Medicine and Health Sciences Commons^™

Screening For Unhealthy Alcohol Use: Implementation Of Screening And Brief Intervention (Sbi) In Primary Care Using The Audit-C, Sarah Bell

DNP Scholarly Projects

Background: In 2021, the NIAAA reported that alcohol use disorder affected 29.5 million Americans. Alcohol Screening and Brief Intervention (SBI) is an evidence-based prevention strategy, recommended by the USPSTF, to reduce alcohol consumption. Unfortunately, less than 50% of patients receive advice from their provider about the harms of excessive alcohol use. This study aimed to implement an effective SBI process in a rural primary care setting utilizing the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) tool while addressing known barriers to proper implementation.

Methods: Donabedian's Structure-Process-Outcome (SPO) framework for Quality Assessment guided this quality improvement design. Intervention planning included considerations …

Implementation Of The Academic Autistic Spectrum Partnership In Research And Education (Aaspire)-Based Guidelines To Improve Perioperative Care Of Patients With Autism Spectrum Disorder, Kayleigh Brink

Graduate Theses, Dissertations, and Problem Reports

ABSTRACT

Implementation of the Academic Autistic Spectrum Partnership in Research and Education (AASPIRE)-based Guidelines to Improve Perioperative Care of Patients with Autism Spectrum Disorder

Kayleigh Brink

Introduction: Autism Spectrum Disorder (ASD) is becoming more prevalent with an increasing need to identify and eliminate barriers to care. Healthcare Providers (HCP) have shown limited knowledge and confidence when managing patients with ASD. The inability to provide specialized care and recognize symptoms of pain or discomfort could result in behavioral difficulties.

Purpose: The purpose of this project was to improve confidence among HCPs to identify ASD characteristics and to improve the use of …

Improving Heart Health In African Americans Using A Cardiovascular Disease Bundle, Loretta N. Bennam

Doctor of Nursing Practice (DNP) Scholarly Projects

Cardiovascular disease (CVD) is a significant cause of mortality in the United States of America. Risk factors include abnormal low-density lipoprotein (LDL) cholesterol, physical inactivity, and unhealthy diets. African American (AA) adults have higher mortality rates from CVD than other demographics. In Houston, Texas, age-adjusted death rates for CVD per 100,000 population by race in AAs were 111, 85.0 in Whites, 62.9 in Hispanics, and 49.5 in Asians. This project evaluated the impact of using a CVD bundle over an eight-week period on cholesterol medication adherence, physical activity, and heart disease knowledge and was titled Improving Heart Health in African …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects

Abstract

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (<140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management …

Improvement Of Hypertension Self-Care Management In African American Older Adults With Uncontrolled Hypertension Through Shared Decision-Making, Sigga Jobe, Deborah Behan

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Hypertension affects nearly half of the population in the U.S., with the prevalence disproportionately higher in African Americans (Centers for Disease Control and Prevention [CDC], 2023). Complications of uncontrolled hypertension, such as cardiovascular disorders and stroke, increase with age, prompting the importance of controlling high blood pressure in older adults. African American older adults are at higher risk of developing uncontrolled hypertension and related complications due to the lack of healthcare access, financial constraints leading to the inability to access healthier food choices, exercise capabilities, weight control, adherence to recommended medications, and knowledge deficit.

Methods: This project focused on …

Creation Of A Structured Rapid Response Team And Early Rrt Activation, Elizabeth Amaka Azie

Doctor of Nursing Practice (DNP) Scholarly Projects

Abstract

Cardiac arrest, unanticipated admissions to the intensive care unit (ICU), and mortality account for about 50% of serious inpatient adverse events (Ko et al., 2020). Efforts to prevent in-hospital cardiopulmonary resuscitation (CPR) require a system to identify deteriorating patients and include an appropriate interventional response, such as a rapid response team (Andersen et al., 2019). A well-structured rapid response team (RRT) has five categories that include team structure, organizational culture, expertise, communication, and teamwork (Jackson, 2017). A community hospital in Texas has been challenged in its attempts to have a well-structured RRT and had an increase in cardiac arrest. …

