Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri, Trinette Radasa, Jo Loomis

DNP Qualifying Manuscripts

Background

Those who have ever been affected by an adverse childhood experience (ACE) have a greater likelihood of having poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. The direct relationship is that Latinas therefore have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice students and Community Health Workers (CHWs) of the Central Valley of California …

Registered Nurse-Led Annual Wellness Visits In Rural Health Clinics: A Program Evaluation Of A New Role, Tina Switzer

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

The passage of the Patient Portability and Affordable Care Act had a goal of increasing access for preventive care. The Medicare Annual Wellness Visit (AWV) has been a free yearly, comprehensive preventive care opportunity for most Medicare beneficiaries since 2011. Because of the time intensive nature of these visits, the overall national completion rate for them has been low as providers often perceive time and resource constraints. Registered Nurses (RNs) have the skill set to complete these visits with minimal provider involvement. Rural residents often face health care access barriers and outcome disparities, and Rural Health Clinics (RHCs) are a …

Improving Glycemic Control During The Covid-19 Pandemic: A Quality Improvement Project, Megan Henderson

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

Diabetes is a costly, chronic health condition. The COVID-19 pandemic has significantly impacted the delivery of health care and exacerbated chronic health conditions, such as diabetes. Diabetes is one of the most significant comorbid conditions associated with poor COVID-19 outcomes (Cariou et al., 2020). Control of blood glucose levels during the COVID-19 pandemic has proved challenging to maintain. The purpose of this quality improvement project is to identify gaps in diabetic self-care and then implement a diabetic toolkit to improve self-efficacy of diabetes self-management. According to the American Diabetes Association (2022), self-management of diabetes, education, and support from providers is …

Implementing A Health Services Google Classroom In A High School Setting, Christina M. Wilkinson

Master's Projects and Capstones

Abstract

Problem: The present study investigated the use of Google Classroom and the impact of providing students with basic self-care information on nurse office visit times.

Context: A School nurses are often responsible for multiple schools and a large population of students. These demands pose challenges for school nurses to appropriately serve the student population.

Interventions: Disseminate basic health information on self-care to students via Google Classroom.

Measures: The outcome measure is to make nurse’s office visits less than ten minutes. The data source being chart reviews and the target is 80% of students. The process measure is to increase …

Diabetes Prevention And Management Education For Punjabi-Sikh Older Adults, Mandeep K. Gill

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: South Asians from Bangladesh, Pakistan, and India have a higher prevalence of diabetes than the general global population and are also more susceptible to developing diabetes due to biological and lifestyle factors. The South Asian diet is high in refined grains and monounsaturated fatty acids, increasing the risk of diabetes.

Local Problem: Congregants of a Sikh gurdwara (place of worship) lacked knowledge of diet and lifestyle in relation to preventing and managing diabetes. Many senior congregants have been diagnosed with diabetes or are at high risk of developing the disease.

Methods: Knowledge of diabetes prevention and management were …

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 …

Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard

Master's Projects and Capstones

The COVID-19 pandemic has profoundly impacted the Adult Day Services program and Adult Day programs across the country. As the Adult Day Services program transitions to an in-person format, goals within the organization include developing appropriate programming, increasing group size, and keeping clients entertained. The framework guiding this quality improvement project is Montessori-Based Dementia Programming ® (MBDP). This project aims to increase client engagement, decrease client anxiety, and decrease staff workload. This will be measured by a self-developed staff workload survey, the Menorah-Park Engagement, and the Affect rating scale. Implementation of MBDP at the Adult Day Center did not meet …

The Usability And Feasibility Of A Nursing Evidence-Based Comorbidity Educational Website For An Urban Mental Health Assertive Community Treatment (Act) Program, Andrea Brudigan, Laurie Sewell-Muller, Kokuvi Sena Tsogbevi

Doctor of Nursing Practice Projects: College of Nursing

Objective: Serious mental illness (SMI) causes an increased risk for comorbidities like heart disease, obesity, metabolic syndrome, and diabetes. Many times, these comorbidities are due to side effects of antipsychotics and poor self-management from low insight and other symptoms of mental illness. This project aims to enhance client care enrolled in an Assertive Community Treatment (ACT) program by providing evidence-based resources tailored to clients with SMI, providing ACT team members with support to promote healthy behaviors in clients.

