Digital Commons Network^™

Lifelong Leadership: Making An Impact Through Service Learning, L. B. Wong, Safiya George Dalmida

Leadership Connection

This presentation will highlight the benefits of service learning to the personal leadership journey and provide resources for participating in service learning opportunities.

Disaster Nursing: From Headline To Frontline, Cynthia Vlasich, K. Joanne Mcglown

Leadership Connection

LEARNING OBJECTIVES By the end of this presentation, the learner will be able to …. • Describe the global frequency, severity and impact of disasters. • Identify potential roles for nurses in the US Federal response system. • Outline various ways in which nurses may enter the disaster response system. • Describe initial expectations of disaster nurses as part of an effective disaster response.

Maternal-Child Health Crisis: Building The Leadership Framework For Effective Global Interventions, Beth Baldwin Tigges, Chun-Mei Li, Shanda Tichelle Harrison

Sigma Global Initiatives

According to the World Health Organization, approximately 830 women die from preventable causes related to pregnancy and childbirth every day, 99% occurring in developing countries. Because quality care can save the lives of women and babies, during this panel presentation Sigma Theta Tau International, in partnership with Johnson & Johnson, will discuss the process and project interventions that have reached over 100,000 people through the Maternal-Child Health Nurse Leadership Academy.

This program is intended to support safe and sustainable communities, ensuring that young nurses are prepared to lead in providing healthy, quality care of women and children and launching interventions …

High-Intensity Exercise In Community-Based Boxing Improves Functional Limitations In Individuals With Parkinson’S Disease, Linnette Ramos, Jessica Watson, Ryan Macalintal, Carrie Ellis

International Journal of Exercise Science

International Journal of Exercise Science 17(3): 1493-1503, 2024. Various exercise types may slow disease progression and improve physical function for people with Parkinson’s disease (PWP), including community-based boxing programs (CBP). Recent research suggests that high-intensity exercise may result in greater benefits for PWP. Participants in CBP, which are typically self-paced, may not be reaching this optimal intensity. This study examines if it is feasible and beneficial for PWP to perform high-intensity exercise in a CBP. Seven subjects diagnosed with Parkinson’s disease participated in a multimodal CBP twice a week for six weeks while wearing heart rate (HR) monitors to help …

Obesity Management: A Pilot Test Of An Electronic Health Record Prompt, Tanya M. Tillman

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

The project objective was to conduct a pilot study to discover primary care providers' responses to using a newly developed obesity screening and management addition to an electronic health record (EHR). Seven providers at a rural community health center pilot tested a red flag body mass index (BMI) prompt, an obesity template, and a resource list placed in the exam rooms to aid in obesity identification and management. Focus group narrative served as the data. A semi-structured interview obtained information about providers' responses to the EHR addition as well as their recommendations for improvements. The results of the pilot study …

Education And Implementation Of Polst Protocols In Northern Arizona, Dawn M. Rivas

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Provider orders for life-sustaining treatment (POLST) is a medical order set that is signed by a physician, nurse practitioner, or a physician assistant and describes how patients wish to be cared for regarding their medical treatment (or refusal of) during times of serious illness and frailty. POLST provides continuity of care across settings of care, increased quality of life and, improved patient satisfaction. POLST is not readily available in all of the United States, and Flagstaff currently has the only POLST program in the state of Arizona. The purpose of this multi-step doctor of nursing practice (DNP) project was to …

Addressing Compassion Fatigue Of A Family Caregiver Of Adolescents In A Mental Health Setting: A Practice Change Project, Suzanne Mcwilliams

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Family members who care for adolescents with a mental health disorder (AMHD) have yet to be recognized as an at-risk population for developing Compassion Fatigue (CF). The project introduced the concept of CF and the development of a program for family caregivers of AMHD at New Haven, a residential treatment center (RTC) for adolescent girls with mental health disorders. Staff therapists, nurses, educators, and support staff attended an educational program on CF, validated screening tools, interventions, and educational materials for family caregivers. A pre/post-Continuing Professional Development Reaction Questionnaire (CPDRQ) was used to measure their intention to change practice. Family caregivers …

