Digital Commons Network^™

Successfully Spreading Improvement Work Using A Proven Framework, Rachel Lynn Wyatt

Doctor of Nursing Practice (DNP) Projects

Background: Hospital-acquired pressure injuries (HAPIs) are rising in the United States, increasing six percent between 2014 and 2017 alone (Agency for Healthcare Research and Quality [AHRQ], 2019). Approximately 60,000 patients die from complications related to HAPI annually (Padula & Delarmente, 2019).

Local Problem: In a Northern California Level II Trauma acute care hospital, HAPIs increased by 422% over two years, 2016-2018, with most of the HAPIs occurring in the Intensive Care Unit (ICU).

Context: This project sought to spread the Interventions by Braden Subscale protocol to seven medical-surgical units in the hospital using the Institute for Healthcare Improvement’s (IHI) Framework …

The Effects Of Naloxone Education Among Adults In Alameda County, Patricia Ronnica Tinglin

Doctor of Nursing Practice (DNP) Projects

Fatal opioid overdose is a growing concern in the United States (U.S.). The pharmaceutical companies assured the medical community that opioid pain relievers were not addictive. As a result, providers prescribed them at a significantly higher rate, which led to more extensive use of authorized and unauthorized opioid use before it was realized that they could be highly habit-forming (The U.S. Department of Health and Human Services [HHS], 2019). A growing body of evidence supports providing naloxone education as a means of harm reduction. The quality improvement project aims to implement educational sessions for adult patients seen at East Bay …

Using Simulation To Improve Covid-19 Code Blue Outcomes, Charity Shelton

Doctor of Nursing Practice (DNP) Projects

Background

Healthcare workers in the acute care setting must be ready to respond to emergencies at any given time. The recent COVID-19 pandemic put strains on the healthcare workforce that have brought challenges and new competencies for how healthcare workers safely respond to emergencies. To ensure healthcare workers maintain these competencies, specific training must occur to improve emergency response and outcomes. Specifically, there needs to be training for healthcare workers to respond to COVID-19 code blue emergencies safely and with skilled interventions.

Problem

A code blue in the acute care setting is a medical emergency that requires nurses, physicians, and …

Agency, Inclusion, And Empathy As Power: The Last Dispatch From My Ma In Engagement Journalism (And My Final Report), Jacqueline Neber

Capstones

My community practicum engaged New York's intellectually and developmentally disabled community, and their families, in the process of making the process of reporting abuse and neglect inside group homes more accessible and transparent. Serious abuse and neglect still happens in group homes for people with disabilities, which has led to death and serious injury, and reporting issues is not necessarily easy. After a year of listening to community concerns, I created a service journalism post that made reporting abuse and neglect easier for families and the public. And most prominently, I created "How to Stand Up for Yourself in Your …

Are The Kids All Right? What Tv Shows Get Wrong About Teen Dating, Radhamely E. De Leon

Capstones

Dating culture and sexuality have changed so much for teens over the years but shows like Euphoria, Gossip Girl and Sex Education seem to stick to the same narratives and bad practices, even as consumers have voiced that they want more from show creators. This article explores how teens feel about the way popular television shows portray characters their age and the realities of teen dating. https://rdeleon915.github.io/capstone/

School Social Workers In Texas, Kayce Stevens

Capstones

School social workers in Texas are underfunded, under-appreciated, and overworked. I spent 18 months interviewing and getting to know school social workers across Texas to find out what their needs were. The main concerns I learned where: not many people know what school social workers do and that limits the resources they can provide, and there are not enough social workers in the schools across Texas which makes their workload unmanageable. I created one-pagers to distribute during the Texas legislative session on why the Texas Education Code should require all schools to provide social services. I also created a chatbot …

The Devotees To Disconnection, Keith Paul Medelis

Capstones

The richest and most connected people are paying to log offline, leaving the rest of us tethered to our devices. We want in on their secret. But at what cost?

An Online Hub For Queens Parents, Abe R. Levine

Capstones

I sought to build a common hub for parents across District 28 in Queens to connect with one another. I did this by creating a bilingual newsletter called the Queens Boletín. The goal of the Boletín was for parents to share and find resources, to advance the conversation on equity, and to build community.

Dear Maliha,, Na-Eela Djemil

Capstones

Dear Maliha is a short documentary film exploring the complexities of spiritual abuse through Maliha Fairooz. Spiritual abuse is a form of abuse that uses spiritual or religious beliefs to control or manipulate others. In some cases, spiritual abuse can be used to describe a religious leader who abuses their platform. But in Maliha’s story, we explore the concept of parental spiritual abuse. However, we learn more about this through Maliha Fairooz and the creative use of her journal.