Methods: A website was developed that provides printable, easy-to-read, evidence-based resources that address physical comorbidities. The ACT team integrated these resources into …

Reducing Risk Factors Of Diabetes Mellitus Type Ii Development In Veterans Post Military Discharge Through The Patient Aligned Care Team Model And The Utilization Of Preventive Programs Involving Lifestyle Changes., Jeni Grundy

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes Type II (T2DM) prevalence is rising in America, becoming a focus for disease prevention. The American Diabetes Association (ADA) has highlighted the need to tackle the increased T2DM precursor, prediabetes, which ultimately leads to T2DM if risk factors remain unaddressed. One group of the American population with a high rate of prediabetes is the 9/11 Veteran cohort. The Veterans Affairs (VA) system has numerous health promotion missions. This system has highlighted its initiatives to address the development of T2DM. Specific to the 9/11 group, their primary T2DM contributory risk factor is obesity paired with the low utilization of already …

Improving Nursing Staff Knowledge For Management Of Geriatric Patients With Confusion In The Emergency Department, Kareem G. Carter

Master's Projects and Capstones

Problem: Staff knowledge of effective management of confusion in geriatric patients (>65yo) may be limited and inconsistent with the current goal of establishing a geriatric-friendly Emergency Department (ED) Model of Care. Suboptimal management of this patient population can result in prolonged ED stays, which increases the cost to the hospital and the patient (Han & Wilber, 2013).

Context: An Emergency Department at a large Bay Area urban hospital hopes to obtain Geriatric Emergency Department Accreditation (GEDA) through the American College of Emergency Physicians (ACEP).

Interventions: Create a simplified checklist for nursing staff using mnemonic devices to …

Mentoring Infection Preventionists: An Infection Prevention Practice Fellowship Program, Sejal Naik

DNP Qualifying Manuscripts

Background: The COVID-19 pandemic created enormous demands on infection preventionists (IPs). It seriously taxed IPs and required hiring new IPs to support these demands. It is highly competitive to hire experienced IPs, and it can take up to two years for new IPs to demonstrate proficiency before pursuing their certification. A gap analysis revealed that current infection prevention (IP) programs did not provide formal training or mentoring.

Methods: The fellowship program will use the Association for Professionals in Infection Control and Epidemiology (APIC) competency model to train and build IP competency. The APIC accelerated training program will provide training to …

Increasing The Prescribing Of Pre-Exposure Prophylaxis (Prep) With A Pre-Exposure Prophylaxis Screening Tool, Cassey Hall

Student Scholarly Projects

Practice Problem: Human Immunodeficiency Virus (HIV) is one of the leading pandemics in the world. In 2019, 38 million people were living with HIV around the world. Of those, roughly 87% were aware of their HIV status.

PICOT: In patients with high risk for HIV, how does implementing a pre-exposure (PrEP) screening tool compared to randomly screening for pre-exposure prophylaxis (PrEP) affect the prescribing of pre-exposure prophylaxis (PrEP) within eight weeks?

Evidence: In 2015, the World Health Organization (WHO) recommended PrEP for the prevention of HIV in high-risk individuals. The patients include men who have sex with …

Substance Use Among Nurses As A Result Of Covid-19, And The Impact Of Rehabilitative Programs On Nurses, Gerome Macaspac

Nursing | Senior Theses

Background: The incidence of substance use among nurses has been a persistent issue for decades. The effects associated with substance misuse depend on what is used, the amount, how often, and how they are taken. Regardless of the substance used, any nurse who enters the workplace using substances puts the lives of others at risk. Due to the widespread effects of the COVID-19 pandemic, there is a risk that the number of nurses resorting to the use of substances may have increased. Therefore, an investigation into drug use among nurses during the pandemic is particularly important.

