Medicine and Health Sciences Commons^™

Pneumococcal And Influenza Vaccine Co-Administration In The Incarcerated Population, Kaitlyn Stroh

Doctor of Nursing Practice Projects

Background/Significance: Streptococcus pneumoniae is responsible for 20-60% of U.S. bacterial pneumonia cases and has a mortality rate of 10-30%. Invasive pneumococcal disease (IPD) occurs when streptococcus pneumoniae invades otherwise sterile sites. Adherence to immunization guidelines is 60-70% effective at preventing IPD. Co-administration of pneumococcal and influenza vaccines has shown promise at increasing uptake of the pneumococcal vaccine and enhancing immunological response. Population/Setting: A state-run Department of Corrections (DOC) clinic system serving just over 30,000 individuals was the site for this project. Incarcerated individuals present an increased risk of contracting pneumococcal disease due to close living quarters. Other risk factors such …

The Threat Of Hospital Wastewater: An Evidence-Based Call To Action, Ann P. Nguyen

DNP Qualifying Manuscripts

Introduction: Hospital wastewater carries a unique composition of pollutants, a burden that includes high chemical and biological residuals. These pollutants are discharged into sewage treatment plants and natural environments where they contaminate human water sources and larger ecosystems. Water treatment plants are not designed to treat the high loads of biomedical waste and persistent organic compounds found in hospital wastewater and therefore pollutants survive in conventionally treated water. Evidence of contaminated soil, municipal wastewater, surface water, ground water, and even drinking water have been demonstrated in studies conducted around the world highlighting the ubiquity of the problem. Hospital effluent as …

The Effects Of Social Determinants On Renal Care Among Eskd Patients In The Philippines: Rural Vs. Urban Areas, Melanie Rojas

Nursing | Senior Theses

From a Public Health Nursing (PHN) perspective, populations who are diagnosed with chronic disease or illness are the most vulnerable to end-stage kidney disease (ESKD) or end-stage renal disease (ESRD). The International Society of Nephrology (ISN) states that the mortality rate for ESKD amounts to roughly 7 million individuals worldwide. In examining causes of ESKD throughout both history and the lifespan, high mortality rates are attributed to the lack of access to life-sustaining therapies such as dialysis or transplantation. The lack of access to therapy or healthcare services has been an immense Public Health crisis in the last few decades. …

What Methods Can The Health Care Industry Implement To Reduce Energy Consumption And Waste Production From Patient Care To Limit Greenhouse Gas Emissions?, Danielle H. S. Good

Senior Honors Projects, 2020-current

Purpose: Climate change is a growing issue all around the world and has negative impacts on the environment and human health. The health care industry is a significant contributor to greenhouse gas emissions amplifying climate change. Health care establishments are in place to improve health but are inadvertently harming it at the same time. Methods:A review of the literature was conducted to determine the impact the health care industry has on climate change and what can be done to limit the impacts on the environment. Resources were collected from trusted organizations databases such as Healthcare Without Harm, …

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 …

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 …

Barriers To Mental Health Treatment In Patients Referred By Primary Care, Rebecca Palmer

Dissertations

Problem: Limited access to mental health treatment is one of many potential barriers to treating mental illness in the United States. Where resources are readily available, reportedly high no-show rates for established mental health appointments suggests further investigation is necessary to identify frequent barriers within that population. This was a quality improvement project to identify common themes in patient-reported barriers to care.

Methods: A 4-question phone survey was offered to individuals that did not appear at their mental health appointment. Data was analyzed to identify the most commonly reported barriers to mental health treatment. Additional data collected includes reported history …

Decreasing Environmental Health Risks In The Philippines: Implementation Of A Culturally Appropriate Screening Tool, Alyssa Samson

Doctor of Nursing Practice (DNP) Projects

Objectives: The purpose of this DNP project was to increase the knowledge of environmental health risk factors in the Philippines among nurses and doctors located within that healthcare system. The overall goal was to educate providers on local environmental health risks, provide training for the use of a screening tool (Tagalog Environmental Health and Safety Assessment Tool [TEHSAT]), and provide resources aimed at increasing screening of at risk populations and provide opportunities for education and health promotion.

