Medicine and Health Sciences Commons^™

Prevention, Recognition, And Treatment Of Pediatric Obesity In The Ambulatory Care Setting, Susan Farrus-Brown

Doctor of Nursing Practice Scholarly Projects

The World Health Organization (WHO) in 1995 described obesity as a chronic disease and one of the most important public health threats and in 2000 reported obesity as a “global epidemic.” The numbers of obese children are increasing in society; moreover, the onset of obesity is occurring at even a younger age than in the past. The prevalence of pediatric obesity is staggering and interventions need to be developed to decrease the risk for chronic and related psychological diseases.

The objective of this project was to provide education on utilization of a tool kit to increase the nurse practitioner (NP) …

Post-Laminectomy Back Pain: Understanding The Progress From Acute To Chronic Pain State, James Derek Calhoun

DNP Projects

In the United States, 74.6% of patients who have lumbar laminectomy surgery have residual low back pain (Hussain & Erdek, 2014) and overall costs of low back pain may reach up to $200 billion per year (Carey & Frebuger 2013). To further address this problem, a study was conducted to determine if treatment in a chronic pain clinic could result in a reduction in the development of a chronic pain state for adult patients who have had lumbar laminectomy surgeries. A convenience sample of 50 patients was selected from the Interventional Pain Associates clinic at the University of Kentucky. Records …

Serum Procalcitonin Levels On Antibiotic Duration & Patient Outcomes In Copd Exacerbations, Monee Carter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Refer to the document.

Reduction Of Unplanned Extubations In The Neonatal Intensive Care Unit, Sharon Fassino

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Unplanned extubations (UE) are a preventable adverse event which occurs when intubated patients have their endotracheal tubes (ETT) accidentally dislodged from their airway. The method of securing the ETT has been identified as the most common reason for unplanned extubations (Veldman et al. , 2006). The purpose of this project was to decrease the rate of UEs in the neonatal intensive care unit from 4.9 UEs per 100 ventilator days to less than two UEs per 100 ventilator days by implementing a standard method of securing the endotracheal tube with a securement device. Methods This was a prospective, controlled research …

Hpv Vaccine Decision-Making In Hispanic And African American Parents: A Secondary Data Analysis, Lavonda Mclennan

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The human papillomavirus (HPV) is the most common sexually transmitted infection (STI) and a highly preventable cause of morbidity and mortality in the United States (U.S.). There are more than 79 million Americans infected with HPV and approximately 14 million newly diagnosed cases ofHPV annually (United States Department of Health & Human Services [DHHS], n.d.). More than 40 strains of HPV can lead to genital warts and various types of cancers, mostly cervical cancer (Centers for Disease Control and Prevention [CDC], 2013a). Although the HPV vaccine can prevent approximately 21,000 HPV related cancers, uptake of the HPV vaccine remains suboptimal. …

What Are The Therapeutic Strategies Used By Mental Health Providers To Create A Therapeutic Alliance And Effective Patient- Provider Relationship For Psychotropic Medication Adherence?, Agnes Okoro

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The annual cost of medication non - adherence problems in United States (U.S.) is approximately $100 billion dollars (Heesch, 2013; Julius, Novitsky, & Dublin, 2009). Mental health providers often encounter psychotropic medication non adherence among incarcerated persons with schizophrenia despite their alliance- enhancing efforts, resulting in increased violence, hospitalization, and an impact on economy. Therapeutic alliance, an effective and collaborative relationship between the health care provider and the patient has a positive association with treatment adherence as supported by the result of many studies (Julius et al., 2009; Kvrgic, Cavelli, Beck, Rusch, & Vaulth, 2013 ; McCabe et al., 2012). …

Policy Analysis: Impact Of Legislative Policy On Infant Mortality, Aimee T. Dunnam

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

This study examined the impact of health policy on infant mortality. Public Use Data Files were used to assess differences in groups before and after the initiation of health policy as law. House Bill 1983 restricted the delivery of infants before 39 weeks gestation when born by elective induction or elective cesarean section. Infants born prematurely are at higher risk for adverse outcomes. A total of 3,078 identified infants were included in the sample. Infants were categorized according to their gestational age of 33-34 weeks, 35-36 weeks, and greater than 37 weeks. Data analyzed showed no statistical significance in the …

Pilot Trial Of An Electronic Family Medical History In Us Faith-Based Communities, Patricia Newcomb, Sharon Canclini, Denise Cauble, Barbara M. Raudonis, Paulette Golden

