Digital Commons Network^™

Implementation Of Intentional Hourly Rounding At Pediatric Hospital, Margaret Bernard

Dissertations

Problem: Intentional hourly rounding improves patient safety and can impact patient fall rates. At a pediatric hospital in suburban Missouri, the fall rate is 25%. This quality improvement project worked to implement a standardized intentional hourly rounding process at a pediatric hospital to bolster their fall prevention program.

Methods: This quality improvement project was conducted using a descriptive, observational design utilizing patient chart review and hospital quality department records. The setting was a 60-bed pediatric hospital in the Midwest with 2 inpatient units that specializes in chronic, complex care. The sample was a convenience sample of 92 male and female …

Implementation Of Postnatal Depression Screening: A Pilot Study, Mollie Gulino

Dissertations

Abstract

Background: Postpartum depression (PPD) is a prevalent problem among women during their childbearing years, affecting approximately 1 in 7 women. Alarmingly, about 50% of PPD cases go undiagnosed and untreated, contributing to poor maternal outcomes, including suicide, which is a leading cause of maternal mortality in the United States.

Issue: Despite its prevalence and severe consequences, PPD often goes unrecognized due to inconsistent screening practices. Current guidelines vary by organization and lack consistent, evidence-based criteria.

Objective: This pilot program aimed to implement universal PPD screening with a validated tool at the six-week postpartum follow-up visit. The goal was to …

Implementation Of The Edinburgh Postpartum Depression Screening Tool For Postpartum Depression In A Midwest Primary Care Clinic, Makenzie Garrison

Dissertations

Problem: Postpartum depression is a prevalent health concern in postpartum women. Screening practices to identify postpartum depression are inconsistent. The purpose of this quality initiative is to determine if the implementation of the Edinburgh Postpartum Depression Screening Tool (EPDS) to screen for postpartum depression in the primary care setting increases the detection of postpartum depression in postpartum women from delivery to one year postpartum.

Methods: This quality improvement project utilizes a descriptive, observational design. A retrospective medical record review was utilized as well as a 12-week data collection period. Retrospective medical record reviews were conducted to assess the rate of …

Implementation Of Quantitative Blood Loss Following Cesarean Section Birth, Layna Victoria Schultz

Dissertations

Problems: Postpartum hemorrhage (PPH) is a significant problem due to potential harm and is a main contributor to maternal morbidity (ACOG, 2019). According to ACOG, of maternal deaths in the United States, 11% are caused by PPH and 54-93% of the deaths related to PPH could be prevented (ACOG, 2019). When institutions adopt quantitative blood loss (QBL) protocols for improved accuracy in blood measurement, PPH can be identified sooner, allowing for earlier intervention. Inaccurate estimation of obstetric blood loss by health care providers is a primary cause of delayed staff response to PPH (ACOG, 2019).

Methods: This quality improvement (QI) …

Symptom Burden, Identity Balance, And Emotional Distress In Cancer Survivors, Lynne Bentley

Dissertations

Emotional distress suffuses the experience of cancer survivors and is associated with adverse outcomes. Emotional distress is a response to a circumstance, which threatens the stability of identity. Of the antecedents to emotional distress in cancer patients, symptom burden accounts for the greatest amount of variance. Qualitative studies in populations of cancer survivors have shown that identity affects the experience of emotional distress related to symptom burden. The purpose of this dissertation research was to measure the relationships among symptom burden, identity balance, and emotional distress by testing whether identity balance mediates the relationship between symptom burden and emotional distress …

Influence Of Social Capital On Community-Based Health Care Programs In Rural Paupa New Guinea: An Ethnographic Study, Carol J. Bett

Dissertations

This descriptive, ethnographic study explored the influence of cultural health beliefs and social capital on the adoption of community-based health care interventions by rural villages in Papua New Guinea. The development of local level resources that lead to improved health indices requires an awareness of both the cultural context and the relational components of social capital that link people within the community. Social capital has been defined as resources that are an inherent part of a social group and the elements of social organization such as trust, networks, and norms of reciprocity that facilitate mutual cooperation (Billings, 2000; Carpiano, 2006). …

Gerontological Continuing Education Needs Of Nurses Employed In Nursing Facilities In North Carolina, Sandra J. Todd-Atkinson

Dissertations

The major purpose of this investigation was to determine the self perceived learning needs of nurses employed in nursing facilities. Questionnaires were utilized to gather these data from nurses employed in fourteen nursing facilities thus representing 10% of all nursing facilities in North Carolina. Nonparametric tests were utilized to analyze the differences in perceived needs and selected independent variables. The selected independent variables were respondents' ages, educational preparation, years of experience, years of experience in a nursing facility, size of the facility, and position held. Two research questions guided the study: (1) what are the specific areas of felt needs …