Increasing Colorectal Cancer (Crc) Screening In Hispanic Adults Using An Evidence-Based Social Determinants Of Health-Oriented Guide For Patient Navigation, Joyce A. Acquah Dnp, Aprn, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. It affects over 140,000 individuals and results in over 50,000 deaths per year. It is estimated that increasing screening to 80% could potentially prevent approximately 300,000 new cases and over 200,000 deaths by 2030. Screening disparity among the Hispanic population is influenced by socio-economic and socio-cultural factors. The aim of this project was to develop a balanced scorecard (BSC), using publicly available data and research files from three databases (Behavioral Risk Factor Surveillance System [BRFSS], Texas Health Care Information Collection [THCIC], and Healthy North Texas …

Impact Of A Discharge Bundle On Boarding Hours In Acute Care Hospitals, Monica L. Herrera, Sharon L. Blackerby

Doctor of Nursing Practice (DNP) Scholarly Projects

The national epidemic of boarding hours in the emergency departments prompted the implementation of a discharge bundle in an acute care hospital. This bundle included an ADT nurse, discharge orders written prior to 11AM, and EVS shifting employee hours. Initial findings indicated a reduction in boarding time by 126 minutes.

Clinical Practice Guideline For The Management Of Depression In Primary Care, Estrella Catherine Villarreal

Doctor of Nursing Practice (DNP) Scholarly Projects

Abstract

Background: The prevalence of depression poses a significant challenge in primary care, emphasizing the urgent need to address this issue during patient visits. Primary care providers are at the forefront of managing depression, yet they encounter difficulties in screening, diagnosing, assessing, and treating this complex condition. Clinical guidelines serve as valuable tools for primary care providers and practices, offering support in identifying and addressing depression effectively. An evidence-based approach to treating depression in primary care, with a focus on collaborative interventions with behavioral health to enhance depression management for American Indian/Alaskan Native (AI/AN) communities.

Methods: The descriptive analysis was …

Using The Electronic Medical Record To Improve Nurse Workload, Sharon C. Le Roux

Doctor of Nursing Practice (DNP) Scholarly Projects

Background

Equitable nurse-patient assignments have been associated with improved nurse well-being, patient satisfaction and outcomes. Despite this, in an academic medical center in the southwestern United States, there is no standardized process to create equitable nurse-patient assignments.

Objectives

The aim of this project was to improve inpatient oncology nurse well-being and satisfaction through the implementation of an EMR based nurse-patient assignment tool.

Methods

The IOWA Model-Revised for evidence-based practice was used as the basis for this project. Data collected included demographics, the Well-Being Index Survey, perception of satisfaction with manual workload tool, along with knowledge and use of the …

Guideline For Creating A Support Group For Adults With Down Syndrome Who Suffer With Prolonged Grief, Brandon Chace Warman

Doctor of Nursing Practice (DNP) Scholarly Projects

Adults with Down syndrome process and express their grief differently from the general population. There are a multitude of support groups and organizations for individuals grieving a loss and experiencing prolonged grief but there are none that exist for people with Down syndrome. This project develops a guideline for creating support groups aimed at adults with Down syndrome who experience prolonged grief. Fifty-one pieces of literature from all over the world were reviewed to formulate recommendations that were graded by seven stakeholders. These recommendations were then used to develop a guideline for creating support groups for this population. Analysis of …

Breastfeeding Support In Your Pocket: Evaluating The Impact Of A Mobile App On Maternal Success, Maygan Brandt

Nursing | Senior Theses

Background: Breastfeeding has well-known benefits for both the nursing infant and the birthing parent. It bolsters the newborn immune system, and reduces the risk of future health conditions in both parties. Due to these advantages, several health organizations internationally recommend exclusive breastfeeding until 6 months of age. However, only a fraction of infants in the United States meet this goal each year. Improved rates and duration of exclusive breastfeeding will lead to better long-term health outcomes for patients. The use of smartphone applications for breastfeeding education and support has not been thoroughly researched. Objective: This thesis explores the feasibility of …