For Maliha journaling is a form of therapy she uses to process her feelings and days. She also uses it as …

Program Evaluation Of Adolescent Intervention Program (Aip): Substance Abuse Education Program For At Risk Adolescents, Shanea Clancy

Doctor of Nursing Practice (DNP) Manuscripts

The purpose of this project is to evaluate the effectiveness of the Adolescent Intervention Program (AIP), a faith-based drug and alcohol recovery program for teens. This is an alternative to jail program. Nearly 1 in 10 Americans, 12 years or older (20.1 million people), have a substance use disorder (SUD), involving alcohol or illicit drugs (National Center for Drug Abuse Statistics, 2019). The average age of first-time alcohol or substance use is 13 years old and nine out of ten addictions start in the adolescent years (National Center for Drug Abuse Statistics, 2019). Adolescents with first-time drug and alcohol arrests …

Improving Lymphedema Self-Management And Screening In Newly Diagnosed Breast Cancer Clients Through The Use Of A Self-Management Lymphedema Toolkit, Kescia Gray

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: With breast cancer effecting women at much younger ages and modern treatments prolonging the life span, survivors are at increased risk of developing breast cancer-related lymphedema (BCRL), a chronic, progressive condition that can cause disability.

Purpose: The purpose of the project was to determine the level of knowledge and awareness of BCRL in newly diagnosed breast cancer clients; and to provided education on self-care after treatment, using of a self-management lymphedema toolkit (SMLT), to decrease risks of treatment-related lymphedema, improve self-efficacy, and enhance quality of life (QOL).

Methods: Newly diagnosed breast cancer clients (N=10) from the Breast …

Implementation Of Cervical Cancer Screening Protocol (Ccsp): A Quality Improvement Project, Emilee Lenhart Hawk

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background and significance: Cervical cancer is the fourth most commonly occurring cancer in women and the eighth most commonly occurring cancer overall (WCRF, 2020). Papanicolaou (Pap) testing is the primary screening for cervical cancer. In the past 40 years the number of cases and deaths from cervical cancer has decreased significantly, resulting from cervical cancer screenings (CDC, 2021). Healthy People 2030 reports to increase the proportion of females ages 21-65 who receive a cervical cancer screening based on the most recent guidelines. The 2030 target is 84.3%. Human papillomavirus (HPV) is a virus that is transmitted through sexual contact …

Optimizing Postpartum Care By Ongoing Care Coordination Initiatives (Cci) In Screening And Management Of Postpartum Depression (Ppd) Among Clients In An Obgyn Practice: A Quality Improvement Project., Jennifer Broussard

Doctor of Nursing Practice (DNP) Manuscripts

Background: Postpartum depression (PPD) is defined as physical, emotional, and behavioral changes that occur after the birth of a child. Postpartum depression is complex and a mix of physical, emotional, and behavioral changes (Cleveland Medical Clinic, 2018). Postpartum depression screening is of high importance at a comprehensive postpartum visit. The consequences of a patient suffering postpartum depression can be serious and early recognition and interventions improve outcomes for the patient as well as the infant. Problem: There is a lack of screening for PPD among postpartum clients and this period is critical for the mother and the infant (American College …

Program Evaluation Of The Rapid Response System Prior To And During A Covid Surge, Sarah Born

Doctor of Nursing Practice (DNP) Manuscripts

Between the years 2004-2008, the Institute for Healthcare Improvement (IHI) and The Joint Commission made a recommendation for healthcare facilities nationwide to implement rapid response systems (RRS). Rapid response systems consist of four limbs: recognition and alert (afferent); response and providing timely patient management (efferent); delivering support and oversight (administrative), and monitoring the RRS patient outcome data (quality improvement). The intent of implementing RRS was to increase patient safety and outcomes within the acute care setting. The following question (PICO) formed the basis of the project: “How does the current rapid response system workflow compare to the rapid response system …

Reducing Opioid Related Deaths And Improving Rehabilitation Access Through The Elk Grove Village Cares Program: A Program Evaluation, Rebecca Barron

Doctor of Nursing Practice (DNP) Manuscripts

Abstract The goal of the Elk Grove Village Cares program is to decrease the deaths and overdoses of those who abuse opioids through harm reduction strategies and provide access to treatment. The article is a program evaluation of the Elk Grove Village Cares program. Surveys, interviews and the synthesis of program data is used to evaluate the efficacy of program activities. Results: The rate of death from opioid use has decreased an average of 1.7 deaths since program implementation in 2018. Law enforcement officers (LEO) and the community responded similarly to many survey questions regarding attitudes surrounding addiction. Within the …

Improving Care Of Children With Acute Decompensated Heart Failure (Adhf) Through Implementation Of A Heart Failure Communication Checklist & Discharge Plan, Dana M. Schneck

Doctor of Nursing Practice (DNP) Manuscripts

Background: Children admitted to the hospital with ADHF have been identified as a low volume high complexity population with high morbidity and mortality rates. Hospitalizations are fraught with prolonged lengths of stay and frequent readmissions prompting increased resource utilization and significant healthcare costs. Pediatric collaborative learning networks, such as the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) seek to close quality gaps by engaging multidisciplinary multi-institutional teams along with patients and caregivers to share expertise, experience, and data prompting translation of evidence into higher quality, safer, cost-effective care.

