Medicine and Health Sciences Commons^™

Increasing Utilization Of Motivational Interviewing To Promote Pediatric Oral Health, Ulyses Reamico

Doctor of Nursing Practice (DNP) Projects

Prevalence of early childhood caries (ECC) remains high even in developed countries such as the United States. An interprofessional education (IPE) project between University of San Francisco (USF) School of Nursing and Health Professions and the University of the Pacific (UoP), Arthur A. Dugoni School of Dentistry was initiated four years ago to enhance nurse practitioner (NP) and dental students’ pediatric oral-systemic health assessment and health promotion communication skills. Since then, USF NP students received pediatric oral health assessment training and spent clinical rotations at UoP to provide pediatric oral care alongside dental students. This doctor of nursing (DNP) project …

Increasing Nursing Policy And Advocacy Engagement, Marketa Houskova

Doctor of Nursing Practice (DNP) Projects

At present, professional nursing does not benefit from strong policy development and advocacy influence in the United States. This project focused on CA nursing policy development and advocacy influence deficit among new members of a statewide professional nursing association. There are nearly 457,000 licensed registered nurses (RNs) in CA (BRN, 2019) and around 3.8 million RNs in the United States (AACN, 2019) making CA RNs twelve percent of the national nursing workforce. Yet only five percent of RNs serve on hospital boards, and legislative efforts to advance important nursing issues such as full practice authority for advanced practice RNs in …

Willow Creek Women's Hospital Internship, Destinee Ross

The Eleanor Mann School of Nursing Undergraduate Honors Theses

While the use of midwifery is proven to improve outcomes for low-risk mothers and infants, many healthcare providers, nurses, and patients in Northwest Arkansas continue to be skeptical about utilizing midwifery care. During my internship, I worked directly with labor and delivery nurses, physicians, and a midwife at Willow Creek Women’s Hospital and provided high-quality care to women during their birthing process. This hospital focuses entirely on women and infant care and provides gynecological, obstetric, and newborn services. Willow Creek Women’s Hospital is also one of the few hospitals in Arkansas to implement a certified nurse-midwife (CNM) and has two …

Local Anesthesia Before Intravenous Cannula Insertion: Recommendations For Registered Nurses In Practice, Vera Campbell-Jones

Electronic Theses and Dissertations

Abstract

Administering local anesthetics, such as intradermal, should become standard practice for RNs in pretreatments for pain control prior to intravenous insertion. Peripheral venous cannulation has provoked the most fear and anxiety in adult patients about everyday practice in hospitals. Adult patients often state that this procedure causes considerable discomfort. Local anesthesia for cannulation is usually not offered to adult patients who are on general medical units. Evidence has indicated inconsistency in the use of pain management strategies during these procedures. The researcher’s goal in this project was to educate RNs about the intradermal pretreatment procedure, provide education on the …

The Implementation Of An Open Source Electronic Medical Record At A Faith-Based Community Clinic, Gabri Warren

Graduate Theses, Dissertations, and Capstones

Faith-based nursing and healthcare is increasingly gaining popularity as the industry looks to minimize costs and improve health outcomes. Historically, qualitative studies have not shown the extent to which individuals and communities are impacted by health initiatives initiated by faith institutions. Healthcare technology can help support the specialty by providing increased quantity and quality data to analyze. Traditional, proprietary EMRs are too costly; however, open source systems offer a low cost, and easily modifiable option to non-profit, or smaller organizations. The data collected by an open source system allows organizations to improve the care that patients receive, and helps guide …

Perceived Stress In Undergraduate Nursing Students, Emily Vore, Abbie Mcgee, Amy Henderson

Nursing Masters Papers

This secondary analysis explored the prevalence of perceived stress in undergraduate nursing students and the effects of self-efficacy and helplessness on the perceived stress. There were three purposes of this study.  The primary purpose was to assess levels of perceived stress among undergraduate nursing students, based on the variables of age, gender, and academic term.  The second purpose was to identify how students’ reported feelings of self-efficacy and helplessness correlated to their overall perceived stress scores. The final purpose was to identify how students applied skills learned in a stress management program. Lazarus’ theory of stress guided this study. Following …

Academic Nursing: Time To Joint The Street Medicine Movement, Jennifer King

DNP Qualifying Manuscripts

Academic based street medicine programs are springing up across the United States to provide critical points of access to persons experiencing homelessness. This innovative specialty care practice was developed by Dr. Jim Withers in 1992. His vision of increasing access to care by bringing healthcare to the streets is a proven solution to improve outcomes while building trust with the larger mainstream healthcare system. Street medicine programs provide teaching learning opportunities for medical professionals. The majority of street programs internationally are founded by medical schools. Nursing schools are well suited to begin street medicine programs and provide immersive experiences for …