Cultural Wounds Find Release: Art Therapy And First Generation Immigrants’ Mental Health, Crystal Soojung Yi, Dennis Chavez Calderon

Nursing | Senior Theses

Background: First-generation immigrants in the United States confront significant mental health challenges rooted in cultural identity conflict. Specifically, these challenges are linked to elevated rates of anxiety, depression, and post-traumatic stress disorder (PTSD), as indicated by Lindert et al. (2009). Art therapy holds promise as an intervention for treating mental health and identity conflicts in a variety of populations. Yet, little is known about how art therapy can improve the experience of first-generation immigrants experiencing cultural identity conflicts.

Objective: This study aims to assess the effectiveness of art therapy in improving the mental health and cultural identity conflicts of first-generation …

A Pulse For Progress – Examining The Efficacy Of Best Nursing Developmental Care Practices For Children With Congenital Heart Disease At Risk For Developmental Delay In The Pcicu: A Prospective Quasi-Experimental Cohort Study, Jasmyn Jansen

Nursing | Senior Theses

Emerging advances in pediatric cardiovascular surgery have significantly decreased the mortality rates in infants born with critical congenital heart disease (CHD), in turn, leading to increasing prevalence in adolescence and adulthood. At the same time, developmental delays (DD) are on the rise among children with CHD. Recent research suggests that prolonged exposure to the pediatric cardiac intensive care unit (PCICU), with its environmental stressors, negatively implicates neurodevelopment raising the question, and risk, of DD. In January 2023, the American Heart Association (AHA) issued a scientific advisory calling hospitals to implement developmental care practices for hospitalized infants and young children with …

Unveiling New Realities: An In-Depth Analysis Of Virtual Reality's Impact On Postoperative Adolescents, Julia Tolentino

Nursing | Senior Theses

The traditional approach to postoperative pain management heavily relies on opioids, but there’s been a surge in their misuse and adverse effects, leading to a significant public health concern. This has led healthcare providers to incorporate a multimodal approach aimed at reducing opioid dependence. This proposal introduces an immersive component, virtual reality (VR), not as a replacement for opioids but as a complementary tool offering distinct advantages for enhancing postoperative pain management. By immersing patients in a virtual environment, VR effectively distracts them from pain and discomfort, allowing for reduced opioid dosages and mitigating the risk of opioid misuse. Additionally, …

At The Heart Of Nursing: A Literature Review On Health Literacy Education In Nursing Curricula And Preparation For Patient Teaching Encounters, Samantha Garcia

Honors Undergraduate Theses

Background: Health literacy is defined as one’s ability to find, comprehend, and utilize information to make health decisions (Office of Disease Prevention and Health Promotion, n.d.). Globally, nursing students are exposed to the concept of health literacy during their degree-seeking years, yet no formal health literacy education exists across nursing curricula in pre-licensure programs at the associate and bachelor levels. This lack of standardization and non-emphasis of health literacy as a formal topic within education has contributed to poor provider performance and, in turn, low health literacy rates that may lead to suboptimal patient outcomes.

Significance: Studies have found that …

Contributing Factors And Interventions For Increased Central Line-Associated Bloodstream Infection (Clabsi) Rates During The Covid-19 Pandemic: A Literature Review, Brittney Perry

Honors Undergraduate Theses

The purpose of this literature review is to determine the contributing factors of CLABSI rate increases during the COVID-19 pandemic and identify interventions which restored CLABSI rates to pre-pandemic levels to guide healthcare professionals’ actions during the next pandemic. Background: In the first two decades of the 21^st century, CLABSI rates were reduced in United States hospitals by innovating safer patient care practices. However, there was a significant increase in the annual CLABSI rate in 2020 and 2021, increasing the average length of stay, mortality rate, and cost to the U.S. healthcare system. Methods: An extensive search of CINAHL …

