Medicine and Health Sciences Commons^™

Effects And Outcomes Of Different Laboring Positions And The Influence From Societal Norms, Amberlyn Heskett

Nursing | Senior Theses

Background

Within labor and delivery, every birth is different. Alarmingly, the U.S. has the highest maternal mortality rate, including death during labor, among developed countries (World Health Organization, 2022). Many maternal deaths may be preventable.

In the U.S., the use of forceps, vacuum-assisted birth, episiotomies, and emergency C-sections are common for women during childbirth. Even though some laboring positions may assist birthing more than others, there often is resistance to allowing various positions due to outside influences, including societal norms, hospital management, and healthcare professional training. Women in labor are vulnerable and look to their nurses for support during the …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Retrospective Evaluation Of Depression Screening Process Among Older Adult Patients In Primary Care For Quality Improvement., Ashley Dru Larson

Doctor of Nursing Practice Papers

Background: Depression is not a normal process of aging; it is a diagnosable and treatable medical condition. The US Preventive Services Task Force (USPSTF) recommends that older adults be screened for depression annually.

Aim: The purpose of this evidence-based practice (EBP) project was to evaluate the depression screening process for older adults (age 65+) in a primary health care setting and provide recommendations to the primary health care clinic for improving it.

Methods: This EBP project involved collecting retrospective data from August to October 2022, including aggregate data (demographics), from all older adults who were seen in …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

A Single Centre Experience Of Local Perforator Flaps In Oncoplastic Breast Surgery: A Cross-Sectional Study, Sana Zeeshan, Lubna Vohra, Uzma Shamsi, Nida Zahid, Danish Ali, Nargis Asad, Cristina Garusi

Section of General Surgery

Background & objectives: Various oncoplastic techniques have emerged over the years to preserve breast cosmesis and symmetry without compromising the principles of tumor excision. One of the newer techniques for breast volume replacement to achieve symmetry and cosmesis is the use of fasciocutaneous pedicled chest wall perforator flaps or local perforator flaps (LPF). The objectives of this study were to document the details of the surgical procedure as well as patient-reported satisfaction and well-being following the procedure using a validated BREAST-Q tool among Pakistani women.
Materials & methods: This cross-sectional study was conducted from March 2019 to February 2021 enrolling …

Factors Affecting Health-Seeking Behaviour Among Men Who Have Sex With Men In Starehe Sub-County, Nairobi City County, Anthony Omariba

MSc in Advanced Practice Nursing

Men who have sex with other men (MSM) exist in Africa, as they do elsewhere. The continued proscription of MSM behavior leads to exclusion and discrimination. According to a global report, MSMs are responsible for most HIV transmission. MSMs in Kenya constantly fear being hurt because of their sexual orientation, and there is scant knowledge of their health-seeking behavior. There is a need to improve the health of this group to lower disease spread to achieve global HIV reduction. This study aims to explore MSM healthcare-seeking behavior, describe barriers to healthcare-seeking, and establish perceptions of the sexual risks associated with …

Perceived Quality Of Senior Care In An Assisted Living Facility Following The Outbreak Of Covid-19, Kaylie Hill

Theses/Capstones/Creative Projects

The COVID-19 pandemic has posed a monumental obstacle to the healthcare field in terms of severely reducing the number of healthcare workers. Among the many industries affected by staffing shortages are assisted living facilities (ALFs), in which residents are dependent on care staff for daily assistance. This study sought to investigate whether long-term residents of ALFs perceive a difference in the quality of their care under the circumstances of the pandemic as opposed to those of pre-pandemic times. Semi-structured interviews were facilitated with 10 long-term residents who have been residing in an Omaha ALF since prior to the outbreak of …

Optimizing Diabetes Self-Management Using Continuous Glucose Monitoring And Improving The Transition Of Care For Adult Patients Discharged From The Hospital, Nikki Rose Angeles

Doctor of Nursing Practice

Background: Diabetes mellitus is a chronic medical condition that affects more than 34 million Americans (Centers for Disease Control and Prevention, 2020). The financial impact of diabetes is significant. Americans spend $327 billion on direct medical costs to treat the disease and its associated complications (American Diabetes Association, 2018). The management of diabetes requires a multidisciplinary approach that involves healthcare providers, diabetes self-management support resources, and a high level of commitment from the patient. Patients with diabetes discharged from the hospital often receive fragmented and inconsistent information about managing their health issues. As they transition from hospital to home, their …

An Interprofessional Prediabetes And Diabetes Self--Management Education Quality Improvement Project Among Vulnerable Populations At A Tuberculosis Hospital, Robert Saul Castro Natal