Use Of Flipped Classroom Learning Activities In Nursing: A Basic Qualitative Study, Tamara J. Steele

Dissertations

This study aimed to explore the experiences of nurse educators using flipped classroom methods with learning activities proven to be successful in students' achievement of learning outcomes. Specifically, it aimed to identify the learning activities that nurse educators have found to be most successful in terms of student achievement of learning outcomes. An additional focus of the study was to identify the flipped classroom and learning activity evaluation methods used by nurse educators and examine how those evaluation results were used to further enhance future nursing courses. An important gap in the extant literature related to a lack of in-depth …

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 …

A Novel Use Of Social Network Analysis And Routinely Collected Data To Uncover Care Coordination Processes For Patients With Heart Failure, Sijia Wei

Dissertations

Effective patient care transitions require consideration of the patient's social and clinical contexts, yet how these factors relate to the processes in care coordination remains poorly described. This dissertation aimed to describe provider networks and clinical care and social contexts involved during longitudinal care transitions across settings. The overall purpose of this dissertation is to uncover the longitudinal patterns of utilization and relational processes needed for effective care coordination in transitional care, so we can redesign interventions that focus on informational and relationship networks to improve interaction patterns and system performance for people living with heart failure (HF) as they …

Unveiling The Path To Lgbtq+ Inclusive And Culturally Competent Healthcare: A Multi-Dimensional Examination Of Trainings, Policies, And Perspectives, Hyunmin Yu

Dissertations

LGBTQ+ individuals encounter enduring discrimination and adverse healthcare encounters within the healthcare system, with profound implications for their health and wellbeing. Policymakers have advocated for the adoption of LGBTQ+ inclusive and culturally competent healthcare, including training for health professionals, to promote health equity among LGBTQ+ populations. However, implementation of these policies within healthcare systems varies, posing structural and individual-level barriers. In this dissertation, I employ an ecological model of LGBTQ+ health disparities and a conceptual model of determinants of health disparities in vulnerable populations within the healthcare system to examine the impact of structural inequities on the implementation of LGBTQ+ …

Characterization Of The Glyoxal Response In Pseudomonas Aeruginosa, Christopher James Corcoran

Dissertations

The toxic dialdehyde glyoxal is found in all domains of life and results as a by-product from a variety of metabolic activities such as DNA oxidation, lipid peroxidation, and autoxidation of sugars such as glucose. If allowed to accumulate, the reactive aldehyde groups of glyoxal have the ability to react with a plethora of molecules including, DNA, lipids, and protein side chains. Most notably, glyoxal can react with arginine, lysine, and cysteine residues, forming irreversible covalent modifications known as advanced glycation end products (AGEs). These glyoxal-derived AGEs can impair protein function, leading to cellular toxicity and eventual cell death. Due …

A Quantitative Content Analysis On Juvenile Crime Rates In Comparison To Student Outcome Data In A Saint Louis Metropolitan High School Setting, Arron Nakia Whitt Sr.

Dissertations

Mental health is one of the most polarizing topics of the 21st Century. Mental health affects those from all economic statuses, races, age ranges, and genders. Since mental health can affect the youth population, the researcher investigated two Saint Louis metropolitan school districts that were listed in provisional accreditation status with the Department of Elementary and Secondary Education (MoDESE).

The purpose of this research was to identify relationships between the graduation rates, dropout rates, and enrollment rates of high school students and compare these data to the crime statistics obtained from the Saint Louis metropolitan juvenile courts. The researcher gathered …

Exploring Student Veterans Barriers, Alexandra Brandriff

Dissertations

The student veteran population in higher education is a unique group of individuals with different skills and life experiences not typically found among traditional students. Through a comprehensive analysis of quantitative and qualitative data, this study explores the complex challenges that student veterans face in higher education. It aims to explore the challenges, barriers, and support programs experienced by student veterans throughout their higher education journey, as well as compare the graduation and retention rates of student veterans and traditional students.