Implementing Recommended Perioperative Pain Practice Guidelines By Incorporating Intravenous Acetaminophen, Sarah Ann Torabi

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Optimizing perioperative pain management is important in decreasing adverse outcomes in surgical patients. The purpose of this project was to implement recommended perioperative pain practice guidelines by incorporating intravenous acetaminophen (IVA) as part of multimodal analgesia at an acute care hospital in Northern Arizona. Lewin's change theory guided this project by using strategies to break barriers in accepting and changing perioperative pain guidelines by completing a retrospective chart review to determine IVA efficacy. Data was obtained from adult surgical patients at this facility from January 1, 2014-July 31, 2014 which resulted in 74 charts that met criteria; 37 patients received …

Identification Of Internal Risk Factors And Interventions To Prevent Exertional Heat Illnesses In Hikers: A Systematic Review, Sheri D. Erwin

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Objective: To identify internal risk factors (e.g., caffeine and alcohol consumption, weight, medications, and medical conditions) and intervention strategies for prevention of exertional heat-related illnesses in hikers.

Methods: A systematic review was conducted using a predetermined list of MeSH headings to identify articles on exertional heat-related illnesses. CINHAL, MEDLINE, and PubMed databases were searched for articles published between 2009 and 2014. The studies were ranked using the Oxford Centre for Evidence-Based Medicine classification system. Studies were included if they had a level of evidence of 3 or higher or a grade of C or better.

Results: The initial search resulted …

Implementation Of A Diabetes Treatment Algorithm In Primary Care For Use In The Adult Hispanic Population, Heidi Marshall Dillenbeck

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Diabetes Mellitus Type 2 (DM2) is a growing problem in the United States. Hispanic Americans have a higher prevalence of diabetes than Non-Hispanic Whites and suffer from more severe complications of the disease. Although advances in diabetes treatment over the last decade has improved, management of diabetes in primary care is inconsistent despite well-publicized guidelines from the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE). With the growth of the Hispanic population expected to reach 25 % of the U.S. population by 2050, practice changes must be made to improve diabetes management. The literature supports the …

Impact Of Equine Programs To Treat Autism On Caregiver Stress, Jennifer May

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

When a child is diagnosed with autism spectrum disorder (ASD), caregivers must navigate a complicated maze of information while experiencing their own emotional journey. Maladaptive behaviors seen in children with ASD can make daily routine tasks difficult to complete and attribute to higher levels of caregiver stress. Complementary and alternative medicine (CAM) approaches in treating ASD are gaining interest as caregivers are becoming involved in care planning. Equine programs are becoming increasingly popular options to treat maladaptive behaviors associated with ASD. The purpose of this project was to evaluate if equine programs in the Phoenix, Arizona area used to treat …

Diabetes: What Are The Barriers To Diet, Exercise And Medication Adherence In A Rural Southern Arizona Clinic?, Ambur Lindstrom-Mette

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Purpose: To identify patient reported barriers to diet, exercise and medication adherence in adults who are diabetic patients in a rural Southern Arizona family practice clinic.

Data Sources: A cross-sectional, quantitative self-reported survey was conducted. The Environmental Barrier Assessment Scale was the used to collect data at routine office visits.

Conclusions: Patients consistently identified problems with health as a barrier to diet, exercise and medication adherence in diabetes. Further discussion with patients is warranted to assist patients and providers to understand what problems are occurring and what the solution may be to help overcome these barriers.

