Medicine and Health Sciences Commons^™

Practice Makes The Deficiency Of Global Motion Detection In People With Pattern-Related Visual Stress More Apparent, Jana Wegrzyn

Student Theses, Dissertations and Capstones

Pattern-related visual stress (PRVS) refers to the perceptual difficulties experienced by some individuals when exposed to high contrast striped patterns. People with PRVS were reported to have reduced sensitivity to global motion at baseline testing and the difference disappears at a second estimate. The present study was to investigate the effect of practice on global motion threshold in adults with and without PRVS. Methods: A total of 101 subjects were recruited and the Wilkins & Evans Pattern Glare Test was used to determine if a subject had PRVS. The threshold to detect global motion was measured with a random dot …

A Clinical Documentation Practice Improvement To Increase Insurance Reimbursement, Allison R. Hamilton

Student Theses, Dissertations and Capstones

Background: The National Institute Mental Health (2015) estimated there were about 44.7 million people diagnosed with a serious mental illness and 62.9% of those diagnosed were without mental health services. The loss of services was due to unemployment, reoccurring hospitalization, inabilities to care for themselves, and lack of participation in societal norms (World Health Organization [WHO], 2014). According to Insel (2011/2015), the U.S. cost of mental healthcare was an estimated $57.5 billion in 2006. This cost was not due to actual care but associated with the economic burden of job loss and the excessive use of community resources. The Affordable …

Improved Use Of Interact To Decrease 30-Day Readmissions From A Skilled Nursing Facility, Folasade Omobowale Adewunmi

Student Theses, Dissertations and Capstones

Background: The rising cost of health care in relation to rehospitalizations continues to be a challenge. Medicare 30-day readmissions have an annual estimated cost of $17.4 billion. Irrespective of these costs and the continued improvement in the quality of care, skilled nursing facilities (SNF) still face high readmission rates. Purpose: The purpose of this quality improvement project was to enhance SNF care processes by improving the utilization of the electronic medical record software program “INTERACT” to increase early identification and treatments of patients to minimize 30-day hospital readmissions. Theoretical Framework: The theory of planned behavior by Icek Azjen was used. …

Implementing A Culturally Sensitive Intervention For Haitian Patients Non-Adhering To Hypertensive Medications, Guilaine Gabriel-Percinthe

Student Theses, Dissertations and Capstones

Background: The pervasiveness of hypertension (HTN), morbidity, and mortality in Haitians immigrants are frightening. Nonadherence with hypertensive medications, disease management, lifestyle modifications, and cultural and spiritual beliefs, including prayer; faith healing; use of herbal teas; and a diet that is deficient in potassium, rich in sodium, high in fat, cholesterol, and carbohydrates result in increased prevalence of HTN and disability in the Haitian community. Purpose: The purpose of this quality improvement project was to examine the existing system for adherence to hypertensive medications, standardized clinical practice guidelines, identify patients at risk for nonadherence to hypertensive medications, disease management, medical follow-up, …

Lived Experience Of Post-Licensure Nurses In A Perioperative Clinical Rotation, Amy Stahley

Student Theses, Dissertations and Capstones

A projected deficit in the perioperative workforce of 32,000 perioperative nurses retiring by 2024, creates an inability to meet the nursing needs of the United States population. The need for experienced perioperative nurses has been increasing while the availability of nurses with perioperative education has been decreasing. The purpose of this phenomenological study was to explore the lived experience of post-licensure nurses who participated in a perioperative clinical rotation within their baccalaureate nursing program and did that experiential experience affect the recruitment and employment for perioperative nursing to halt the impending shortage. The integrations of Kolb’s experiential learning theory and …

Use Of Evidence-Based Test Development In Pre-Licensure Nursing Programs: A Descriptive Study Of Faculty Beliefs, Attitudes And Values, Richild Berrick

Student Theses, Dissertations and Capstones

Background: Effective testing in pre-licensure nursing programs is a challenge in nursing education. Implementing evidence-based test development is essential to successful assessment of students’ competence and preparation for licensure. Purpose: Identifying the beliefs, attitudes and values of nursing faculty will contribute to the use of best practices in student assessments, ultimately contributing to increased retention of competent students and increasing the workforce within the healthcare industry. Theoretical Framework: This study is based on Rokeach’s theory of beliefs, attitudes and values. Methods: A quantitative descriptive research methodology was used in this study using survey data collection. A purposive, non-probability, convenience sample …

Chinese Immigrants With Non-Insulin-Dependent Diabetes Mellitus: Nutritional Self-Management Approach, Winnie Manlai Wong

