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Articles 1 - 30 of 169
Full-Text Articles in Medicine and Health Sciences
Implementation Of A Peer Support Program To Increase Resilience In Nurse Managers In Acute Care Hospitals: A Pilot Study, Juana Castillo
Implementation Of A Peer Support Program To Increase Resilience In Nurse Managers In Acute Care Hospitals: A Pilot Study, Juana Castillo
Doctoral Projects
Background: Nurse managers are at risk for experiencing stress and burnout. The peer support program was implemented to increase resilience among nurse managers.
Methods: A one-group pretest and posttest design was employed to examine the impact of peer support on nurse manager resilience. The nurse managers participated in bi-weekly 30-minute peer sessions over 12 weeks. The Connor-Davidson Resilience Scale was utilized prior to and following the intervention along with demographic and satisfaction surveys.
Results: There were six nurse managers who participated in the peer support program; however, only four completed both the pre- and post-survey. The peer support program intervention …
Utilization Review And Utilization Of Evidence-Based Guidelines, Rosetta E. Hairston
Utilization Review And Utilization Of Evidence-Based Guidelines, Rosetta E. Hairston
Doctoral Projects
The quality improvement project focused on determining why utilization review nurses submitted epidural steroid injection treatment requests within evidence-based guidelines to peer review. The study reviewed six months of data from June 2022 through December 2022 to develop a pre-training baseline for the number of epidural steroid injection treatment requests approved by the nurse and approved by peer review. Deming's method for quality improvement was identified as the framework for implementing changes. The UR nurses were provided four weeks of refresher training on applying evidence-based guidelines to epidural steroid injection treatment requests. Post-group training sessions reflected a 91% increase in …
Does The Enhanced Recovery Pathway Decrease Length Of Stay And Readmission Rates In Patients Undergoing Gynecologic Surgery?, Trinh T. Nguyen
Does The Enhanced Recovery Pathway Decrease Length Of Stay And Readmission Rates In Patients Undergoing Gynecologic Surgery?, Trinh T. Nguyen
Doctoral Projects
The Enhanced Recovery After Surgery (ERAS) pathway promotes an early recovery after surgery using an evidence-based multidisciplinary approach. The ERAS protocol is aimed at standardizing care to improve patient outcomes. There is consistent evidence that ERAS pathways reduce hospital length of stay (LOS) and readmission rates, decrease healthcare costs, and improve patient satisfaction and outcomes. By attenuating the surgical stress response and supporting the return of physiological function, the ERAS pathway achieves its effectiveness. This scholarly project aimed to evaluate how ERAS improves patient outcomes in gynecology patients at a county hospital. A standardized method for improving patient recovery was …
Implementation Of Web-Based Patient Education In Newly Transplanted Kidney Recipients, Tabo Mwikisa-Kelly
Implementation Of Web-Based Patient Education In Newly Transplanted Kidney Recipients, Tabo Mwikisa-Kelly
Doctoral Projects
Kidney transplantation is the preferred treatment for patients suffering from kidney failure. It is a complex process that is intended to improve one’s quality of life by adhering to a lifelong treatment plan of immunosuppressant therapy. Therefore, it is essential for patients or their caregivers to have adequate knowledge to care for themselves following post-transplant, which can contribute to better patient outcomes. In a metropolitan Bay area hospital in Northern California, the current state of practice involves educating newly transplanted kidney recipients through face-to-face interactions with the patient and handing out a transplant booklet during their initial transplant hospital stay. …
Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus
Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus
Doctoral Projects
Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …
Nursing Professional Development Practitioner’S Experience Of Use Of Instructional Design Industry Standards, Denise Renfro
Nursing Professional Development Practitioner’S Experience Of Use Of Instructional Design Industry Standards, Denise Renfro
Doctoral Projects
Instructional design (ID) is a critical skill for nursing professional development practitioners (NPDs). Instructional design seeks to solve gaps in knowledge or skill by identifying both the educational issue and the outcomes by designing how to achieve the outcomes. There are complex and advanced instructional design needs for problem solving that requires an educational foundation in instructional design and experience. The purpose of the quality-improvement project was to assess the changes in NPD practitioners’/nurse educators’ adaptation to industry standards for ID pre- and post-implementation of a standardized instructional design model. The Nurse Educator Self-Assessment in Measuring Learning survey was developed …
Examining The Effectiveness Of Physical Activity Patient Education In Improving Hba1c, Nadieh Samiaei
