Medicine and Health Sciences Commons^™

A Multimodal Smartphone Application Intervention To Achieve Target Weight Goals In Overweight Adult Diabetics, Michael Thomas Schwuchow

Evidence-Based Practice Project Reports

Obesity is the leading risk factor for developing type 2 diabetes mellitus (American Diabetes Association, 2022). Diabetes mellitus (DM) and obesity put individuals at higher risk for developing heart disease, stroke, and hypertension, therefore, it is essential to properly manage both conditions. The purpose of this project is to determine if the implementation of an evidence-based weight loss intervention, MyFitnessPal© will result in reduction in body mass index (BMI) and lower hemoglobin A1c (HbA1c) levels in overweight adults with DM. A comprehensive literature search of six databases, hand searching, and citation chasing yielded 13 pieces of moderate to high quality …

Secondary Data Analysis: Predictors Of Employment Among Young Adults With Cerebral Palsy, Eduardo Santos Del Rosario

Theses & Dissertations

Young adults with cerebral palsy have lower employment rates as compared to young adults in general, as they may be confronted with complex interactions between cognitive delays, physical impairments, activity limitations, participation challenges, and personal and/or societal barriers as they progress to adulthood. These challenges are clear, the solutions, less so. Understanding the predicting factors of employment is vital to future generations of this population. The purpose of this study is to identify predictor variables and examine the relationship of those variables to employment. It has explored existing Rehabilitation Services Administration (RSA-911) data through the lens of the International Classification …

The Effect Of Implementing Behavioral Counseling For Elevated Ldl Levels, Blake L. Hansen

Evidence-Based Practice Project Reports

Hyperlipidemia is a key risk factor in cardiovascular mortality, and is prevalent in approximately 38% of American adults (CDC, 2022b). Cholesterol levels are intensified by unhealthy lifestyle choices, which means a change in lifestyle behaviors could prevent cardiovascular related deaths (WHO, 2022). The PICOT question for this project was: In adults aged 20 years or older in the primary care setting who have elevated low-density lipoprotein (LDL) levels (P), does the implementation of behavioral counseling on lifestyle modifications (I) compared to current practice (C) decrease LDL levels (O) over a 10- to 12- week period (T)? Fourteen participants from a …

Perceptions Of Nursing Staff On Restraint Alternatives, Adelia S. Perea

Doctor of Nursing Practice Scholarly Projects

Physical restraint is often used as a nursing intervention for patients with behavioral issues despite current evidence that indicates their use is actually more harmful than helpful. Nursing staff at UNMH are required by policy to use other methods such as restraint alternatives before placing patients in restraint. However, they do not have the necessary resources or tools to comply with the policy. The NPCU conducted a quality improvement project that introduced 5 restraint alternatives followed by a survey focused on nursing perceptions. The results revealed 2 alternatives (Gamewright GoPOP sensory toy & Playtivity sensory disc) were perceived by nursing …

Implementation Of A Comprehensive Diabetic Foot Care Program In Primary Care, Peguy Sylvain

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Diabetes Mellitus is a growing health problem in America. Uncontrolled diabetes can result in vascularcomplications. One of the most common complications of diabetes is diabetic peripheral neuropathy. Early foot carescreening can help prevent Diabetic peripheral neuropathy and other complications such as skin injuries, burns, falls,infection, lower- extremity amputations, and peripheral arterial disease. Interventions that have been shown to improve theidentification of diabetes foot complications include staff education, screening and assessment, use of monofilament,tuning fork for diabetic foot assessment, patient education/ self-care, standardization, and use of electronic medical records(EMR)/electronic reminders.

METHODS: The Plan Do Study Act method of quality improvement …

Introduction Of Hiv Point-Of-Care Testing In Adolescent Primary Care: A Quality Improvement Project, Jennifer Quinn Belfry

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: HIV, first identified in 1981, remains a persistent public health problem affecting 1.1 million Americans today. Detection is a critical first step to ending the HIV epidemic and the CDC recommends universal HIV screening for all patients 13-64 years of age regardless of risk factors. HIV screening rates are suboptimal especially in adolescent and young adult populations who face unique barriers to screening. The aim of this project was to improve HIV screening rates in adolescent and young adult patients at a large, urban FQHC.