Understanding Baccalaureate Nursing Education Progression From The Student Perspective Using A Grounded Theory Approach, Jennifer Jean Dahlman

Dissertations (1934 -)

National data provides evidence there is a significant gap between the number of first-generation college students (FGCs) and members of underrepresented minority groups (URMs) who are enrolling in baccalaureate programs of nursing (BSN) and those that persist beyond graduation and become members of the nursing workforce. There is a need to graduate more underrepresented student populations from BSN programs and understanding their progression through baccalaureate education can inform our efforts to support them. The purpose of this study was to explore and understand the needs of FGCs and URMs enrolled in BSN programs and to use online mentoring as a …

The Lived Experience Of Spirituality In The Lives Of Caribbean Men, Camille A. O. Hamilton

Dissertations, Theses, and Capstone Projects

This is a qualitative phenomenological study exploring the lived experience of spirituality in the lives of English-speaking Caribbean men, aged 40-60 years old, living with chronic illness and residing in the United States. In this study Caribbean men living with chronic illness are asked to reflect on their lived experiences and evolution of the experienced phenomenon of spirituality. A purposive sample of eleven English-speaking men from the Caribbean, living with chronic illness were recruited and interviewed for this study. Max van Manen’s 1997 Methodological Structure of Human Science Research was used as the phenomenological guide. The exploration uncovered 4 essential …

Relations Amongst Power, Self-Health Patterning, And Quality Of Life In Older Adults With Chronic Illness, Philip J. Gimber

Dissertations, Theses, and Capstone Projects

The aim of this study was to examine the relationships between power, self-health patterning, and quality of life in older adults with chronic illness using Rogers’ science of unitary human beings and Barrett’s theory of power. A cross-sectional, correlational design was used to examine the variables in a sample of approximately 100 older adults with chronic illness. This study revealed that power, self-health patterning, and quality of life are related to one another and that both power and self-health patterning are associated with enhanced quality of life.

Prospectus For Creating A Nurse Suggestive Acuity-Based Staffing Model In Ambulatory Infusion Settings To Improve Patient Safety And Quality Of Care, Yongli Qiu

Master's Projects and Capstones

Due to the lack of reliable and valid infusion nurse suggestive acuity-based staffing model, ambulatory infusion settings are burden with potentially compromised patient safety, poor quality of patient care with over-scheduling of unexpected complex patients, limited resources related to nurses and infusion chairs, the dissatisfaction of patients and family members, and infusion nurses’ burn out. This project seeks to determine the appropriate nurse to patient acuity-based point ratio in staffing and scheduling factors that influence nurse staffing model, and established nurse staffing strategies. This three-month project was conducted with the infusion nurses, a nurse manager, a nurse supervisor, an assistant …

Contemporary Nursing In Rural Appalachia: A Hermeneutic Study, Evelyn Brewer

Electronic Theses and Dissertations

Nurses make up a significant source of direct care for individuals, families, and communities. The problematic distribution of nurses and the potential to lose practicing nurses emphasizes the importance of retention and support of nursing professionals, especially in rural locations. One of the best ways to discover what is important to nurses is to ask and listen to the replies.

The focus for this dissertation is the lived experience of registered nurses in a six-county area in three adjoining states in rural South Central Appalachia. The purpose of this study is to interpret and understand the lived experience of contemporary …

Ischemic Stroke, Rachele Gualtieri

Nursing Student Class Projects (Formerly MSN)

Stroke is one of the leading causes of death in the United States, and a very large percentage of those who suffer a stroke experience an ischemic stroke. It is detrimental that the healthcare providers caring for these patients are proficient in understanding the pathophysiology and treatment of a stroke to preserve maximal function of the brain and promote a full recovery. It is also crucial that providers are aware of risk factors for stroke, events leading up to an ischemic injury, and the events that follow an ischemic injury. This poster discusses the underlying pathophysiology, signs and symptoms, risk …

Melanoma, Dianna Lauer

Nursing Student Class Projects (Formerly MSN)

There are many types of skin cancer prevalent in the world today. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma (Watson et al, 2015). In the words of Hawryluk & Tsao (2014), “Melanoma is an aggressive malignancy borne of melanocytes, the pigment-generating cells of the skin”. Melanoma is known to cause the most deaths of the three main skin cancers and has many risk factors. The personal risk factors include, “family history, multiple moles, fair skin, blue eyes, red hair, and freckles” (Watson et al, p.e92, 2015). There are risk factors …

The Ward-Based Nurse Clinical Educator: Impact On Student Learning Outcomes And Student And Preceptor Experiences, Karen Ann Mccarthy

Theses: Doctorates and Masters

Aim

This study aimed to determine the impact of the implementation of a ward based Nurse Clinical Educator (NCE) role on students and staff at one health service whilst students were on clinical practicum at a Western Australian regional health care facility.