Methods: This project included a two-part educational training session. The first part included a preliminary presentation on environmental health and the use of …

Evidence-Based Study Of Medication Compliance Project In Hiv Prevention Using Pre-Exposure Prophylaxis (Prep) Antivirals For Hiv-Negative Males, Ming-Chun Ho

Doctoral Projects

In 2012, emtricitabine/tenofovir was the only Food and Drug Administration-approved medication for pre-exposure prophylaxis (PrEP) used in human immunodeficiency virus (HIV) prevention. To date, there is little research on open-label and mixed-payer characteristics supporting medication compliance of men who have sex with men (MSM). The purpose of this research was to describe individual demographic variables associated with PrEP medication adherence and to examine the effect of a follow-up phone call from a nurse once a month for 3 months. A total of 30 MSM were recruited and data were collected using a demographic questionnaire, medication adherence tool and follow-up phone …

Evaluation Of Intimate Partner Violence Screening In A Metropolitan Public Health Department, Niani Conerly

DNP Scholarly Projects

Routine intimate partner violence (IPV) screening has been recommended for all health care settings to prevent subsequent short and long term health consequences of survivors. However, provider adherence remains low. The purpose of this quality improvement project is to evaluate current screening practices, identify the needs of, and provide resources to three family planning clinics within a metropolitan public health department. The project utilized Donabedian’s Structure, Process, and Outcomes Model to map current protocols within three family planning clinics to identify current practices. A chart review including 105 patient charts was done to identify documentation of IPV screening/discussion as well …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …

Improving Patient Outcomes: Early Mobilization Of Intensive Care Patients, Casey Teves

Honors College Theses

Early mobilization of intensive care patients has gained the interest of researchers within the last few years due to its safe and practical application and numerous benefits it can provide. Reviewing the literature on this topic reveals the substantial benefits of early mobilization and the detrimental effects of prolonged bed-rest. Despite recent evidence proving that this practice will increase quality of care, many intensive care units still utilize bed-rest as a standard. Understanding the barriers and facilitators of this change can help transform this research into practice and improve patient care outcomes. Nurses are the key facilitators in the initiative …

Zika Virus, Nurto A. Abdulla

Nursing Student Class Projects (Formerly MSN)

Zika virus infection, a mosquito-borne flavivirus that causes febrile illness associated with rash, has been rapidly emerging in the Western Hemisphere over the past few months. The virus was rarely identified until outbreaks occurred on Yap Island in the Federated States of Micronesia in 2007, Fresh Polynesia in 2013, and Easter Island in 2014 (Chen & Hamer, 2016). The virus was initially detected in Brazil in 2015, in the northeast, and was subsequently identified in other states and several South American countries, including Colombia, Ecuador, Suriname, Venezuela, French Guyana, and Paraguay. Local transmission has been documented in Central America in …

Public Access To Naloxone: Exploring Intention To Prescribe Among Tennessee Nurse Practitioners, Kathryn L. Dambrino

DNP Scholarly Projects

Background

Drug overdose deaths have become an escalating epidemic in the U.S. and surpassed motor vehicle collisions as the leading cause of accidental death. To combat opioid overdose, naloxone distribution to the public has been initiated in some states as a harm reduction strategy. Naloxone has been used for many years among hospital professionals as a life-saving antidote to reverse the respiratory depression effects of opioids, and the FDA has approved take-home naloxone devices for layperson use. Though legislation has been introduced in many states, such as Tennessee, to allow provider prescription of naloxone to laypersons, minimal data have been …

Developing A Vermont Nurse Triage Line: A Systems Improvement Project, Andrew D. Kehl

College of Nursing and Health Sciences Nursing Master Project Publications

Nurse Triage Lines (NTL) have been utilized since the 1970s as a healthcare service delivery model. The efficacy of their utilization has been proven in non-acute, mainly primary care settings. During the 2009 H1N1 pandemic in the United States, NTLs proved their efficacy in an acute emergency event. The Minnesota FluLine, the exemplar case study, showed a significant reduction in unnecessary healthcare resource utilization as well as a significant economic cost savings.

This project performed an organizational assessment for the Vermont Department of Health (VDH) focused on implementing an NTL. Through qualitative semi-structured interviews with key informants, key themes surround …

Patient Engagement In Transitional Care, Sheeree Dela Pena

Master's Projects and Capstones

The Clinical Nurse Leader Master’s project was conducted about a public health program called the Transitional Care Program that was working in partnership with a county hospital system, Santa Clara Valley Medical Center. The specific aim was to reduce hospital re-admissions of high-risk patients by supporting patient motivation and engagement in the Transitional Care Program by May 2015. Over a four-month period, data was collected through ten client visits, interviews with two public health nurses, information available about the program, and current research conducted on transitional care, hospital discharges, and patient engagement. Various aspects of the program were assessed, such …

