Medicine and Health Sciences Commons^™

Increased Concern Of Suicide Behaviors In The Adolescent Population, Jaime Shareen-Porter Earle

Doctor of Nursing Practice Projects

This quality improvement project focused on addressing the concern for the increase of depression, anxiety, and self-harm behaviors among adolescents, which can lead to suicidal ideation and attempts. Suicide behaviors have increased among adolescents, and research revealed that suicide is the second leading cause of death in this population. An educational PowerPoint was presented to members of the community on suicide behaviors, how to identify the behaviors, and where to get support and resources in the community. Pre- and post-surveys were used to assess the participants' knowledge and confidence levels before and after project implementation. The surveys contained the same …

Implementation Of A Mindfulness Intervention To Increase Adolescent Resilience In An After-School Program: A Quality Improvement Project., Katie Thomas

Doctor of Nursing Practice Papers

Background: Globally, fourteen percent of adolescents ages 10 to 19 years old suffer from mental health problems (World Health Organization, 2021). Resilience is a fundamental concept of the mental health promotion framework (CAMH, 2022).The WHO (2020) “Guidelines on Mental Health Promotive and Preventive Interventions for Adolescents” includes the recommendation that universal interventions to promote mental health and reduce mental disorders should include social and emotional learning (SEL), such as emotional regulation, mindfulness, stress management, problem solving, and interpersonal skills. Mindfulness-based interventions (MBIs) are one evidence-based method of accomplishing this goal (Sapthiang et al., 2018). Purpose: The purpose of …

Pediatric Streptococcal Pharyngitis Testing And Treatment Practices, Amanda Welch

Dissertations

Objective: The purpose of this pilot quality improvement study was to implement SmartPhrases and assess its impact on adherence to the Infectious Disease Society of America (IDSA) guideline for Group A Streptococcus (GAS) pharyngitis testing and treatment in pediatric patients ages 1-16 years old. The aim was to use SmartPhrases to improve adherence with the IDSA guideline by 30% for GAS pharyngitis swabbing and 10% for appropriate antibiotic prescribing in three months.

Methods: A retrospective data analysis approach was used, in reviewing SmartPhrases data from the electronic health records (EHR) in a metropolitan Urgent Care. This data were collected from …

School-Based Development And Implementation Of Adolescent Mental Health Educational Toolkits, Chantel M. Kilford Ms

Doctor of Nursing Practice (DNP) Projects

After the onset of the COVID pandemic, there were significant increases of adolescents with anxiety, behavioral and conduct problems. These disorders have devasting individual, social, and economic ramifications and school-based staff play a key role in identification, assessment, and treatment. Evidence suggested that healthcare providers, school counselors and teachers were not confident or knowledgeable about adolescent mental health. The purpose of the change in practice project was to increase knowledge and confidence among school-based healthcare providers, school counselors and teachers by providing an adolescent mental health tool kit. The toolkit focused on disruptive behavior and other prevalent mental health disorders …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

School-Based Development And Implementation Of An Educational Toolkit, Chantel M. Kilford Ms

Doctor of Nursing Practice (DNP) Projects

The purpose of this evidence-based change in practice is to increase knowledge and confidence among healthcare providers and teachers within a high school setting by providing an educational tool kit about behavioral disorders in children. The disorders that will be focused upon are conduct disorder, oppositional defiant disorder, and common co-morbidities of these disorders. There will be education about an appropriate childhood, evidence based mental health assessment tool that assesses childhood mental health, including how to score the tool and interpret the results. Evidence suggests that healthcare providers and teachers are not confident or knowledgeable about identification, assessment, and behavioral …

Nursing Interventions To Decrease Depressive And Anxious Symptoms In Hispanic-American Youth, Vanessa C. Hernandez

Honors Undergraduate Theses

Introduction: Hispanic-American youth are less likely to receive mental health services despite being at increased risk for depression and anxiety. Having depression and anxiety at a young age can have detrimental long-term effects such as sexual risk behavior, delinquency, and suicide. Various kinds of nurses interact with this age group which can be a missed opportunity to intervene for the welfare of these youth. Interventions exist for depression and anxiety; however, they are not specific to nurses who care for young Hispanic-American patients. Methods: An integrative literature review was performed to identify nursing interventions for Hispanic American youth with depression …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Implementation And Evaluation Of Asthma Education Cell Phone Application: Asthmaxcel, Within An Allergy And Asthma Specialty Practice., Michael Stefan Swift

Doctor of Nursing Practice Papers

Abstract

Background: Asthma is the leading chronic illness among pediatric patients. One of the most significant obstacles facing asthma care is adherence to asthma management plans. In the pediatric population, adolescents (ages 12-17) traditionally have poor asthma management. Research shows that adolescents respond well to technology-based education and that improving adolescent healthcare literacy leads to better asthma control.