LOCAL PROBLEM: In the state of Rhode Island, 1 in 10 persons living with …

Tele-Sim For Nurse Practitioner Clinical Education: An Online, Real-Time, Educational Innovation Using Simulation And Telehealth For Learning Physical Assessment Skills, Kat Tremblay

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

Background: Increasing numbers of nurse practitioner (NP) educational programs are being offered online, with little or no face-to-face contact among students and instructors. Students express lack of confidence in their physical examination skills and want live instructor demonstrations, observed practice, and real-time feedback from their clinical instructors.

Significance: NP students need to acquire physical examination skills to increase competency in assessing patients for enhanced clinical judgment and improved patient outcomes.

Purpose/Aims: to improve and measure the competency and confidence in the performance of advanced physical assessment skills of NP students in an advanced health assessment (AHA) clinical course with an …

Meditation-Type Exercise For The Management Of Chemotherapy Related Cognitive Impairment In Breast Cancer Patients, Christine Cain

Evidence-Based Practice Project Reports

Chemotherapy-related cognitive impairment (CRCI), or “chemobrain”, is one of the most troublesome side effects of chemotherapy (Dijkshoorn et al., 2020). Ongoing CRCI may negatively affect relationships, confidence, sleep, fatigue, anxiety, and the ability to return to work activities leading to a decreased quality of life (Johns et al., 2016; Gokal et al., 2018). The purpose of this evidence-based practice (EBP) project was to assess the efficiency of a meditation-type exercise intervention, chair yoga, on decreasing perceived cognitive impairment (PCI) in breast cancer patients. The PICOT question for this project was: In breast cancer patients with chemotherapy related cognitive impairment (P), …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

Simulation Scenarios For Nurse Practitioner Educators: A Faculty Guide, Priscilla Simms-Roberson, Amber Roache, Jenny Holcombe, Laurie Allen, Farron Kilburn, Leslie Moro, Megan England, Natalie Owsley

Open Textbooks

Simulation provides a safe environment for students to practice clinical and communication skills needed in advanced practice nursing. Faculty at the University of Tennessee at Chattanooga (UTC) formally incorporated simulation into the nurse practitioner (NP) program curriculum. The UTC NP simulation program was developed utilizing the Healthcare Simulation Standards of Best PracticeTM, Simulation Guidelines and Best Practices for Nurse Practitioner Programs, and the Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP) (International Nursing Association for Clinical Simulation and Learning [INACSL], 2021; Lewis, 2017; Lioce et al., 2020a). The 15 simulation scenarios were developed and integrated into the …

University Campus Breastfeeding, Knowledge, And Perceptions Of Support: An Exploratory Study, Allison L. Scott, Ann W. Lambert, Chih-Hsuan Wang, Kelly V. Johnson, Jessica Weiss, Tony Stankus

The Eleanor Mann School of Nursing Faculty Publications and Presentations

Breastfeeding is often considered principally a biological issue but success is impacted by the socio-ecological environment of the lactating parent. Identifying current attitudes towards breastfeeding is essential in the effort toward normalizing breastfeeding in communities, including university campuses. The study explored campus community knowledge, awareness, and attitudes about breastfeeding, including available resources and applicable laws on two university campuses in the southern United States. This cross-sectional, self-reporting study utilized the Iowa Infant Feeding Attitude Scale and an adaptation of the Breastfeeding Behavior Questionnaire to survey a convenience sample. Results revealed decreased awareness of protective laws, availability of private lactation space, …

Interdisciplinary And Innovative: A Nursing And Computer Science Collaboration To Create A Barcode Medication Administration System, Jodi Lisbeth Berndt, Peter Ohmann, Imad Rahal, Lindsey Hoeschen, Andrew Rothstein

Nursing Faculty Publications

Preventing medication errors remains a priority in nursing education. The implementation of Barcode Medication Administration (BCMA) systems is one strategy that has been used to reduce medication errors. Practice using BCMA in simulated settings may enhance the transfer of these skills to the clinical practice setting. However, the purchase of BCMA educational products available for nursing students can be cost prohibitive for many nursing programs. To overcome the barrier of cost, an interdisciplinary and innovative collaborative approach was used to create a fully functional low-cost BCMA system.