Family And Child Development Education For Harrisonburg Adolescents, Mollie M. Moran, Jennifer E. Corser, Julia M. Glauber

Senior Honors Projects, 2010-2019

The pregnancy rate among 15- to 17-year-old women in Harrisonburg is double Virginia's state rate (Townsend, 2008). While meeting administers and guidance counselors of Harrisonburg High School we learned that Harrisonburg High School views this issue as one that cannot be addressed by teaching abstinence in their public school. They have found that because of cultural beliefs, abstinence is not an effective tool for preventing teenage pregnancy. Instead, HHS teaches their students about safe sexual practices and how to have a healthy pregnancy in the event they were to become pregnant. The high school offers a class called “Child and …

Pink Goes Red For A Day: Is Your Heart Healthy?, Quierra W. Jones

Honors College Theses

There is a major lack of public health education among college aged students at many colleges and universities across the country. Even further, many minority college students are unfamiliar with one of the most life-threatening health issues that affect them the most: heart health. As a nursing student and member of Alpha Kappa Alpha Sorority Inc., I strive to uphold our “service to all mankind” motto and also educate the public about important heart health matters. On February 4, 2014, I presented a program through my sorority entitled Pink Goes Red for a Day in which I educated the primarily …

Overdose Education And Naloxone Distribution: Implementation In The Acute Care Setting, Emily A. Daniell

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The number of opioid related overdose deaths has increased significantly over the past ten years. In order to combat this problem, many drug treatment programs have implemented Overdose Education and Naloxone Distribution programs as a harm reduction technique. While these programs are fairly new, initial research demonstrated effective reduction in the number of opioid overdose related deaths. The risk of overdose deaths increases when an opioid addicted person is abstinent for a period of time and loses tolerance. Individuals who have been incarcerated, completed inpatient detoxification, or who have been admitted into an acute care setting face the risk of …

Hypertension Management Among Cambodian-Americans In Rhode Island, Rathana Long

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Hypertension is a major risk factor for heart disease and stroke and the focus of much study in the US. However, there is limited transfer of this knowledge in terms of hypertension management in certain recent immigrant groups such as the Cambodian-­‐Americans. Cambodian-­‐Americans are often included among the Asian/Pacific Islanders and are one of the fasting growing populations in the US. The purpose of this study was to explore how Cambodians in Rhode Island manage hypertension. This study used a survey design with a convenience sample of 30 participants who could read, write, and understand English. It was conducted at …

Preventing Ventilator-Associated Pneumonia: Educating Emergency Room Nurses, Dana M. Ferrazzano

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Ventilator-associated pneumonia (VAP) is the second most common hospital acquired infection and is primarily found in the intensive care units. The presence of an endotracheal tube is the primary risk factor for developing VAP. Many times the process of intubation occurs pre-hospital, in the emergency room (ER) or in the operating room. Ventilator associated pneumonia is associated with increased hospital stay and costs. Evidence-based guidelines have been developed to decrease the occurrence of VAP and decrease patient mortality. Preventative measures are initiated on the intensive care unit once the patient is transferred. The purpose of this study was to evaluate …

Intravenous Acetaminophen Use In Postoperative Pain Management, Selvi K. Kumar

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Surgery is a most common source of acute pain and effective postoperative pain management is crucial for wound healing and recovery. Opiods are the mainstay for acute pain management but have various adverse effects including death. The multimodal approach involves the use of multiple drugs with varying mechanism of action to achieve optimal pain relief with less adverse effects. Intravenous acetaminophen (IVAPAP) is a new addition to the multimodal approach that appears to afford effective pain relief with a low risk profile. The purpose of this research study was to examine the impact of IVAPAP use in multimodal pain management …

Development Of A Community-Based Lactation Support Program, Susan D. Bryant

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background. Despite the recommendations from leading health organizations and the documented health benefits for both mother and infant, breastfeeding success rates continue to be suboptimal.

Design. A program development design was used for this Community-Based Lactation Support Program. This pilot was the first step in accomplishing the long term goal of expansion of the program to the entire community of Scituate and the state of Rhode Island.

