Digital Commons Network^™

Engaging Middle School Emergent Bilinguals In Language Awareness: A Practitioner Researcher Study, Carol Lickenbrock

Dissertations

This practitioner research study (Cochran-Smith & Lytle, 2009) traced the journey toward critical literacy of a group of seven emergent bilinguals and me, their teacher, over the course of a four-month unit on argument as part of our English for Speakers of Other Languages 3 (ESOL3) class. Many of these students, like many emergent bilinguals in the United States, had been disempowered because they had not had access to the academic texts of school. As part of this research, students worked with tools of Systemic Functional Linguistics (SFL) to analyze the interpersonal, ideational and textual metafunctions of argumentation in lessons …

Measuring The Impact Of Cognitive Behavioral Coaching With Nonverbal Immediacy On The Self-Efficacy Of Undergraduate Students In Stem Courses, Christopher Miller, Melissa Joy Benton

Dissertations

A quasi-experimental study explored whether the practice of cognitive behavioral coaching with an intentional focus on nonverbal immediacy has an impact on the self-efficacy of undergraduate students taking college-level STEM (Science, Technology, Engineering, and Mathematics) courses. A positive impact to self-efficacy for students who receive the coaching intervention was anticipated. The research took place at a public research university located in the Midwest. Subjects included students who were required to work with a success coach as a condition of their enrollment and/or financial aid eligibility. Information obtained included perception of nonverbal immediacy of the coaches and self-efficacy of the student, …

Explaining Relationships Between Stress And Resilience In Pharmacy Students, Rebecca Jones

Dissertations

ABSTRACT

Stress is a growing issue on college campuses, and students in a professional pharmacy program may be at an even greater risk for associated problems. The purpose of this study was to gain information about resilience and its relationship with stress, high-risk behaviors, and grade point averages (GPAs) in students who just completed their first professional (P1) year of a pharmacy program. The research questions for this study were: 1) What is the relationship between levels of stress and level of resilience in these pharmacy students, 2) What is the relationship between high-risk behaviors and level of resilience?, and …

Utilizing Mindfulness-Based Exercises To Reduce Anxiety Severity Scores According To The Gad-7, Kelly Calhoun

Dissertations

Abstract

Problem: Generalized anxiety disorder (GAD) affects thousands of Americans every year. Mindfulness, a practice of bringing oneself into the present moment, has been shown to impact anxiety symptoms positively.

Objective: This prospective observational correlational study utilized mindfulness-based exercises to help decrease anxiety severity according to the generalized anxiety disorder-7 (GAD-7) in an outpatient psychiatric practice.

Methods: Participants practiced mindfulness exercises for two months. The GAD-7 was completed three times to monitor symptom severity. Two participant satisfaction surveys were completed to determine whether participants felt the exercises were beneficial for decreasing their anxiety.

Results: A repeated measures ANOVA was used …

Bridging The Gap In Primary Care Of Inflammatory Bowel Disease (Ibd) Patients, Deanna Dial

Dissertations

Abstract

Problem. Patients in rural or medically underserved areas (MUAs) with inflammatory bowel disease (IBD) have limited access to primary care preventative services, making them even less likely to obtain preventative care, placing them at even greater risk for adverse health outcomes.

Methods. A two-phase retrospective chart review utilizing a convenience sample of patients diagnosed with IBD from a privately-owned gastroenterology office to evaluate the effectiveness of increasing preventative screenings for IBD patients. The first review included 53 patients seen from January to April 2019. A preventative screening

evaluation tool (PSET) was developed based on literature recommendations, including the American …

Effects Of Genetic Testing On Clinical Outcomes Of Patients With Obsessive Compulsive Disorder, Jessica Higlen

Dissertations

Problem: The National Institute for Mental Health (NIMH) reports that only 1.2% of adults suffer from OCD, but over 50% are severe (Obsessive Compulsive Disorder (OCD), n.d.). Meier et al. (2016), found that patients with OCD faced a 40% higher chance of early mortality. Individuals with psychiatric conditions are more at risk for poor physical health, poor education, economic struggles and crime (Mental Health by the Numbers, 2019). Emergency departments claim tens of millions of visits per year related to psychiatric issues resulting in billions in costs each year (Mental Health by the Numbers, 2019). Genetic testing is becoming a …

Diversity In Pre-Nursing Majors And Nursing Program Applicants, Christel Fehr

Dissertations

Problem: The population of the US has become increasingly ethnically diverse. This diversity has not been reflected in the nursing workforce with approximately 70% being Caucasian and 85% being female, resulting in a disparity in healthcare delivery by minorities. The purpose of this project was to perform an analysis of race, ethnicity, and gender diversity in undergraduate nursing applicants at a rural midwestern university.