Methods: A13-item pediatric-specific Heart Failure Communication Checklist (HFcc) and Heart Failure Discharge …

Ley Olimpia: Examining Policymaking Around Digital Violence, Andrea Alejandra Capella-Castro

Undergraduate Honors Theses

The topic of this thesis is policymaking and regulations around digital gender violence. This work intends to examine what methods effectively regulate and eradicate Online-Gender Based Violence (OGBV), a new type of Gender-Based Violence (GBV). Effective policymaking for the digital space has a significant impact on our society and especially on women as they remain the most objectified, attacked, and harassed on social media platforms. Therefore, social media needs an effective policy to address digital gender violence. Furthermore, the topic is relevant because policymaking around digital gender violence will advance the feminist movement’s fight and protect women and social media …

Telehealth Appointments To Increase Therapy Compliance In Patients With Mosa, Tracy J. Partington

Doctor of Nursing Practice (DNP) Projects

Background: At the VA Puget Sound Healthcare System, care as usual for patients with a new diagnosis of mild obstructive sleep apnea (MOSA) is a letter directing the patient to call the continuous positive airway pressure (CPAP) clinic to establish ongoing care.

Local Problem: This model has resulted in low therapy compliance and does not afford patients the ability to discuss their diagnosis and treatment options with a licensed healthcare provider. A literature review showed telemedicine interventions increase therapy compliance in patients with MOSA.

Context: The Doctor of Nursing Practice project implemented an evidence-based practice change to improve therapy compliance …

Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Abstract

Introduction: Patient agitation is a phenomenon that presents itself to the emergency department (ED) on a daily basis. Agitation can manifest from an array of physical or psychological complaints. Behavioral health patients presenting with agitation is a growing subset of the total agitation population within EDs. A better understanding of behavioral health patient agitation in the ED setting is needed to guide best practices in treating this fragile population with therapeutic, patient-centered care.

Methods: A review of literature was conducted on agitation and behavioral health in ED settings, using the search terms emergency department, agitation, restraints, sedation, and behavioral …

Use Of Simulation To Improve Nurse's Response To Covid-19 Code Blue: A Literature Review, Charity Shelton

Doctor of Nursing Practice (DNP) Projects

Background

Healthcare workers in the acute care setting must be ready to respond to emergencies at any given time. The recent COVID-19 pandemic put strains on the healthcare workforce that have brought challenges and new competencies for how healthcare workers safely respond to emergencies. To ensure healthcare workers maintain these competencies, specific training must occur to improve emergency response and outcomes. Specifically, there needs to be training for healthcare workers to respond to COVID-19 code blue emergencies safely and with skilled interventions.

Problem

A code blue in the acute care setting is a medical emergency that requires nurses, physicians, and …

Transcatheter Aortic Valve Replacement: Implementation Of Shared Decision-Making, Liesel Buchner

Doctor of Nursing Practice (DNP) Projects

Background: The setting for this study is the structural heart program of a large healthcare organization in the Greater Sacramento area in California. Aortic stenosis (AS) is the most common cardiovascular valvular disease in the elderly. The treatment of AS is complex and over the last decade, the transcatheter aortic valve replacement (TAVR) procedure has changed the management of this high-risk group and has become the standard of care.

Problem: The structural heart team performs an average of 170 TAVR procedures annually. The program is relatively new, and although it is performing above the national averages for specific program outcome …

Computational Thinking For Teachers, Susan Imberman

Open Educational Resources

This is a syllabus for a course in computational thinking. The course described introduces preservice and inservice teachers to the fundamental concepts of computer science, including web design, coding, ethics, computational thinking, course resources, etc.