Objective: To explore the …

Safe Practices For Preventing Covid-19 Among School-Aged Children, Meleena Reyelle Banda-Garcia

Nursing | Senior Theses

Communicable diseases and infections are common health problems among children. Among the most impactful communicable diseases present today is COVID-19, a disease caused by a virus named SARS-CoV-2, which has forced many school closures due to rapid transmission. Despite children not being the main driving factor of the spread of the disease, severe complications underlying COVID-19 incidence have resulted in increased hospitalization among school-age children.The initial global response to the spread of COVID-19 included the closure of school systems; however as the disease continues to be effectively managed, communities are starting to re-open schools partially or entirely nationwide. Although pharmaceutical …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Rising Costs Of Insulin And Effects Of Self-Management In Type 1 Diabetes, Justine Yadao

Nursing | Senior Theses

Background

Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes is a chronic condition where the pancreas may not be able to produce little to no insulin. This type of diabetes can be attributed to some factors such as age, family history, environmental factors or types of viruses. It is seen more often in children or adolescence but can develop in adults, averaging approximately 5-10% of the population.

Insulin is a type of hormone produced in the pancreas naturally or can be manufactured in the laboratory. People with Type 1 Diabetes need insulin from an exogenous source to …

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

The Clinical Healthcare Provided To Homeless Communities Across The United States: A Literature Review, Saylor Sisemore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Homelessness has become a global public health concern as it results in poorer physical and mental health than age-matched people living in permanent housing (Ortiz & Roser, 2017). The area that comprises Northwest Arkansas (NWA), like other areas of the United States experiencing rapid growth, has seen a marked increase in the number of people experiencing homelessness in recent years. The homeless population is one of the most vulnerable and underserved groups of individuals in NWA and beyond. Public health nursing as a discipline is dedicated to providing compassionate care and exceptional service for all members of communities, with special …

Pick Your Plate: A Nutrition Education Study, Emmalyn Tucker

Honors College Theses

Childhood obesity has become a cause for concern among many nutrition experts. Childhood obesity can contribute to several health problems such as type 2 diabetes, asthma, high blood pressure. The large percentage of children affected with childhood obesity suggests a lack of essential nutrition education in our country. Junk food consumption and inadequate intake of the USDA’s MyPlate food groups have become essential areas for intervention. Multiple school-based nutrition education interventions have been explored to improve both children’s nutrition knowledge and improve healthy eating behaviors. “Pick Your Plate” is a nutrition education study designed to improve nutrition knowledge regarding junk …

Transient Ischemic Attack And Admission To A Dedicated Unit, Bandi Davini

Student Scholarly Projects

Transient ischemic attacks account for admissions of approximately 70% of patients who present to the emergency department with transient vascular symptoms, with an average length of stay of one to seven days, costing, on average, $22,087 (Qureshi et al., 2013). A hospital organization's bed efficiency directly affects quality metrics. Reducing the length of stay in TIA patients by having them admitted to a dedicated unit with whom the staff has experience managing stroke patients and the understanding of specific criteria needing to be met before discharge can directly impact quality metrics and provide cost-effective delivery of care. The PICOT question …

Telehealth And Hospital Readmissions For Heart Failure Patients: A Literature Review, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Currently heart failure affects over six million people and is expected to increase to over eight million people by 20230. The US Census Bureau estimates over 60 million people live in a rural setting. This literature review seeks to determine the state of the science regarding the utilization of Telehealth to reduce heart failure readmissions in rural areas.

The Role Of Telehealth In Reducing Hospital Readmissions For Heart Failure Patients, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Heart failure affects over six million people annually, and is expected to increase to over eight million by 2030. Over 60 million people live in the rural United States. Telehealth is a tool to improve access to care, provide early intervention, and follow up with patients within 48 hours of a hospital discharge. Utilizing Telehealth to conduct a medication reconciliation within 48 hours of discharge to address any medication errors or admission, and reinforce adherence is a way to improve access to care to those living in rural areas.

Physical Activity, Daily Step Counts And Functional Ability In Older Adults: Using Nhanes Database, Chunfang(Maggie) Chen

Doctoral Dissertations

Maintaining functional ability and independence are essential in the healthcare of older adults. Physical activity(PA) has been acknowledged as effective and economical health promotion strategies in older population. However, the amount of PA needed to maintain functional ability in older adults remains unclear. This investigation used PRISM Dose-response Curves Stimulation Variable slope model to explore the relationships between the amount of PA and functional ability in community-dwelling young-old, middle-old and old-old age group adults. ANOVA analysis was used to examine the relationship between functional ability and self-perceived active level changes compared to 10 years ago. NHANES 2005-2006 older participants datasets …

Connecting And Communicating To Support Youth Mental Health, Michele Davide

Seton Hall University Dissertations and Theses (ETDs)

The nation is experiencing a pediatric mental health crisis amid a shortage of pediatric mental health care providers. The Connecting and Communicating project explores a strategy pediatric primary care practitioners can employ to bridge this gap and maximize their impact on supporting youth mental health in a community.