Nursing Faculty Publications & Presentations - Archive

In spite of the acknowledged importance of collecting family health information, methods of collecting, organizing, and storage of pedigree data are not uniformly utilized in practice, though several electronic tools have been developed for the purpose. Using electronic tools to gather health information may empower individuals to take responsibility in managing their family health history. The purpose of this study was to describe the feasibility and outcomes of introducing small groups to the My Family Health Portrait tool in faith-based communities using faith community nurses (FCNs). This pilot project adopted a mixed methods approach to assess the potential of an …

Cardiovascular Disease Risk Factors Among Emerging Adults In College, Demetrius A. Abshire

Theses and Dissertations--Nursing

The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions of cardiovascular risk among emerging adult men in college; 2) compare differences in unhealthy behaviors and obesity between emerging adults in college living in rural, Appalachian Kentucky and urban Fayette County, Kentucky; and 3) compare measures of general and abdominal obesity in predicting blood pressure among …

The Utility Of The U.S. Diabetes Conversation Map As An Intervention To Promote Diabetes Self-Management Adherence, Lisa Gale Jones

Theses and Dissertations--Nursing

Diabetes has reached epidemic levels, to the currently estimated 29 million individuals who are living with diabetes. Those with diabetes must manage their disease through a combination of medication, physical activity recommendations, and nutritional guidelines. The consequences of non-adherence to recommendations include cardiovascular disease, kidney failure, vision loss, or ultimately, death. Despite the risks of non-adherence, individuals often do not adhere to recommended treatment. Researchers have attempted to identify strategies to promote diabetes self-management adherence, thereby decreasing complications related to the disease.

Specific Aims:

1. describe the factors that prohibit individuals from adhering from diabetes self-management behaviors as well as the …

Developing A Lifestyle Modification Toolkit To Prevent And Manage Hypertension Among African American Women, Julia Ugochi Ugorji

Walden Dissertations and Doctoral Studies

Hypertension is a global public health issue affecting many people in the United States. African American women remain the highest in percentage by race and ethnicity for developing hypertension with poor risk awareness. Hypertension has costly implications for the health care system. Through lifestyle modifications in the form of a nutrition plan called Dietary Approach to Stop Hypertension and increased physical activity, hypertension could be prevented. Among African Americans, the incidence of hypertension increases in their late thirties. The purpose of the project was to develop a toolkit of resources for African American women between the ages of 20 to …

Diminishing Incontinence In Long-Term Care Using Electronic Health Records, Catherine Rodgers

Walden Dissertations and Doctoral Studies

Urinary incontinence affects up to 70% of residents living in a long-term care facility and can affect their quality of life. Specifically, urinary incontinence has a direct impact on older adults in regards to self-esteem, pressure ulcer development, falls, urinary tract infections, and psychosocial wellbeing. The goal of this quality improvement pilot project was to determine if an electronic health record (EHR) assessment tool could help older adults remain continent longer and assist in maintaining an independent lifestyle. Orem's self-care deficit theory and social cognitive theory were used to determine how the electronic health record incontinence template could be used …

African American Race And Culture And Patients' Perceptions Of Diabetes Health Education, Linda Marie Keenan

Walden Dissertations and Doctoral Studies

African Americans diagnosed with diabetes are less likely to self-manage diabetes-specific modifiable risk factors. As a result, utilization of healthcare services occurs at a greater rate than other racial groups, and thereby incurs higher than expected healthcare costs. This ethnographic study explored the elements of diabetes educational material African Americans in a large city in the southern part of the United States found most useful to facilitate self-management of their disease. Bandura's self-efficacy theory provided the theoretical framework. Research questions addressed the preferred educational content, layout of material, and methods for educational delivery and caregiver support. A purposive sample of …

Primary Stroke Prevention: 3-Hydroxy-3-Methyl-Glutaryl-Coenzyme A (Hmg-Coa) Reductase Inhibitor (Statin) Use In The Diabetic Patient, Amy L. Hatcher

DNP Projects

Purpose: The primary objective for this retrospective chart review was to evaluate provider adherence to the 2011 AHA/ASA Primary Stroke Prevention guideline of prescribing a statin to all diabetic patients for primary prevention of stroke, regardless of dyslipidemia. A second aim of this study is to identify provider facilitators and barriers to prescribing a statin therapy for primary prevention.

