Medicine and Health Sciences Commons^™

Global Standards And Protocols For Oral Care In Pediatric Cancer Patients: Systematic Review Protocol, Meghna Pandit, Baby S. Nayak, Vasudeva K. Bhat, Suneel C. Mundkur, Judith A. Noronha, Sridhar N

Manipal Journal of Nursing and Health Sciences

Introduction Childhood cancer is a global health challenge, with over 275,000 cases annually among individuals under 19 years. Cancer treatments such as chemotherapy and radiation therapy lead to significant oral complications, including mucositis, xerostomia, and infections, adversely affecting treatment adherence and quality of life. Effective oral care is essential for mitigating these complications, particularly in resource-limited settings like India.

Objectives This systematic review aims to identify, assess, and summarize global guidelines and protocols for oral care in pediatric cancer patients, focusing on the prevention and management of oral complications during treatment.

Methods The protocol adheres to PRISMA-P guidelines and is …

Application Of Transformational Leadership In Nursing-An Integrative Review, Sudha R, Dhanalakshmi R

Manipal Journal of Nursing and Health Sciences

Nurses play a crucial role as leaders in healthcare and have the ability to turn their vision into reality. The different styles of leadership directly or indirectly affect both nursing and patient outcomes. Among these styles, Transformational Leadership (TFL) is the most preferred. Transformational leaders empower individuals to believe in themselves and have been found to have numerous benefits in nursing and other fields. As a result, this study aims to gather evidence for its application in nursing. The study employed an integrative review approach and searched literature from online databases such as PubMed and Google Scholar. Additionally, articles were …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

DNP Qualifying Manuscripts

Introduction: Suicide among adolescents and youth is such a serious issue that immediate, appropriate interventions are needed to reduce rates of suicide ideation and suicide mortality. The increasing rate of suicide among this population profoundly affects families, friends, and the community. Identifying and implementing appropriate interventions in schools could identify individuals who are suffering from mental illness and support suicide prevention.

Aim: The purpose of this integrative literature review was to examine the literature on suicide prevention interventions for young adolescents and teenagers aged 12-17 years old and identify the best, evidence-based practices for the school setting. The aim …

“But The Trauma Did Not Fade Away” Childhood Sexual Abuse, Adolescent Pregnancy, And Rurality, Cynthia H. Mcniss

Electronic Theses and Dissertations

Childhood sexual abuse (CSA) and adolescent pregnancy are critical public health issues that intersect in complex ways, particularly in rural areas. Adolescents who have experienced CSA are at a significantly higher risk of becoming pregnant before the age of 19 compared to their peers without such a history (Madigan et al., 2014). Rurality is also associated with elevated rates of adolescent pregnancy due to various socio-economic and healthcare access challenges ("Rural Health Information Hub," 2024). This study employed a grounded theory approach to develop a comprehensive understanding of the social and psychosocial processes influencing the choices, actions, and decisions of …

Improving The Preparedness And Confidence Of Healthcare Providers In The Detection And Management Of Preeclampsia And Acute Stroke In Perinatal Patients: A Quality Improvement Initiative, Beth Karasin

Seton Hall University Dissertations and Theses (ETDs)

Pregnancy-related stroke (PRS) is a cerebrovascular injury that occurs during and up to six weeks after pregnancy. This includes hemorrhagic and ischemic strokes, however, regardless of the type, strokes in this special population are on the rise and preeclampsia is a major contributing factor. It is paramount for healthcare providers to not only understand the physiologic changes that occur during pregnancy, but also remain aware of the risk factors, symptoms, and currently accepted management of perinatal preeclampsia and strokes. Aware of the missed opportunities at a single center institution this quality initiative aimed to equip healthcare providers with education in …

Minimizing Infant Injury Risk By Utilizing Parental Education In A Primary Care Setting, Courtney Munroe, Erin Kuehl, Rachel Mahlberg

Doctor of Nursing Practice Projects: College of Nursing

Introduction

Accidental injury and death to infants has been correlated to lack of proper education to parents of infants in the primary pediatric care setting. Sudden infant death syndrome (SIDS) and unintentional injuries were the second and third leading causes of post neonatal death during this period of time (Centers for Disease Control and Prevention [CDC], 2016). Studies have found that motor vehicle accidents are a leading cause of child injury and death for infants under 12 months of age. The CDC found that drowning, suffocation, and poisoning were other leading causes that contributed to child injury and death rates …

Understanding Widowhood Cultural Practices, Values, And Beliefs, Of Nigerian American Women: An Ethnonursing Study, Prisca Anuforo

Electronic Theses and Dissertations

Introduction: Many widowhood cultural practices are detrimental to the health and well-being of widows in Nigeria. Little is known about the experiences of widowhood for Nigerian American women, their cultural practices, and how it affects their health.

