Medicine and Health Sciences Commons^™

Transitioning Teens With Diabetes To Adult Healthcare, Rebecca Ann Meyer

Dissertations

Adolescents must enter adult health care services at age 18, yet most are not ready and have not mastered daily self management of their type 1 diabetes. The purpose of this study was to determine the feasibility of a transition planning intervention, focused on educating adolescent/parent dyads about diabetes self management in preparation for the transition from pediatric to adult health care, using a newly developed transition plan and framework. The setting was a diabetes endocrinology clinic where 95% of young type 1 diabetics in the metropolitan area are seen. The intervention included supporting the parent in the relinquishing of …

Using Technology To Improve Diabetes Self-Management Within A Federally Qualified Community Health Center, Lisa Diane Morgan

Doctoral Projects

The Patient Centered Medical Home (PCMH) concept places the patient and family at the center of healthcare. The patient becomes actively involved in their own care. One aspect of PCMH is managing care and increasing chronic disease self-management. Diabetes, a chronic disease, is a leading diagnosis among the patients served by the federally qualified community health center (FQCHC). The prevalence of diabetes in Mississippi in 2012 was 12.3%. The purpose of this DNP Capstone project was to implement a pilot study to increase diabetes self-management knowledge. The program utilized the current technology of text messaging to send biweekly supportive and …

Implementation Of The Transition To Practice Regulatory Model For Nurse Preceptors In A Rural Setting, Donna Renee Honour

Doctoral Projects

Registered nurse turnover is a recurring problem for healthcare organizations. The inability of hospitals to retain registered nurses threatens the adequacy of healthcare delivery and increases personnel and patient care cost. The purpose of this capstone project was to take a leadership role in translating evidence into practice by successfully preparing preceptors to help new graduates transition successfully from the role of student to that of a profession nurse.

Healthcare organizations require a stable, highly proficient and totally engaged nursing staff to provide effective and efficient levels of patient care. The first year of practice for a nurse graduate, the …

A Systematic Approach In Treating Post Concussion Syndrome, Donna Susan Freeborn, Ryan S. Francis

Student Works

Concussions and their associated symptoms are a growing health concern. The CDC reported in 2010 over 2.5 million people visited an emergency room for treatment of concussions and associated injuries: a 70% increase over the past decade.1 As the incidence of concussions continues to grow, Nurse Practitioners (NP) will be involved in the management of their follow-up care. Correctly managing these concussed patients is extremely important because a concussion can cause “... impairment affecting an individual’s memory, behavior, learning, and/or emotions. Appropriate diagnosis, management, and education are critical for helping these patients recover quickly and fully .” 2 The purpose …

Follow Up: Promoting Self-Management Through Adherence Among Heart Failure Patients Discharged From Rural Hospitals: A Study Protocol., Lufei Young, Sue Barnason, Van Do

Journal Articles: College of Nursing

UNLABELLED: Background Heart failure is one of the most prevalent chronic conditions in adults, leading to prolonged morbidity, repeated hospitalizations, and placing tremendous economic burden on the healthcare system. Heart failure patients discharged from rural hospitals, or primarily critical access hospitals, have higher 30-day readmission and mortality rates compared to patients discharged from urban hospitals. Self-management improves heart failure patients' health outcomes and reduces re-hospitalizations, but adherence to self-management guidelines is low. We propose a home based post-acute care service managed by advanced practice nurses to enhance patient activation and lead to the improvement of self-management adherence in heart failure …

Transitional Care Of Adult Patients With Diabetes Following Hospitalizations, Eric Tobin

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project was to incorporate a diabetes transitional care program using group visits to improve self-care management behaviors and glycemic control in diabetic patients at a southern California hospital.

