Digital Commons Network^™

Remote Learning - The Future Of Education: Effective Instructional Strategies Used By Parent Educators And Recommendations For Building Capacity, Raelene Ferguson Haugen

Dissertations

Purpose: The purpose of this mixed methods Delphi study was to identify the remote learning instructional strategies used by expert Southern California parent educators for implementing the anticipatory set, modeling, checking for understanding, and guided practice elements of Madeline Cheek Hunter’s Instructional Theory Into Practice (ITIP) framework. The study sought to identify how expert Southern California parent educators rated the effectiveness of the remote learning instructional strategies in the aforementioned elements of Hunter’s ITIP framework. Additionally, the purpose was to generate recommendations from expert Southern California parent educators to build capacity in the identified effective instructional strategies.

Methodology: The classical …

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

Dissertations

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

Abstract

Problem

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

Method

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

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

Dissertations

Abstract

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

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

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

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

Dissertations

Abstract

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

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

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

Dissertations

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

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

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

Dissertations

Abstract

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

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

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

Dissertations

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

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

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

Effect Of A Turn Clock On Hospital-Acquired Pressure Injury Incidence, Sydney Warren

Dissertations

Problem: Hospital-Acquired Pressure Injuries (HAPIs) are the only quality metric increasing in incidence and are preventable. HAPIs are wounds to bony prominences during a hospitalization and can increase hospital costs, morbidity, and mortality. HAPIs could be prevented through interventions, including repositioning patients every 2 hours and using a turn clock method. The aim of this quality improvement (QI) pilot project was to decrease HAPI incidence.

Methods: A turn clock method was implemented on a general medicine floor at a mid-sized, suburban medical center utilizing a descriptive retrospective observational design. Data was collected for the pre-intervention timeframe from June through August …

Effect Of A Trauma Informed Care Tool In A Pediatric Cardiac Intensive Care Unit, Taylor Park

Dissertations

Problem: Parents of infants less than one-year-old with complex congenital heart disease (CCHD) experience significant stress while their child is admitted to the pediatric cardiac intensive care unit (PCICU), often resulting in trauma to parents and their families. Trauma informed care (TIC) seeks to minimize the impact of emotional trauma and it acknowledges previous trauma an individual may have experienced.

Methods: The purpose of this quality improvement (QI) project was to assess the thrive guide’s ability to decrease parental stress in the pediatric cardiac intensive care unit (PCICU). The aim was to decrease parental Perceived Stress Scale (PSS) scores by …

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

Implementing A Standardized Nursing Communication Tool To Improve Inpatient Nursing Communication, Ashley D. Nator

Dissertations

Implementing a Standardized Nursing Communication Tool to Improve Inpatient Nursing Communication

Ashley D. Nator

B.S. Nursing, University of Missouri-St. Louis, 2018

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice with an emphasis in Family Nurse Practitioner

August 2022

Advisory Committee

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C

Chairperson

Sarah Jackson, DNP, APRN, FNP-C

Amy Terbrock, MSN, PCCN, SCRN, RN

Copyright, Ashley D. Nator, 2021

Original: 08/2021 Revised: 09/2021, 10/2021, 04/2022

Abstract

Problem: Patient handovers occur among nurses more than 4,000 times …

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 …

Evaluation Of Neonatal Ankyloglossia, Ellen M. Ray

Dissertations

Problem Ankyloglossia occurs when the tongue cannot extend past the gums or lips due to frenulum restriction. In breast feeding, proper movement of the tongue around the nipple is hindered causing difficulty for the infant to obtain a proper latch. This may result in slow weight gain (SWG), failure to thrive (FTT), and dehydration due to poor milk production. Evaluating for ankyloglossia is difficult, however, the Hazelbaker Ankyloglossia Tool for Lingual Frenulum Function (HATLFF) may be of benefit.

Method Observational descriptive design utilizing a retrospective medical record review. The HATLFF was utilized in full term neonates suspected of ankyloglossia in …

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 …

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 …

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. …

Relationships Between Monomer Chemical Structure, Network Architecture And Thermal Stability In Glassy Polycyanurates, Rebecca Haber

Dissertations

We study monomer melt properties and polymer properties using two approaches. The first approach takes advantage of molecular dynamics to calculate monomer melt properties. The second approach involved an experimental investigation of polycyanurate networks with varying monomer functionality and rigidity.