Environment: This project took place at an allergy and asthma specialists office. This private practice includes primary care allergy, asthma, and immunology services that follows roughly 120 adolescents with asthma.

Purpose: The purpose of this project was to provide the allergy and …

Evaluating Sbirt In A Behavioral Health Urgent Care, Christina L. Williams

Dissertations

Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU …

Intimate Partner Violence Education For Pregnant And Postpartum Adolescents And Young Adults, Tatiana Filajdic

Dissertations

Abstract

Problem The commencement of intimate partner violence (IPV) often begins with relationships during adolescence and young adulthood; hence, young age is a risk factor. Young adult females, pregnant and post-partum adolescents are at high risk of experiencing intimate partner violence (IPV).

Methods A prospective, descriptive design evaluating the impact of three IPV education sessions offered over a three-month period at a non-profit shelter specific for young adult, pregnant and post-partum adolescents.

Results Twelve participants attended the sessions (N=12), and seven (n=7, 61.5%) of shelter residents attended at least one IPV education session. A two-proportion z …

Adolescent Anxiety: Implementing Mindfulness Techniques To Lessen Mental Health Crises, Britt Schultz

Theses and Graduate Projects

Adolescence is one of the most challenging times in life as many transitions occur while a child grows into a young adult. In a school-based program, this doctoral of nursing practice project implemented mindfulness techniques to lessen mental health crises in anxious adolescents. This scholarly project educated adolescents in a small town in rural southeast Minnesota on the effective coping exercises of mindfulness and deep breathing to lessen anxiety and decrease mental health crises. Jean Watson’s Theory of Human Caring is the framework for the project and three of her Carative Factors guided this project. A literature review identified opportunities …

A Community Educational Intervention To Improve Firearm Safety Behavior In Families, Elizabeth G. Choma Msn, Rn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background: Every day in America children, are injured or killed from the accidental shooting of firearms. Additionally, few households with children report storing all guns unloaded and locked up. Recent evidence supports education on safe firearm storage as an effective intervention in promoting firearm safety in families with children. However, Pediatric healthcare providers often do not have enough time for firearm education during well visits.

Objective: This Quality Improvement (QI) project aimed to use an educational intervention with statistics on firearms in children and implemented the Asking Saves Kids (ASK) campaign to assess and improve firearm safety behaviors in families …

Adolescent Suicide Prevention Via Parental Education, Junelle Shepard, Mary Val Palumbo

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose. Up to 24% of children from the ages of 12 to 17 have reported suicidal ideation, with 7-11% reporting at least one suicide attempt in the past 12 months (Hetrick, 2017). In a study by Jones et al (2019) over 50% of parents were unaware their child was exhibiting suicidal ideation. This project aims to increase community awareness of suicidal ideation and teach community members how to talk with adolescents about this sensitive topic.

Methods. Five online training sessions were offered in Fall 2021, with each session lasting 90 minutes. Using Smith et al.’s Suicide Knowledge and Skills Questionnaire, …

Improving The Healthcare Transition For Adolescents With Asthma: Implementing A Transition Readiness Assessment, Andrea Pauley

DNP Projects

BACKGROUND: Asthma is the most common pediatric chronic disease in the United States and adolescence represents the highest prevalence among all age groups. Transition planning is recommended for all adolescents, especially those with special health care needs (SHCN). Only 17% of adolescents with SHCN receive adequate transition planning.

PURPOSE: The purpose of this study was to implement the Transition Readiness Assessment Questionnaire (TRAQ) for adolescents age 12 years and older with asthma to identify the current level of transition readiness and identify factors associated with readiness.

