Medicine and Health Sciences Commons^™

A Demonstration Project To Address Juvenile Drug Addiction, Mary Ellen Broaddus

Graduate Theses, Dissertations, and Capstones

The rise in adolescent drug use and addiction is becoming a worldwide phenomenon. An eleven year study of youth in European countries found drug use widespread and increasing (Molinaro, Sicilian, & Curzio, 2011). In 2013 there were over 2.8 million new users of illicit drugs, over half of whom were under 18 years of age (‘Drug Facts’, 2015).

Adolescents are at unique risk because biochemical distinctions in their brains, when compared with adults, prompt more risk-taking behaviors (Gallager, 2014). Health risks are considerable and include hypertension, stroke, convulsions and seizures, and liver disease such as cirrhosis and hepatitis. In 2013 …

Reduction In Delayed Patient Care On The Medical-Surgical Unit, Lina Tran

Master's Projects and Capstones

The focus of this project is to improve daily bedside rounds through utilizing the BRT, which could enhance patient safety and satisfaction by reducing delayed patient care on 3 North medical-surgical department at CPMC. The data retrieved from nurses in the past 3 months has shown that 30% of the patients had delayed care due to daily bedside rounds. By utilizing late medication as an indicator, my goal is to observe a reduction in late medication documentation due to daily bedside rounds by 10% by the end of August 2017. CPMC Davies campus adult medical-surgical department holds 44 inpatient beds. …

Pursuing Equity In Diabetes Population, Aisha Rawlinson

Master's Projects and Capstones

Abstract

Background

Poor glycemic control (HbA1c >8) overtime leads to microvascular and macrovascular complications after the first and third years respectively, ultimately resulting in death after five years (Karter, 2016). Current Kaiser Permanente (KP) data stratified by race, ethnicity, age, and gender shows a significant disparity gap between Hispanics/Latino and Caucasian populations. The Pursuing IHI initiative is over a 2-year period completed at a microsystem that is focusing on health equity practices to reduce disparity gaps.

Project aim

KP Riverside, microsystem selected has a large population of Hispanic/Latino KP members, with focus on health equity. The project aim is to …

A Delphi Study: Guidelines For Researchers Working With Teenage Mothers, Alison M. Chamberlain

Nursing Theses and Dissertations

Problem: It is difficult to get teenage mothers to participate in studies, yet some researchers have been successful. Researchers who understand the barriers to conducting studies with a vulnerable population and are guided in ways to overcome these barriers, will experience greater success when doing studies with this group. Improved study methods can lead to larger numbers of teenage mothers who participate in studies. Researchers who follow developmentally appropriate guidelines are more likely to conduct and replicate studies with this population. Access is essential to advance the science related to care for teenage mothers who are at risk for many …

Enhancing The Well-Being Of Older Adults And Young Adults With Developmental Disabilities Through Participation In An Intergenerational Community Garden: Participatory Action Research, Diane L. Keen

Doctorate of Nursing Science Dissertations

The purpose of this Participatory Action Research (PAR) study was to discover ways to enhance well-being in young adults with DD and older adults in the Oak Grove community. This dissertation details how PAR was used in the Oak Grove community to identify ways to enhance purpose and meaningful activity for older adults while developing positive relationships with younger adults with DD through qualitative methods.

Ryff and Keyes (1995) discovered that although some elements of well-being remain stable as a person ages, purpose-in-life drops significantly in older adults. In addition, young adults with developmental disabilities (DD) lack meaningful relationships, which …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

A Healthcare Provider Needs Assessment Regarding Transgender Patient Health For A Student Health Services Center, Dorothy J. Cochran

Dissertations

Objective: This study sought to identify education and training needs of university health service providers regarding transgender patient care. Transgender patients are a vulnerable population who tend to have negative health outcomes. Limited information exists regarding transgender patients and their providers at student university health services nationally.