Doctor of Nursing Practice

Background. Patients greatly benefit from diabetes self-management education (DSME) as it boosts knowledge and self-efficacy, decreases body weight, fasting blood sugar, and hemoglobin A₁C levels, and improves overall health outcomes in a cost-effective manner. Unfortunately, many individuals with prediabetes and diabetes who qualify for DSMEs do not attend these classes nor receive sufficient prediabetes and diabetes support elsewhere to attain guideline recommended metrics. However, individuals from vulnerable populations and without DSME education experience disproportionate diabetes-related complications worsening health outcomes. Aims: Increase general prediabetes and diabetes knowledge, facilitate behavior change, improve glycemic, metabolic, and lipid values, and increase …

Addressing Obstacles In Following Prescribed Medication Regimens In Patients With Type 2 Diabetes Mellitus, Cristina Sarro

Doctor of Nursing Practice

Background. Type 2 diabetes is the ninth leading cause of death in the United States. Micro/macro vascular complications are common in diabetes. Purpose. To implement an evidence-based protocol addressing obstacles for patients with type 2 diabetes in following their prescribed medication regimens to reduce glycosylated hemoglobin levels. Evidence. Failure to follow treatment plans increases diabetes complications. Perceptions and complexities of treatment plans, side effects of therapies, and cost contribute to patients not taking their medications as prescribed. Goals. To increase the number of patients with type 2 diabetes who follow their prescribed medication regimen and reach their targeted glycosylated hemoglobin. …

Implementing The Depression Screening Tool Phq-9 In The Annual Wellness Exam Of Concierge Family Medicine, Eric Iglesias

Doctor of Nursing Practice

Abstract

Background: Depression has been one of the most common mental health disorders that our population fact but is underdiagnosed and undertreated. Primary care providers are often the first line of defense in detecting depression. Because of this, implementing a depression screening tool in a primary care setting will improve holistic management of care and improve quality of life.

Project Aim: The aim of this project was to increase the number of clients who are evaluated for depression by using the PHQ-9 screening tool during their annual wellness exam and initiate treatment according to the Veteran’s Affairs/Department of Defense Depression …

Patient Care Management Of Hypertension Through Improving Follow-Up And Reducing Missed Appointments In A Primary Care Clinic: A Qi Project, Victoria Idubor

Doctor of Nursing Practice

Background. Missed follow-up appointments constitute significant problems clinics and health centers face nationwide. A significant portion of primary care providers’ patients will require follow-up appointments to manage their chronic illnesses. About 20 to 40% of patients seen at this clinic have a history of hypertension. Uncontrolled hypertension has been shown to increase the risk of certain cardiovascular disease events and mortality. Follow-up appointments are crucial for patients with hypertension to monitor for more life-threatening signs and manage their overall care. Purpose. The purpose of this project is to improve the timely management of care for patients with hypertension …

The Influence Of African American Women's Values And Beliefs On Moderate Intensity Physical Activity: A Qualitative Study, Shannon Whitehead

Nursing Dissertations - Archive

THE INFLUENCE OF AFRICAN AMERICAN WOMEN’S VALUES AND BELIEFS ON MODERATE INTENSITY PHYSICAL ACTIVITY: A QUALITATIVE STUDY Routine participation in moderate intensity physical activity (MIPA) is one of the most important low-cost activities people can do for optimal health (USDHHS, 2018). Yet, for more than four decades, MIPA participation rates for AAW have been among the lowest compared to other races, and consequently, their health has been among the poorest. AAW have higher prevalence rates for obesity, heart disease, stroke, breast cancer, type II diabetes, and associated premature death. Instead of MIPA participation rates improving, they begin to decline in …

How Is Health Seeking Behavior And Patient Outcomes For Latin Immigrants Affected By Language Barriers, Socioeconomic Status And Health Literacy?, Cassandra Sanchez

Nursing | Senior Theses

Background

Language barriers cause a disconnect between patients and health care workers. What further causes a disconnect is when patients have a lower level of education in addition to having a language barrier. I will be focusing on Latin immigrant individuals in the United States for my research. Many Latin immigrant patients may not have gone to school in their native countries, so their education level is lower making it harder to understand discharge information or patient teaching. When patients are unable to have that health literacy it may lead to negative patient outcomes due to not adhering to medication …

Factors Impacting Organ Transplant Outcomes, Katelyn Grubich

Nursing | Senior Theses

Organ transplants are crucial to the survival of those on the receiving end. With medicine advancing, so has transplantation. Health care providers are becoming more aware of the strategies necessary to prolong the transplanted organ and how to obtain better outcomes. Heart, lungs, kidney, liver, pancreas, and some where more than one organ are involved, are the types of organ transplants performed.