Examining The Effectiveness Of Physical Activity Patient Education In Improving Hba1c, Nadieh Samiaei
Doctoral Projects
Regular physical activity plays an important role in maintaining good health and managing and reducing HbA1c among type 2 diabetes patients. The goal of this study is to examine the effectiveness of physical activity in reducing the HbA1c among the type 2 diabetes patients of a local community health center in San Leandro, California. A quasi-experimental, pretest-posttest single site design project was conducted among a sample of 24 patients who had type 2 diabetes. The participants were selected to attend regular patient education classes promoting physical activity, diet, and lifestyle change as a measure of controlling diabetes. A paired sample …
Experiences Of Transitioning Medics And Hospital Corpsman, David Renfro
Experiences Of Transitioning Medics And Hospital Corpsman, David Renfro
Doctoral Projects
Approximately 2,000 medics transition from military service to civilian jobs annually, and the civilian workforce currently does not have a mechanism to utilize the skills of these transitioning veterans. Medics and Hospital Corpsmen are not licensed or certified, making transferring into employment in the community difficult. The Veterans Affairs (VA) has an intermediate care technician (ICT) program that provides employment for previous active-duty medics and hospital corpsmen. Understanding the transition of medics and hospital corpsmen better positions the Department of Defense and the VA leadership to support the transitioning veteran.
This DNP project used a quality improvement framework, and a …
Standardizing Initial Inpatient Palliative Care Consultations For Patients Receiving Left Ventricular Assist Devices At A Large Urban Hospital, Deborah A. Szeto
Standardizing Initial Inpatient Palliative Care Consultations For Patients Receiving Left Ventricular Assist Devices At A Large Urban Hospital, Deborah A. Szeto
Doctoral Projects
For patients with advanced heart failure (HF) ineligible for or awaiting heart transplantation, left ventricular assist device (LVAD) implantation can be considered. LVADs have helped to improve recipients’ survival rates and quality of life. However, LVAD patients are at risk for complications such as stroke, bleeding, infection, and right ventricular failure. Moreover, events such as end-stage malignancy or progression of a neurodegenerative disorder may occur. Such complications and repeated hospitalizations can pose questions about the acceptability of LVAD therapy. As such, both the Centers for Medicare and Medicaid Services and The Joint Commission require that palliative care (PC) be part …
Implementation Of An Online Suicide Prevention Training Program With Undergraduate And Graduate Students At A California State University, Cheryll May P. Villamor
Implementation Of An Online Suicide Prevention Training Program With Undergraduate And Graduate Students At A California State University, Cheryll May P. Villamor
Doctoral Projects
Background: One of the leading causes of death in the college age population is suicide. While colleges provide opportunities in the acquisition of knowledge and skills for future careers; those same opportunities can also bring about challenges that put students at risk for suicide such as: dealing with their mental health issues, finding and maintaining support system, financial costs, and the pressure from ensuring academic success. One of the ways to help student at risk for suicide is by early intervention by connecting them with mental health support system such as crisis counselors. Question, Persuade, and Refer (QPR) is a …
Expanding Labor Support Education To Nurses Caring For Women In Labor, Ana L. Viera-Martinez
Expanding Labor Support Education To Nurses Caring For Women In Labor, Ana L. Viera-Martinez
Doctoral Projects
The ability to provide emotional and physical support to a patient during one of the most significant moments of her life is a privilege afforded to intrapartum nurses who attend to laboring and delivering mothers. Labor support improves birth outcomes, reduces cesarean birth rates, and decreases anesthesia use. More labor support education needs to be made available to intrapartum nurses. Within the hospital context, this quality improvement (QI) project investigated the effects of educating intrapartum nurses about labor support and providing them with hands-on training. Surveys, including the Self-Efficacy Labor Support Scale, were as given pre- and post-education to evaluate …
Health Promotion Module For Migrant Youth Adults In Obesity Prevention: A Pilot Project, James Chongsu Wong
Health Promotion Module For Migrant Youth Adults In Obesity Prevention: A Pilot Project, James Chongsu Wong
Doctoral Projects
The obesity epidemic continues to worsen. It is estimated there are over one half billion adults worldwide struggling with obesity. In the United States of America, 42% of the adults and over 15 million children are obese. Obesity leads to a myriad of other chronic diseases such as diabetes mellitus, hypertension, and hyperlipidemia. With an annual spending exceeding 173 billion dollars, obesity not only has a negative impact on quality of life but also a huge economic impact on the health care system.