Background: Diabetes is a challenging healthcare problem associated with significant mortality and morbidity issues. In 2012, 29.1 million people, or 9.3% of the U.S. population, were diagnosed with diabetes, and 28.9 million of those patients were 20 years of age and older. Today, diabetes is of epidemic proportion worldwide, and a projection of 5.4% of the adult population will have diabetes by 2025. The …

The Effect Of An Educational Intervention On Knowledge And Intent To Participate In Cervical Cancer Screening, Ann Marie Trapp

Evidence-Based Practice Project Reports

Globally, cervical cancer ranks third among cancers affecting women (Arbyn et al., 2013). In the United States, approximately 12,000 women are diagnosed with cervical cancer and approximately 4,000 women die yearly (Centers for Disease Control and Prevention, 2014). Papanicolaou (Pap) screening is an effective means of detecting precancerous cell changes of the cervix with early cervical cancer diagnosis carrying a 91% five-year survival rate (Gonzalez et al., 2012). The purpose of this evidence-based practice project was to identify interventions that increase adherence to cervical cancer screening and to implement best practices to reduce unnecessary deaths related to late diagnoses of …

Using Education And A Prevention Protocol Tool To Decrease The Incidence Of Pressure Ulcers In A Nursing Home, Kristina L. Scalzitti

Evidence-Based Practice Project Reports

Over 1.3 million persons are residents in nursing homes (NHs); one in ten have pressure ulcers. The purpose of this evidence based practice project was to determine if implementation of a pressure ulcer prevention tool, along with staff education, decreases the incidence of pressure ulcers within the NH. Florence Nightingale’s Environmental Model and the Stetler Model were used to guide this project. The setting was a NH in northwest Indiana. Eleven nurses attended a 15 minute educational session on pressure ulcer prevention and implementation of the Pressure Ulcer Prevention Protocol Intervention (PUPPI) tool. PowerPoint slides were distributed and flyers about …

Effects Of Multimodal Fever Education On Parents Of Febrile Children, Teresa S. Parkhouse

Evidence-Based Practice Project Reports

Insufficient knowledge regarding the physiology and appropriate management of fever in children often contributes to an increased parental anxiety, inappropriate antipyretic use, and overutilization of medical resources (Chang, Liu, & Huang, 2013; Crocetti, Moghbeli, & Serwint, 2001; Schmitt, 1980). Parental concerns regarding childhood fever can lead to an overuse of health care resources as febrile illness in children accounts for approximately 20% of emergency department visits, 30% of office visits, and over 50% of after-hour phone calls to private physicians (Zomorrodi & Attia, 2008). Research shows that multidimensional educational interventions are most effective in improving parental management of fever (Young …

Diabetes Type 2 Self-Management Education Program: Short Messaging From Patient Portal To Web-Enabled Device, Lynn S. Holcomb

Evidence-Based Practice Project Reports

Only one in eight adults with diabetes reaches target goals for disease management, which can lead to clinical complications, costly both economically and in quality and duration of human life. The standard of care is a quarterly 15-minute face-to-face visit-- arguably inadequate to impart self-care knowledge. The purpose of this EBP project was to deliver a 30-day diabetes self-management education program (DSMEP) utilizing widely accessible web-based technology to facilitate adults with diabetes to reach targeted goals. Using the Chronic Care Model as a framework, the DSMEP design was based on an extensive literature review of the delivery of DSMEP in …

The Effects Of Implementing Best Practices On 30-Day Readmission Rates In Adults Following Cabg Surgery, Linda Elaine Kline

Evidence-Based Practice Project Reports

Coronary artery bypass graft (CABG) surgery is one of the most frequent and expensive cardiac surgical procedures in the U.S. today. Complications from CABG surgery are one of the top causes of 30-day hospital readmissions. Readmissions after CABG surgery are often preventable and add to health care costs. Recent government legislation mandates penalties for hospitals with excess readmission rates. The purpose of this evidence-based practice project was to determine if implementation of best practice recommendations effected 30-day readmission rates following CABG surgery. A critical appraisal of the literature was conducted to identify best practice recommendations. The Iowa model and Lewin’s …

The Effect Of An Educational Intervention On Oral Anticoagulation Therapy Knowledge In Primary Care, Elizabeth D. Deck

