Medicine and Health Sciences Commons^™

Interprofessional Collaborative Attitudes: Comparing Social Work Learners To Their Medicine And Nursing Peers, Joseph Bartholomew, Marcia Mount French, Hea-Won Kim

Florida Public Health Review

Interprofessional learning activities in higher education aim to unite healthcare professionals in their future practice, thus reducing duplication and fragmentation of services. This study uses a social learning perspective to examine advanced practice medicine, nursing, and social work learners’ attitudes toward interprofessional education and collaborative practice activities within their university programs. The authors used a cross-sectional design to administer a questionnaire that included the Interprofessional Attitudes Scale (IPAS) to 151 advanced practice health care learners (internal medicine residents, nurse practitioner students, master’s-level social work students). Findings indicated significant differences in three subsections of the IPAS. Social work learners possessed a …

Importance Of Asking For Pronouns: Assessing Cultural Competency Among Bsn Nursing Students, Vincent Doan, Carlee Correia, Julie Baker-Townsend

Showcase of Osprey Advancements in Research and Scholarship (SOARS)

As evidenced by research, the use of personal pronouns in the clinical setting is not very common and is why the LGBTQ+ patient population experiences health care disparities. The improper use of personal pronouns is due to a lack of culturally competent training and awareness among health care workers. This is a quality improvement project for the proper use of gender pronouns, endorsed by the American Nurses Association. It is essential to ask about patient preferences regarding pronouns because it creates a safe space for gender minorities and members of the LGBTQ+ community. Correctly identifying pronouns as healthcare professionals shows …

Planning Care For Visually Impaired Children In The Inpatient Setting: A Literature Review., Aubrey Townsend

Showcase of Osprey Advancements in Research and Scholarship (SOARS)

Project of Merit Winner

Topic: In visually impaired children experiencing hospitalization (P), how do specific and age-appropriate interventions (I) compared to that for a child with no visual deficits (C) affect the quality of care (O) during an overnight hospital stay? (T) Methods: This literature review was conducted through PubMed and CINAHL. The keywords searched were “Visual Impairment,” “Visually Impaired,” “Blind*,” “Pediatric*,” “Hospital*,” “VIP,” “Inpatient” and “Child.*” Results: The literature review yielded 20 articles, which were eventually narrowed down to 8 applicable articles. Analysis of the articles identified the need for further research on this topic. Analysis: Two systematic reviews …

Painful Body Surface Area Variance Between Pre-Op And Post-Op Lung Cancer Patients, Brianna Pendergrass, Keesh Powell-Roach, Prashant Singh, Yingwei Yao, Diana J. Wilkie

Showcase of Osprey Advancements in Research and Scholarship (SOARS)

Honorable Mention Winner

The focal point of my study is painful body surface area (BSA). BSA is the calculated surface area of the human body. Alot of studies focus on pain intensity (PI) variance rather than painful BSA variance. In this study, painful BSA will be measured before and after lung cancer patients under-go a thoracotomy (lung resection surgery). At the conclusion of this study, the following questions should be answered. Does painful BSA increase, decrease, or remain constant after a thoracotomy surgery? Is there a relationship between PI and BSA? If so, are they inversely related or directly related? …

Factors Associated With Overall Experience In Advanced-Practice Doctoral Programs, Kristi Chipman

UNF Graduate Theses and Dissertations

Advanced-Practice Doctoral (APD) students are working professionals who are often returning to school after several years of practice. Multiple areas and concerns may affect overall experience as well as retention rates in doctoral programs.

This mixed-methods research study utilized both qualitative (interview) and quantitative (survey) methods. Students from three different APD programs (Doctorate in Clinical Nutrition, Doctor of Education, and Doctor of Nursing) were asked to participate in a semi-structured interview. The interview was used to help guide the development of a survey. Students from the three groups (n=65) were asked to participate in a one-time, non-incentivized, survey. The survey …

Nonnutritive Sweetener And Weight Management: A Potential Paradox In Modern Dieting, Katharine Mary Wright

UNF Graduate Theses and Dissertations

Obesity is a serious health concern in modern society. One way to reduce caloric intake is with nonnutritive sweeteners (NNS). However, recent research suggests they may be compounding the obesity problem. Nonnutritive sweeteners have been linked to increased body mass in a few studies and may be a barrier to effective weight management for some individuals.