This quality improvement project utilized 4 educational modules as intervention and measured the mean changes using a …
Improving Breastfeeding Rates Through Education, Julianna Youssef
Improving Breastfeeding Rates Through Education, Julianna Youssef
Doctoral Projects
Background: Breastfeeding is beneficial for newborn babies, but there are many challenges that new mothers face that prevent them from exclusively breastfeeding.
Objective: To evaluate if re-educational training in RN’s and LVN’s is an effective way to increase the exclusive breastfeeding rates in the hospital setting.
Methods: We utilized a pretest/post-test quasi-experimental design and had the goal sample size was about 50 nurses. The nurses were given an educational PowerPoint at a monthly staff meeting. Pretests were given to the staff immediately before and posttests two weeks later. Additionally, exclusive breastfeeding rates were monitored for the three months before the …
Speak Up For Hand Hygiene And Decrease Healthcare Associated Infections, Bernadette Priya Pandya-Orozco
Speak Up For Hand Hygiene And Decrease Healthcare Associated Infections, Bernadette Priya Pandya-Orozco
Doctoral Projects
Background: Hand hygiene (HH) is one of the most cost-effective and simplest ways to reduce healthcare associated infections (HAIs). Incorporating Speak Up for hand hygiene enables healthcare workers (HCW) to communicate without fear when they observe noncompliance with HH requirements.
Objective: To increase HH compliance by utilizing Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS education to encourage Speak Up for HH and lead to reduction in HAIs.
Methods: The researcher provided educational training on “Speak Up for Hand Hygiene” and performed regular audits to examine its effects on one hospital unit in a California Bay Area healthcare system. A …
An Evaluation Of A Structural Competency Training For School Nurses, Rachel J. Torres
An Evaluation Of A Structural Competency Training For School Nurses, Rachel J. Torres
Doctoral Projects
The aim of this quality improvement project was to use structural competency as a tool to highlight the broad social, political, and economic structures that influence health and subsequent inequities and disparities. A one group, pre-and post-design quality improvement project was used to determine whether the Structural Competency Working Group curriculum influenced school nurses’ thought processes regarding the factors that influence health outcomes. The curriculum was adapted to a 1.5-hour training and delivered to a group of school nurses from a highly populated and socially, economically, and culturally diverse urban county in northern California. The results showed that after the …
Evaluation Of A Care Management Program On Family Caregivers Of Persons With Dementia, Victoria L. Jackson
Evaluation Of A Care Management Program On Family Caregivers Of Persons With Dementia, Victoria L. Jackson
Doctoral Projects
Dementia due to Alzheimer’s and other disease is a growing concern for healthcare providers as the number of individuals in the U.S. population ages. Persons with dementia (PWDs) rely on caregivers, primarily family caregivers (FCGs), for basic and instrumental activities of daily living as the disease progresses. There may be negative outcomes, such as depression, strain, and distress for FCGs of PWDs. Routine assessment and intervention by healthcare providers can address needs of FCGs of PWDs. There are multiple interventions that have demonstrated effectiveness in caring for PWDs and FCGs; one such intervention is care management. The University of California, …
Understanding The Effectiveness Of Diabetes Self-Management Education On Psychological Distress And Self-Care Activity Measures: A Focus On Latinx Community, Anita Khadka
Doctoral Projects
The psychological distress that people with diabetes experience makes them twice likely to have clinical depression. Diabetes self-management education and support is an effective strategy to improve psychological distress and increase self-care activity measures. However, there has been limited knowledge on the impact of formal diabetes self-management education and support DSME/S on psychological distress among minority populations such as Latinx. The primary objective of this study is to explore the impact of diabetes self-management education on psychological distress and self-care activity measures. This study also explores the impact of demographic variables of the Latinx respondents on psychological distress and self-care …