Methods: The researcher conducted a one hour semi-structured focus group with the professional staff at a Midwestern state university health service. The focus group conversation was guided by a list of prepared questions but other issues were allowed to arise. Two readers qualitatively analyzed the focus group transcripts for predominant themes.

Participants: The …

The Influence Of Psychosocial Factors On Academic Performance Of Adolescents: A Quality Assurance Project, S. A. Gulzar, Tazeen Saeed Ali, Amina Aijaz, Neesha Hussain

Tazeen Ali

Adolescence is a time of rapid psychological and physiological changes and is associated with anxiety and mental distress. This project looks at the potential of school-based programs to reduce these negative effects of academic performance in both the short- and long-term. This study was conducted in a private school in Karachi, Pakistan between October 1998 and December 2006 on 305 students with low academic performance. Results show that students scoring low grades had a mean of 55 + 2.8 and postintervention score of 56 + 2.6. The intervention package significantly created a difference in reducing the number of students receiving …

The Public Health Harms Of Pornography: The Brain, Erectile Dysfunction, And Sexual Violence, John D. Foubert

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Effectiveness Of Co-Payment Policies In The Correctional Healthcare Setting: A Review Of Literature, Andrew L. Glick, Megan Ehret, Valori Banfi, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

Objective: To investigate the effects co-payment policies in the correctional health environment on access and utilization of healthcare services, cost-effectiveness of care, and health outcomes. Methodology: A literature search yielded 97 articles, 15 duplicates were eliminated. Thirty-three additional articles not in peer review journals were eliminated; 40 were eliminated because they did not focus on the research question and four were eliminated because they did not adequately present their data. A decision was made to retain the four quantitative studies in the review, and to utilize the single qualitative study to support conclusions and, or the discussion section. The Reporting …

A Review Of Treatment Programs For Offenders With Co-Occurring Addictive And Mental Disorders: Support For Booster Interventions, Annette T. Maruca, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

Background: Treatment interventions are essential in supporting psychosocial skills, health promotion and successful reintegration to community living for incarcerated persons. Booster interventions are presumed to be important methods for maintaining the effects of treatment effects for persons with addiction and mental disorders, but there has been remarkably little empirical attention to this assumption. Objectives: This review aims are: (1) to describe existing literature on treatment programs for offenders with addiction and mental disorders in the reentry process, and, (2) to add to the literature on this topic by evaluating the impact of booster interventions upon maintenance of treatment effects and …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …

Evaluating An Employee Health Tobacco Cessation Program For Enhanced Success, Leah Griffiths, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Tobacco smoking is the number one cause of preventable death in the US. It increases risk for cardiovascular and respiratory disease, diabetes, and many types of cancer. When contrasted with nonsmoking employees, smokers have a greater amount of lost productivity, as well as cost of health and life insurance claims due to illness. The purpose of this evidence-based project was to identify current smokers and monitor the consistency of their progression through the 5 A’s framework within an employee health clinic. Data was collected over two years and 600 charts were reviewed. After the data was analyzed, it was estimated …

Perceived Barriers To Contraceptive Use: An Exploratory Study Of Women Living In Rural Haiti, Jocelyne De Gouvenain

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Maternal health is defined by the World Health Organization (WHO) as the health of women during pregnancy, childbirth, and the postpartum period (WHO, 2016). Maternal health is a very important determinant of Haiti’s familial, educational, economic, and environmental development. One key to maternal health is family planning which can empower women to fulfill their familial and community roles. Family planning through contraception offers women the opportunity to gain time between child births by deciding when to get pregnant in relation to their other life obligations. Having fewer children and longer spacing between births provides women and children a better quality …

Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano

Doctor of Nursing Practice (DNP) Projects

Background: Healthcare workers are 4 times more likely to be exposed to workplace violence than workers employed in private industry, with assault rates as high as 7.8 per 10,000 workers. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults, and or threats of assault, directed toward persons at work or on duty” (OSHA, 2015, p. 2). Verbal de-escalation techniques that assist with care of the agitated patient are not routinely taught to Family Nurse Practitioners (FNPs) throughout their years of advanced coursework, yet it is something they are likely to encounter …