For our computational study we applied an existing voids method by Solca et al. to calculate melting temperature for four different cyanate esters: (a) 2’-(4-cyanatophenyl) propane (BADCy), (b) 4,4'-(ethane-1,1-diyl) bis(cyanatobenzene) (LECy), (c) tris(4-cyantophenyl) methylsilane (SiCy-3), and (d) bis(4-cyanatophenyl) dimethylsilane (SiMCy). For systems with 1 to 10% voids, the predicted melting temperature decreased due to a decrease in the free energy …

Power-Of-Speech Styles’ Hedges, Hesitations, Intensifiers, And Tag Questions Effects On Perceived Information Manipulation, Honesty, And Speakers’ Character, Competence, And Sociability: A Multi-Parallel And Serial Mediation Exploration, Kevin Bryant

Dissertations

This dissertation used Power of Speech Style (POS) theory’s powerless linguistic cues (hedges, hesitations, intensifiers, and tag questions), Information Manipulation Theory and McCroskey’s Speaker Credibility Scale to determine if perceived honesty mediates the relations between a speaker’s use of powerless linguistic cues and evaluations of that speaker’s credibility. Two studies were conducted. The first study tested these variables' relationships with an experimental design involving reading a courtroom witness transcript. An EFA was conducted to determine appropriate factors for perceived information manipulation. Then mediation analysis using PROCESS included four parallel mediators from the previously tested EFA. The second study provided replication …

Characterizing Endogenous Dicer Products To Unravel Novel Rnai Biogenesis Pathways, Jacob Oche Peter

Dissertations

ABSTRACT

RNA interference (RNAi) is a pervasive gene regulatory mechanism in eukaryotes based on the action of multiple classes of small RNA (sRNA). Exploiting RNAi pathways in non-model systems have great potential for creating potent RNAi technologies. Here, we accessed RNAi-mediated control of gene expression in the two-spotted spider mite, Tetranychus urticae (T. urticae) using engineered dsRNA designed to modulate the host RNAi pathway and increase RNAi efficacy. Analysis of Dicer (Dcr) generated fragments revealed how exogenous RNAs access the host RNAi pathway in this animal, opening avenues for designing RNAi technology for their control. Further, some organisms …

Personal Digital Assistants: Their Influence On Clinical Decision-Making And The Utilization Of Evidence-Based Practice In A Baccalaureate Nursing Students, Carol S. Gorelick

Dissertations

During the last decade, the advent of the personal digital assistant (PDA) and the development of clinical software specific to nursing practice have changed the way that many nurses manage information and workload. More recently, PDAs have become a standard tool in undergraduate nursing education. Though there is substantial discussion in the literature on PDA technology, the emphasis there has been descriptive and anecdotal. Since 2002, nurse authors have reported that PDA use has reduced medication errors and streamlined data gathering. This has lead to speculation that use of the PDA is a clinical tool that supports evidence-based practice and …

Latina Superintendents And The Role Cultural Intelligence Plays In Their Leadership: El Líderazgo Inteligente De Superintendente Latinas, Cristina Cortes

Dissertations

Purpose: The purpose of this qualitative multicase study was to describe the culturally intelligent leadership practices used by Latina superintendents based on Earley and Ang’s (2003) cultural intelligence scale. The four dimensions of cultural intelligence (CQ) are metacognition, cognition, motivation, and behavior.

Methodology: This phenomenological multicase study was conducted through interviews of four Latina superintendents of California public schools. The researcher selected a qualitative method because it would describe the culturally intelligent leadership practices based on Earley and Ang’s (2003) dimensions of CQ.

