Medicine and Health Sciences Commons^™

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Development Of A Comprehensive Staff Development Program About Outpatient Diabetes Clinic Care For Patients With Type 1 And Type 2 Diabetes Mellitus, Cynthia G. Sanders

Electronic Theses and Dissertations

The purpose of this DNP project was to evaluate if focused staff education about the many aspects of outpatient diabetes care has the potential to increase knowledge and impact attitudes about diabetes in staff providing care to patients with type 1 and type 2 diabetes mellitus. Diabetes is a disease with wide ranging implications, in terms of cost, consumer health, and quality of life, for populations worldwide, including the United States. It is critical that staff who participate in the care of patients with diabetes mellitus have a role-specific educational foundation to support their contribution to patient care. The researcher …

Pediatric Obesity In Primary Care, Lynne C. Liggins

Electronic Theses and Dissertations

The purpose of this evidence-based quantitative quasi-experimental research was to compare if providing the parents with information on the health risk associated with childhood obesity would cause the parents to make healthier food choices and encourage their children to be involved in a full hour of physical activity a day. Participants included parents and pediatric and adolescent children 5 to 18 years of age at a solo practice primary care office in a large city in Southern, California, which specializes in treating pediatric and adolescent patients. A pre- and postquantitative intervention design were used and analyzed using the paired t …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Cultural Care Needs Of Spanish Speaking Parents With Limited English Proficiency Whose Children Are Hospitalized: An Ethnonursing Study, Jennifer Stephen

Electronic Theses and Dissertations

Purpose: Parents’ inability to speak English proficiently is associated with communication barriers in the care process of their children, social determinants of health, and poor child health outcomes. Research exploring perspectives of Spanish speaking parents with limited English proficiency (SSP-LEP) whose children are hospitalized in the context of culture is lacking in the literature. The purpose of this study was to explore the cultural experiences, values, and beliefs of SSP-LEP, of Mexican origin, whose children were hospitalized and understand nurses’ role in providing culturally congruent care.

Design and Methods: Leininger’s qualitative, ethnonursing method was used for this study. The Theory …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Cultural Beliefs About Healthy And Unhealthy Weight In Children 2 To 11 Years Of Age Among Parents Of Mexican Heritage, Nathalie Confiac

Electronic Theses and Dissertations

Introduction: Despite multisectoral preventive interventions, the obesity prevalence among children of Mexican heritage remains the highest of all ethnic groups in the US. Methodology: Guided by Leininger’s Culture Care Diversity and Universality Theory, this study explored the culture care beliefs and practices of Mexican heritage parents about healthy and unhealthy weight in children 2-11 years of age using the ethnonursing research method. Eight key and 17 general informants were interviewed, and the four phases of ethnonursing data analysis guided analysis. Results: Twenty-six categories were identified which led to seven culture care patterns revealing four themes. Informants shared the …

School Nursing Practice And Experiences During School Closures, Susie E. Birden Brown

Electronic Theses and Dissertations

This evidence-based quality improvement project was to evaluate public school nurses’ relationships and reaction to their new work environment during the closure of schools in Northern California resulting from the COVID-19 pandemic. This project addressed the change in school nursing, especially the nurses’ working environment. A stress management program was offered to the school nurses as an intervention to give them information on perceived stress. The stress management program included mindfulness and stress-relieving techniques over a 1-month period. The research methodology used in the project was a pre- and postintervention using the Perceived Stress Scale-10 (PSS) to measure if the …

Use Of The Cameo Ii Acuity Tool To Decrease Burnout For Nurses Working In A Pediatric Intensive Care Unit, Frances Lynn Feria-Clement

Electronic Theses and Dissertations

The World Health Organization (WHO) reported registered nurse burnout is an occupational hazard resulting in serious consequences for patients, healthcare organizations, and individual registered nurses (Woo et al., 2020). The purpose of this project was to see if the Complexity Assessment and Monitoring to Ensure Optimal Outcomes II (CAMEO II) Acuity Tool, used as an intervention for staffing and scheduling, would have a positive effect against nurse burnout in a pediatric critical care setting in a pediatric medical center. Maslach’s Burnout Inventory- Human Services Survey for Medical Personnel (MBI-HSSMP) was used as a pre- and postsurvey to measure the emotional …

Medical Noncompliance In A Pediatric Patient Living In A Single-Parent Household, Lucy Obianuju Norrell

Electronic Theses and Dissertations

Abstract Noncompliance is a patient’s inability to comply with the recommended treatment for their complete recovery from an ailment, while compliance is the extent to which a patient adheres to the provider’s directive, such as medication and orders given. The purpose of this study was to determine if motivational interviewing when applied to noncompliant pediatric patients from single-parent households, would improve global medical compliance in this population as compared to the standard of care at the end of three months. Thirty-two participants were recruited using the homogeneous purposeful sampling. The project employed a mixed-method approach. Fred Kleinsinger’s noncompliant behavior tool …

Risk Factors Associated With Pressure Injury In Pediatric Congenital Heart Disease Patients, Ashlee Shields