Purpose: Understand widowhood cultural practices among Nigerian Americans and how these experiences may affect health and wellbeing.

Methods: The qualitative ethnonursing method was used to collect data from 25 Nigerian American widows. Data were analyzed using NVivo qualitative data manager software guided by Leininger’s four phases of qualitative analysis.

Results: Widowhood cultural practices are modified and undertaken to preserve health and honor the …

Implementing A Transition Plan For Adolescents With Adhd Transitioning To Adult Care, Emily Anderson

Seton Hall University Dissertations and Theses (ETDs)

Background: Annually in the United States approximately 750,000 children with special health care needs transition from pediatric to adult health care. Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders and nearly two thirds of children who have symptoms of ADHD in childhood have symptoms that persist to adulthood (Inman et al., 2017). The Child Development Center at a large medical center in northern New Jersey, prior to this project, did not have a transition process or procedure in place to aid providers to successfully prepare adolescent patients with ADHD for transition to adult care. Transition …

Implementing The Morisky Medication Adherence Scale To Improve Medication Adherence In Patients With Hiv And Mental Illness, Kyle Ransom

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this scholarly project was to implement a standardized process for assessing patient medication adherence through the use of a high-quality self-report questionnaire.

BACKGROUND The project was implemented at a federally funded outpatient HIV specialty clinic.

METHODOLOGY Patients seen by the clinic’s psychiatric/mental health nurse practitioners completed the Morisky Medication Adherence Scale during the nurse triage encounter. Patients who scored poorly (below 6) were then referred to the clinic’s interprofessional team (e.g., social workers and pharmacists) to address barriers to medication adherence. Medication adherence was measured using data collected from the on-site pharmacy records in order to …

Promoting Confidence And Evidence-Based Practices For Attention-Deficit/Hyperactivity Disorder Among Integrated Primary Care Providers: A Qualitive Improvement Education Initiative, Omar Samateh, Margaret Emerson, Kayla Meisinger, Taylor Wilson, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Primary Care Providers (PCPs) are seeing growing number of patients presenting for adult attention-deficit/hyperactivity disorder (ADHD) evaluations as a result of social media influences highlighting ADHD. Yet, PCPs report lacking confidence and education with adult ADHD. The purpose of this quality improvement study was to develop educational materials to promote confidence, competence, and adherence to ADHD evidence-based recommendations among integrated care PCPs. Methods: A literature review and retrospective chart review of 19 patients were used to create 1) Baseline ADHD Provider Education (PE) tool, 2) Standardized ADHD Diagnosis (SAD) referral process, 3) ADHD Assessment, Treatment, and Monitoring …

Implementation Strategies To Improve Medication Adherence In Adolescents (Aged 13 To 17 Years) With Antipsychotic Induced Weight Gain: Educational Toolkit For Clinicians, Joy Asike

Doctoral Dissertations and Projects

Nonadherence to medication leads to relapses of condition, frequent hospitalization and poor outcomes. Although antipsychotics are effective in the management of mental disorders and psychosis, the side effects, especially weight gain negatively influence medication compliance. Anti-psychotics related to weight gain is one of the most concerning treatment-emergent side leading to a great burden on patients, parents, and clinicians. Obesity and antipsychotic-related weight gain increase the risks to short- and long-term physical health problems such as metabolic syndrome, dyslipidemia, diabetes, hypertension. Evidence has shown that there is generally low guideline adherence regarding the monitoring of antipsychotics, especially in children and adolescents. …

Implementing A Patient Decision Aid Tool To Improve Knowledge Of Lung Cancer Screening And Lung Cancer Screening Rates In A Primary Care Setting, Emily Evans Brown