Under the framework of the health belief model, the research question was: Does this pattern of NNS-BMI covariance exist in young adults at the University of North Florida and, if so, are there other dietary or activity differences that might partially explain this relationship? …

Meta-Analysis Of Herbal Cannabis Therapy For Chronic Pain, Michael J. Seneca

UNF Graduate Theses and Dissertations

Since the first so-called “medical marijuana” legislation was passed in California in 1996, a total of twenty states and the District of Columbia have passed laws permitting limited use of cannabis. Despite the changes in state laws, cannabis remains illegal for any purpose under federal law. Changes in state laws have coincided with a renewed interest in the substance for the treatment of a variety of conditions. There has been a significant increase in published data over the past twenty years examining the efficacy of cannabis as an appetite stimulant, antiemetic agent, and analgesic adjuvant. The purpose of this meta-analysis …

Improving Anesthesia Professional Adherence To Hand Hygiene, Martha E. Seneca

UNF Graduate Theses and Dissertations

Performance of hand hygiene is among the most effective means of preventing healthcare associated infections (HAI) among patients. Deaths resulting from HAIs are one of the top ten leading causes of death in the United States. Any improvement in the frequency of hand hygiene among healthcare professionals may have a direct impact on patient mortality and associated costs. While anesthesia professionals have been found to have low rates of hand hygiene adherence, few targeted studies seeking to improve hand hygiene adherence among this group exist. Studies conducted to improve hand hygiene among health care professionals have reported limited improvement, with …

Evaluating The Effects Of An Educational Lifestyle Modification Intervention On Blood Pressure In Adults With Prehypertension, Andrea M. Patterson

UNF Graduate Theses and Dissertations

The purpose of this project was to evaluate the effectiveness of an educational lifestyle modification (LM) intervention on blood pressure (BP) among adults with prehypertension. Prehypertension is a precursor to hypertension (HTN) and is a public epidemic in the United States. Approximately 68 million (31%) U.S. adult’s aged ≥18 years have hypertension. Hypertension can cause significant target organ damage, lead to coronary heart disease, heart failure, stroke, and kidney failure. Early identification and the primary treatment of persons with prehypertension with LM have the potential to minimize the progression and delay the onset of comorbidities associated with hypertension. This quality …

Novel Oral Anticoagulants: Bedrest And Bleeding In Patients Undergoing Atrial Fibrillation Catheter Ablation, Lynn Mcwhirter

UNF Graduate Theses and Dissertations

Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and …

Quality Improvement Measures For Cervical Screening Guidelines In A Clinic For Uninsured Adults, Julie Ann Baker-Townsend

UNF Graduate Theses and Dissertations

Cervical cancer, a completely curable disease with early detection and management, is an international concern. Early identification allows for treatment of the disease, which prevents or slows progression, ultimately reducing morbidity and mortality. Due to the regressive nature of most cervical lesions, the duration between cervical cytology has been lengthened to prevent over diagnosis and treatment. This was reflected in the 2012 United States Preventative Services Task Force (USPSTF) clinical practice guideline for cervical cancer screening.

The purpose of this project was to determine the effectiveness of a quality improvement initiative to increase adherence to the 2012 USPSTF guideline at …

Increasing Physical Activity In Post Liver Transplant Patients, Jennifer Lynn Serotta

UNF Graduate Theses and Dissertations

The purpose of this quality improvement project was to increase physical activity among postoperative adult liver transplant patients, improve documentation of daily activity, and ultimately influence quality of life (QOL). Quality of life has been shown to improve dramatically after liver transplant, as patients enter transplant severely debilitated with limitations on their physical activity which carry over following transplant. The literature supports that liver transplant patients should engage in physical activity which may improve QOL. Thirteen liver transplant patients were recruited within the seven days of their post-operative hospitalization. Twelve patients consented, were educated about the benefits of walking, given …

Midline Catheter Use In The Newborn Intensive Care Unit, Tricia L. Romesberg

UNF Graduate Theses and Dissertations

Ongoing evaluation of current practice and incorporation of evidence based research into guidelines and protocols is a requirement for the provision of high quality, cost efficient care. Despite some literature describing observational data, midline catheters (MCs) are not an appropriate vascular access device for Newborn Intensive Care Unit (NICU) patients due to insufficient high level evidence demonstrating safety and efficacy. In addition, national guidelines for MC use in neonatal and infant patients lacks sufficient information for safe and effective use of MCs.