Culturally Tailored Diabetes Self-Management Educational (Dsme) Program And Its Impact On Motivation And Self-Efficacy Among Hispanic Adults With T2dm: A Pilot Study, Andrellie P. Van Wageningen
Culturally Tailored Diabetes Self-Management Educational (Dsme) Program And Its Impact On Motivation And Self-Efficacy Among Hispanic Adults With T2dm: A Pilot Study, Andrellie P. Van Wageningen
Doctoral Projects
Type 2 diabetes mellitus in the United States is an epidemic that disproportionately affects Hispanics in the state of California. Many factors have been attributed to this phenomenon because of their unique characteristics. As recent studies have pointed out, their social determinants of health, cultural influences, and genetic predisposition often lead to poor health outcomes and impaired quality of life. A targeted approach is critical in promoting increased diabetes knowledge, enabling skills to master self-care activities, and positive self-care behaviors to avert poor outcomes. The purpose of this doctoral project is to examine whether culturally tailored DSME influences an individual’s …
Improving Readiness For Nursing Practice Via Simulation In Workplace Violence Mitigation, Paul J. Weingartner
Improving Readiness For Nursing Practice Via Simulation In Workplace Violence Mitigation, Paul J. Weingartner
Doctoral Projects
Workplace Violence (WPV), a significant problem in health care in the United States and worldwide, causes emotional and physical harm to nurses, negatively affects quality care delivery, and contributes to burn out, job dissatisfaction, and attrition. Clinical simulation was used to educate registered nursing students about WPV and train them in mitigation techniques in an effort to improve their awareness and readiness for professional nursing practice. Data from 37 students in their final semester of nursing school were collected anonymously prior to and after reviewing online materials about WPV and attending a 3-hour simulation experience in which two scenarios were …
Evaluating Pre-Anesthesia Telehealth Visit Outcomes In Cardiac Surgery Patients At A Tertiary-Level, Private, Academic Hospital, Ann Pan
Doctoral Projects
Telehealth is a dynamic, growing field in healthcare. Research has alluded to the potential of telemedicine in the pre-anesthesia area. With infection risk concerns brought to the forefront of healthcare due to the COVID pandemic, telemedicine offers an alternative evaluation method. Telehealth extends care to patients who otherwise would not have access to more comprehensive pre-anesthetic care and surveillance. Although studies show telemedicine's potential and positive effects, institutions have not extended virtual visits for all cardiac surgery pre-anesthesia patients. This retrospective evaluation study aimed to assess the impacts of telehealth on cardiac surgery pre-anesthesia assessments in a tertiary-level, private, academic …
How Implementing A Digital Competency Management System Reduced Nurse Training Cost And Improved Npd Practitioner Satisfaction In A Pediatric Hospital, Dionne Margallo
How Implementing A Digital Competency Management System Reduced Nurse Training Cost And Improved Npd Practitioner Satisfaction In A Pediatric Hospital, Dionne Margallo
Doctoral Projects
Healthcare organizations must have high-quality nursing staff to deliver optimal patient care. Educators and managers evaluate nurses by their performance through nursing competencies, or “knowledge, skills, [and] abilities” (KSA) (American Nurses Association, 2015, p. 86). Traditional competency evaluations and manual tracking posed a problem within one pediatric hospital. Leaders did not have a transparent way to see the knowledge and skills of their nursing staff. This resulted in increased organizational costs due to retraining and increased workload and job dissatisfaction among educators. The purpose of this quality improvement (QI) project was to evaluate how implementing a digital competency management system …