Evaluating Implementation Of Diabetes Screening In Family Practice, Makilah Furlan

Masters Theses/Capstone Projects

Poster presentation on implementing diabetes screening in family medicine practice.

Type 1 Diabetes In The Classroom, Ursula Herrell

Undergraduate Honors Theses

Type 1 diabetes [T1D] is an autoimmune disease that presents in a pathophysiological disorder as insulin deficiency. Managing this illness during childhood is a constant challenge of maintaining blood glucose levels within a healthy range, resulting in increased stress for children and caregivers. School attendance is one factor that may result in increased stress. Studies have highlighted the fact that teachers of students with T1D may receive little education regarding management of the disease and may be required to make accommodations which can result in confusion, miscommunication, and increased psychosocial stress. The goal of this research was to learn about …

School-Based Study To Assess The Nutritional Status (Bmi Based) Of Adolescents Of Gojra City Of District Toba Tek Singh, Punjab, Pakistan, Shagufta Perveen, Rozina Karmaliani, Rubina Barolia, Rozina Mistry

School of Nursing & Midwifery

Adolescence is the make-or-break stage of life. Major physical, mental, and psychological growth takes place at this age. Adequate and balanced nutrition is a vital requirement to support this phase. Adolescents living in developing and low-income countries are more likely to face nutritional challenges. Poor nutritional status during adolescence is an important determinant of health outcomes.
Objective: To analyze the nutritional status (BMI based) of school-going adolescents in Gojra city, Punjab, Pakistan.
Methods: A school-based cross-sectional survey was carried out covering 635 (6-8 grade) school-going adolescents (boys and girls) from public schools in Gojra city. Data were collected through anthropometric …

Factors Affecting The Success And Persistence Of Pre-Nursing Students, Leslie Ann Jennings

Nursing Dissertations - Archive

This article-based dissertation consists of two manuscripts related to factors affecting the success and persistence of pre-nursing students. The first manuscript was a matched cohort study that compared selected academic variables between two groups of pre-nursing students admitted to a pre-licensure baccalaureate nursing program via two different routes. The purpose of this study was to determine if there were any differences in academic performance between these two groups of students in the first semester of a formal nursing program. Analyses of the data revealed a difference in semester grade point average (GPA), but no significant differences in the RN Fundamentals …

Multidisciplinary Teamwork Perceptions When Mobilizing Ventilated Neurosurgery Patients, Adrianna Vinar

Nursing Dissertations - Archive

This two-manuscript dissertation focuses on mobilization in ventilated neurosurgery patients along with the nursing and multidisciplinary perceptions associated with this patient care task. The first manuscript consists of a published comprehensive literature review based on 20 published articles from the years 2010-2020. This review provides background information on the topic of mobility, nursing and provider perceptions, and teamwork for vulnerable critically ill populations including neurosurgery patients on mechanical ventilation. The evident gaps in knowledge based upon these findings and premise for the second article will also be discussed. The second manuscript submitted for publication focuses on a quasi-experimental pilot study …

Optimizing Sepsis Care In A Medical Surgical Telemetry Unit, Rezart Chili

Master's Projects and Capstones

Problem: Sepsis is a potentially fatal condition that must be identified and treated immediately. Sepsis is a significant concern at Hospital X in California, as it is in many healthcare facilities worldwide. Sepsis is a life-threatening condition that occurs when the body's response to infection becomes dysregulated, leading to widespread inflammation and organ dysfunction. At Hospital X, efforts are made to identify and treat sepsis promptly and effectively. The hospital employs various strategies, such as implementing early recognition protocols, educating healthcare providers on sepsis identification, and utilizing evidence-based interventions to improve patient outcomes. By enhancing sepsis awareness, providing timely interventions, …