Providing patients information will allow them to be a part of their treatment and can help to ease their anxiety knowing what is being performed and what can be expected. Health care providers must ensure that patients and …

Safe Practices For Preventing Covid-19 Among School-Aged Children, Meleena Reyelle Banda-Garcia

Nursing | Senior Theses

Communicable diseases and infections are common health problems among children. Among the most impactful communicable diseases present today is COVID-19, a disease caused by a virus named SARS-CoV-2, which has forced many school closures due to rapid transmission. Despite children not being the main driving factor of the spread of the disease, severe complications underlying COVID-19 incidence have resulted in increased hospitalization among school-age children.The initial global response to the spread of COVID-19 included the closure of school systems; however as the disease continues to be effectively managed, communities are starting to re-open schools partially or entirely nationwide. Although pharmaceutical …

Beyond The Boundaries Of Nursing Care: A Phenomenological Study, Tri Ismu Pujiyanto, Shindi Hapsari, Umi Hani

Jurnal Keperawatan Indonesia

The COVID-19 pandemic created an emergency and challenging situation, especially for nurses, who have experienced feelings including fear and questions concerning their job responsibilities and professional ethics. They needed to maintain safety on the basis of their knowledge and skills. This study aimed to explore nurses’ experiences related to the pandemic. This research was conducted by using qualitative research with a descriptive phenomenological design. The participants were 15 nurses on duty in COVID-19 units at hospitals and who were delivering or had delivered direct care to patients with COVID-19. Data were collected from in-depth interview and analyzed with Colaizzi technique. …

Cluster Analysis Of The Productivity Of Nurses’ Work, Hermansyah Hermansyah, Agung Riyadi, Rina Delfina

Jurnal Keperawatan Indonesia

Productivity is a measure of performance, including effectiveness and efficiency. The importance of work productivity for nurses includes its evaluation role in contributing to continuous improvement. The purpose of this study is to determine the classification of nurses in clusters based on work productivity in the inpatient room. It is an analytic study with a cross-sectional design. The study sample were 130 nurses in the inpatient room at the Bengkulu Provincial Hospital, selected using the proportional random sampling technique. A questionnaire was employed for the data collection. Data analysis was performed univariately, and multivariately with cluster analysis. The study results …

Evaluation Of Human Trafficking Training/Educating Of Nursing Professionals, Emily Morris

Capstone Experience: Master of Public Health

Background: Human trafficking (HT) is a serious public health issue. Victims may present to medical facilities for a variety of health concerns, and therefore, healthcare professionals can identify and provide aid to trafficking victims. However, research shows that providers do not feel adequately trained to identify and support victims. This study evaluates the outcomes of a three hour in-person HT workshop for nurses.

Methods: We administered an online survey with closed- and open-ended questions before and after the workshop to assess improvement in knowledge, health impact, strategies for identification and assessment, and response and follow up of HT.

Results: At …

Association Between Breastfeeding, Oxytocin, And Risk Of Postpartum Hemorrhage, Jordan Davis, Sophia Nelson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Rates of maternal morbidity and mortality are far too high in the United States compared to other developed countries. Additionally, breastfeeding is often poorly prioritized, leading to a negative community connotation and low rates of exclusive breastfeeding. The purpose of this study was to compile the available research on breastfeeding initiation and its association with risk for postpartum hemorrhage. Fifteen peer-reviewed articles were collected from databases and other scholarly articles and screened for correlation between breastfeeding and maternal health risk. Overall, many articles suggest that skin-to-skin contact and early initiation of breastfeeding may be the most effective way to reduce …

Counselors’ Experiences With Infant And Young Child Feeding Tele-Counseling: A Phenomenological Study, Fajar Tri Waluyanti, Yeni Rustina, Hadiyati Fudla, Nani Nurhaeni, Jen-Jiaun Liaw, Insi Farisa Desy Arya, Milawati Milawati, Firda Dewi Yani

Jurnal Keperawatan Indonesia

The global COVID-19 pandemic has influenced the intervention delivery of Indonesia’s stunting reduction program. In this context, e-counseling can be adapted as an innovative approach to deliver interventions. This study aimed to explore counselors’ experiences when conducting tele-counseling. The five participants in this phenomenological study were counselors who had received breastfeeding and infant and young child feeding (IYCF) counseling training and participated in counseling service activities. The participants were selected using a purposive sampling technique. In- depth interviews were conducted with each of the participant until data saturation was reached. Each interview was transcribed and analyzed using thematic analysis method. …

Increasing The Prescribing Of Pre-Exposure Prophylaxis (Prep) With A Pre-Exposure Prophylaxis Screening Tool, Cassey Hall

Student Scholarly Projects

Practice Problem: Human Immunodeficiency Virus (HIV) is one of the leading pandemics in the world. In 2019, 38 million people were living with HIV around the world. Of those, roughly 87% were aware of their HIV status.

PICOT: In patients with high risk for HIV, how does implementing a pre-exposure (PrEP) screening tool compared to randomly screening for pre-exposure prophylaxis (PrEP) affect the prescribing of pre-exposure prophylaxis (PrEP) within eight weeks?