Implications for Practice: Identification …

Preventing Type 2 Diabetes In Native Americans Through Nutrition, Dana M. Griffin, Dorothy Sansom

Group: Nebraska Methodist College

Diabetes is a chronic condition that disproportionately affects the Native American population. A means of improving the outcomes was through an education program aimed at a younger target population. The purpose of this project was to determine if nutritional knowledge can reduce the risk of Type 2 diabetes in the Native American population. Changes in dietary habits can reduce the risks of Type 2 diabetes for high risk populations like Native Americans. Having knowledge of nutrition can assist people in making educated choices in deciding what foods to consume. Determining nutritional knowledge by implementing a test followed by a dietician …

Continuous Glucose Monitoring And Behavior Change, Aubrey Molgaard

Group: Nebraska Methodist College

Clinical usage of continuous glucose monitor (CGM) devices has started to become a novel way to integrate glucose control with improvement in lifestyle with behavior change by seeing blood glucose levels in real-time. CGM and real-time data predicts what is happening with blood glucose levels and when people wearing the device views the data it allows the person with diabetes to guide lifestyle changes to better assist in blood glucose levels and less variability of blood glucose levels.

The study aim was to determine whether using CGM had an impact on behavior change with lifestyle choices consisting of activity or …

Reducing The Intake Of Red And Processed Meats In Food Pantry Consumers, Lisa J. Lehr, Jeannie Hannan

Group: Nebraska Methodist College

Background: Nutrition interventions prevent chronic disease and improve health outcomes. Often, these affect socioeconomically advantaged populations disproportionately, widening the gap in health disparities. Of the interventions studied, those with several approaches attempting to reach a smaller target were most effective. Targeting people in their natural environment has been proven effective to increase the power of education. Purpose: The purpose of this project was to assess whether an evidence-based educational nutrition intervention that involved visual cues within the pantry setting, samples of plant-based food, and an educational nutrition resource pack designed for low income populations would affect the protein intake habits …

The Impact Of A Virtual Poverty Simulation On Undergraduate Nursing Students' Attitudes, Beliefs, And Awareness, Kimberly A. Sullivan, Alice Kindschuh

Group: Nebraska Methodist College

Purpose: The purpose of this project was to determine the impact of a virtual simulation on undergraduate nursing students’ attitudes, beliefs, and awareness of poverty. Methodology: The SPENT virtual poverty simulation was conducted in a small private college located in the Northeast. The program was implemented during a Community Health nursing class with 22 students. Participating students were given a pre- and post-questionnaire to assess how the implementation of a virtual poverty simulation impacts undergraduate nursing students’ attitudes, beliefs, and awareness of poverty. Implications/Conclusion: There was no statistically significant results obtained from pre to post test results. Two-tailed t-tests were …

Sleep Hygiene Education For Rural Adults, Amber R. Rogers, Linda Carol Hughes

Group: Nebraska Methodist College

This is a DNP Capstone paper. This DNP project examined what effect a community based sleep hygiene education program had on the quantity and quality of sleep in rural adults. Participants received a 45 minute oral PowerPoint presentation on sleep hygiene and were given an educational handout. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to subjectively evaluate a participant's sleep habit pre- and post-intervention (Buysse et al., 1989). Strong evidence suggests that the sleep hygiene intervention improves the overall PSQI global scores and overall quality of sleep. A paired sample t test was calculated to compare the means …

Best Practice Tool Kit For Implementation Of A Patient Education Program For Congestive Heart Failure Education, Sarah Poe, Lyndsi Hall

Group: Nebraska Methodist College

Problem: Congestive heart failure (CHF) is a challenging health concern and generates a multitude of issues including increased mortality rates and hospital readmission rates, and drastically decreases the quality of lives for patients affected with this health issue. This project was designed to investigate whether or not patients receiving care within a large cardiology clinic in the Midwest gained increased knowledge and disease management skills regarding their diagnosis, prognosis, dietary and activity guidelines, as well as symptom recognition and management when participating in CHF education classes provided by a designated CHF nurse educator over a four-week period.

