Medicine and Health Sciences Commons^™

Chinese Immigrants With Non-Insulin-Dependent Diabetes Mellitus: Nutritional Self-Management Approach, Winnie Manlai Wong

Student Theses, Dissertations and Capstones

Background: Chinese immigrants (CIs) with non-insulin dependent diabetes mellitus (NIDDM) generally have poor control in their diet regimen. Due to the variation in body mass, physiology, and cultural differences as compare with the general American population, special attention must be conducted in treating diabetes in Cis, emphasizing culturally sensitive care and nutrition therapy that acknowledge the differences. Purpose: The purpose of this project was to assess cultural challenges in self-management for CIs living with non-insulin dependent diabetes mellitus and evaluate the effectiveness of a diabetic nutritional self-management guide tailored to this population. Theoretical Framework: Havelock’s theory of change is a …

Undergraduate Bulletin, 2019-2020, Minnesota State University Moorhead

Undergraduate Bulletins (Catalogs)

No abstract provided.

The Quest For Self: Using Mandala Art In Reflective Practice Journaling, Kathleen Quinn

Comparative Woman

This article is a nexus of research, personal journaling reflections, and mandala creation from the authors own journals and focuses on the use of Mandalas as part of a reflective practice journaling process. Attention to mandala usage within reflective practice considering depth interiority, engaging and sharing with others. The authors approach to mandala construction is included followed by an exercise for observation and assessment of mandalas. The structure for reflective practice helps shape transformational leaders, using expressive arts, narratives in journaling. This transformational Discovery pathway and narrative exercises can be used for creating professional learning communities. This form of reflective …

Improving Wound Care Using The Time Framework, Pavel Kulikov

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and purpose:Although wound care guidelines are available for primary care providers, barriers to assessment and treatment remain. This paper examines current evidence, guidelines, and discusses the need for improved training, education, and a simplified approach to wound management in primary care. The goal of the project was to increase the provider’s comfort level in assessing and initiating wound care treatment in the clinical setting. Methods:An evidence-based wound treatment framework, identified as the TIME (tissue, infection, moisture, epithelial) framework, was selected for the project. The framework was tailored by subject matter experts to provide a distinctive approach …

Stroke Clinical Order Pathway Education (Scope) For Apns, Varsha Singh

Seton Hall University DNP Final Projects

More than 795,000 American adults have a stroke annually. About 610,000 are first or new strokes. Almost 140,000 Americans of all ages die of a stroke every year (Centers for Disease Control and Prevention [CDC], 2017). Stroke requires emergent treatment and an exact clinical order pathway to ensure better patient outcomes and compliance with the standards of care defined by regulatory bodies such as the Joint Commission (TJC) and the Centers for Medicare and Medicaid Services (CMS). While stroke management teams often include an Advanced Practice Nurse (APN), there is a lack of a standardized protocol across New Jersey (NJ) …

Access To Care And The Use Of Healthcare Services By Women In Rural Cameroon: A Participatory Action Research Study, Grace Tadzong-Awasum

Electronic Theses and Dissertations

Women in rural Cameroon do not access health care as timeously and as often as they should. They fail to get screened for common diseases, with the consequence that such diseases are often diagnosed at a very advanced stage. This accounts for the high morbidity and mortality rates as well as low life expectancy recorded among women. The purpose of this study was to explore and understand the health access experiences of women in rural Cameroon. Methodology: Participatory action research was used guided by a Focused ethnography in phase one. Twenty-five women aged 21-77 years were recruited through local the …

Probiotic Use In Trauma Patients: A Pathway To Determining The Standard Of Care To Improve Outcomes, Heather Vitko

Electronic Theses and Dissertations

The gut microbiome consists of normally non-pathogenic bacteria, viruses, and fungi. These friendly microbes serve to maintain GI barrier function and integrity, play a role in host nutrient and drug metabolism, immunomodulation, and prevent pathogenic bacteria from colonizing or causing disease. The importance of a healthy microbiome for the overall health of the host is just recently being appreciated within the medical and science communities. Disruption of the microbiome places one at greater risk for illness and infection. Patients who suffer a traumatic injury are among those at highest risk for complications associated with microbial imbalance, or dysbiosis. In addition …

Adaptations Made To Evidence-Based Public Health Programs In Low- To Middle- Income Countries: A Concept Mapping Analysis, Elizabeth Holguin