Palliative Care Integration Into Critical Care In People With Terminal Conditions, Arielle Westfall

Honors Undergraduate Theses

Palliative care is of value to the quality of life in people with terminal conditions when initiated early. The purpose of this literature review was to identify barriers to early initiation of palliative care consultation. The secondary purpose was to examine characteristics that prompt palliative care consultation. The TLC model of palliative care was used to explore palliative care in the critical care setting in people with terminal conditions. The concepts of the model support optimal palliative care as collaborative and comprehensive, with shared decisions made by the patient, practitioners, and loved ones. A literature review was conducted to identify …

Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez

Nursing | Senior Theses

Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand the …

Developmental Effects Of Child Abuse: The Relevance Of Timing, Laura Luz Alvarez Pineda, Karla Susana Saldaña

Nursing | Senior Theses

Background: Early physical, sexual, and emotional child abuse has been associated with long-life cognitive, emotional, and physical health repercussions. Purpose: The current paper, in addition to a literature review, proposes a research design to examine the emotional outcomes of physical, emotional, and sexual child abuse on Hispanics when a psychosocial therapy program is implemented. Methods: Participants will be recruited from children’s hospitals, daycares, and preschools around the Bay Area. Parental-informed consent will be obtained prior to participation. This longitudinal quantitative quasi-experimental study will be comprised of three phases to measure posttraumatic stress and depression symptoms, and suicidal ideation. Results: Multivariate …

Reducing Mortality Among African American Mothers Related To Postpartum Hemorrhage By Implementing Early Education And Risk Assessments, Don'ya Truesdale

Theses and Dissertations

African American women are at the highest risk for hemorrhaging during childbirth (Okunlola, 2022). A hemorrhage can occur among postpartum mothers for many reasons, with the main causes being uterine atony, tissue trauma, and clotting issues. However, risks for Black mothers differ. The comorbid and social factors within the Black community greatly influence the likelihood of Black mothers experiencing postpartum hemorrhage. Additionally, the lack of assessment and attention catered towards those risk factors lead to an increased mortality among African American (AA) mothers compared to Caucasian mothers and all other ethnicities. Nonetheless, as maternal risk assessments and education increase, mortality …

Benefits And Barriers Of Using Prefilled Precedex Syringes In The Operating Room: A Cost Comparison, Ashley White

Graduate Theses, Dissertations, and Problem Reports

According to a report published by the Institute of Medicine, at least 44,000 and possibly up to 98,000 Americans die each year because of medical errors in hospitals. More than 7,000 of those deaths are from medication errors alone (Stucki et al., 2013). Anesthesia providers in the operating room (OR) are at even greater risk to commit medication errors due to their easy access to medications and their autonomy to make independent choices for medication administration. A small rural community hospital in Pennsylvania lacks a protocol for Precedex preparation. Evidence-based research show the benefit of prefilled ready-to-administer syringes, but the …

How The Lockdown Of Covid-19 Influenced The Neurocognitive And Psychosocial Development Of Preschoolers, Kay Picson

Nursing | Senior Theses

COVID-19 caused schools to turn to online learning through platforms such as Zoom or Google Meet. The influence and effects caused by the transition to online lessons and quarantine were seen across all patient populations and demographics, but none more so than preschool children, who are regarded as one of the more vulnerable populations due to their susceptibility to change. This research aims to fill gaps in the existing literature by evaluating the similarities and differences of the neurocognitive and psychosocial development of preschoolers exposed to the pandemic and those who were not. This study involves a comparative cohort approach …

Reducing Emergency Department Visits For Children With Autism Spectrum Disorder: Nurse-Led Home Interventions, Teri Nguyen

Nursing | Senior Theses

In the realm of pediatric healthcare, children diagnosed with Autism Spectrum Disorder (ASD) face unique challenges alongside their caregivers. Caregivers face challenges in accessing appropriate support and resources to effectively address the needs of children with ASD. Children with ASD struggle with sensory sensitivities, impaired safety awareness, and difficulties perceiving potential dangers which put them at greater risk for injuries. As a result, children with autism have higher rates of emergency department visits compared to their neurotypical peers. This research aims to assess the effectiveness of nurse-led home injury prevention and education in reducing emergency department visits for children with …