Evidence: In 2015, the World Health Organization (WHO) recommended PrEP for the prevention of HIV in high-risk individuals. The patients include men who have sex with …

Evidence-Based Best Practice For Nursing Skills Competency Assessment: A Policy Development Project For Standard Work Utilizing The Donna Wright Competency Model, Iselda Gentry

Student Scholarly Projects

Practice Problem: Traditional nursing competency assessments use a process-focused approach determined by leaders. A checklist methodology for conducting nursing competencies does not empower nurses to create their own learning experiences.

PICOT: The PICOT question that guided this project was: In an acute care setting (P), how does the development of an evidence-informed policy for competency assessment utilizing the Donna Wright Competency model (I) compared to current competency assessment practices (C), improve the guidance for nurse educators in the development of standard work and communications regarding competency assessment (O)?

Evidence: Studies using the DW Competency Assessment Model have shown that this …

Improving The Perioperative Experience Of Patients And Families In A Pediatric Setting, Anjanette Pong

Student Scholarly Projects

Practice Problem: The experience of surgery for pediatric patients and their families can be dependent on multiple factors including adequate preparation, English language proficiency and realistic expectations. Anxiety can contribute to a negative experience that may result in poor outcomes and a damaging reflection of the healthcare team and organization.

PICOT: The PICOT question that guided this project was: In preoperative pediatric patients and their families, how do therapeutic communication style and the provision of information about the perioperative experience affect their healthcare experience over eight weeks?

Evidence: A multi-modal approach to providing tailored preoperative education for the child and …

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore …

Impact Of Intergenerational Trauma Among Immigrant And Refugee Families: Effects On The Mental Health And Acquisition Of Care, Loralee Chea

Nursing | Senior Theses

Intergenerational trauma is described as a discrete form of trauma that occurs when traumatic effects are passed across generations without the descendants of trauma survivors having exposure to the original event (Isobel et al., 2021). It is a silent suffering experienced among immigrant families from all across the world who have survived war, genocide, displacements, loss, and other psychological trauma. An exploration of literature has also shown that the healthcare crisis from this form of trauma can be identified and intervened with preventative or treatment measures in clinical practice. The purpose of this research paper is to explore the mental …

Rising Costs Of Insulin And Effects Of Self-Management In Type 1 Diabetes, Justine Yadao

Nursing | Senior Theses

Background

Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes is a chronic condition where the pancreas may not be able to produce little to no insulin. This type of diabetes can be attributed to some factors such as age, family history, environmental factors or types of viruses. It is seen more often in children or adolescence but can develop in adults, averaging approximately 5-10% of the population.

Insulin is a type of hormone produced in the pancreas naturally or can be manufactured in the laboratory. People with Type 1 Diabetes need insulin from an exogenous source to …

Preventing Postpartum Complications Using A Home Visitation Model Of Care, Jenna Ingram

Nursing | Senior Theses

Background

The United States is currently facing a health crisis among the maternal postpartum population. As stated by The Commonwealth Fund in a study released in 2020, “In 2018, there were 17 maternal deaths for every 100,000 live births in the U.S. – a ratio more than double of most other high-income countries” (Roosa, 2020). Most often, mothers with uncomplicated pregnancies and births are discharged soon after the delivery of their new baby. In most outpatient settings, providers do not expect a follow up appointment for the mother until roughly three to six weeks after discharge. During this transition period …

Substance Use Among Nurses As A Result Of Covid-19, And The Impact Of Rehabilitative Programs On Nurses, Gerome Macaspac

Nursing | Senior Theses

Background: The incidence of substance use among nurses has been a persistent issue for decades. The effects associated with substance misuse depend on what is used, the amount, how often, and how they are taken. Regardless of the substance used, any nurse who enters the workplace using substances puts the lives of others at risk. Due to the widespread effects of the COVID-19 pandemic, there is a risk that the number of nurses resorting to the use of substances may have increased. Therefore, an investigation into drug use among nurses during the pandemic is particularly important.

Objective: To explore the …

Compassion Fatigue: The Impact On Nurses During The Covid-19 Pandemic, Adrian Huynh

Nursing | Senior Theses

Background

Compassion fatigue comes from the physical, emotional, and psychological impact of helping others through stressful and traumatic experiences. It is a form of fatigue linked to burnout and secondary traumatic stress. Many nurses are vulnerable to compassion fatigue from repeated exposure to the trauma of their patients. While compassion fatigue has been a continuing issue, the COVID-19 pandemic has increased the risk and number of nurses developing compassion fatigue. This can affect patient care, workplace and personal relationships, and lead to development of more serious mental health issues.

Objective

To investigate the effects of compassion fatigue on the registered …