Methods: Using a retrospective study design, a random sample of 100 medical records of diabetic patients presenting to a university women’s health clinic within the previous year were reviewed for statin use and rationale.

Results: Of the 100 diabetic patients sampled, …

A Developmental Disabilities Program: A Proposed Education Program For Direct Support Professionals, Yurlene Sales Dela Cruz

Walden Dissertations and Doctoral Studies

Nurses can play integral role in collaborating with community leaders and identifying health promotion strategies, such as physical activity and nutrition classes, for people with developmental disabilities (DD). This study identified a role that nurses can establish among Direct Support Professionals (DSPs) who serve important functions in the daily supervision and care of clients with DD. The data reviews from the archival results from Association of Individual Development Health Matters Assessment Reports in August 2012 and September 2013 indicated DSPs' need for further training in their roles as health instructors. The Health Matters Assessment Report in 2012 indicated low scores …

Skin To Skin In The Operating Room For Cesareans, Marietta Sperry

Books, Presentations, Posters, Etc.

Is there a difference in outcomes with both mothers & babies in mothers that deliver by Cesarean Section who experience Skin to Skin Contact (SSC) in the Operating Room (OR) compared to those who do not have SSC after a Cesarean Delivery?

Medical Ethnography--Making Meaning That Matters (What It Is And What It Is Not), Melinda Hermanns

Nursing Faculty Publications and Presentations

A presentation for Southern Nurses Research Society in San Antonio, TX, about Ethnography, what it is, and what it is not.

Changing Places: Adult Children And The Transition Of Aging Parents, Sarah Martin Gilbert

MUSC Theses and Dissertations

Purpose: This dissertation analyzed measurement of relocation transition in older adults, assessed research for the manner in which older adults make the decision to move, and the adult child's role in the transition of their aging parents. Design: Using Hawker, Payne, Kerr, Hardey, & Powell's (2002) mixed research review method, two integrative reviews were conducted. The first examined how relocation transition is measured in the literature while the second applied the Theory of Planned Behavior (Ajzen, 1985) to determine the behavioral beliefs, subjective norms, and perceived behavioral control of older adults as they contemplate a relocation from independent living to …

Noongar Women's Birth Experience, Judith Pamela Wilson

Theses

This qualitative study used a descriptive interpretive approach that drew heavily on the methodological underpinnings of interpretive phenomenology in order to explore the lived experience of Noongar women in childbirth. The aim of the study was to give voice to Noongar women, who despite having poorer outcomes than the wider population, remain marginalised and mute in childbirth reform. The purpose of the study was to acknowledge as authoritative, Noongar women’s wisdom and understanding of their childbirth experience.

This study was conducted at the cultural interface, by a non-Indigenous researcher who implemented a collaborative and power sharing model of enquiry. Ten …

Alcohol Use, Misuse, And Abuse Among Nursing Students: A Photovoice Study, Julie Mcculloh Nair

MUSC Theses and Dissertations

Existing knowledge about alcohol misuse and abuse and nursing students is founded upon studies conducted primarily in the 1980's and 1990's, thus raising questions as to its relevance in 2014. The patterns of alcohol use and other substances over the past 30 years by students raise several questions concerning this phenomenon, which needs further explanation beyond just the high stress and demands of nursing education. The literature was examined first to identify existing knowledge on alcohol misuse and abuse among nursing students. From this review, we concluded that policy plays a vital role in this issue. Therefore, we next reviewed …

Home Health Nurses' Knowledge And Beliefs Of Suffering, Artificial Nutrition And Hydration In People With Late Stage Dementia, Lenora Ward Smith

MUSC Theses and Dissertations

Purpose: This dissertation examined the concept and dimensions of suffering in individuals with late stage dementia and the knowledge and perceptions of home health nurses with regard to artificial nutrition and hydration and suffering in individuals with late stage dementia. Design: Using Caron and Bowers' method of dimensional analysis, the concept of suffering in people with late stage dementia was examined. A pilot study was conducted on home health nurses in Western North Carolina to test the reliability of the instrument used in the study, and a mixed methods exploratory study was conducted to measure home health nurses' knowledge and …

Exploring Self-Efficacy In The Current Era Of Type 1 Diabetes Management In Youth, Lisa Ellen Rasbach