METHODS: This study was an exploratory, cross-sectional design to evaluate and describe participants’ level …

Effects Of Heavy Screen Time On The Adolescent, Taylor Lim

Nursing | Senior Theses

In today’s modern age, the great majority of society utilizes many readily available technological inventions. Adults have incorporated these creations not only into their daily lives, but also into the lives of their children. The current Covid-19 pandemic has taken away a key component of pediatric development, which is in-person schooling. Most children are attending school via online classes and a laptop, which adds more time on top of their usual daily screen time exposure. The current literature has studied the effects of high screen time consumption on the pediatric patient pertaining to body mass index, sleeping patterns, lifestyle habits …

Opioid And Naloxone Training In A Rural School District, Allyson C. Waldron

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic is a national health emergency in the United States, with over 128 people dying each day due to an opioid overdose. It is estimated that 4.3 million people over the age of 12 use opioids without a medical need, and 1.3 million youth ages 12-17 use opioids inappropriately. Drug overdose deaths have become the leading cause of accidental death in the United States, prompting the U.S. Surgeon General and the World Health Organization to advise that more Americans have access to naloxone and understand how to use this life-saving drug correctly. Naloxone is an opioid antagonist, used …

Exploring The Lived Experience Of Adolescent Caregivers, Abbigale Laurentius

Honors Theses

In today’s society, the population is aging, and any member of the family could find themselves in the role as an informal caregiver. Adolescents between the ages of 12 and 18 years old may have these caregiving responsibilities, and it is imperative that healthcare professionals recognize and support this change of roles. A literature review revealed a general lack of research from within the last five years regarding adolescent caregivers. Those studies that were analyzed in the review presented themes of depression, anxiety, lack of education, and insufficient social supports for the adolescent. An unfolding case study was then designed …

Improving Health Care Transition Planning In Pediatric Primary Care, Angela M. Brisson

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: For adolescents and young adults (AYAs), health care transition (HCT) is the purposeful and planned process of moving from pediatric, adult-supervised care to adult-oriented care. The use of evidence-based guidelines and interventions can ensure AYAs receive the services necessary to transition successfully.

Purpose: This project aimed to improve a pediatric office’s ability to educate AYAs and parents/caregivers on the practice’s approach to HCT and HCT planning (HCTP) by using Got Transition’s Six Core Elements of Health Care Transition™ 3.0 model to guide the development and dissemination of a Transition and Care Policy/Guide (TCP/G). The adoption of a TCP/G is …

Integrating Community Into Middle School Sexual Education, Sierra Miller, Margaret Aitken

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Problem Statement: Most middle school sexual education does not include parents or community members. Evidence shows family and community attitudes towards sex and sexuality are significant factors in adolescent risky sexual and health practices.

Background: Comprehensive sex education (CSE) reduces risky sexual practices and negative health outcomes. National and local organizations have identified CSE as a public health goal. CSE works best when culturally relevant and the community is involved.

Methods: Interviews with the health educator identified community needs. Resources were created in line with the current curriculum focusing on sex education, its importance, and how to talk about …

The Impact Of Bullying Victimization And Sexual Orientation On The Severity Of Suicidal Behavior, Annalyn Demello

Dissertations & Theses (Open Access)

Background: Lesbian, gay, and bisexual (LGB) youth face a disproportionate risk of suicidal ideation and attempt compared to their heterosexual counterparts. The Minority Stress Theory and Interpersonal Theory of Suicide posit that chronic stress, which can occur as a result of bullying victimization, can lead to loneliness, self-hate, and suicidal ideation. The escalation from ideation to attempt can occur quickly, and most youth who survive suicide attempts pursue subsequent, riskier attempts. It is crucial to intervene when behaviors are less severe. The primary aim of this study was to compare the magnitudes of association between independent variables (bullying and sexual …

The Effect Of Dance Movement Therapy On The Mood Of Hospitalized Psychiatric Adolescents, Amy Chiu

Nursing | Senior Theses

Mental illness in children has increased over all aspects throughout the years to right now (CDC, 2019). Many of these children do get treatment for these disorders but there are still a percent that do not receive any treatment or find effective ways to maintain non-pharmaceutical alternatives for mood stabilization. The alternative therapies that are introduced in hospital settings plays a role in allowing for alternative therapies to be apart of the treatment plan for patients. Dance Movement therapy (DMT) is an alternative therapy that uses movement to conduct change in patient’s emotions based on their own choices of movement …

Identification And Management Of Adolescent Alcohol Use: Screening And Motivational Interviewing, Kelsie L. Berger

Evidence-Based Practice Project Reports

Adolescent alcohol consumption is a serious health problem in the United States. Alcohol is the most widely used substance, and it continues to be the drug of choice for adolescents (CDC, 2018). Over 7 million adolescents and approximately 30 percent of high school students in the U.S. that admit to drinking more than a few sips of alcohol in the past 30 days (NIAAA, n.d.). Underage alcohol use can lead to many complications such as social, school, and legal problems, and when initiated early in life is associated with the development of alcohol use disorder (NIAAA, n.d.). The purpose of …

Moderate-Intensity Risk Reduction Counseling And Acquisition Of Sexually Transmitted Infection, Cindy M. Farina