Promotion Of Advance Care Planning For Individuals Experiencing Homelessness, Sarah A. Hubbell

Doctor of Nursing Practice (DNP) Projects

Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet healthcare needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to discuss end-of-life preferences. A Doctor of Nursing Practice project consisted of designing, implementing, and evaluating an educational intervention in two settings for nurse practitioners and other clinicians on advance care planning with individuals experiencing homelessness. The intervention was associated with increased knowledge and confidence in advance care planning ability. Participants expressed positive intention to change individual practice …

Process Improvement Manual: Front And Back Office, Hafsah Badar

Master's Projects and Capstones

The global aim of this project is to decrease variations and improve efficiency in the tasks assigned to the support staff at an outpatient breast clinic. The breast center has a five-person administrative team who rotate through four positions monthly. The specific aim is by May 1, 2017, 100% of the five employees will have a comprehensive knowledge of their role, and adhere to a standardized way of completing tasks. The CNL Leadership themes used were Educator, Team Leader Manager, and Outcomes Manager. Informative interviews were conducted with the staff to gauge the unique needs of the team. 100% of …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Implementation Of Sbar Reporting In The Ed, William Russel Carpenter

Master's Projects and Capstones

Implementation of SBAR reporting in the ED

Abstract

In our emergency department, reports given to the accepting floor nurse, transfer of care between emergency department nurses and nurses reporting to physicians are given in many different formats with no continuity. It has been reported that 1,744 deaths and $1.7 billion in hospital costs related to miscommunications (CRICO Strategies, 2015). With the implementation of the SBAR reporting tool, we can begin to see a decrease in miscommunications, and improve patient and staff satisfaction. The SBAR framework not only enhances the clarity and efficiency of communication between team members but also assures …

Improving Health Outcomes And Lifestyle Choices In An Underserved Community Through The Implementation Of A Wellness Program, Ekaterini Boutos

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was to implement a wellness program with the purpose of bridging the gap in lifestyle and disease knowledge in a socioeconomically vulnerable mentally ill population. The participants were members of an adult day mental health facility which aided the local underserved population. The wellness program emphasized improving knowledge of chronic health conditions, healthy lifestyle habits and the practice of mindfulness meditation.

Significance: The significance of this project is the advancement of health status via health education from a wellness perspective. Vulnerable populations who are at higher risk of chronic physical and mental illness can …

Text Messaging Appointment Reminders To Increase Patient Appointment Adherence Within A Prevention And Wellness Program, Janel Willingham

Graduate Theses, Dissertations, and Capstones

Abstract

Healthcare organizations want to provide quality care, decrease costs, and promote preventative services for the communities they service. Mobile health units have become an extension of many healthcare organizations and provide different types of services, such as mammography. Providing mammography and wellness exams on a mobile unit presents several challenges; appointment adherence is one of them. Mobile units typically travel to underserved areas to serve people at risk for various health conditions such as breast cancer. Breast cancer is estimated to affect over 250,000 women in the United States during 2017; women have a 1:8 lifetime risk of being …

Effect Of Activity Trackers And Text Messaging On Exercise, Fitness, And Physical Activity Self-Efficacy Of Middle School Students, Alison F. Pittman

Nursing Theses and Dissertations

A decrease in physical activity as children age is a contributing factor to the U.S. obesity epidemic. Middle school children are particularly vulnerable to sedentary activities. Activity trackers show promise as a means to motivate children and adults to increase physical activity (PA). This study examined the effect of a text messaging intervention and use of activity trackers with a companion social website on the body mass index (BMI), body fat percentage, physical fitness, and PA self-efficacy of middle school children. Children aged 11-14 (n=102) were randomly assigned to one of three groups for a 10-week intervention: activity tracker group; …