MUSC Theses and Dissertations

Type 1 diabetes is a chronic incurable autoimmune disease characterized by dysregulated carbohydrate metabolism. Nearly 3 million individuals in the United States with type 1 diabetes are challenged to meticulous self-management to avoid diabetes-related complications. Self-efficacy is an important construct associated with health behavior change that may be relevant for adherence to diabetes self-management tasks involving diabetes technologies, such as continuous glucose monitoring (CGM). Yet, there is a fundamental gap in understanding how self-efficacy relates to CGM use in youth with type 1 diabetes. This dissertation focuses on the behavior of CGM use in youth with type 1 diabetes as …

Childhood Obesity In Asia: The Value Of Accurate Body Composition Methodology, Andrew P. Hills, Najat Mokhtar, Sharon Brownie, Nuala M. Byrne

School of Nursing & Midwifery, East Africa

Childhood obesity, a significant global public health problem, affects an increasing number of low- and middle-income countries, including in Asia. The obesity epidemic has been fuelled by the rapid nutrition and physical activity transition with the availability of more energy-dense nutrient-poor foods and lifestyles of many children dominated by physical inactivity. During the growing years the pace and quality of grow this best quantified by a combination of anthropometric and body composition measures. However, where normative data are available, this has typically been collected on Caucasian children. To better define and characterise overweight and obesity in Asian children, and to …

A Single Competency-Based Education And Training And Competency-Based Career Framework For The Australian Health Workforce: Discussing The Potential Value Add, Sharon Brownie, Janelle Thomas

School of Nursing & Midwifery, East Africa

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation …

Efficacy Of Bydureon In Adults With Type 2 Diabetes, Katie L. Fetter

UNF Graduate Theses and Dissertations

Type 2 diabetes is still rapidly on the rise today, affecting 10.5% of individuals in the United States between the ages 45 to 64 and 18.4% of those between the ages of 65 to 74. In the past two decades, type 2 diabetes has doubled in all age groups. Many adults with type 2 diabetes experience difficulty managing their blood sugars, which can result in a range of further complications. One of the newest treatment options on the market today is a glucagon-like peptide-1 (GLP-1) receptor agonist, Bydureon. Similar to Byetta, Bydureon has a main ingredient of exenatide. It offers …

Quality Improvement Measures For Cervical Screening Guidelines In A Clinic For Uninsured Adults, Julie Ann Baker-Townsend

UNF Graduate Theses and Dissertations

Cervical cancer, a completely curable disease with early detection and management, is an international concern. Early identification allows for treatment of the disease, which prevents or slows progression, ultimately reducing morbidity and mortality. Due to the regressive nature of most cervical lesions, the duration between cervical cytology has been lengthened to prevent over diagnosis and treatment. This was reflected in the 2012 United States Preventative Services Task Force (USPSTF) clinical practice guideline for cervical cancer screening.

The purpose of this project was to determine the effectiveness of a quality improvement initiative to increase adherence to the 2012 USPSTF guideline at …

Novel Oral Anticoagulants: Bedrest And Bleeding In Patients Undergoing Atrial Fibrillation Catheter Ablation, Lynn Mcwhirter

UNF Graduate Theses and Dissertations

Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and …

Improving Anesthesia Professional Adherence To Hand Hygiene, Martha E. Seneca

UNF Graduate Theses and Dissertations

Performance of hand hygiene is among the most effective means of preventing healthcare associated infections (HAI) among patients. Deaths resulting from HAIs are one of the top ten leading causes of death in the United States. Any improvement in the frequency of hand hygiene among healthcare professionals may have a direct impact on patient mortality and associated costs. While anesthesia professionals have been found to have low rates of hand hygiene adherence, few targeted studies seeking to improve hand hygiene adherence among this group exist. Studies conducted to improve hand hygiene among health care professionals have reported limited improvement, with …

Anesthesia Safety: Filter Needle Use With Glass Ampules, Debran L. Harmon

UNF Graduate Theses and Dissertations

Glass particle contamination of medication occurs when opening ampules which may cause patient harm. The use of filter needles reduces this risk. Many anesthesia providers use ampules daily, but do not use filter needles when aspirating medications from ampules. In addition, filter needles may not be readily available at the anesthesia medication preparation site. Not using filter needles or having them available for use can increase the risk of patient harm by glass particle contamination. The purpose of this project was to increase anesthesia provider’s knowledge thereby improving compliance with evidence-based standards when preparing medications from ampules. The goal is …

Partnership, Maine Medical Center

Annual Reports

Biennial Report on Nursing, 2013-2014