Nursing ETDs

One of the most challenging barriers to implementing successful and sustainable evidence-based programs in public health is the ability to remain faithful to original protocols grounded in scientific evidence while adapting programmatic components to reflect the reality of the communities they are meant to benefit. It is generally accepted that some degree of adaptation should occur in order to achieve positive, sustainable outcomes in public health programs. A concept mapping methodology was used to explore types of adaptation that occur during implementation of evidence-based global health programs in low- to middle-income countries (LMICs). Purposive and snowball sampling produced a sample …

The Role Of An Advanced Practice Provider (App) And Its Relation To Physician Shortages And Rural Healthcare Survival: A State-By-State Analysis, Allen Anderson

Dissertations, Theses, and Projects

The extent that Advanced Practice Providers (APPs) are able to practice independently with a full scope of practice varies state-by-state. The purpose of this paper was to review how APPs could help in a number of different areas of healthcare. This analysis examines the state of rural healthcare and reviews physician shortage statistics and hospital closures by state. In the examination, it also evaluates which states have full scope, reduced scope, and restricted scope of practice laws and cross-references that with states that have experienced a hospital closure. Through case studies, this research finds that APPs can be an alternative …

Health-Services Utilisation Amongst Older Persons During The Last Year Of Life: A Population-Based Study, Danielle Ní Chróinín, David E. Goldsbury, Alexander Beveridge, Patricia M. Davidson, Afaf Girgis, Nicholas Ingham, Jane L. Phillips, Anne M. Wilkinson, Jane M. Ingham, Dianne L. O'Connell

Research outputs 2014 to 2021

BACKGROUND: Accurate population-based data regarding hospital-based care utilisation by older persons during their last year of life are important in health services planning. We investigated patterns of acute hospital-based service use at the end of life, amongst older decedents in New South Wales (NSW), Australia.

METHODS: Data from all persons aged ≥70 years who died in the state of NSW Australia in 2007 were included. Several measures of hospital-based service utilisation during the last year of life were assessed from retrospectively linked data comprising data for all registered deaths, cause of death, hospital care during the last year of life …

A Simulated Learning Experience In Advanced Care Planning Conversations, Brandy Ellis

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: The CDC (2012) reports that 1/3 of Americans have no advance care planning (ACP), which is essential for maintaining autonomy when people are no longer able to communicate wishes directly. IOM (2014) reports that providers have limited training in communication techniques and low confidence in holding advanced care planning conversations. Nursing simulation is an effective method of teaching clinical skills in a safe environment. The development of a high fidelity (HF) standardized patient simulation, using the Jeffries Simulation Framework, combined with evidence-based practice classroom curriculum, may increase knowledge and confidence in holding ACP conversations for nurse practitioner students.

Methods: …

Outcomes And Experiences Of An Rn To Bsn Online Cohort: An Academic-Practice Partnership, Donna Copenhaver Dr., Marilyn Dubree Msn, Rn, Chris Wilson Msn, Rn-Bc, Martha Buckner Phd, Cathy R. Taylor Drph, Kathy Jordan Msn, Rn

International Journal of Health Sciences Education

Abstract

This article describes the result of an academic-practice partnership between a School of Nursing (SON) and a University Medical Center (UMC) for the purpose of promoting BSN education in response to the Institute of Medicine’s recommendation that 80% of RNs hold a baccalaureate degree or higher by 2020. The mutually beneficial partnership worked together to offer a pilot online RN-BSN nursing program, increase the number of BSNs in the workforce, and to collect information from RN-BSN students returning to school about their challenges, recommendations for future programs, and why they were interested in returning to school. The BSN graduates …

The Effect Of Competency-Based Education On Medical And Nursing Students' Academic Performance, Technical Skill Development, And Overall Satisfaction And Preparedness For Future Practice: An Integrative Literature Review, Haris Saud, Ruth Chen

International Journal of Health Sciences Education

Purpose: This article provides an integrative review of competency-based education (CBE) in medical and nursing programs and examines the effect of CBE on students’ academic performance, technical skill development, and overall satisfaction and preparedness for future practice.

Background: In recent decades, CBE has increasingly been discussed in medical and nursing education programs. The impact of the CBE curriculum on learning outcomes including academic performance, technical skill development, overall satisfaction, and preparedness for future practice has not been fully elucidated.

Method: A review of the literature was conducted, and multiple databases were searched for studies that analyzed the impact of CBE …

The Effects Of Psychotropic Medications On Developing Brains, Abass Jafuneh

Nursing Capstones

No abstract provided.