Evaluating The Impact Of An Evidence Based Practice Education Program In A Nurse Residency Program On Evidence Based Practice Beliefs, Implementation And Competency, Amy Hu
Doctoral Projects
For organizations to ensure that they are providing safe and quality patient care, they must promote a culture of care based on Evidence Based Practice (EBP). To improve healthcare quality nurses must make care decisions based on the most current scientific evidence. In fact the Institute of Medicine set a goal that 90% of clinical decisions be evidence based by 2020 (Institute of Medicine, 2008). Unfortunately it can take up to 15-20 years for newly discovered treatments to be implemented into patient care (Institute of Medicine, 2001). Healthcare providers continue to base healthcare decisions on outdated practices derived from tradition …
Implementing High-Intensity Trauma-Informed Sexual Behavior Risk Reduction In Justice-Involved Women, Lakisha M. Holton
Implementing High-Intensity Trauma-Informed Sexual Behavior Risk Reduction In Justice-Involved Women, Lakisha M. Holton
Doctoral Projects
Sexually transmitted infections continue to be a source of significant morbidity in people with a history of incarceration, particularly women. Justice-involved women are at exceptionally high risk of long-lasting and severe health consequences of contracting an STI. This evidence-based practice implementation project used a repeated measures design to compare sexually transmitted infection knowledge acquisition and condom use self-efficacy in a group of incarcerated women before, immediately after, and three weeks following participation in the Safer Sex Self-Efficacy Workshop. Of the participants (N= 21), 100% demonstrated a significant increase in sexually transmitted infection knowledge and condom use self-efficacy between pre- and …
Preparing Nurses For The Transition To Practice With Virtual Simulation, Jennifer Holm
Preparing Nurses For The Transition To Practice With Virtual Simulation, Jennifer Holm
Doctoral Projects
This project assessed the clinical reasoning objectives of first-semester nursing students who had up to 75% of their clinical time using virtual simulations compared to those who primarily had traditional direct-care clinical experiences with up to 12% of their time in simulation. The principal investigator reviewed clinical reasoning measures within student evaluations from the Fall 2019 and Fall 2021 cohorts of an Associate Degree in Nursing (ADN) program. The results of a two-tailed independent samples t-test demonstrated a slight reduction in the clinical reasoning abilities of the cohort with a higher proportion of simulation. However, there were several possible confounding …
A Retrospective Evaluation Of Pain Management Of The Postpartum Inpatient After Birth, Ronda Harden
A Retrospective Evaluation Of Pain Management Of The Postpartum Inpatient After Birth, Ronda Harden
Doctoral Projects
A multimodal plan of care to manage pain can effectively help reduce the risk of opioid dependency and addiction. The concerns about the rise in the rate of new persistent opioid use among women exposed in postpartum indicate a need for a practice change in managing pain after birth. This retrospective study evaluated the impact of implementing a multimodal plan of care in treating the pain of the postoperative postpartum patient. A notable finding was that fewer milligrams of opioids were administered after a practice change. The mean total was significantly different between the pre-and post-group, with a higher percentage …
Implications Of Educational Counseling On Prep Uptake In Msm At A Community Health Clinic, Thanh T. Dinh
Implications Of Educational Counseling On Prep Uptake In Msm At A Community Health Clinic, Thanh T. Dinh
Doctoral Projects
HIV pre-exposure prophylaxis (PrEP) medication is 99% effective at preventing HIV acquisition if used daily (CDC, 2020; FDA, 2019). Despite its effectiveness and wide availability, PrEP uptake and adherence remained low, especially among MSM of color (Bradley et al., 2019; Kuhns et al., 2017). Prior studies have shown that participants exposed to PrEP information, counseling, and education were more likely to show interest in PrEP and uptake of PrEP. Although various studies support the effectiveness of educational interventions in increasing PrEP uptake, it has not been widely implemented in the practice setting in communities that would benefit from it. The …