Method: A retrospective review of nursing applications, enrollment reports, and graduation rates were examined for three academic years.

Results: 326 students (N=326) applied to the nursing program from Fall 2016 through Spring 2019. Of …

Nurse Practitioner Student Confidence And Competence In Common Women's Health Diagnostic Procedures, Jessica Cowan

Dissertations

Problem: In areas with limited health resources, such as Guatemala, cost-effective and reliable methods for sexually transmitted infection and cervical cancer screenings are needed. The purpose of this Quality Improvement (QI) project was to develop standardized training in Vaginal Wet Mount (VWM) preparation and cervical cancer screening using Visual Inspection with Acetic Acid (VIA) for Nurse Practitioner students who traveled to Guatemala for a week-long global immersion experience.

Methods: This was a QI project with a prospective descriptive design utilizing a purposive sample of 10 University of Missouri-St. Louis Nurse Practitioner students who traveled to Guatemala on medical mission trip …

Screening For Delirium In The Emergency Department, Melissa Minks

Dissertations

Abstract

Delirium is a problem for many older adults who are acutely ill. Delirium often comes on suddenly, can be severe, and is often difficult to diagnose, especially in the presence of dementia. Missed delirium has a mortality rate of 30.8% and costs millions. What is the purpose of this study?

Methods The 4A’s Test screening instrument was implemented and evaluated in the Emergency Department of a rural Midwestern hospital from May 1, 2019 through August 31, 2019.

Results There were 122 participants in the study with 61 in each cohort. In 2018, three (5%) were diagnosed with delirium without …

Evaluation Of Mcgeer Criteria For Uti Determination In A Nursing Home, Julie Rehagen

Dissertations

Problem: Urinary tract infection (UTI) is one of the most complex and challenging medical diagnoses to make in the long-term care (LTC) population. The unnecessary treatment of a UTI can increase cost of care and the likelihood of multi-drug resistant organisms.

Methods: The McGeer criteria which focuses on UTI in the LTC population was utilized to complete a quality improvement initiative. A descriptive cohort project utilizing retrospective and prospective data was completed to determine if an implemented McGeer criteria protocol improved the avoidable treatment of asymptomatic bacteriuria (ASB).

Results: Before implementation of the protocol, 62.5% of residents were unnecessarily treated …

Comparison Of Nursing Student Academic Achievement And Satisfaction Based On Face-To-Face Interaction Versus Distance Education In Teaching Therapeutic Crisis Management Techniques, Jennifer S. Graber

Dissertations

Nursing education today is very different with advances in science and technology. Nurse educators are using distance education in an effort to offer students the ability to practice varying skills in a safe non-threatening environment. This quasi-experimental, post-hoc causal comparative study had a two group post-test only design. There were two conditions: face-to-face classroom delivery of course content and distance education with online course content. The study was designed to compare effectiveness of distance education and face-to-face interaction through reviewing test grades and class grades. Additionally students were asked to rate their satisfaction of the different modalities.

Needing Help And Waiting: Symbolic Threats To Independence In The Nursing Home, Evelyn Jane Driver

Dissertations

The meanings of independence for nursing home residents were explored using qualitative research methods within the constructivist paradigm. Purposive sampling was used for selection of the interview site (church related, not-for profit nursing home, admitting Medicaid eligible residents) as well as selection of participants

A Mixed- Methods Study Investigating The Perceptions Of Culture Among Faculty, Staff, Adjunct Instructors, And Administrators In A Four-Year, Private, Midwestern University, Amanda J. Price

Dissertations

This mixed-methods study investigated the different perspectives between faculty, staff, adjunct instructors, and administrators utilizing the Competing Values Framework developed by Cameron & Quinn (2011). The quantitative portion of this study analyzed how each employee type viewed the institution’s current culture and how these perceptions were similar or dissimilar to the preferred culture. The qualitative portion, on the other hand, aimed at understanding each group’s viewpoints on the university’s ability to achieve its mission and purpose, adapt and change, clearly communicate, and to effectively lead. These insights were necessary for the researcher to gain insight into the institution’s culture beyond …

Adolescent Resilience Following Parental Death In Childhood And Its Relationship To Parental Attachment And Coping, Marjorie M. Heinzer

Dissertations

Adolescent resilience following loss has been linked with supportive social relationships and coping. Retrospective studies have found that parental death during childhood has been a risk factor for serious mental health problems in adolescence. However, health care professionals and researchers have also reported positive outcomes of increased competency, self-worth, and health in other adolescents. These adolescents have demonstrated resilience, the dynamic ability or strength that enables persons to adjust readily to loss and to mobilize resources. The purpose of this study was to investigate the relationships among parental attachment to the surviving parent, adaptive coping, and resilience of adolescents following …

The Effectiveness Of Multiple-Choice Test Items In Assessing The Clinical Judgement Abilities Of Prelicensure Registered Nursing Students, Tracy D. Holt

Dissertations

The purpose of this study was to evaluate the effectiveness of multiple-choice questions in assessing the clinical judgment abilities of prelicensure registered nursing students. Nurse educators are responsible for ensuring fairness in testing and evaluating the development of clinical judgment abilities of students throughout the nursing program of study. This study compared multiple-choice test items developed using the current NCSBN® NCLEX-RN test item writing guidelines to multiple-choice test items developed using the new guidelines proposed by the NCSBN® Next Gen NCLEX-RN® project.