Influence Of Socioeconomic Status And Family Support On Disability, Depressive Symptoms, And Perceived Poor Health In Older Korean Adults, Insook Lee, Young Ko

Asian/Pacific Island Nursing Journal

This purpose of this study is to identify factors associated with older Korean adults’ disability, depressive symptoms, and perceived poor health, with a focus on their socioeconomic status and family support. This is a secondary data analysis of the initial survey data from a home visiting center in 2009. The data were analyzed using frequencies, percentages, and multivariate logistic regression. We observed significant differences in perceived health between men and women based on their socioeconomic status. Type of medical insurance was strongly associated with depressive symptoms among the men and women. Results also indicated that being unschooled was significantly related …

Sexually Transmitted Infection Prevention In 18 To 24-Year-Old Heterosexual Men: Pilot Study, Susan P. Mckeefrey

Doctoral Projects

The CDC reported that there were over 20 million cases in the United States and half affected young adults, 15 to 25-year olds. Strategies STD prevention have been developed by the CDC but does not include avoiding alcohol or other similar agents in the context of a sexual encounter. The purpose of this study was to assess the effectiveness of STD prevention education intervention by improving Condom Use Self-Efficacy in heterosexually 18 to 24-year old men. It was hypothesized self-efficacy would improve with a face-to-face brief educational intervention. A quasi-experimental, pre-/post-test design with simple randomization of subjects into control and …

African American Men And Ostrich Behavior, Debbie Slack-Gay

Doctoral Projects

This project explores why African American men choose Ostrich Behavior when it comes to health care prevention and maintenance as related to hypertension. The population was African American men, ages18–80, in Northern California. Men were recruited while getting a haircut or waiting for one or after church services. Blood pressure readings were taken and a health questionnaire was administered. The results show that even if hypertension is known, men ages 18–45 go to fewer office visits than African American men in other age groups, and older men tend to seek medical care and take medication if prescribed.

Improving Patient Outcomes: Early Mobilization Of Intensive Care Patients, Casey Teves

Honors College Theses

Early mobilization of intensive care patients has gained the interest of researchers within the last few years due to its safe and practical application and numerous benefits it can provide. Reviewing the literature on this topic reveals the substantial benefits of early mobilization and the detrimental effects of prolonged bed-rest. Despite recent evidence proving that this practice will increase quality of care, many intensive care units still utilize bed-rest as a standard. Understanding the barriers and facilitators of this change can help transform this research into practice and improve patient care outcomes. Nurses are the key facilitators in the initiative …

Exploring The Effects Of Caring For Congestive Heart Failure Patients On Caregiver Well-Being: A Descriptive Study, Hanna S. Curtis

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: As the incidence of heart failure (HF) quickly becomes the leading cause of disability among older adults, the need for non-professional, in-home caregivers increases as well. Many caregivers are family members who receive no compensation for their efforts, but all are an invaluable tool in the fight against a debilitating disease. Patients with caregivers experience an improved quality of life and lower mortality rates than patients with little social support. The caregiver of a patient with HF may be responsible for everyday activities such as housekeeping and shopping, as well as more complex disease-related necessities as managing medication …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

Poster: Communication Strategies For The School Nurse Mentor: A Pilot Training Program, Amy Hotler Dnp, Rn, Lsn, Aphn-Bc

Doctor of Nursing Practice Scholarly Projects

Mentorship has widespread support among many disciplines for the impact on improved job satisfaction, decreased job turnover and decreased costs to organizations. Ongoing support through mentorship is critical to nurses transitioning to a new role and nurse mentors must be prepared for the role with relevant education tailored to their needs . Though literature describing training programs for mentors is limited, some studies have reported an increase in confidence among mentors after training. In addition, improved mentoring skills (that includes communication) is in literature.

In one large urban school district in Ohio, a school nurse, mentorship program was developed and …