Intervention: The CHF …

Awareness Of E-Cigarettes And Association Of Use Among High School Students, Kimberly A. Sullivan

Group: Nebraska Methodist College

Background: According to the 2018 National Youth Tobacco Survey (NYTS) data, e-cigarette use among high school and middle school students has increased at an alarming rate between 2017 and 2018, with a reported 3.8 million youth currently using various types of e-cigarette products (U.S. Food & Drug Administration, n.d.). As of February 18, 2020, a total of 2,807 confirmed hospital cases of severe respiratory illnesses and 68 deaths have been reported to the Centers for Disease Control and Prevention (CDC) from all 50 states, the District of Columbia, and two United States territories (Centers for Disease Control and Prevention, n.d.). …

Improving Suicide Risk Screening In A Pediatric Outpatient Clinic, Annie Bowman

Group: Nebraska Methodist College

Objective: The purpose of this project was to determine if implementation of an educational intervention for clinical providers and staff on the Ask Suicide Screening Questions (ASQ) tool improved knowledge and confidence on suicide risk screening in a pediatric ambulatory setting. Participants: Behavioral health clinic in which 9 participants completed pre survey and 8 participants completed both pre and post survey (N = 8). Study Method: Pre and post test design with intervention of an online education presentation for staff and clinicians in the behavioral health clinic. A 12 item pre and post-test survey was created to assess participant …

Vitamin B12 Screening And Treatment In Patients Taking Metformin, Ashlee Denny

Group: Nebraska Methodist College

Background: Long-term metformin therapy is linked with the potential side effect of vitamin B12 deficiency. Although screening is recommended, there is no standardized screening guideline. Vitamin B12 deficiency is frequently unrecognized. An electronic medical record-based alert may lead to more identification and better patient outcomes.

Purpose: The purpose of this project was to determine the impact of focused education on clinician perceptions about the importance of using an electronic medical record-based alert to ensure routine vitamin B12 monitoring in type II diabetic patients prescribed metformin.

Methodology: The organization site for this doctoral project was a single, stand-alone, primary care clinic …

Improving Patient Education To Increase Nurses’ Confidence, Aisha N. Washington

Group: Nebraska Methodist College

Effective patient education is something every interdisciplinary healthcare team member should aim for at each educational session. When patients understand the intended education, their ability to manage their chronic conditions at home is greatly affected. Patients have difficulties comprehending critical information more commonly than they should. Bedside nurses in the acute care hospital setting spend more time with patients than do their physicians and do much of the patient teaching. However, many nurses do not feel confident in implementing effective patient education. A structured patient educational tool was created for this project for nurses to implement when educating patients using …

Importance Of Patient Education On Hemoglobin A1c And Dietary Modifications, Joseph Giramata

Group: Nebraska Methodist College

Research shows that only less than 25% of adult patients who are being treated for diabetes can recall their previous and most recent hemoglobin A1c levels. It is the providers' role to educate adult patients at every visit about their hemoglobin A1c levels and the benefits related to knowing the levels coupled with increase in physical activities and a plant-based diet. The purpose statement guiding this project is: In medical providers caring for adult patients diagnosed with DM2, does provider education on hemoglobin A1c and dietary modifications affect medical providers management of DM2? The project consisted of an educational intervention. …

Determining The Impact Of Using A Social Determinants Of Health Screening Tool In Identifying Unmet Needs, Barriers To Care, And Basic Awareness Of Social Resources, Maelene Schuhmacher-Omar, Kari Wade

Group: Nebraska Methodist College

The purpose of this project was to determine if conducting a short, social determinants of health (SDOH) assessment identified one or more unmet needs, one or more barriers to care, and to assess basic awareness of social resources. Conditions affecting people where they work and live have a strong influence on health outcomes. Social complexity, meaning having one or more unmet need, is directly related to poorer health outcomes. Individuals marginalized by poor social capital, health inequities and ongoing disparities, especially those in low income populations, experience higher morbidity and mortality. These unmet needs also affect the shared-decision making process …

The Impact Of Health Partner Participation In Cardiac Rehabilitation On Health Partner Knowledge Of Cardiac Disease Risk Factors, Nathan T. Shank