How Provider Education On Identification And Referral Of Eligible Patients To A Care Management Program Affects Readmission Rates: An Evidence-Based Project, Kosisochi Agube

Doctor of Nursing Practice Projects

Hospital readmissions cost the U.S. healthcare system approximately $17.4 billion each year. Minimizing hospitalizations among Medicare beneficiaries is therefore a high priority. This study aimed to evaluate how identifying patients at high risk of hospital readmission—i.e., patients with complex health needs, such as those with chronic conditions—and referring them to a transitional care program impacts readmission rates in a primary care clinic. The PI hypothesized that identifying high-risk individuals and enrolling them in a care management program to improve their health would lessen their need for inpatient and other high-cost healthcare services.

The PICOT question for this project is as …

Effects Of Reporting Fever Sessions And Caresense On Fever Reporting By Gastrointestinal Cancer Patients Receiving Chemotherapy, Odasy Elejarde

Doctor of Nursing Practice Projects

Patients with cancer who undergo chemotherapy are at risk of immune system compromise. Fever in a patient with cancer who receives chemotherapy can indicate presence of an infection. In patients with a compromised immune system, an infection requires immediate further evaluation and management. Thus, patients receiving chemotherapy must understand when to notify physicians of a fever for prompt evaluation and management.

Purpose. This project aimed to increase the number of fevers gastrointestinal oncology patients receiving chemotherapy reported within 24 hours of detection to MyChart messaging, CareSense, or by calling the physician's office.

Methodology.All gastrointestinal oncology patients who underwent chemotherapy …

Medication Compliance And Decreases In Viral Load Status In Patients With Hiv, Tangela Woodland- Ballard

Doctor of Nursing Practice Projects

Background: The human immunodeficiency virus (HIV) epidemic has been a worldwide challenge for several decades. Proper medication adherence, following the Centers for Disease Control guidelines, has proven effective in decreasing patients’ viral load, thus improving their quality of life, and reducing the spread of the disease. The current literature identifies a lack of knowledge, support, and resources as barriers to medication compliance.

Purpose: To increase medication compliance among persons with HIV.

Methods: This evidence-based practice project utilized the Modified Morisky Scale to help minority HIV patients adhere to strict medication regimens. Repeated measures analysis of variance was conducted to …

Impact Of Teamstepps Training On Teamwork Perception In Two Primary Care Clinics, Brittaney Shaw

Doctor of Nursing Practice Projects

Background: Most healthcare delivery involves teams. After teamwork and communication breakdowns, poor patient care, errors, and inefficiencies follow. Employee engagement surveys from two Galveston County clinics showed concern with teamwork and value. TeamSTEPPS, a team training program, improved attitudes, knowledge, and outcomes, according to the Agency for Healthcare Research and Quality. Purpose: The project examined how TeamSTEPPS training affected healthcare professionals’ and administrative employees at two Galveston County primary care clinics' teamwork perspectives. PICOT Question: Among entire staff in two primary care clinics (P), what is the impact of TeamSTEPPS (I) on improving teamwork perception (O) comparing pre-post TeamSTEPPS Teamwork …

Barriers And Facilitators Of Dairy Consumption Among Individuals With Metabolic Syndrome., Kofi Amoh-Mensah

Electronic Theses and Dissertations

About 35% of the United States adult population meets the criteria for metabolic syndrome, representing about 85 million individuals. Consuming dairy products protects against the development of the metabolic syndrome and protects against the development of complications associated with it. However, approximately 10% of the U.S. population meets the daily recommendation for dairy products. Information about the use of dairy products among people living with metabolic syndrome is relatively unknown, even though it will benefit them the most. About 49% of respondents met the guidance of three servings per day, and the most common facilitator was access to dairy products.