Doctoral Dissertations and Projects

It is well known that lung cancer is a devastating disease affecting many individuals in the United States. Through education and early screening efforts, lung cancers can be identified earlier when they can be more easily treated. This evidence-based practice project was developed for the purpose of improving patient and provider knowledge of lung cancer screening and to increase lung cancer screenings in primary care. The evidence-based lung cancer screening educational tool, referred to as a patient decision aid tool, was implemented in a family medicine practice setting over a 10-week period. After the 10-week implementation, there was an increase …

Factors Associated With Cognitive Flexibility In People With Opioid-Use Disorder: A Pilot Study, Paul S. Regier, Thais Costa Macedo De Arruda, Laura Sinko, Anne M. Teitelman, Anna Rose Childress

College of Nursing Faculty Papers & Presentations

The ability to adapt to changing circumstances has strong survival value. Individuals with substance use disorders tend to get "stuck" over-responding to drug-reward signals and pursuing drugs despite negative consequences. A lack of flexibility may be tied to impairments in neurocognition, including learning, memory, and executive function. However, results are often mixed, potentially due to heterogeneity in factors such as mental health, personality traits, or prior adversity. This study aimed to identify which factors influence neurocognitive variations within the opioid use disorder (OUD) population. Based on prior literature, we hypothesized that individuals with OUD would show deficits (vs. controls) in …

Promoting The Use Of Suicide Prevention Mobile Applications Among Clinicians To Reduce Suicide & Suicidal Behaviors In Adults Aged 18-45, Papetua Jepkoech Kimutai

Doctoral Dissertations and Projects

Suicide among adults aged 18-45 has increased significantly and has become a challenge to public health worldwide. The purpose of this scholarly project was to promote the use of suicide prevention mobile applications by clinicians to reduce suicide and suicidal behaviors among adults (18-45 years old). Safety Plan suicide prevention mobile app was used in addition to the standard method of preventing suicide. A quasi-experimental design was conducted to promote a suicide prevention mobile app in clinical practice. The clinician participants included three family nurse practitioners (FNPs) and five psychiatric mental health nurse practitioners (PMHNPs)The data were collected using pre …

Improving Early Detection Of Skin Cancer Through Enhanced Screening Practices, Ashley Cline

Doctoral Dissertations and Projects

With an effort to enhance early detection and intervention, this research investigates the urgent need for better skin cancer screening procedures. Developing and evaluating a multicomponent intervention to improve skin cancer screening and increase skin cancer early detection rates in primary care settings was the purpose of this project. In order to assess the use of improved screening procedures for early skin cancer detection in the primary care setting at the Complete Health organization’s Ormond Beach branch, the evidence-based practice study used a quasi-experimental approach. The project focused on the clinical question of whether implementing enhanced screening practicessuch as patient …

Hormone Therapy Among Women Within A Clinical Setting: Health Literacy And Teach Back Method To Increase Understanding Of Potential Benefits And Risks Of Treatment, Mariah L. Petersen

Doctoral Dissertations and Projects

The purpose of this project was to examine hormonal therapy among women between the ages of 40 and 55 within a clinical setting. This project assessed women’s understanding of hormonal therapy for various treatments as well as the risks. The intervention utilized the teach-back method. The project also included the 10 essential elements the provider needs to be competent in the teach-back method. A pre- and post-test were given to patients to measure improvement of knowledge and understanding. The goal is to improve patients’ understanding of these treatments and to help them ask questions if they do not fully understand …

Tailored Activity Program For Ltc Residents With Dementia, Madison Olds, Rebecca King

Fall 2024 OTD Capstone Symposium

Nursing home residents with dementia diagnoses should have the opportunity to participate fully in community activities and receive the proper assistance and accommodations to do so. This project developed a tailored activity program to promote socialization, occupational justice, and quality of life for residents in an assistive living facility with various diagnoses. This program provides both environmental and activity adaptations to support full engagement for all participants regardless of any preexisting deficits.

An Evidence-Based Preceptor Development Program For Nurse Anesthetists, Raleigh Todd

Doctoral Projects

Abstract

Problem Statement: The success of the student registered nurse anesthetists (SRNA) is heavily influenced by experiences in the clinical setting, often encompassing a variety of preceptors throughout their respective anesthesia programs. Despite the importance of the preceptor role, many preceptors feel unprepared, and it is estimated most certified registered nurse anesthetists (CRNAs) who precept students have received no formal training in the preceptor role.