Exploring The Impact Of Swimming On Asthma Management In Asian Americans, Trishtine Tran

Nursing | Senior Theses

Asthma is a respiratory disease that leads to narrowing of the airways in the lungs due to inflammation and mucus. Common symptoms include cough, wheezing, asthma attacks, excess mucus production, and decreased exercise tolerance. Pharmacological treatment methods for asthma include bronchodilators, corticosteroids, and allergy medications. Nonpharmaceutical treatments include monitoring of exposure to allergens and breathing exercises, however swimming is not as commonly suggested. The purpose of this study is to investigate whether implementation of a swimming education class will influence the effectiveness of swimming on asthma management in Asian Americans. This study aims to examine quality of life, changes in …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Senior Theses

Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child within …

Male Caregiver Strain: The Mental Effects Of Being An Informal Caregiver For A Family Member With Dementia And Alzheimer's Disease, Alessandra M. Barillas, Elijah Rammel B. Borja

Nursing | Senior Theses

Background: Caregivers are vital in fulfilling patients' primary care needs, and families prefer them over sending their loved ones to skilled nursing facilities (SNFs). Alzheimer's Disease and Dementia are prevalent conditions necessitating continuous assistance due to memory and cognition impairments. As a result, support is essential for tasks like mobility, feeding, bathing, and perineal care, as well as emotional and physical challenges inherent in caregiving. Purpose: Upon diving into the mental health impacts of serving as an informal caregiver for individuals with Alzheimer's Disease and Dementia, a notable research gap becomes evident, especially concerning male caregivers. This lack of information …

The Effect Of Nursing Education On The Utilization Of Kangaroo Mother Care And Weight Gain Of Preterm And Low Birth Weight Infants, Jhenalynn Valete

Nursing | Senior Theses

Aim: The goal of this quantitative study is to investigate if educating nurses about the significance of KMC will increase its utilization and promote weight gain in low birthweight and preterm infants. Additionally, it aims to find the optimal duration of KMC required to maximize health outcomes for the infant. This research proposal aims to provide nursing professionals with valuable insights, allowing them to effectively educate parents on practices that promote maximal weight gain in neonates.

Background: This is a cost-effective and natural way to enhance health outcomes such as temperature regulation, weight gain, respiratory function, pain mitigation, …

App-Lying Knowledge: Mypcos App Guiding Symptomatic Women To Pcos Awareness, Khanh Hoang

Nursing | Senior Theses

This study delves into the effectiveness of educating women about polycystic ovarian syndrome (PCOS) alongside the utilization of a dedicated mobile health application in raising awareness about PCOS and promoting healthcare-seeking behavior. PCOS, a prevalent endocrine and metabolic disorder affecting 8-13% of women in their reproductive age, lacks definitive remedies, and its underlying causes remain elusive. The primary objective is to establish that empowering women with knowledge about PCOS, facilitated by the MyPCOS mobile app, can lead to increased awareness and encourage them to seek further evaluation from healthcare providers. Rooted in the Health Promotion Model (HPM), the study adopts …

Cervical Cancer Education & Prevention For Women In The Philippines, Kate Isabel Juanillo

Nursing | Senior Theses

Although cervical cancer is preventable, it continues to pose a significant health concern in the Philippines as evidenced by high cervical cancer diagnosis rates. The purpose of this quantitative study is to investigate low cervical cancer screening rates and the effectiveness of educational interventions in increasing awareness and screening rates. A literature review will examine topics such as low cervical cancer screening rates, cervical cancer screening methods, and barriers. This research proposal involves a quasi-experimental study that investigates education as an intervention for increasing cervical cancer awareness and cervical cancer screening rates. Fifty Filipino women will be randomly assigned to …