Electronic Theses and Dissertations

Pediatric congenital heart disease (CHD) patients have unique risk factors associated with the pathophysiology of abnormal heart function. This vulnerable population is likely at an increased risk of acquiring a pressure injury during hospitalization. There are limited studies that include congenital heart disease patients and more specifically, factors unique to these patients. The purpose of this study was to identify risk factors associated with development of pressure injury in pediatric CHD patients. This retrospective study used a convenience sample from hospital-acquired data including subjects with congenital heart disease. The results demonstrated an association between pressure injury development and variables both …

Caring For Victims Of Child Maltreatment: Pediatric Nurses’ Moral Distress And Burnout, Angela Karakachian

Electronic Theses and Dissertations

Background: Moral distress is a significant concern for nurses as it can lead to burnout and intentions to leaving the profession. Pediatric nurses encounter stressful and ethically challenging situations when they care for victims of suspected child maltreatment. Data on pediatric nurses’ moral distress in this situation are lacking, as most research in this field has been done in adult inpatient and intensive care units.

Aims: The purpose of this study was to describe pediatric nurses’ moral distress and determine the impact of caring for victims of suspected child maltreatment on nurses’ moral distress, burnout, and intention to leave.

Design …

Exploring Maternal Factors Linked To Weight Status In Salvadorian Infants, Carmen M. Kiraly, Melanie Turk, Melissa Kalarchian, Cheryl Shaffer

Electronic Theses and Dissertations

Background: Obesity rates in the US have risen dramatically, especially among Hispanic adults and children. Because of the high prevalence of overweight and obesity in Latino children by preschool age, it is prudent to examine maternal factors potentially linked to weight status during an infant’s first year of life. The literature on risk factors of child obesity has focused primarily on children of Mexican descent, and little research exists for other Latino populations, such as Salvadorans. Objective: To investigate maternal physiologic and infant feeding factors associated with infant overweight and/or obesity in a sample of Salvadoran mother-infant dyads. Methods: A …

The Effects Of Learning Mindfulness Based Stress Reduction On Psychosocial Variables And Hba1c In Adolescents With Type 1 Diabetes, Denise Van Sant - Smith

Electronic Theses and Dissertations

ABSTRACT

THE PHYSIOLOGICAL AND PSYCHOSOCIAL EFFECTS OF AN ONLINE MINDFULNESS BASED STRESS REDUCTION INTERVENTION ON ADOLESCENTS WITH TYPE 1 DIABETES

By

Denise E. Van Sant – Smith

Date: 4-5-2019

Dissertation Supervised by Linda Goodfellow, PhD, RN, FAAN

Background: Stress has been shown to increase glucose levels through a sympathetic physiological response resulting in a release of chemicals such as adrenalin and cortisol, a response which results in an even greater need for insulin. Adolescents with Type 1 Diabetes may not be able to change or decrease the amount of stress in their lives but they may be able to …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

Perceptions Of Pediatric Nurses And Parents Of Hospitalized Children Engaged In Shared Decision Making., Lisa English Long

Electronic Theses and Dissertations

Achievement of optimal quality in today’s healthcare environment practices means that clinical practices must be based on evidence. Evidence-based practice (EBP) is the integration of research findings, clinician expertise, and patient-centeredness that includes a focus on preferences and values (Melnyk & Fineout-Overholt, 2015). An area within EBP needing increased attention is the aspect of patient preferences and values. The process of Shared Decision Making (SDM) incorporates assessment of preferences and values within a process in which where patients, families and healthcare professionals collaborate to make decisions regarding patient care. The purpose of this study was to describe perceptions of parents …

Parents Of Children Who Had Hypoxic-Ischemic Encephalopathy: A Mixed-Methods, Exploratory Study, Natalene Kramer

Electronic Theses and Dissertations

Background: There is scant literature addressing the parents of children who had hypoxic-ischemic encephalopathy (HIE). therefore only inferences may be made as to issues of that experience affecting parents.

Purpose: The purposes of this study was to uncover the lived experiences of parents of children who had HIE, evaluate issues of stress, depression, coping, and impact of neurologic disability in order to better care for them and thus their families

Methods: A parallel, convergent mixed-methods design was used to explore experiences and perceptions of these parents regarding their experiences and life changes. The quantitative strand addressed four research questions which …

Patients' Perception Of The Use Of Motivational Interviewing For Childhood Obesity Treatment: A Qualitative Study, Penelope L. Neal Dr.

Electronic Theses and Dissertations

The purpose of this qualitative interpretive descriptive study was to better understand children’s perceptions of the use of motivational interviewing (MI) as a communication style for childhood obesity treatment. Childhood obesity in the United States has reached epidemic proportions and much research effort has been dedicated to reversing this trend. One approach that has demonstrated positive outcomes in the clinical setting is MI. Leading organizations in pediatric healthcare now recommend MI as a communication style to be used for childhood obesity-related behavior change. Although empiric studies have demonstrated improvement in outcomes when this communication style is used with patients and …