Interference And Control Of The Nosocomial Transmission Of Methicillin-Resistant Staphylococcus Aureus, Sen Pei, Flaviano Morone, Fredrik Liljeros, Hernan Makse, Jeffrey L. Shaman

Publications and Research

Methicillin-resistant Staphylococcus aureus (MRSA) is a continued threat to human health in both community and healthcare settings. In hospitals, control efforts would benefit from accurate estimation of asymptomatic colonization and infection importation rates from the community. However, developing such estimates remains challenging due to limited observation of colonization and complicated transmission dynamics within hospitals and the community. Here, we develop an inference framework that can estimate these key quantities by combining statistical filtering techniques, an agent-based model, and real-world patient-to-patient contact networks, and use this framework to infer nosocomial transmission and infection importation over an outbreak spanning 6 years in …

Relationships Between Aprn State Practice Authority, Perceived Autonomy, Professionalism, And Interprofessional Team Function Among A National Sample Of Aprns In The U.S., Patricia Rae Gilman

Nursing ETDs

Healthcare that includes high performing interprofessional clinical teams (IPTs) is one recommended strategy to provide optimal quality and cost-effective care delivery. Highly functional IPTs are characterized by effective communication, trust, respect, collaboration, information-sharing, and conflict resolution and are more efficient than individual providers working alone. Internally, IPT members’ relationships and understanding of both one’s own professional identity and others’ role and responsibilities are crucial to team functionality and effectiveness. Externally, factors including regulatory practice environments might influence the effectiveness and performance of both individual team members and the team overall. Inconsistencies between states’ practice authority (SPA) for advanced practice nurses …

Reducing Polypharmacy, Gladys A. Ndege

Nursing Capstones

No abstract provided.

Meditation On The Soles Of The Feet Practice Provides Some Control Of Aggression For Individuals With Alzheimer’S Disease, Nirbhay N. Singh, Giulio E. Lancioni, Oleg N. Medvedev, Rachel E. Myers

Faculty and Research Publications

Alzheimer’s disease is a progressive neurodegenerative condition that affects cognition, mental and physical health, and functionality of older people. As the disease progresses from the mild to moderate stage, there is a concomitant increase in several behavioral variables, chiefly agitation, anger, and aggression. Currently, there are no evidence-based treatments for these behaviors in this population. Three individuals with moderate Alzheimer’s disease were taught an informal mindfulness practice, meditation on the Soles of the Feet (SoF), as a self-management strategy within a multiple-baseline design across participants. All three were able to learn and use the SoF practice to manage their verbal …

Evaluation Of The New Onset Diabetic Education Program For Navajo Adults, Denise S. Bartley

Nursing ETDs

The prevalence of diabetes mellitus (DM) is higher in American Indians/Alaska Natives (AI/AN) than in any other racial or ethnic group in the United States (U.S. Department of Health and Human Services [USDHHS] Centers for Disease Control and Prevention [CDC], 2018). In response to this escalating health issue, the U.S. government funded a number of DM education and treatment programs focusing on AI/AN populations. The purpose of this study was to evaluate the New Onset Diabetes Education Program (NODEP) based at Northern Navajo Medical Center (NNMC) in Shiprock, N.M.

The Navajo philosophy of learning was used as a guiding framework. …

Nurse Practitioner Knowledge, Attitudes, And Beliefs When Caring For Transgender People, Catherine Paradiso, Robin M. Lally

Publications and Research

Purpose: The aim of this study was to explore Nurse Practitioner (NP) knowledge, attitudes, and beliefs when working with transgender people and to inform about Practitioner education needs.

Methods: A qualitative descriptive design was used to explore (NP) experiences. Focused semistructured interviews were conducted in 2016 with 11 (N = 11) NPs in the northeastern United States who represent various years of experience and encounters with transgender patients. The interviews explored NP knowledge attitudes and beliefs when caring for transgender patients and described their overall experiences in rendering care in the clinical setting. The interviews were professionally transcribed and analyzed …

Treatment Challenges Of Delusional Disorders, Amanda Mikhaeil

Nursing Capstones

No abstract provided.

Precision Of Provider Licensure Data For Mapping Member Accessibility To Medicaid Managed Care Provider Networks, Nathaniel Bell, Ana Lòpez-Defede, Rebecca Wilkerson, Kathy Mayfield-Smith

Faculty Publications

BACKGROUND:

In July 2018, the Centers for Medicare and Medicaid Services (CMS) updated its Medicaid Managed Care (MMC) regulations that govern network and access standards for enrollees. There have been few published studies of whether there is accurate geographic information on primary care providers to monitor network adequacy.