The researcher first gathered and analyzed qualitative data from student veterans’ responses to a survey utilized to gain their …

An Exploration Of Literacy Instruction In Higher Education Programs In Missouri, Melinda Odom

Dissertations

Literacy supports all content areas and is crucial to the academic achievement of all students (Birdyshaw et al., 2017). The International Literacy Association (ILA, 2017) posits that teachers are the most crucial factor in content and pedagogical achievement. The ILA (2019) stresses that students have a right to a highly effective and knowledgeable educator who can provide evidence-based reading instruction. Research illustrates that students who do not learn to read by the third grade continue to struggle throughout school (Rickenbrode & Walsh, 2013). Rickenbrode and Walsh (2013) confirm that most of these students will remain poor readers and are more …

The Choice Of Pre-K: An Examination Into Black Caregivers’ Early Childhood Care Decisions And How Early Childhood Care Predicts Black Children’S Educational Outcomes, Anna Grace Rollins

Dissertations

Despite the national push for increased Pre-K enrollment, findings on the effects of attending Pre-K are contradictory and inconsistent. Due to conflicting research and viewpoints on traditional education outcomes, many families are choosing not to send their children to Pre-K. This study focused on the often overlooked thoughts and experiences of Black parents and guardians when making decisions about early childhood education for their children, as well as the academic and behavioral effects of attending Pre-K for Black children in subsequent years. Through surveys and interviews, this study explored factors that influence Black parents’ decisions about enrolling their children in …

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 …

What Are The Odds? Integrated Stem And Student Conceptual Understanding Of Genetics Dihybrid Inheritance, Jessica Cooper

Dissertations

Integrated Science Technology Engineering Math (STEM) education allows students to build conceptual understanding by connecting material to other content areas and real-world contexts. Strong conceptual understanding allows students to move beyond factual recall and instead synthesize and transfer their knowledge to new applications. In high school biology, students need to develop a strong conceptual understanding of genetic inheritance in the context of dihybrid inheritance. This qualitative case study was designed to understand the influence of an integrated STEM approach on student conceptual understanding of genetic dihybrid inheritance. The situated STEM learning and conceptual change theoretical frameworks guided the research design …

Satellite Campus Enrollment: A Qualitative Investigation Of Enrollment Preferences Of The Post-Traditional Student, Alexis K. Wood

Dissertations

For many, the “American Dream” involves earning a college degree. This degree promises a brighter professional and personal future and an improved overall quality of life. The steps taken to achieve this dream are graduating from high school, heading straight to college, graduating with that bachelor’s degree, and moving forward in the “perfect” career. While this step-by-step process seems natural to most, the reality is that in the fall of 2022, 69.2 percent of high school graduates entered the workforce, opting to pursue that degree much later in life ("College Enrollment," 2023). Researchers refer to this type of student as …

Inpatient Staff Perspective On Verbal De-Escalation Within A High Acuity Population, Giovanna Dezutti

Dissertations

This study explored inpatient staff’s perspective of verbal de-escalation within a high acuity population as well as the factors that make either a positive or negative impact on the effectiveness of verbal de-escalation as used in high acuity impatient settings. This phenomenological study used semi-structured interviews of 5 participants working in this setting. Participants were recruited through snowball sampling, and interviews were conducted via zoom. This study found that participants unanimously agreed that the training they received regarding verbal de-escalation was not sufficient and that employment of certain personality traits and behaviors were more effective than using only the methods …

Poly(Thioether) Thermosets With Gated Photodegradation, Surabhi Jha

Dissertations

Photodegradable polymer networks are attractive due to the precise spatiotemporal control and large-area applicability of light. Chemical linkages that enable these polymer networks to be photo-responsive, also hinder their applicability in ambient light. Photostable and photodegradable networks have recently been reported to overcome this challenge by combining other stimuli with light for degradation. We report the design of a network that responds to a simultaneous, dual stimulus for photodegradation. We design poly(thioether acetal) networks with benzylidene acetal moieties that are known to undergo β-scission in the presence of free thiols. By blocking these free thiols with a thermally labile protecting …

A Qualitative Study Exploring The Management & Implications Of Power Differentials Experienced By Pre-Licensed Supervisees In Clinical Supervision Settings, Joyti Jariwala

Dissertations

The focus in this qualitative study was to explore how power differentials in supervision create positive and negative experiences between licensed psychologists and pre-licensed doctoral students. The study results provide insight into how supervisees navigate these dynamics during supervision, which typically involves experiential learning environments in which trainees discuss progress, receive feedback, and enhance their skills. The theoretical framework grounding the study was social learning theory, which is based on the idea that individuals learn from modeling, observation, and imitation in a social context (Bandura, 1986). Reflexive thematic analysis was used to recognize similarities in findings gathered via two sets …

Student Perceptions Of Integrated Stem Education In A High School Geometry Class, Alyssa Noland