The results of this small, online survey indicate that while some neonatal nurses and Nurse Practitioners report the …

Anesthesia Safety: Filter Needle Use With Glass Ampules, Debran L. Harmon

UNF Graduate Theses and Dissertations

Glass particle contamination of medication occurs when opening ampules which may cause patient harm. The use of filter needles reduces this risk. Many anesthesia providers use ampules daily, but do not use filter needles when aspirating medications from ampules. In addition, filter needles may not be readily available at the anesthesia medication preparation site. Not using filter needles or having them available for use can increase the risk of patient harm by glass particle contamination. The purpose of this project was to increase anesthesia provider’s knowledge thereby improving compliance with evidence-based standards when preparing medications from ampules. The goal is …

Efficacy Of Bydureon In Adults With Type 2 Diabetes, Katie L. Fetter

UNF Graduate Theses and Dissertations

Type 2 diabetes is still rapidly on the rise today, affecting 10.5% of individuals in the United States between the ages 45 to 64 and 18.4% of those between the ages of 65 to 74. In the past two decades, type 2 diabetes has doubled in all age groups. Many adults with type 2 diabetes experience difficulty managing their blood sugars, which can result in a range of further complications. One of the newest treatment options on the market today is a glucagon-like peptide-1 (GLP-1) receptor agonist, Bydureon. Similar to Byetta, Bydureon has a main ingredient of exenatide. It offers …

Increasing Practitioner Knowledge Of Ketamine As An Adjunct Analgesic For Postoperative Pain, Allison Goldfarb

UNF Graduate Theses and Dissertations

Postoperative pain is of serious concern to patients and anesthesia providers alike. Management of a patients’ pain is a central component of anesthesia care. Ketamine as an anesthetic agent has been available for 50 years. It has been utilized as a general anesthetic and selectively as an anesthetic agent for high-risk patients. Due to dysphoric side effects associated with the dosage required to render general anesthesia, anesthesia providers may be reluctant to utilize this medication to its full potential. Recently there has been a resurgence of interest in ketamine as an analgesic agent. The researcher for this project performed a …

Adolescent Athletes With Type 1 Diabetes: Experiences With Continuous Subcutaneous Insulin Infusion, Regina Tow

UNF Graduate Theses and Dissertations

Adolescent athletes with type 1 diabetes (T1DM) face unique challenges when compared to peers with and without diabetes. Continuous subcutaneous insulin infusion (CSII) provides a method of insulin delivery that can enhance flexibility in insulin regimens and lifestyle that may be especially appealing to the adolescent athlete. No studies have explored the impact of athletics in this population. This descriptive qualitative study explored and described the experiences of adolescent athletes using CSII as their primary insulin delivery method, with a focus on athletic participation and performance.

The purposeful sample consisted of four adolescent athletes, ages 13 to 15 years with …

Effect Of Blood Collection Practices On Emergency Department Blood Specimen Rejection Rates, Barbara K. Vernoski

UNF Graduate Theses and Dissertations

The practice of obtaining blood as part of the placement of a new peripheral venous access device (p-VAD) is a frequent practice in the emergency department (ED). Of the concerns related to this practice is the possibility of laboratory specimen rejection due to p-VAD catheter size, use of the wrong collection device, and the absence of a standardized collection process. The objective of this study, therefore, was to examine the effect of the use of evidence-based venipuncture and p-VAD blood collection protocols on the rejection rate of blood specimens drawn by staff in the adult areas of an urban academic …

Practitioners' Use Of Clinical Practice Guidelines: An Evidence-Based Approach, Sondra Michelle Phipps Santana

UNF Graduate Theses and Dissertations

Pre-diabetes is a serious health problem in the United States. Distinguished by plasma glucose levels that are above the normal threshold, patients with pre-diabetes are 10 times more likely to develop type 2 diabetes. Patients with pre-diabetes suffer the same complications as patients with diabetes including diabetic retinopathy, nephropathy, and microalbuminuria.