Antecedents Of Three-Year-Old Child Health Status, Candice C. Bowman

Dissertations

This study sought to assess a set of factors that were proposed to influence child health status at 3 years of age. The sample (N=4940) was drawn from the 1988 National Maternal Infant Health Survey and the 1991 Longitudinal Follow-up, conducted by the National Center for Health Statistics. Only mothers who gave birth to live, singleton infants in 1988 and whose children were still alive and living with them in 1991 were used in the analysis (N=4940). Relationships were specified between the following latent variables: maternal social advantage to birth outcomes and from birth outcomes to child health status, measured …

A Theory-Based, Web-Mediated Physical Activity Intervention For College Women, Lynne L. Ornes

Dissertations

Physical inactivity increases the risk for heart disease, type 2 diabetes, and obesity. Females, more than males, become increasingly inactive as they age. The primary aim was to develop and measure the effect of a theory-based, Web-delivered, physical activity intervention on walking behavior in college-aged women. The secondary aim was to perform a process evaluation to determine the efficacy of the intervention and explore potential mediating variables that explain changes in health behavior.

Nursing Interventions To Reduce Unilateral Neglect In Right Hemisphere Stroke Patients, Sawsan M. Majali

Dissertations

Unilateral neglect is described as the failure of an individual, despite normal primary sensation, to report, respond, or orient to novel or meaningful stimuli presented to the side opposite the brain lesion (Heilman & Valenstein, 1979). Heilman and associates (1985) proposed that neglect is an attention-arousal deficit due to decreased activation of the right hemisphere. The purpose of this study was to determine whether selected interventions that increase the activation of the damaged right hemisphere will reduce the severity of unilateral neglect on the left.

Baroreflex Sensitivity During Positional Changes In Patients With Traumatic Brain Injury, Norma D. Mcnair

Dissertations

Traumatic brain injury (TBI) affects 1.7 million Americans annually leading to significant morbidity and health care costs. An important cause of morbidity in TBI is secondary brain injury due to abnormal cerebrovascular autoregulation (CA). Standard measures of CA are not amenable to use outside of the intensive care unit (ICU) and patients continue to be at risk for secondary brain injury post- ICU. Baroreflex sensitivity (BRS) is a non-invasive assessment of autonomic tone that may be useful in evaluating CA. Evaluation of BRS and its relation to CA has not been examined in patients with TBI and predictors of CA …

Knowledge And Health Beliefs About Breast Cancer Screening Among Rural Palestinian Women: Pilot Study, Hanan Saca-Hazboun

Dissertations

Breast cancer is the most frequent type of cancer among women and the risk increases with age, with an estimated 1.67 million new cases in 2012 and a 25% incidence of all cancers in women in both developed and developing countries. It is the most frequent cause of cancer death in women in less developed regions (324,000 deaths, 14.3% of total), (Ferlay, Soerjomataram, Dikshit, Eser, Mathers, Rebelo, et al., 2015). Breast cancer is diagnosed at advanced stages of the disease in women who reside in the developing countries of the Eastern Mediterranean region (Jemal, Bray, Center, Ferlay, Ward, & Forman, …

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

Dissertations

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

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

Results: Faculty …

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

Dissertations

Abstract

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

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

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

Dissertations

Abstract

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

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

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

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

Dissertations

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

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

Dissertations

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

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

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

Dissertations

Abstract

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

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

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

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

Dissertations

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

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

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

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

Dissertations

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

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

The Development Of Science Identity In Undergraduate Stem Majors: A Case Study Of Urban High School Students, Charles Mcwilliams, Benjamin Nims, Kathleen Dwyer

Dissertations

The STEM fields, science, technology, engineering, and mathematics, face a significant challenge: the underrepresentation of women and minority racial groups entering STEM degree programs and careers. Addressing this STEM gap requires more than quality curriculum and educational supports; there is a need to understand the social psychological processes that influence students’ perceptions, motivation, and interest in STEM. The concept of science identity has been posed as a research perspective to understand participation and persistence in STEM. Enacting a science identity may include describing oneself as a scientist, having a high sense of self-efficacy to do scientific work, displaying an interest …

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

Dissertations

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