Purpose: The purpose of this project is to develop and evaluate an evidence-based preceptor education program for CRNA preceptors, utilizing evidence from literature and input from practicing nurse anesthetists. This program helps provide support by …

Increasing Leisure Activity Participation And The Quality Of Life Of People With Dementia And Their Caregivers, Karla Vela, Rebecca King, Keegan Mckay

Fall 2024 OTD Capstone Symposium

The problems associated with the progression of dementia, such as increased stress, and a decrease in engagement in leisure activities and social participation have a negative impact on the patients’ and caregivers’ quality of life. In addition, there is limited research on the long-term impact of occupational therapy leisure activity programs on patients with dementia and their caregivers’ quality of life. A leisure activity program was created for people with dementia and their caregivers to improve their leisure activity engagement and quality of life. Overall, the participant’s and caregivers benefitted from this program and had positive opinions based on the …

A Program To Support Kangaroo Care Of Preterm Infants In The Nicu For The Caregivers, Katherine Blake Carby Cooksey, Mary Jan Greer, Debbie Johnson

Fall 2024 OTD Capstone Symposium

This presentation is about an educational program developed to help educate the caregivers about kangaroo care while their baby is in the neonatal intensive care unit (NICU). This program is to emphasis in the occupations of social interaction and family involvement with kangaroo care. Caregivers/parents are able to learn about the what kangaroo care is, the different type methods of kangaroo care, the benefits of kangaroo care, the importance of kangaroo care while being in the NICU. This program development for the caregivers is able to help with their journaling experience while in the NICU and adjusting kangaroo care into …

Older Adult's Fall Prevention Program, Myles Butler, Rebecca King

Fall 2024 OTD Capstone Symposium

The decline in bodily functions with aging increases older adults' vulnerability to falls, which is a leading cause of death within this population. The poster presents an educational based fall prevention program focused on safety awareness and risk management for older adults. In conclusion, implementing a fall prevention program leads to increased awareness regarding risk factors that are detrimental to the safety and well-being of the older adult community

Reducing Restraints In Adolescent Psychiatric Inpatient Units Through Trauma-Informed Care, Alanna G. Mejia

Doctor of Nursing Practice Final Project Abstract

Purpose: This Doctor of Nursing Practice project explores the impact of implementing trauma-informed care (TIC) training and screening interventions within an inpatient adolescent psychiatric unit. The goal is to reduce physical restraint use and improve patient care by fostering a more compassionate and effective treatment approach.

Background: Adolescents in psychiatric settings often experience restraints, which can cause trauma and harm therapeutic relationships. Implementing TIC strategies equips staff with de-escalation techniques and structured trauma screenings, creating safer environments and improving patient outcomes.

Methodology: The Plan-Do-Study-Act (PDSA) cycle was chosen to guide improvements, aligning with best practices in quality improvement by allowing …

Evaluating Pulmonary Tuberculosis Knowledge Deficits Among Nursing Students In The United States, Jamie Lynn Woo

Nursing | Student Research Posters

The healthcare field consistently faces patients with a wide range of diseases and illnesses. Pulmonary Tuberculosis is an infectious lung disease with established tools to prevent, detect, and treat it. Yet, there has been a significant rise in cases within the past year. Amidst this troubling situation, it is crucial that all healthcare workers, nursing students, and nurses in particular, are properly educated on caring for TB patients. This research proposal aims to determine if there are TB treatment knowledge gaps among nursing students in the United States by conducting a 20-question survey utilizing the Likert Scale. If results show …

Navigating Caregiving: Community Resources And Support Systems For Individuals With Severe Mental Illness Living With Aging Parents, Adam Thai

DNP Qualifying Manuscripts

People with severe mental illness (SMI) who are cared for by aging parents are a growing concern within the community, due to their potential high utilization on healthcare facilities and community infrastructure. Many utilize hospitals and emergency departments to seek behavioral, social, and housing support instead of outpatient behavioral healthcare. There is a disconnect in finding social support that is a result of learned reliance and dependence on their aging parents for financial and caregiving support. Healthcare providers should be mindful of the long-term issues this population faces once they are without parental support, such as increased risks for criminality …

Maternal Adverse Childhood Experiences And Infant Visual-Limbic White Matter Development, Catherine H. Demers, Benjamin L. Hankin, Mercedes Hoeflich Haase, Erin Todd, M. Camille Hoffman, C. Neill Epperson, Martin A. Styner, Elysia Poggi Davis

Psychology: Faculty Scholarship

Background

Maternal adverse childhood experiences (ACEs) are robust predictors of mental health for both the exposed individual and the next generation; however, the pathway through which such intergenerational risk is conferred remains unknown. The current study evaluated the association between maternal ACEs and infant brain development, including an a priori focus on circuits implicated in emotional and sensory processing.