Evidence-Based Practice Project Reports

It is estimated that three million people in the United States are on oral anticoagulation therapy (warfarin). Populations studied have been found in therapeutic range 64% of the time (Pernod, Labarere, & Bosson, 2008). The low percentage of therapeutic range is attributable to (a) adherence, (b) monitoring infrequency, (c) Vitamin K antagonists, and (d) the effects of aging and comorbidities. The purpose of this evidence-based practice (EBP) project was to examine whether an educational intervention would improve the knowledge of patients receiving warfarin therapy. Roy’s model for patient adaptation and the Stetler Model for EBP were used as frameworks for …

Illness Beliefs And Adherence Among Louisiana Adults With Type 2 Diabetes, Denise L. Stagg

Nursing Theses and Dissertations

Type 2 diabetes mellitus (T2DM) is having an enormous impact on the health of the nation. New cases of diabetes are diagnosed yearly across all states. Currently, 9.3% of the population has diabetes (Centers for Disease Control and Prevention {CDC}, 2014). While the prevalence of this disease is nationwide, it is not evenly distributed. Louisiana currently has a rate of 11.5%, with some parishes having rates of 14.5% (CDC, 2014). This rate places increased demands on healthcare and financial systems in Louisiana. Cultural elements and population distribution may be parts of this phenomenon. While many studies explored new medications and …

Use Of Immunotherapy In The Treatment Of Peanut Allergies In The Pediatric Population, Bethany Rauscher

Senior Honors Theses

Peanut allergies are a serious issue that must be monitored and treated effectively to avoid severe adverse effects and death. In the last decade, their incidence has increased significantly, due to indeterminate factors. Because people typically do not outgrow peanut allergies and the effects of exposure can be life-threatening, it is important that a cure or management method is developed and refined. Recent research regarding treatment for peanut allergies has focused on the use of immunotherapy, a process aimed at desensitizing children's immune systems so that they do not reject foods that contain peanuts. Some studies utilizing immunotherapy have provided …

New Edition Of Top Nursing Book Released, University Communications, Illinois Wesleyan University

News and Events (Discontinued Series)

No abstract provided.

Advocacy: A Vital Step In Attaining Full Practice Authority For The Advanced Practice Registered Nurse, Mandi Cafasso

Doctor of Nursing Practice Scholarly Projects

Problem Statement

Recent passage of the Affordable Care Act has made the imminent concern of poor patient/provider ratios a reality. Unfortunately, despite increasing numbers of advanced practice registered nurses graduating annually, the access to healthcare issue continues. Advanced practice registered nurses (APRNs) are limited in the care they can provide as a result of Ohio law.

The Ohio Nurse Practice Act requires APRNs to work in a collaborative relationship with a physician and also requires that prescribing practices be guided by an inclusionary formulary (Nurse Practice Act, 2014). Thus, APRNs in Ohio cannot practice to their fullest scope of education …

Development Of A Personalized Education Program Based On An Assessment Of Knowledge Of Coronary Heart Disease And Risk Factors In A Filipino-American Community In New York City, Mervin David

Doctor of Nursing Practice Scholarly Projects

Abstract

Filipino-Americans (FAs) are considered the fastest growing Asian immigrant population in the United States. There are about 2.6 million Filipino-Americans living in the United States (U.S. Census, 2010). Coronary Heart Disease (CHD) is the leading cause of death among FAs in the United States (National Vital Statistics, 2009). Research studies on CHD and CHD risk factors among FAs are limited. The purpose of the study was to explore FAs’ knowledge of CHD, risk factors for CHD and to provide a personalized educational intervention in raising awareness and changing attitudes about CHD among FAs aged 35-75 in a community setting …

The Contemporary Use Of Nurse Practitioners In U.S. Emergency Departments, Jeffrey L. Bevan

Doctor of Nursing Practice Scholarly Projects

Problem: The increased demand for emergency care in the United States (U.S.) has been well-documented and there is growing utilization of nurse practitioners in U.S. emergency departments. However, little is known about the nurse practitioner (NP) role in the emergency department setting within the past five years.

Purpose: The purpose of this project was to describe the demographic characteristics of patients, patient conditions treated, diagnostic tests ordered, and procedures performed by nurse practitioners in a national sample of U.S. emergency departments.