Psychometric Evaluation Of Phq–9 And Gad–7 Among Community Health Volunteers And Nurses/Midwives In Kenya Following A Nation-Wide Telephonic Survey, Sabina Odero, Paul Mwangi, Rachel Odhiambo, Brenda Nzioka, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya.

Methods: Between June and November 2021, a national survey on mental well-being …

Patients With Heart Failure – A Qualitative Study, Elisa St. Clair Stehling

Nursing Dissertations - Archive

PATIENTS WITH HEART FAILURE – A QUALITATIVE STUDY People living with heart failure manage their diagnosis in diverse ways. The lived experiences of qualitative study participants are valuable for helping healthcare providers understand patient perspectives. When interviewed, the themes expressed by people living with heart failure aligned with the resilience theory by Greene (2002). Healthcare providers can use this theory to guide questions when interviewing people with heart failure and designing effective plans of care for this group of patients. Participants with heart failure were recruited for the phenomenological research project using ResearchMatch.org - an online volunteer organization of people …

Work Engagement, Burnout, And Well-Being In Nursing Professional Development Practitioners, Marlene Torres Porter

Nursing Dissertations - Archive

This article-based manuscript dissertation will follow a two-manuscript process. The two manuscripts are related to work engagement, burnout, and well-being in the nursing professional development (NPD) practitioner. The first completed manuscript is a literature review that examines personal resources that affect work engagement, uncovers strategies to improve work engagement, and discusses the implications for the NPD practitioner. Fourteen studies met the inclusion criteria for the literature review identifying self-efficacy, resilience, optimism, meaning, mattering, hardiness, and grit as personal resources influencing work engagement. Strategies identified to improve work engagement included policy development, implementing self-awareness programs, and providing resilience, strengths, and gratitude …

Medication Safety In Community-Dwelling Older Adults, Fatoumata Jallow

Nursing Dissertations - Archive

This article-based thesis comprises two manuscripts on medication safety strategies in community-dwelling older adults. A phenomenological method was used to conduct semi-structured interviews with 28 community-dwelling older adults over 65 years who took five or more prescription medications daily. Caregivers were encouraged to participate in interviews. The objective of the first manuscript was to explore the roles of patients, pharmacists, and providers in medication safety from the perspective of community-dwelling older adults. Inductive thematic analysis revealed six themes indicating varying perceived roles of medication safety by older adults. In addition, results show that the provider and pharmacist roles overlap but …

Tiny Tusks Internship: The Marketing Of Infant Formula, Valeria De La Torre

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Less than half of the world’s infants and young children are breastfed despite the major benefits and recommendations by WHO. Commercial milk formula has been advertised so intensely that it has produced many misleading marketing styles that lead parents to believe commercial milk formula has better benefits than breastmilk. The United States is one of the few countries that have yet to act on WHO’s International Code of Marketing for Breastmilk to decrease the aggressive marketing styles in place. By only placing pictures of happy babies on the formula cans, it leads parents to believe that their baby would be …

Barriers And Facilitators To Anti-Retroviral Therapy Adherence Among Adolescents Aged 10 To 19 Years Living With Hiv In Sub-Saharan Africa: A Mixed-Methods Systematic Review And Meta-Analysis, Londiwe D. Hlophe, Jacques L. Tamuzi, Constance Shumba, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Background: Human Immunodeficiency Virus (HIV) significantly affects adolescents globally, with the sub-Saharan Africa (SSA) reporting a high burden of the disease. HIV testing, treatment, and retention to care are low among adolescents. We conducted a mixed-method systematic review to assess anti-retroviral therapy (ART) adherence; barriers and facilitators to ART adherence and ART outcomes among adolescents living with HIV and on ART in sub-Saharan Africa.

Methods: We conducted searches in four scientific databases for studies conducted between 2010 and March 2022 to identify relevant primary studies. Studies were screened against inclusion criteria and assessed for quality, and data was …