Objectives. The objectives of this program were to increase exclusive and sustained breastfeeding rates in the town of Scituate through education and support and to ensure a positive breastfeeding experience for the …

A Nurse-Driven, Exercise-Based Intervention For Patients With Cancer-Related Fatigue When Severe Fatigue Interferes With Daily Activity, Nancy B. Opaluch-Bushy

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Cancer affects more than 1 million people each year. Of all of the symptoms related to cancer, the most frequently experienced is fatigue. Cancer-related fatigue (CRF) is an extreme tiredness that contributes to morbidity and mortality due to resulting inactivity. Extreme inactivity related to CRF may cause severe complications affecting multiple body systems. The Oncology Nursing Society (ONS) recommends exercise as the only evidence-based intervention shown to be significant for CRF. The purpose of this project was to provide a nurse-driven, exercise-based intervention to combat severe CRF. The site was an oncology out-patient clinic of a 247 bed Magnet hospital …

Timelines Of Oral Care And Early-Onset Ventilator Associated Pneumonia Prevention, Kristen M. Francoeur

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Hospital-acquired infections, including ventilator associated pneumonia (VAP), are a significant cause of morbidity and mortality and associated with increased costs and length of stay (Chastre & Fagon, 2002; NNIS, 2004). Ventilator associated pneumonia is believed to primarily result from aspiration of oropharyngeal secretions around the endotracheal tube cuff into the lungs (Grap, Munro, Unoki, Hamilton, & Ward, 2012). A randomized control trial tested early application of oral chlorhexidine (CHG) on oral microbial flora and VAP in trauma patients and suggested that early (within 12 hours of intubation) application may reduce VAP rates in trauma patients (Grap, Munro, Hamilton, Elswick, Sessler …

Nurses Perceptions Of Family Presence During Resuscitation In The Emergency Department, Jennifer L. Jennings

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Family presence during resuscitation has been a controversial and much debated topic for many years. In the past decade, the movement toward family presence has steadily grown. The Emergency Nurses Association (ENA) and the American Heart Association (AHA) have endorsed family presence and incorporated guidelines for its implementation. Although becoming more accepted in practice, there are still many hospitals without family presence policies, and some nurses and other health care providers continue to identify concerns about its’ use. The purpose of this project was to survey nurses’ perceptions of family presence during resuscitation in the Emergency Department. A researcher developed …

Exploring Nurses' Knowledge About Heart Failure Before And After The Implementation Of A Heart Failure Education Program, Suzanne H. Richmond

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Heart failure (HF) has become a national epidemic, with 5.7 million Americans currently living with HF. Although HF is incurable, it is manageable if health care professionals apply current practice guidelines to patient teaching. Nurses are charged with providing comprehensive education about HF self-­‐management and it is imperative they stay abreast of evidence-­‐based guidelines. The purpose of this project was to explore the current HF knowledge of Home Based Primary Care (HBPC) registered nurse Care Managers employed at the Providence Veterans Administration Medical Center (PVAMC). The logic model and Knowles andragogy theory assisted this researcher in the creation of a …

Nurses' Knowledge Related To Heart Failure Essentials, Ann Mary Garris

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Heart Failure is a complex syndrome which continues to be a major health issue in the United States and worldwide. Strategies and educational interventions implemented by hospitals to reduce hospital admissions and readmissions for this costly chronic disease have not been consistently successful. Patient education is an important strategy for the management of HF to improve quality of life, optimize patient outcomes, and reduce the use of healthcare resources by reducing readmissions. The purpose of this program development was to increase nurses’ knowledge regarding HF education to be provided to HF patients prior to discharge from the acute care setting. …

Surgical Skills For The Aprn Student: A Low-Fidelity Simulation Experience, Jason C. Heath

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

There are many contemporary areas of practice available to the ACNP to date that encompass a surgical component of practice. Surgical specialty settings require a practitioner to be competent in a specialized base of knowledge as well as possess a fundamental set of psychomotor skills to practice competently. Unlike the training of the PA, ACNP programs do not typically address surgical theory or skills. The purpose of the program was to increase graduate nursing student confidence in basic surgical skills. The review of the literature examined the differences between the educational preparation of the PA and the NP, expansion of …

The Dnp: A Descriptive Study Of Student Experiences And Factors Contributing To Pursuing This Degree, Daniel J. Neilson

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Since 2004 discourse pertaining to a terminal clinical degree in nursing has increased nationally, however few articles were found that discussed why advanced practice registered nurses (APRNs) were choosing to pursue this degree, and their lived experiences while doing so. This descriptive, qualitative research study aimed to identify contributing factors in the decision to pursue the DNP degree, and to explore the experiences of DNP student experiences. Rogers’ theory of diffusion of innovations (2003) guided the study. Snowball recruitment led to seven participants from who data was collected using email conversations. Five major themes were identified: (1) personal development, (2) …