There is considerable evidence to support the idea that early identification and aggressive treatment of pre-diabetes has the potential to delay disease progression. The American Diabetes Association’s clinical practice guideline recommends management of with lifestyle modification and metformin for patients who are at risk for developing type 2 diabetes. …

The Impact Of The Clinical Nurse Leader/Navigator On Clinical Outcomes And Patient Satisfaction, Diane Smith Raines

UNF Graduate Theses and Dissertations

In an era of value based purchasing and healthcare reform, hospitals face the challenge of delivering high quality care in an environment of diminishing resources. This performance improvement project describes the use of master’s prepared nurses on medical surgical units to improve quality and patient satisfaction. The setting was five medical surgical units in a 200+ bed hospital in the southeastern United States. Declining resources necessitated an increase in the nurse to patient ratios on the units (from 5:1 to 6:1). The project involved the modification of the model of care through the change in nurse/patient ratios and the addition …

Outcome Comparison Of An Evidence-Based Nurse Residency Program To Other Orientation Models, Debra A. Harrison

UNF Graduate Theses and Dissertations

The purpose of this evidence-based project was to compare one-year outcomes for newly licensed Registered Nurses (NLRNs) in three organizations within the same healthcare system. All three have lower than nationally reported turnover and strategies for NLRN retention. Only one is using a Nurse Residency Program (NRP).

NRPs are recognized as an effective strategy to retain newly licensed registered nurses (NLRNs) in their first year of employment (Institute of Medicine [IOM], 2010; The Advisory Board, 2007; Spector, 2007). The Commission on Collegiate Nursing Education (CCNE) (2008) defines an NRP as a series of learning sessions and work experiences that occur …

Body Image And Healthy Lifestyle Behavior Among University Students, Tracy L. Wright

UNF Graduate Theses and Dissertations

Children develop beliefs about ideal body image and carry these perceptions into adulthood. Consequences of poor body image may include decreased self-esteem, depression, unhealthy lifestyle, and eating disorders. Understanding healthy lifestyle behaviors and the relationship between body image and these behaviors can empower individuals to engage in behaviors to improve health. Pender’s health promotion model provided the theoretical framework for this study. The purpose of this study was to identify the relationship between body image and healthy lifestyle behaviors among undergraduate university students. An email was sent to undergraduate students, providing a link to the survey that included: demographic, body …

Implementation Of A Beta Blocker Protocol, Jody L. Heriot

UNF Graduate Theses and Dissertations

Background: Beta blockers are recommended by the American College of Cardiology/American Heart Association Guidelines for high and intermediate-risk cardiac patients undergoing non-cardiac surgery. Beta blockers are a class of drugs that moderate the effects of increased catecholamine levels on the heart by selectively blocking beta receptors in the heart and blood vessels, resulting in a lower heart rate and blood pressure. Beta blocker use perioperatively has been shown to reduce the risk of ischemia and infarction.

Purpose: The purpose of this project is to address beta blocker use in a group of anesthesia providers who routinely attend to high-risk and …

Hospital Loneliness And The Patient-Physician Relationship: A Preliminary Analysis Of Associations With Recovery In Bone Marrow Transplant Patients, Lindsay E. Balfour

UNF Graduate Theses and Dissertations

The purpose of the present study was to examine general loneliness, hospital loneliness, and the patient-physician relationship in regards to their associations with Bone Marrow Transplant (BMT) recovery outcome variables (days until engraftment and quality of life). Fifteen (66.7% female, 33.3% male; 93.3% white, 6.7% Black/African American; average age 61.73) individuals who had an allogeneic or autologous BMT at The Mayo Clinic of Jacksonville completed the FACT-BMT, UCLA-Loneliness Scale Version 3, the CARE Measure, and provided disease and treatment information at the 6 month posttransplant date (+/- 30 days). Patients recovering from BMT indicated significantly higher scores of hospital loneliness …

Improving Quit Rates For Tobacco-Dependent Hospitalized Patients, Marion G. Mann

UNF Graduate Theses and Dissertations

Abstract

Purpose: The purpose of this project was to evaluate outcomes of an existing inpatient tobacco cessation counseling program with 30-day follow-up among recently admitted tobacco-dependent patients who were tobacco-dependent.