Methods

The sample included 101 mother-infant dyads from a longitudinal study. Maternal ACEs were assessed with the Adverse Childhood Questionnaire dichotomized into low (0 or 1) and high (≥2) groups. White matter microstructure, as indexed by fractional anisotropy (FA), was assessed …

Advanced Practice Clinician Outcomes: Pre/Post Implementation Of An Advanced Practice Clinician Council, Jeannine M. Moss

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Improving access to quality, affordable, and timely healthcare is a national priority. Health systems across the United States are utilizing Advanced Practice Clinicians (APCs) to fill the void in healthcare delivery. As provider shortages continue and the demand for APCs increases, organizations must develop robust structures to support APC engagement, retention, job satisfaction, and professional growth. Currently, 44% of the provider workforce within a large urban health system are APCs, yet despite substantial APC provider labor pool representation, the organization had little infrastructure to support APC professional growth and no mechanism for organizational involvement. This quality improvement (QI) project aimed …

Implementation Of An Advanced Practice Provider Into The Outpatient Neurology Clinic To Improve Access To Care And Medication Compliance, Sean O'Laughlin

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The American Association of Neurology (AAN) recommended that post-stroke and TIA patients receive follow-up care within 2–4 weeks of discharge to reduce complications, improve medication adherence, and decrease readmission rates (2023). However, in 2022, a Central Virginia neurology practice reported an average wait time of 98.66 days for outpatient follow-up appointments, significantly exceeding the AAN recommendation, while medication adherence was only 72.23%, compared to the national average of 80%. Research by the American Academy of Neurology Workforce Task Force (2013) and Woo et al. (2017) highlighted that incorporating advanced practice nurses into outpatient settings could enhance access to care and …

Naloxone Prescribing At Hospital Discharge: A Quality Improvement Initiative, Timothy Ford

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Opioid overdose deaths remain one of the largest public health challenges in the United States. Naloxone allocation is an important tool to help combat opioid overdose deaths. The literature supports that hospitalized patients are generally receptive to receiving naloxone and opioid education and interdisciplinary teams working together can help facilitate identification of high-risk patients for naloxone allocation. This quality improvement change, guided by the IHI Triple Aims and Model for Healthcare Improvement frameworks, sought to increase the rate of patients leaving the Hospital Medicine Service with naloxone. To accomplish this, during the target units’ daily interdisciplinary rounds, providers were prompted …

Implementation Of A Standardized Screening And Referral Process For Social Determinants Of Health For Families With Children Within Two Rural Health Clinics, Laura Britton Stace

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The American Academy of Pediatrics Bright Futures Guidelines recommends social determinants of health (SDOH) screening at well-child checks (WCCs). Social determinants of health are environmental factors, including food accessibility, mental health, and substance use, that can affect quality of life.

Rural health clinics (RHCs) in a county in Virginia did not routinely use a standardized screener to identify pediatric SDOH risks, nor did they have a standardized referral process for identifying SDOH risks. A hospital community needs assessment found that over 20% of the county households were below the federal poverty level. It is estimated that many children in …

Improving Immunization Rates In Children Under Two Years Of Age In Linn County, Kansas Through Nursing Education, Heather L. Webber

Doctor of Nursing Practice Scholarly Project

Immunizations are one of the most beneficial preventive health measures available to children under two years of age. Failing to receive these preventative immunizations during these crucial years could result in the child developing serious diseases that may lead to long term disability or even be fatal. By increasing immunization rates, children will be more protected against common childhood diseases which will allow them to grow and thrive. The purpose of this scholarly project was to identify ways to improve vaccination rates in children under two years of age at specific clinics in Linn County, Kansas, using healthcare professional education. …