For this project, a pediatric primary care nurse practitioner created a pilot educational video with the dual purpose of educating parents and school staff on the importance of connecting with adolescents using the proven evidence supported communication technique of validating strong emotions without judgement, and partnering with pediatric health stakeholders by requesting …

Telehealth, During Covid-19 Pandemic Did It Increase Access To Care?, Annette Allegra

Seton Hall University Dissertations and Theses (ETDs)

Abstract

The purpose of this project was to implement an Advance Practice Nurse-led Quality Improvement (QI) initiative to assess telehealth intervention during the Covid-19 pandemic and determine if it increased access to healthcare. This Doctor of Nursing Practice (DNP) project used interventions noted in the literature review to assess effectiveness and acceptance of telehealth use with psychiatric patients to increase access to healthcare in the setting of a medical center. Psychiatric patients often have poor compliance with healthcare visits and treatment due to the challenges of an inability to afford medications, transportation to appointments, poor community support and stigma to …

Improving Patient Outcomes In Substance Use Disorder Through Behavioral Therapy In Depression Development And Impacts Of Social Determinants Of Health During And After Substance Use Treatment, Jerry Ryan Armstrong, Chyanne Napp

Doctoral Projects

Substance Use Disorder (SUD) is a growing problem in the United States (U.S.) and worldwide and relapse is a common occurrence among those facing SUD. Limited scholarly research has been published addressing evidence-based treatment improvement strategies. This study focused on improving SUD treatment through the incorporation of depression tracking from admission to and discharge from inpatient treatment, as well as the incorporation of social determinants of health education during treatment, with an evaluation of relapse rates 30-days after inpatient treatment discharge. Results indicated a significant improvement in depression scores from admission to discharge. Results also revealed improved knowledge regarding social …

Improving Hypertension Self Management In African American Men, Elizabeth C. Felix

Electronic Theses and Dissertations

Hypertension is a cardiopulmonary condition linked to genetic, environmental, and social factors. Left untreated, it can lead to fatal conditions such as heart disease. In the United States, African Americans experience disproportionately high rates of hypertension, earlier onset of symptoms, greater severity, and higher related mortality rates. African Americans also statistically have more difficulty self-managing their hypertension than other demographics. The aim of this project was (a) to identify, define, and measure perceived barriers to self-management of hypertension among African American men and (b) to target these barriers and increase patient engagement through personalized intervention plans. The researcher recruited 24 …

Biomarker, Treatment, And Socio-Demographic Factors Affecting Opioid Use Disorder Treatment Retention, Fernand A. De Los Reyes

Dissertations, Theses, and Capstone Projects

ABSTRACT

Biomarker, Treatment, and Socio-Demographic Factors

Affecting Opioid Use Disorder Treatment Retention

by

Fernand A. De Los Reyes

Advisor: Martha Velasco-Whetsell

Increasing mortality from opioid overdose and low treatment engagement are significant public health concerns. Along with increasing health care and criminal justice enforcement costs, there is an urgent need to study the factors associated with treatment retention in opioid use disorder. The study investigated the relative impact of the biomarker cholesterol on treatment retention in an opioid treatment program (OTP) clinic. Further, it examined the medical comorbidities, treatment, and socio-demographic variables that impact opioid use disorder treatment retention. This …

Is Trauma Informed Care Practiced In Public Std Clinics In New York State, Antonia Brewer

Electronic Theses and Dissertations

Introduction: Sexually transmitted diseases (STDs) are increasing in the United States and often result in long-term adverse health outcomes. New York State (NYS) local health departments (LHDs) provide public STD clinics for high risk populations also found to have high rates of violence. This study examined if/how trauma informed care (TIC) is implemented in these settings. The study sample were LHD STD Program Directors in NYS.

Method: A convergent parallel mixed methods study design was used which included an online survey and follow up interviews. Survey data were analyzed using univariate statistics and conventional content analysis was used to analyze …