METHODS:

We analyzed a sample of nurse practitioner (NP) and physician address data registered in the state labor, licensing, and regulation (LLR) boards and the National Provider Index (NPI) using employment location data contained in the patient-centered medical home (PCMH) data file. Our main outcome measures were address discordance (%) at the …

The Role Of Interest Groups In Shaping U.S. Governmental Responses To Military Sexual Trauma, Patricia Ann Harnois-Church

Nursing ETDs

Military sexual trauma (MST) is a significant problem in U.S. military service branches, service academies, and National Guard units, with both immediate and longer term traumatic effects on survivors who are disproportionately female. MST includes sexual harassment or assault during military service and the ensuing consequences for physical health and psychosocial well-being of service members and veterans. The Department of Defense is committed to reducing the incidence of sexual assault and harassment among service members, encouraging victims to report, and mitigating the impact of MST. However, the estimated prevalence of sexual assault among active duty service members remains unacceptably high, …

Synthetic Cannabinoid-Induced Psychosis, Kenna Kennedy

Nursing Capstones

No abstract provided.

Psychostimulants And Psychosis, Cherri L. Runde

Nursing Capstones

No abstract provided.

The Effectiveness Of Bispectral Index Monitoring On Intraoperative Awareness In Adult Surgical Patients Undergoing General Anesthesia, Eugene D. Lee

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

Intraoperative awareness (IA), or the unexpected and explicit recall by patients of events that occurred intraoperatively, is a rare but serious event. Incidences of IA have been associated with extreme anxiety, physiologic stress, and the development of post-traumatic stress disorder. Anesthesia has debated the efficacy of brain monitoring devices, such as the Bispectral (BIS) index monitor, to reduce the incidence of IA. By analyzing EEG waves, these monitors can be used to alert the anesthesia provider when the patient may not be sufficiently anesthetized. An integrative review was conducted to evaluate the current evidence on the use of BIS monitoring …

Effects Of A Crisis Intervention Team Assessment Center On Emergency Department Length Of Stay, Carlissa Lam

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Introduction: Emergency departments are overburdened with mental health patients who lack adequate access to behavioral health resources. The influx of patients has led to an increased length of stay in the emergency department for patients who are being evaluated for mental health concerns. Overcrowding can lead to delays in treatment, undesirable medical events, and patient mortality. Crisis Intervention Team (CIT) models bring law enforcement, mental health providers, emergency departments, and individuals with mental illness together to improve care for patients in crisis. They have been instrumental in identifying patients in crisis and transporting them to a Crisis Intervention Team Assessment …

An Interdisciplinary Code Sepsis Team To Improve Sepsis Bundle Compliance In The Emergency Department, Jill M. Delawder

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Purpose: Sepsis is one of the leading causes of mortality with over 700,000 hospitalizations and 200,000 deaths annually. Various tools exist to aid in the early identification and treatment of sepsis including electronic alert systems, standardized order sets, nurse-initiated protocols and specialty trained teams. Despite available guidelines, mortality rates for severe sepsis and septic shock are near 50%.

Methods: The aims of this rapid cycle quality improvement project were 1) to develop and implement an interdisciplinary team to address early implementation of evidence-based sepsis bundles in the emergency department and 2) to compare sepsis bundle compliance three months pre-and three …

Improving Lead Screening In A Pediatric Practice: A Quality Improvement Project, Audrey Myers

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract

Background: Detectable lead levels in children’s blood have been associated with increased cognitive difficulties, attention deficits, and poorer academic performance. Children enrolled in Medicaid have higher rates of elevated blood lead levels, yet requirements to test all children at age 1 and 2 who are enrolled in Medicaid are not being met. Nationally, 34% of children enrolled in Medicaid do not undergo proper blood lead level screening. The aim of this project was to increase required blood lead level screening rates for children with Medicaid insurance at a private pediatric practice in the Shenandoah Valley in Virginia.

Methods: The …

Use Of Telemedicine To Improve Cpap Non-Adherence In Patients With Obstructive Sleep Apnea, A Pilot Study, Kristin L. Hanger

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract

The aim of this project is to improve continuous positive airway pressure (CPAP) non-adherence in patients newly diagnosed with obstructive sleep apnea. Obstructive sleep apnea (OSA) is caused by recurrent collapse of the upper airway during sleep. Untreated, OSA is associated with co-morbidity and decreased quality of life. The standard for OSA treatment is CPAP. Adherence to CPAP is not optimal. Applying telemedicine technology to monitor adherence of CPAP treatment, allows for early intervention. Prior research has shown mixed results with use of telemedicine on non-adherence rates.

This is a pilot study using telemedicine to monitor adherence data to …