Background/Significance: Tobacco use is considered the number one most preventable cause of disease, disability, and death in the United States. Despite associated dangers, approximately 21% Americans currently smoke. This has led to increased hospital admissions and chronic disease management, costing the United States approximately $96 billion per year. Decades of research and evidence-based clinical practice guidelines substantiate that inpatient tobacco cessation counseling has the potential to improve quit rates post-hospital …

Dermoscopy: An Evidence-Based Approach For The Early Detection Of Melanoma, Angela Armstrong

UNF Graduate Theses and Dissertations

The purpose of this project was to evaluate the effectiveness of a practice-based dermoscopy training program for dermatology healthcare providers in order to improve their technique of performing clinical skin exams for the early detection of melanomas.

The overall incidence of melanoma continues to rise. More than 75% of all skin cancer deaths are from melanoma. Advanced melanoma spreads to lymph nodes and internal organs and can result in death. One American dies from melanoma almost every hour (American Cancer Society [ACS], 2009). Early diagnosis and excision are essential to reduce morbidity and to improve patient survival.

This one-group before-and-after …

Emerging Evidence In Infection Control Effecting Change, Melissa Dawn Machan

UNF Graduate Theses and Dissertations

Current procedures for cleaning anesthesia airway equipment have been reported to be ineffective. The potential for cross-contamination from some airway equipment to a patient has been documented in several studies. In order to prevent potential infections, it should be ascertained as to why all anesthesia providers are not using disposable laryngoscope blades. The purpose of this evidence based project is to determine the perceptions of anesthesia providers regarding the use of disposable laryngoscope blades. Their frequency of use, their evaluation of ease of use, and any complications encountered when using the disposable blade before and after an in-service program designed …

Effects Of The Use Of A Heart Failure Diary On Self-Care And Quality Of Life, Claudette Walker

UNF Graduate Theses and Dissertations

Heart Failure is a growing and costly problem in the United States. There have been advancements in medical therapy, but unfortunately patients continue to have frequent exacerbations and hospital readmissions. The reason for this may be inadequate Heart Failure self-care, which is the most important aspect of disease management. Literature strongly encourages self-care, but there is minimal research focusing on the use of a Heart Failure diary. The study was a one group pretest/posttest design. The intervention included individualized education, provision of the Heart Failure Diary, and weekly follow-up for a total of four weeks. The Heart Failure Diary was …

Physical Activity And Self-Esteem In Females During Late Adolescence, Katrina Dembeck

UNF Graduate Theses and Dissertations

In the United States, obesity is on the rise while physical activity is declining. Educational funding cuts result in less time and resources for physical education in schools and youth are increasingly more sedentary with technological advances. Advance practice nurses have a role in promoting physical activity and health in this population.

The purpose of this study was to examine the relationship between physical activity and self-esteem in females during late adolescence and the effect of perceived benefits and barriers to physical activity on this relationship. E-mail invitations to participate in an online survey were sent to female undergraduate students …

Use Of Simulation To Reinforce Evidence-Based Collection Processes, Deborah Christeleit

UNF Graduate Theses and Dissertations

Proper collection of blood cultures is needed to identify pathogens causing serious infections and direct appropriate antibiotic therapy. Blood culture contamination can lead to longer hospital stays, incorrect antibiotic treatment, additional testing, and overall increased costs for the patient and hospital. Blood culture collection technique is the most important factor affecting contamination rates.

The purpose of this project was to determine the effect of simulation reinforcement of blood culture collection processes on the rate of contamination of blood cultures drawn by nurses in a community medical center emergency department.

This one-group before-and-after cohort study utilized a convenience sample of 50 …