Question

The research question was: “What impact does the NCE support intervention have on students and clinical staff during clinical practicum?” Background Clinical experience for undergraduate student nurses (students) undertaking their bachelor’s degree is of utmost importance for gaining both competence and registration. Students encounter difficulties in obtaining opportunities to practice their skills and develop competence when on …

Nitrous Oxide Use For Minor But Painful Pediatric Procedures, Samantha Kremer

Dissertations

Problem: Nitrous oxide (N₂O) is used for mild to moderate pain control and anxiolysis. Registered nurses (RN) as providers of N₂O administration may decrease the number of missed opportunities for pain control or anxiolysis. The purpose of this quality improvement initiative was to evaluate the type of procedures and rate of N₂O administration by providers, and cost difference between them.

Method: A descriptive, cohort-design for pediatric patients in the Imaging and Sedation Department between October through November of 2017 and 2018. Data was compared between physicians in 2017 and either a physician or RN …

Improving Sepsis Bundle Compliance Through Comprehensive Education, Stacy Mikel

Doctor of Nursing Practice Projects

Purpose: The purpose of this project was to improve emergency department compliance with sepsis bundles by educating registered nurses and licensed practical nurses on the proper use of sepsis screening tools, make changes to screening tools identified through chart reviews, and finally to evaluate the impact of these changes once initiated. This project sought to increase staff knowledge using an educational module.

Methods: This project began with the delivery of a pre-test questionnaire. The facility's target audience was asked to complete this to determine their current knowledge level regarding sepsis. Once these questionnaires were completed, they were reviewed, and information …

Dementia And The Role Of Alzheimer Disease, Jodi Kiessling

Nursing Student Class Projects (Formerly MSN)

Alzheimer disease is a progressive disease causing cognitive and functional decline with the hallmark sign of plagues and tangles within the brain. Genetics, inflammation, accumulation of beta-amyloid protein and breakdown of the blood brain barrier are all contributing factors in the disease. Treatment is not curative and is focused on symptom management and management of pre-existing chronic diseases.

An Investigation Of The Relationships Between And Among Disaster Preparedness Knowledge, Perceived Use Of Intuition, And Triage Decision Making Of Emergency Department Registered Nurses In Acute Care Hospitals Using Benner’S Novice To Expert Theory, Brian Charles Schneider

Seton Hall University Dissertations and Theses (ETDs)

Background: Disasters are man-made or natural events that challenge resources and support in an environment lacking rules and regulations. Nurses represent the largest resource in healthcare and are among the first to encounter victims of disaster, thus having knowledge of disaster preparedness is essential to disaster response. However, there is a lack of empirical evidence concerning the relationships between everyday elements of nursing practice such as intuition and triage decision-making and disaster preparedness knowledge.

Purpose: The purpose of this study is to examine the relationships between and among disaster preparedness knowledge, perceived use of intuition, and triage decision-making in emergency …

The Effects Of A Mobile Fitness Application On Weight Management And Physical Acticity Amongst University Students, Erica Deenihan

Evidence-Based Practice Project Reports

The prevalence of obesity, and obesity related diseases throughout America, specifically in regard to the college student population has steadily climbed over the course of the last forty years, due largely in part to the increase in sedentary lifestyle behaviors, amongst other factors (Swanson, 2016). Physical activity has been widely recognized as a valid means of combatting obesity and weight gain while promoting health related quality of life (Swanson, 2016). Therefore, implementing strategies aimed at increasing physical fitness in attempt to control weight management is imperative to promoting improved health outcomes. The purpose of this evidence-based project was to examine …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

Clinical Practice Guideline Adherence: Primary Prevention Of Cardiovascular Disease In At-Risk Adults, Sharnita L. Rice

Evidence-Based Practice Project Reports

The American College of Cardiology (ACC) and the American Heart Association (AHA) (2013; 2016), as well as the American Diabetes Association (ADA) joined forces to create clinical practice guidelines (CPGs) recommendations for healthcare providers (HCPs) to follow with the aim of preventing cardiovascular disease (CVD). Cardiovascular disease is the leading cause of morbidity and mortality in the United States. The Centers for Disease Control (2017a) estimates CVD costs 325 billion dollars annually. Although CVD has an astronomical cost associated with it, CPG adherence continues to be an issue among HCPs and improvement is warranted. The purpose of this EBP project …