Methodology: This secondary analysis used a non-experimental quantitative, descriptive exploratory design to review data from the National Hospital Ambulatory …

Implementation Of Educational Program For Nurses To Improve Knowledge And Use Of Discharge Planning Best Practices, Eric C. Snyder

Doctor of Nursing Practice Scholarly Projects

Abstract

Problem Statement: The frequency and severity of hospital post-discharge events has become a national problem. The increase in readmission rates post-discharge has a negative impact on the patients overall morbidity and increases healthcare costs (Jack, 2012). Non-comprehensive discharge planning contributes to post-discharge events such as less than 30-day readmissions (Jack, 2012). Best practices for discharge planning should be utilized.

Purpose: The purpose of this project was to evaluate the impact of Project Re-engineering Discharge (RED) education to increase nurses' knowledge and use of best practices on discharge planning. An adapted Project RED educational intervention, using Knowles' adult learning …

Promoting Oral Health Knowledge In African American College Students, Terri Huff-Simmons

Doctor of Nursing Practice Scholarly Projects

Objective. The primary aim was to assess African American college student's knowledge of oral health and healthcare access.

Methods. The project was a quantitative descriptive study using a pre and posttest design. A pre questionnaire containing items regarding oral hygiene and oral health based on the recommendations of the American Dental Association (ADA) as well as questions about access to oral healthcare was distributed to African American college students to measure their knowledge. A demographic questionnaire was distributed. Students participated in a 20-30 minute oral health educational program. A post-test was given 4-6 weeks after the initial pre-test.

Results. …

Advanced Practice Nurses Knowledge And Use Of Fall Prevention Guidelines, Katherine Hays

Doctor of Nursing Practice Scholarly Projects

Falls are a significant public health issue resulting in a significant economic and social burden on society. Specific strategies are available that can reduce the risk of falling for older adults age 65 and older; however, providers have failed to integrate these guidelines into clinical practice (Rubenstein, Solomon & Roth, 2004; Chou, Tinetti, King, Irwin, & Fortinsky, 2006; Jones, Ghosh, Horn, Smith, & Vogt, 2011). The CDC has published the STEADI toolkit, a healthcare resource for integrating fall prevention guidelines into clinical practice; but little information is available on the knowledge and use of the STEADI toolkit by Advance Practice …

Improving Vaccination Compliance Among Amish Children In Knox County, Ohio, Laura J. Segraves

Doctor of Nursing Practice Scholarly Projects

Abstract

Children living in Amish communities in Ohio are under-immunized and under-immunized communities are reservoirs for preventable childhood diseases. A recent measles outbreak in central Ohio involved 9 counties and 377 cases of this vaccine-preventable disease. There were 5 hospitalizations related to this measles outbreak in Knox County. Vaccine-preventable illnesses contribute to pediatric morbidity and mortality and are cost prohibitive to individuals and society.

The purpose of this study was to identify real and perceived barriers to immunizations among Amish parents in Knox County, Ohio. The information obtained in this study will be disseminated to the Knox County Health Department …

Radon Potential, Geologic Formations, And Lung Cancer Risk, Ellen J. Hahn, Yevgeniya Gokun, William M. Andrews Jr., Bethany L. Overfield, Heather Robertson, Amanda T. Wiggins, Mary Kay Rayens

Nursing Faculty Publications

OBJECTIVE: Exposure to radon is associated with approximately 10% of U.S. lung cancer cases. Geologic rock units have varying concentrations of uranium, producing fluctuating amounts of radon. This exploratory study examined the spatial and statistical associations between radon values and geological formations to illustrate potential population-level lung cancer risk from radon exposure.