Asthma Care By Unlicensed Personnel In The Elementary School Setting: A Training Program, Teresa Eligio
Asthma Care By Unlicensed Personnel In The Elementary School Setting: A Training Program, Teresa Eligio
Doctoral Projects
This Quality Improvement project (QI) aims to improve the competence and confidence of unlicensed school health staff in identifying asthma symptoms, reading an asthma action plan, asthma care, emergency response, medication delivery tools, and trigger reduction in the school setting. The QI project transpired in an Elementary School District in Los Angeles County, CA. The Project Manager, an asthma instructor trained by the American Lung Association, provided evidence-based Asthma-Basics training for health clerks (HCs), substitute health clerks (SHCs), licensed vocational nurse health clerks (LVN HCs), school office coordinators (SOCs), school office attendance clerks (SOAs), and substitute school office staff (SDO). …
Game-Based Refresher Training For Registered Nurse Providers Of Neonatal Resuscitation, Renee Billner-Garcia
Game-Based Refresher Training For Registered Nurse Providers Of Neonatal Resuscitation, Renee Billner-Garcia
Doctoral Projects
Based on evidence suggesting resuscitation provider knowledge and skill decay can occur as soon as four weeks post-training, the American Heart Association (AHA) recommends more frequent resuscitation refresher training. While current resuscitation training and education practices center on simulation training, its cost in terms of supplies, equipment, and personnel may be creating barriers to increasing the frequency of refresher training. This quality improvement project implemented a game-based, refresher training for registered nurse providers of neonatal resuscitation with a focus on improving the time to initiation of positive pressure ventilation (PPV) per Neonatal Resuscitation Program (NRP) guidelines. Using commonly available free …
Tiered Centralized Education In The Transition-To-Practice Program To Improve Nurses' Level Of Confidence On Nursing Sensitive Indicators Outcomes, Froiland Agana Ascaño
Tiered Centralized Education In The Transition-To-Practice Program To Improve Nurses' Level Of Confidence On Nursing Sensitive Indicators Outcomes, Froiland Agana Ascaño
Doctoral Projects
A tiered Centralized Education in the Transition-to-Practice (TTP) Program is crucial to improving nurses' Level of Confidence on nursing-sensitive quality indicators. The benefits of a structured orientation program taught by trained content experts are evident in the literature. In addition, training transition-to-practice RNs during onboarding with training and assessment sessions throughout the orientation program to increase frequency provides skills acquisition. This study examined the impact of a house-wide education program on the nurses' confidence levels of CLABSI prevention, a measured nursing-sensitive quality indicator. This quasi-experimental quality improvement study measured the confidence and comfort levels of transition-to-practice RNs and identified that …
Improving The Process Of Pain Management By Implementing Best Practices In A Nursing Home, Sukhjit Dhillon
Improving The Process Of Pain Management By Implementing Best Practices In A Nursing Home, Sukhjit Dhillon
Doctoral Projects
Pain is often untreated or undertreated among older adults living in nursing homes. The lack of standardized pain management protocols makes it difficult to address pain in this population. Deficiencies in pain management and documentation were identified in a nursing home and a performance improvement project was implemented with the aim to improve pain management, pain documentation, and staff knowledge of pain management. A pre-and post-intervention study design was used, and data analysis included descriptive statistics and a paired samples t-test. Participants (n=12) included seven registered nurses and five licensed vocational nurses who provide direct care to the residents in …