Findings: Close examination of data from interviews and artifacts yielded 221 frequencies for the four domains of …

Analysis Of The Cyclic Behavior And Fatigue Damage Of Low Alloy Steels, Zahra Salemi Najafabadi

Dissertations

Fatigue is the most common type of failure in many structures and components subjected to cyclic loading. Surface effects in fatigued materials are of particular importance, since in most cases the surface is the preferred site of fatigue crack initiation. Microcracks originate at the metal surface due to stress concentration introduced by macro notches and micro defects in the surface layers. The microcrack initiation and propagation are controlled by the localized plastic deformation in the surface layers especially in the initial stage of fatigue failure process. Therefore, the knowledge regarding the cyclically induced changes in deformation resistance at the metal …

Channeling Influence On Noise And Aerodynamic Performance Of Naca 0012 Airfoil As A Possible Solution Of Wind Turbines Noise, Hussein Khudhayer Mohammad

Dissertations

This work numerically and experimentally investigates the effect of using channels inside airfoils on the noise level as a possible resolution for aerodynamic noise generated by wind turbines. The work also investigates aerodynamic performance and turbulence around the employed airfoils. The results reveal that some of the samples show some improvement in reducing the aerodynamic noise. The reduction of the aerodynamic noise is explained as the trailing edge blowing injection that reduces the wake momentum deficit of the blade and reduces the pressure fluctuation which is responsible for noise production. Particularly, the angles of channel inclination with respect to the …

Three Essays In The Economics Of Education, Md Ohiul Islam

Dissertations

This dissertation explores three distinct topics in the economics of education. These topics explore the relationship between factors such as race, gender, national origin, and educational and labor market outcomes. Educational attainment in the STEM (Science, Technology, Engineering, and Mathematics) areas receives a major focus in this dissertation; a college-level specialization in STEM areas generally leads to high incomeyielding career tracks. Below I briefly explain the research objectives and findings of each chapter.

The first chapter focuses on the impact of teacher-student demographic mismatch on student success in classrooms at the high school level. When students, particularly those of disadvantaged …

Factors In Graduate Student Resilience And Intention To Persist During Doctoral Study, Amber Mosley

Dissertations

Attrition is a major problem for the doctoral education system and in particular for underrepresented groups. Research has proposed several reasons for students dropping out that include both personal and programmatic variables. A review of the literature identified several factors that overlap in the research on attrition, resilience, and intention to persist however, there have also been varied results across studies and very few studies focused specifically on doctoral students. Doctoral education can be considered in three phases of the education process, each with its own stresses and challenges. Factors and variables that could be the most helpful for universities …

Investigating Pedestrian Distraction By Phone At Intersection Crossings, Safety Implications And Potential Treatments, Lusanni Mercedes Acosta Rodriguez

Dissertations

Road user distraction is a major safety concern. The issue is not only for drivers, but also for vulnerable road users such as pedestrians. Every year people are involved in potential and real crashes due to being distracted while walking/crossing streets. Although there are several ways by which pedestrians are distracted, phone use while crossing streets is among the riskier and growing behaviors. Crossing an intersection, especially those with heavy traffic, requires full attention from the individual. Inattentiveness to traffic while on a phone call, texting, web-surfing, listening to music before crossing a street can lead to a fatal crash. …

Using A Design Thinking Approach In Human Resource Practices In North America, Corinne Diane Eswar

Dissertations

Global forces have changed the landscape of the today’s global economy, with such disruptive forces reshaping the workplace, the workforce, and the work itself. Human Resource (HR) functions are no exception to these changes. HR departments must simplify their processes, build a culture of collaboration, help employees manage the flood of information at work, manage complexity, and encourage innovation and creativity. The concept of design thinking has been adopted widely across multiple disciplines and industries as a tool for innovation, however it has yet to be a major influence in the Human Resources field.

This research explored the use of …

They Don'y Expect You To Know Much: Black African International Students Encountering And Countering The Afropessimistic Attitude Within Academic Spaces, Margaret Sergon

Dissertations

Black African international students in the United States are vulnerable to increased microaggressions because of their minority statuses. In addition to being Black and speaking with non-native accents, African students must contend with Afropessimism which in this study refers to the Western world’s negative perception of Africa. The study is a mixed methods study that seeks to understand how the Afropessimistic attitude impacts the way Black African international students are perceived and interacted with, within the academic spaces. The findings indicate that African international students consistently encounter the Afropessimistic attitude, and it impacts their academic engagement. The findings also suggest …