METHOD: This was a secondary data analysis of observed radon values collected in 1987 from homes (N = 309) in Kentucky and geologic rock formation data from the Kentucky Geological Survey. Radon value locations were plotted on digital geologic maps using ArcGIS and linked to specific geologic map …

The Effects Of An Evidence-Based Food Allergy Management Plan To Keep Children With Food Allergies Safe At School, Scarlet R. Spain

Evidence-Based Practice Project Reports

The prevalence of food allergies in children has increased 18% between 1997 and 2007 (CDC, 2013). Furthermore, 84% of food allergic children will experience a reaction at school (Powers, Bergren, & Finnegan, 2007). An exposure in a sensitive child may progress quickly into potentially life threatening symptoms and death if not treated. The purpose of this evidence based practice (EBP) project was to determine if implementation of a food allergy management policy in a school setting reduced overall incidence rates of food allergy reactions in school children and to examine compliance to policy guidelines. The project encompassed implementation of a …

The Pupillometer In Practice: Identifying And Overcoming Barriers, Audrey Lee Paulson

Doctoral Projects

Problem: The pupillometer is an assessment tool that provides an accurate assessment of pupil reactivity. It is appropriate for patients who are neurologically impaired due to injury or illness. This tool, available and in use at a local community hospital, has minimal perceived importance in the Neuroscience Intensive Care Unit (NSICU), due to a disconnect experienced by the staff. The hypothesis was that understanding the pupillometer information was insufficient and that improving the knowledge would increase the perception of usefulness. Method: Conduct a survey to determine the cause of the lack of interest and use of the pupillometer. Once the …

Perceptions Of Incivility In Nursing Education: A Survey Of Associate And Baccalaureate Program Nursing Students, Kim Elaine Young Vickous

Dissertations

This study explored differences of nursing students’ perceptions of student and faculty incivility, measured using the Incivility in Nursing Education survey, across semesters and between Associate and Baccalaureate of Science nursing students. A sample of 262 Associate and Baccalaureate of Science nursing program students enrolled in second, third, and fourth semesters from a state university located in the mid-south participated in the study. Descriptive statistics, Analysis of Variance, and Independent t-tests were conducted to examine the research questions. These questions explored what student and faculty behaviors were perceived as uncivil and most frequently occurring (disruptive and threatening) uncivil behavior in …

Chhs May 2015 E-Newsletter,, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Support For Breastfeeding Mothers: Are You Violating The Law?, Phillip Atherton, Christine Buttrick

Nursing Student Publications

On March 23, 2010, President Obama signed the “Break Time for Nursing Mothers” law in the Patient Protection and Affordable Care Act that requires employers to provide an opportunity for nursing mothers to breastfeed while at work. The law necessitates employers give a “reasonable” amount of time and a private space that is not a bathroom for the first year of a new infant’s life. In order to help mothers have access to breastfeeding, awareness of this law must be expanded, and the implementation of lactation programs in every workplace must be enforced so that mothers can continue to breastfeed …

Psychometric Instrumentation: Reliability And Validity Of Instruments Used For Clinical Practice, Evidence-Based Practice Projects And Research Studies, Ann Mayo Rn, Dnsc, Faan

School of Nursing and Health Science: Faculty Scholarship

Clinical Nurse Specialists and other advanced practice nurses (APNs) are relied upon for their expert data based decision-making to ensure excellent clinical practice, high quality evidence-based practice projects, and efficacious research studies. Using measurement instruments to collect data that lack reliability and validity can compromise decisionmaking leading to deleterious results for patients, nurses, and healthcare organizations. The ultimate goal is to choose reliable instruments that produce valid data so that clinical trends, project evaluations, and research findings are trustworthy. Determining the quality of a given instruments is most often done through a critique process. Critiquing potential instruments for use is …

The Use Of Yoga For Chronic Pain Management In The Pediatric Population, Annabeth Huff

HIM 1990-2015

Chronic pain has an adverse impact on the quality of life in children and adolescents. It can impair a child’s physical, psychological, and social functioning, leading to lower satisfaction with life and poor self-image related to health status. Forty-five percent of children experience chronic pain related to either disease processes or idiopathic causes. Not all children who suffer from chronic pain respond to traditional therapies. The purpose of this literature review was evaluation of current research on the use of yoga as an integrative therapy for chronic pain management in the pediatric population. A database search of CINAHL, MEDLINE, and …