Winning The Battle, Winning The War, Malka Herman

William & Mary Law Review Online

This Article analyzes Derrick Bell's interest-convergence theory and its utility for lawyers when litigating for the rights of nondominant groups. The first part of this Article studies four different cases in which plaintiffs or amicus curiae chose arguments that highlighted the ways their interests converged with potential allies. The Article uses these cases as examples of four different ways that a lawyer can engage in interest-convergence litigation. The strategies examined in this Article rest on two axes: dominant/nondominant narrative convergence and natural/unnatural ally convergence. An analysis of the effects of each of these techniques makes it clear that dominant narrative …

Philosophical Anthropology And Biblical Interpretation In John Paul Ii’S Theology Of The Body, Shawn Conoboy

Electronic Theses and Dissertations

In the Theology of the Body, through a series of Wednesday Catecheses, John Paul II presents a magisterial understanding of the sacrament of marriage and of marriage and family ethics. At the same time, John Paul II presents a theological anthropology, which forms a basis for the magisterial teaching. His theological anthropology is developed through an exegesis of selected biblical texts, especially Genesis 1-3 and Ephesians 5, and through an application of a philosophical anthropology articulated by Karol Wojtyła. This dissertation draws the connection between the philosophical anthropology of Wojtyła, especially as it is articulated in his major works, …

Relational And Social Aggression: A Scoping Literature Review, Angela Fidazzo

Electronic Theses and Dissertations

School violence is an omnipresent problem within the United States, at worst, resulting in the death of children and teachers across the nation. Over time, numerous strategies and tools have been introduced in order to reduce aggression within schools. However, as both overt and covert forms of aggression contribute to school violence, it is necessary for researchers to investigate covert, indirect forms of aggression as a way to better identify and prevent a salient contribution to this problem. Although much research has investigated bullying in general, further research is needed in better understanding the forms of covert bullying, relational and …

Counselors Dumbfounded: Implications For Counseling Ethics, Ivan Irizarry

Electronic Theses and Dissertations

How counselors should make ethical decisions frequently differs from how counselors actually make ethical decisions, which is often a non-linear process. Social Intuitionist Theory (Haidt, 2003) suggests this process entails a socially influenced intuitive judgment followed by post hoc rationale. The purpose of this study was to examine whether moral dumbfounding, which entails maintaining a moral judgment without supporting reason, occurs with practicing counselors. The results of survey data and open-ended coding showed that 58.5% of counselors were dumbfounded at least once when presented with four moral or ethical vignettes. Additional analyses exploring differences in dilemma-based vs. non-counseling vignettes, moral …

The Effect Of School-Based Mindfulness Intervention On Student Attention And Executive Function: A Meta-Analysis, Sarah E. Rea

Electronic Theses and Dissertations

Schools are facing increasing responsibility to foster the social-emotional development of students. One way in which schools can improve student functioning is through school-based mindfulness interventions. Using mindfulness practices, in particular, can teach students to increase their attention of surroundings and internal experiences, and awareness of their thoughts and behaviors. While the evidence-base for mindfulness interventions in schools continues to grow, there are several studies that show promising outcomes. The purpose of this study was to determine how large the effect sizes for school-based mindfulness studies are in regard to increasing student attention, cognitive flexibility, and working memory. Results indicate …

Detecting Viral Particles In Vitro Using Photoacoustic Flow Cytometry, Anie-Pier Samson

Electronic Theses and Dissertations

The Covid-19 pandemic is a powerful example of just how damaging the rapid spread of an unknown virus can be. Viruses have the ability to spread rapidly amongst individuals if not treated and controlled. The first key step towards treatment is the timely and specific diagnosis of the virus causing the infection. An innovative method for the rapid detection of viral particles in solution consists of tagging the viral particles paired with using photoacoustic flow cytometry to irradiate the particles and get a signal. The high affinity of Streptavidin for Biotin can be used to bind Streptavidin-coated microspheres to biotinylated …

Cgrp-Driven Lateralization Of Pain Modulation By The Central Amygdala, Heather Allen

Electronic Theses and Dissertations

The central amygdala (CeA) is a bilateral, mid limbic brain region involved in the processing of pain and emotion. Interestingly, the left and right CeA are functionally lateralized in the context of bladder pain, with the left and right CeA having opposing effects on bladder pain-like behavior. However, the specific mechanisms driving these divergent functions are unknown. Nociceptive signals from the bladder are relayed to the CeA via projection neurons in the parabrachial nucleus (PBN) that express high levels of calcitonin gene-related peptide (CGRP). In these studies, we investigated the influence of PBN CGRP signaling in the left and right …

Investigating Relationships Between Diabetes Distress, Diabetes Self-Care Behaviors, Intention To Use And Actual Use Of A Personal Health Record Within 30 Days Of Hospital Discharge In Persons With Type 2 Diabetes, Khaliah Fisher-Grace

Electronic Theses and Dissertations

Background: Diabetes distress (DD) is defined by emotional and behavioral challenges caused from diabetes and its management. Diabetes self-care behaviors can be compromised by DD. Personal Health Record (PHR) use has been associated with improvements in HbA1c, blood pressure, and LDL-C, but the relationship between DD and PHR use is unknown. Aims: 1) to determine differences between sociodemographic variables and intention to use and actual use of PHR in hospitalized persons with Type 2 Diabetes Mellitus (T2DM), 2) to investigate the relationship between DD, intention to use a PHR and actual use of a PHR within 30 days of hospital …