The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava

Evidence-Based Practice Project Reports

The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient outcomes, …

A Literature Review On Improving Nurse-Patient Communication Manuscript, Irene Gabbedon

DNP Qualifying Manuscripts

Effective communication happens when the sender of the message sends it, and it is conveyed and understood by the receiver (Gilbert & Hayes, 2009). Medical errors are the third leading cause of death in the United States alone (McMains, 2016). The Joint Commission (TJC) (2019) implemented National Patient Safety Goals (NPSG) in 2002, and improving communication among caregivers has been a goal that has been frequently revised. Due to ineffective communication, life-threatening errors are created among healthcare workers. Nurses play an important role in the communication channel and barriers can be created when there is a lack of health literacy. …

Unraveling Sex Trafficking Through Screening And Referrals, Rebecca Sarabia

Doctor of Nursing Practice Projects

Abstract

Human trafficking is a form of modern-day slavery; sex trafficking is one form of human trafficking. Previous research has demonstrated that most trafficking victims encounter the healthcare system at some point during their trafficking experience. Patients who have been sex trafficked may experience profound psychological and physical trauma. Healthcare personnel are in key positions to screen for trafficking and to provide appropriate referrals; if an awareness of the problem exists. The purpose of this project was to increase OB/Gyn office staff confidence with sex trafficking screening and to complete appropriate referrals to address the identified needs. The project began …

A Multifaceted Approach To Antibiotic Stewardship In The Outpatient Clinical Setting For Bronchitis, Elizabeth A. Weaver

Evidence-Based Practice Project Reports

Antimicrobial resistance is a world-wide health crisis (Infectious Disease Society of America [IDSA], 2016; World Health Organization [WHO], 2017) expedited by the overuse/inappropriate use of antibiotics. In the outpatient setting it has been determined that approximately 60% of antibiotic therapies are prescribed (Centers for Disease Control and Prevention [CDC], 2016). Antibiotic stewardship is the coordinated effort to improve the use of antibiotic therapies, minimize misdiagnosis and delayed diagnosis and select appropriate antibiotic drug regimens (IDSA, 2016). The purpose of this evidence-based practice project was to evaluate the effects of an antibiotic stewardship program (presentation, survey collection, bimonthly e-mail reminders, patient …

Implementation Of An Advance Care Planning Protocol To Increase Advance Directive Completion Rates, Christine Engle

Evidence-Based Practice Project Reports

Advanced directives (AD) allow an individual to retain autonomy in end-of-life decisions and can prevent unnecessary costs and treatments associated with aggressive life-prolonging measures. As of 2017, only an estimated 36.7% of the United States adult population had a form of advance directive documented (Yadav et al., 2017). The purpose of this evidence-based project was to determine if implementation of an advanced care planning (ACP) protocol would increase ACP discussions, AD completion, and result in a modification in stage of change or behavior. The Transtheoretical Model (TTM) and Stetler Model of evidence-based practice were used as the framework to guide …

Use Of Smartphone Application To Facilitate Weight Loss And Promote Accountability In Obese And Overweight Patients, Angela M. Turner

Evidence-Based Practice Project Reports

In 2015, the U.S. Department of Health and Human Services published a National Health and Nutrition Survey (NHANES) on obesity from 2011 through 2014. From the survey, it was determined that the prevalence of obesity in the U.S. was 36% in adults and 17% in young adults/children (Ogden et al., 2015). Lifestyle modifications including moderation of caloric intake and increased exercise have been shown to be effective for both prevention and treatment of obesity. The purpose of this evidence-based practice (EBP) project involved the design, administration, and evaluation of a technology-assisted weight loss intervention to address the health problem of …

Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean

Evidence-Based Practice Project Reports

Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …

Emergency Nurse Perceptions Of Disaster Preparedness After The Implementation Of A Department Emergency Operations Plan, Angela R. Gentry

Theses and Dissertations from 2019

Emergency departments (ED) are the entryway into the healthcare system during a disaster event and patients often arrive in the first thirty minutes after an event has occurred. This creates unique challenges for ED nurses. The purpose of the Quality Improvement (QI) project was to measure the impact of a Department Emergency Operations Plan (DEOP) on the ED nurse’s perception of disaster preparedness. This study included a convenience sample of 126 full time and part time registered nurses working in the ED at a Level 1 Trauma hospital. Institutional Review Board (IRB) approval was obtained by both Arkansas Tech University …