Group: Nebraska Methodist College

Background: Cardiac disease remains the top cause of mortality and morbidity in the United States. In order to achieve optimal long-term outcomes, people who have experienced an acute cardiac event must undergo several lifestyle and behavioral changes. With the importance of social support on health, it is equally important for a person's identified health partner to learn the recommended lifestyle changes that promote good health in post-acute cardiac patients. Many of these behaviors can be learned through participation in a cardiac rehabilitation program, but few studies have been performed on the benefits that a spouse receives from attending cardiac rehabilitation …

Constipation Management In Congestive Heart Failure Patients, Jordan Radel

Group: Nebraska Methodist College

Constipation within congestive heart failure patients admitted to the hospital poses a significant health burden, decrease in quality of life, and potential for complications. Based on a review of literature, nursing staff are the front line of patient care for these patients and can provide individualized nursing assessments that target constipation risk factors, potentially decreasing the risk and prevalence. A nursing led Cardiac Constipation Management Tool provides an effective means of risk assessment assigning appropriate categories of constipation risk, and ultimately leading to provider notification, designated constipation order set activation, and therefore decreased constipation rates. Upon admission the tool was …

Retrospective Data Analysis To Support The Use Of Small Body Movements As An Intervention For Prevention Of Pressure Ulcer Development, Leah Trautman, Valerie Lynn Anderson

Group: Nebraska Methodist College

Pressure ulcers cost the healthcare systems millions of dollars every year. The current literature indicates that a multi-modal approach must be used in order to provide the best prevention of pressure ulcers. The use of small body movements is a simple intervention that could be utilized in addition to the regularly used prevention methods. A retrospective data analysis was used to assess the possible need for an additional pressure ulcer prevention intervention and the possible effectiveness it may have had on the intensive care patient population. Data was collected 60 days prior to the implementation of the new intervention in …

Food Insecurity Screening Among Hospitalized Older Adults With Cardiovascular Disease, Claire Montoya

Group: Nebraska Methodist College

Objective: To implement a food insecurity (FI) screening process using the HVS^TM for adults age 60 and older on an inpatient cardiac unit. The intent was to better understand the prevalence of FI, to evaluate current nutrition resource use, and to assess for any significant relationship between resource use and FI screening result among this specific patient population.

Methods: Screenings were administered by registered nurses on the cardiac unit to any adult age 60 or older admitted to the unit. Screening forms consisted of the two-item HVS^TM and a third question screening for use of nutrition resources (SNAP, …

Magnesium Sulfate In Relation To Preeclamptic Postpartum Mothers, Megan Lihs, Nancy Murray, Valerie Lynn Anderson

Group: Nebraska Methodist College

Magnesium sulfate is often used from the onset of labor and during the postpartum period to stabilize maternal blood pressure. Because little is known about magnesium sulfate, there is a concern that allowing mothers to pump or breastfeed while receiving this medication may place additional stress on the mother’s body. The purpose of this project was to determine whether preeclamptic postpartum mothers receiving magnesium sulfate who initiated breast-pumping within 1-4 hours post-delivery experienced elevated blood pressures, as evidenced by a rise above 140/90 mm Hg. A retrospective chart review of mothers who delivered in 2017, received magnesium sulfate, required immediate …

A Peer Support Program For Adolescents With Type 1 Diabetes, Amber A. Fuller

Group: Nebraska Methodist College

Type 1 diabetes mellitus (T1D) is a chronic condition impacting young children and subsequently follows them throughout life. The disease causes the body to lose the ability to produce insulin resulting in elevated blood sugar levels causing a cascade of detrimental complications. As children navigate through the different phases of life, especially during adolescence, the challenges of self-management of this disease can become difficult. In research, peer support programs have shown to be an effective method to approaching this challenge. This quality improvement project focused on the T1D adolescent population and created, implemented, and evaluated a peer support program, called …