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a public health problem in the United States, with adolescents and young adults to age 25 bearing a disproportionate burden of infection. Risk reduction counseling (RRC) as a strategy to decrease STI incidence has been a focus of scholars. Research examining RRC efficacy has suggested that RRC is effective for 6 to 12 months after treatment. However, study samples have varied by age, ethnicity, race, gender, and geographic location. Whether RRC is effective for more than 1 year is unknown. The purpose of this post hoc chi-square study was to examine the efficacy of moderate-intensity …

Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens

Walden Dissertations and Doctoral Studies

Adolescent obesity is a worldwide multifaceted epidemic. This disease affects the medical, physical, psychosocial, and family aspects of adolescent life. Identification, diagnosis, and referrals to providers that can initiate early interventions that improve weight status have been recommended as critical steps in curtailing childhood obesity. This evidence-based clinical practice guideline (CPG) was developed for the healthcare providers at a rural clinic in Southwest Arkansas to provide consistency in the identification, diagnosis, and referral of adolescents. The health belief model (HBM) and the trans-theoretical model (TTM) were used to consider adolescents’ individual characteristics and beliefs as well as their readiness to …

Evaluating The Feasibility Of Practice Change: The Use Of The Phq-2 In The Urgent Care Setting, Helena Laubach

Doctor of Nursing Practice Projects

Adolescents in the United States may go unscreened for mental health disorders, such as depression, despite current recommendations. This population has an increased use of urgent care clinics (UCC) for their acute and primary care needs, where they might not be screened for depression at regular intervals. This project looked at determining the feasibility of implementing a two-question depression screener in the urgent care setting – the PHQ-2. Additional aims were to increase screening rates and to determine barriers to screening. Healthcare providers at a pediatric urgent care setting used the PHQ-2 to screen all adolescent patients over a two-week …

Adolescent Pregnancy: A Clinical Guideline For School Nurses In New Mexico, Karin Ludi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall purpose of this project is to ensure that school nurses and health assistants are knowledgeable and have the resources to care for pregnant adolescents in the public school system. New Mexico has consistently ranked in the top 10 in the United States for teen births to women aged 15-19 years. The New Mexico School Health Manual is currently used to guide school nurses and health assistants in the care of pregnant adolescents, but it is vague and addresses emergencies such as labor and bleeding.

From this author’s experience as a school nurse in the public school system, it …

A Vaccine Administration Training Program To Increase Adolescent Vaccination Rates, Claire Jensen

Dissertations

Abstract

Immunizations have been proven to control life-threatening diseases. Often Registered Nurses (RNs) administer vaccines but are unsure how to discuss vaccines with vaccine hesitant patients. Missouri’s adolescent vaccination rates are below its neighboring states. This initiative’s purpose was to increase adolescent vaccine administrations at a Missouri County Health Department (MCHD).

This quality improvement initiative had an observational, cross-sectional, descriptive design. RNs employed at three MCHD clinics attended an adolescent vaccine administration training program (VAT) and completed pre-/post-tests regarding the Advisory Council on Immunization Practices recommendations. Medical record reviews from March 1-April 30, 2018 and March 1-April 30, 2019 compared …

Improving Access To Youth-Friendly Health Services In A Rural California Community, Elena Higley

Doctor of Nursing Practice (DNP) Projects

Adolescents and young adults experience relatively high rates of preventable morbidity and mortality due to injuries, mental health disorders, suicide, substance use, and reproductive health issues. It is paramount for healthcare providers to address risky behaviors early to thwart future adverse outcomes. Rural communities especially struggle with meeting the healthcare needs of their youth because there are fewer resources specifically dedicated to serving adolescents and young adults. This issue is evident in Grass Valley, California, a rural community in Nevada County, an area located in the foothills of the Sierra Nevada mountains. In response to limited access to youth-friendly healthcare …

Pediatric Patients With Diabetes Transition To Adult Care, Sara Jennings

Doctoral Projects

The purpose of this study was to identify the optimal age to target transition to adult care education for adolescent and young adults (AYA) with Type 1 and Type 2 Diabetes Mellitus (DM) as they transition from pediatric endocrinology providers to adult DM providers. A secondary purpose of this study was to identify if there was a relationship between attendance rate, age, gender, years diagnosed with DM, ethnicity, insurance type, Type of DM, and current county of residence with control of diabetes, measured by glycosylated hemoglobin (HgbA1c). A quantitative study through chart audits was conducted at Valley Children’s Healthcare, VCH, …