime seriousness and how race of the juvenile offender impacts the overall seriousness rating. An online survey that included 15 crime scenarios was completed by 176 participants. It was hypothesized that a crime would be rated as more severe when the juvenile offender is African American as compared to a Caucasian juvenile offender. Results found that participants overall rated the seriousness of offenses as significantly higher for Caucasian …

Perceptions Of Out-Of-School Reading Motivation For Female Middle School Students, Danielle Porch

Dissertations

Literacy engagement and motivation to read is lacking in middle school reading classrooms. Educators struggle with the challenge of motivating students to read and actively engage with text both inside and outside of school. Research indicates that female and male middle school students have unique characteristics and habits as readers. The purpose of this qualitative study was to examine the perspectives of female middle school students regarding their out-of-school recreational reading time, their attitudes towards reading, and their reading habits. The themes derived from this study indicated the students’ desires to have their reading instruction personalized and have their reading …

No One Can Whistle A Symphony: Analyzing Growth In Proficiency For English Learners In Coteaching, Debra Ann Cole

Dissertations

K-12 ELs in the U.S. are increasing in number and diversity (Park, et al., 2018), requiring schools to establish and grow language instruction education programs (LIEPs) that facilitate language acquisition for a wide range of learners, while also providing equitable opportunities to learn. The study used a quantitative, pretest-posttest, research design to address gaps in the literature noted by Takanishi & Menestrel (2017), regarding which LIEPs are most effective for various EL subgroups, and to explore the effects of Coteaching for ELs (COTEL) on growth in proficiency. Data from 723 ELs in two Midwestern districts was disaggregated three ways to …

Using Contingent Praise To Increase Visual Engagement In An Asynchronous Online Learning Environment: An Eye Tracking Study, Andrew Rozsa

Dissertations

As more students move to online learning, this results in not only new barriers but new opportunities in academia. The purpose of this study was to examine how behavior-contingent praise affects visual engagement with an online video lecture when using WebGazer, a publicly available eye tracking software, with a user’s integrated webcam. A second aim of this study was to examine if using WebGazer with an integrated webcam was a valid alternative to hand scoring when collecting visual engagement data. Results of WebGazer measurement indicated a moderate effect size for three participants in the presence of contingent praise, and …

Fostering Teacher-Student Relationships: A Case Study Connecting Middle School Teachers, Authentic Local History, And Empathetic Competence, Richard A. Buschard Jr., Diane Clark, Lauren Cobb, Brian J. Esselman

Dissertations

TThis co-authored qualitative case study explores the challenge of teachers connecting with their students at the middle school level, especially when White teachers serve predominantly African-American students in large urban metropolitan areas like St. Louis, Missouri. While research has established the need for teachers to better understand the background experiences of their students, more research is needed to explore the value of place-based professional development in promoting more effective teacher-student relationships (TSRs). Using a psychological theory known as Relational-Cultural Theory (RCT), we sought to examine the following research questions while also applying this theory to the field of education: What …

Parent Distress, Parent-Child Interactions, Child Distress And Child Cooperation During Cancer Treatment-Related Port Starts: A Caring Perspective, Jinbing Bai

Dissertations

Children reported more suffering from cancer treatment-related painful procedures than cancer itself. Appropriate parent interaction behaviors can help children cope with these painful procedures. Swanson's Theory of Caring provides a framework to formulate parent interaction behaviors. This dissertation consisted of three separate papers to investigate parent-child interactions during cancer treatment-related port starts.

Media Narrative Competition Between The U.S. And China During Covid-19, Zhenzhu Zhang

Dissertations

This study examines the narratives that were presented in Chinese and American media by using Dr. Li Wenliang (one of the first people who tried to raise the alarm about the outbreak of COVID-19), and the COVID-19 origin controversy as case studies to understand how these news stories conflicted and which tellings became dominant. The way these two cases have been depicted in the media has changed over time. Understanding how that depiction changed is important because it helps demonstrate how narratives function to frame crises. The current study uses narrative, and framing theories to support thematic analysis of news …

An Exploration Of Factors That Impact Role Strain Among Undergraduate Clinical Instructors Teaching In Wisconsin Nursing Programs, Julie A. Astrella

Dissertations

The United States is in the midst of a nursing faculty shortage, particularly those that provide clinical instruction. Clinical instructors play an integral role in undergraduate nursing education by bridging the gap between theoretical knowledge and nursing practice; this position is also the most difficult to recruit for and retain. The factors negatively impacting faculty retention are complex, but research finds that role strain is a prominent reason for job dissatisfaction and a contributor to faculty attrition.

Provider Education And Routine Implementation Of The Scoff Questionnaire On The Detection Of Eating Disorders At The Primary Care Level: A Program Development Project, Emily Archer

Dissertations

The detection of eating disorders has been cited as a challenge at the primary care level. Literature has shown both a lack in provider knowledge on eating disorders, as well as the routine use of a single, all-inclusive tool to identify distorted eating behaviors and habits in the primary care setting. Early detection of eating disorders is vital as they are associated with long-term and potentially fatal ramifications.

Masculinity, Health Beliefs And Implications For Health Policy Among Men In Trinidad And Tobago, Oscar N. Ocho

Dissertations

Over the last three decades, men's health has emerged as an area of research interest. The relationship between male socialization, the performance of masculinity and health behaviour has been well established. Within the Caribbean, however, there is a gap in the literature on how masculinity affects health beliefs and behaviour.

This study explored men's accounts of "doing" masculinity and the implications for health beliefs and behaviours in order to make recommendations for developing male sensitive health services.