Dissertations

Integrated Science Technology Engineering Mathematics (STEM) education provides students with opportunities to solve integrated real-world problems. Integrated STEM instruction aims to develop 21^st-century skills in students and promote interest in STEM subjects through authentic real-world tasks. Student perceptions can help educators and administrators to understand the benefits and constraints of integrated STEM instruction. This qualitative case study was designed to understand student perceptions of integrated STEM instruction and student perceptions of the value or applications of mathematics. The situated STEM learning and social constructivism theoretical frameworks guided the design of the lessons and methods of the study. High …

Shattering The Mask: Unveiling The Destructive Force Of Misogynoir, Ledominique Hubbard

Dissertations

As a Black woman, my professional journey has been consistently marred by encounters with racism and gender bias. In this research, I employed autoethnography to shed light on my experiences and meticulously examine the challenges of misogynoir I faced while holding pivotal positions, including that of a detested team leader, an ingenious instructional teacher, and an anti-racist assistant principal across three distinct school campuses in two states. My narrative unfolds in various contexts, notably as the sole Black female teacher and team leader within nine elementary schools in a predominantly white, female-staffed rural district. Furthermore, I underscore my role as …

The Effect Of A Contextualized Dosage Calculation Learning Intervention On Pre-Nursing Students' Math Self-Efficacy And Ability To Pass High Stakes Dosage Calculation Examination On First Attempt, Eileen V. Weatherby

Dissertations

Many students in pre-licensure nursing programs struggle with calculating accurate medication dosages even though they meet the numeracy requirements for application to the nursing programs. Most pre-licensure programs require that nursing students pass dosage calculation exams at a specified level of accuracy before progressing to the next term. Students typically have three tries to pass at the specified level and should they not succeed, they must withdraw. If they wish to continue in the program, they must complete the requirements for reentry which may include space availability restrictions. Factors influencing dosage calculation performance include fear of mathematics, low math self-efficacy, …

Emotional Intelligence And Critical Thinking In Practical Nursing Students: A Quantitative Study, Jennifer L. Knaack

Dissertations

The aim of this study was to understand if emotional intelligence was predictive of critical thinking in practical nursing students enrolled in a practical nursing program. The literature shows that nursing students' emotional intelligence and critical thinking directly affect student success; however, there is limited research focused on emotional intelligence and its predictability of critical thinking in practical nursing students enrolled in a practical nursing program. This quantitative, predictive study was designed to fill the gap in the literature on the relationship between emotional intelligence and critical thinking in nursing students enrolled in practical nursing programs.

The Effect Of Deliberate Practice Combined With High-Fidelity Simulation Scenarios On Psychomotor Skill Competency And Retention In Prelicensure Nursing Education: A Mixed Methods Pilot Study, Cynthia E. Johnson

Dissertations

Graduating students who are proficient in the representative skills of nursing are vital for providing safe, quality patient care. The purpose of this pilot mixed method study was to examine the combined effect of deliberate skill practice prior to high-fidelity simulation (HFS) sessions and skill practice during HFS scenarios of the urinary catheter insertion skill on psychomotor skill competency and retention in prelicensure nursing students. The study was based on Ericsson's framework of deliberate practice for skill acquisition and expert performance.

Nursing Student Perceptions Of Presence In A Virtual Learning Environment: A Qualitative Description Study, Jason R. Thrift

Dissertations

Multifaceted approaches to learning are used for educating student nurses. One common teaching modality in nursing education, simulation, provides hands-on experiences in a safe environment to prepare student nurses for professional roles. High quality simulation standards recommend an engaging immersive experience, with physical, emotional, and conceptual fidelity to clinical practice. Presence is the perception of being there in a simulation as if it were real. Studies have reported improved learning outcomes with increased sense of presence. A simulation modality seldom used in nursing education is virtual reality simulation (VRSim) a three dimensional, immersive experience. VR-Sim with head mounted visual and …

National Identity Constructions In United States Foreign Policy Approaches To International Conflict, Frederick W. Tillman Ii

Dissertations

This study observes the role of national identity as a tool of the presidents of the United States in framing foreign policy approaches. Examining application for such phenomena reveals the puzzle of how strategic vs subjective decision-makers are when articulating policy addressing international conflicts. The interplay between the two aspects brings together the multiple traditions of national identity and the Wittkopf-Holsti-Rosenau approach model. Occurring over a longitudinal design, this study cuts across four administrations as they address events during the War in Afghanistan and the conflict regarding Taiwan. By coding and analyzing the statements from Presidents George W. Bush, Barack …

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 …