Student Theses, Dissertations and Capstones

Background: Chinese immigrants (CIs) with non-insulin dependent diabetes mellitus (NIDDM) generally have poor control in their diet regimen. Due to the variation in body mass, physiology, and cultural differences as compare with the general American population, special attention must be conducted in treating diabetes in Cis, emphasizing culturally sensitive care and nutrition therapy that acknowledge the differences. Purpose: The purpose of this project was to assess cultural challenges in self-management for CIs living with non-insulin dependent diabetes mellitus and evaluate the effectiveness of a diabetic nutritional self-management guide tailored to this population. Theoretical Framework: Havelock’s theory of change is a …

Lose To Win: Fighting Obesity In The Workplace, Latoya Dotson

Student Theses, Dissertations and Capstones

Background: Obesity is a significant healthcare problem in modern American society. It has led to decreased longevity of employees and decreased productivity in day-to-day duties of healthcare workers. There are more negative attributes to obesity than positive, regardless of the race affected. One of the leading causes of death in 2012 was cardiovascular disease. Due to poor dietary choices, the promotion of sedentary lifestyle has led to complications of obesity such as high blood pressure and diabetes. Major improvements can be made within a community that acknowledges the risks of obesity and seeks to implement preventive programs. Increasing one’s physical …

Implementation Of The Essential Competencies For Evidence-Based Practice In Baccalaureate Nursing Education, Elizabeth Whorley

Student Theses, Dissertations and Capstones

Integrating evidence-based practice into healthcare education has been a recommendation for the past 16 years. Despite this, barriers still exist with the utilization of evidence-based practice. The purpose of this study was to describe the current state of EBP scholarship in the curriculum of baccalaureate pre-licensure nursing programs. Essential Competencies for Evidence-Based Practice in Nursing (Stevens, 2009) was utilized to measure the state of EBP scholarship. The research question stated: how is evidence-based practice scholarship addressed within baccalaureate pre-licensure nursing programs? The research design was guided by Rogers’ diffusion of innovations theoretical framework and the star model of knowledge transformation …

Senior Nursing Students' Knowledge, Attitudes, And Perceived Competency About Older Adults, Deborah Denise Brabham

Student Theses, Dissertations and Capstones

Background: Nurses entering the workforce may have limited education in gerontological nursing. Therefore, many nurses are unprepared to provide quality care to older adults. An unprepared nursing workforce could negatively influence older adults’ health outcomes and care experience. Purpose: To determine differences in senior nursing students’ knowledge, attitudes, and perceived competency about older adults based on enrollment in a bachelor of science in nursing degree (BSN), associate’s degree nursing (ADN), and practical nursing (PN) program that offers geriatric content in curricula. Theoretical Framework: Bandura’s social cognitive theory, triadic reciprocal determinism model provided the theoretical framework. Methods: A non-experimental, descriptive survey …

Effect Of Three Different Contamination Removal Methods On Bond Strength Of Ceramic To Enamel Contaminated With Aluminum Chloride And Ferric Sulfate, Cesar Gonzalez

Student Theses, Dissertations and Capstones

Background: The need to control moisture and contamination is crucial in adhesive dentistry, especially when rubber dam isolation is not feasible. Hemostatic contamination can negatively affect adhesion to tooth substrate. To achieve better outcomes, hemostatic agents should be rinsed off properly using a method that will remove the contamination and will not affect the μ-SBS. Objective: To evaluate and compare the effect of three different aluminum chloride and ferric sulfate contamination removal methods on the μ-SBS of lithium disilicate glass-ceramic bonded to enamel and to compare the type of fracture between samples. Material and Methods: Lithium disilicate blocks (IPS e.max …

Effect Of Air-Abrasion Preparation On Shear Bond Strength Of Orthodontic Brackets To Enamel Surface, Elliott Katz

Student Theses, Dissertations and Capstones

Introduction: An optimal orthodontic bonding system must minimize damage to the enamel during conditioning, have enough bond strength to prevent bracket de-bonding during treatment, and allow bracket removal at treatment completion, such that minimal damage is inflicted to the tooth.1 Pumice followed by acid etching has been the standard for many years; however, Groman Inc. (Margate, FL, USA) has stated that using their air-abrasion product will result in a tripling of bond strength. This method claims a three-fold increase in bond strength compared to traditional acid etching techniques by substituting air-abrasion using the EtchMaster® (Groman Inc., Margate, FL) 50 μm …

Ancestral Dependence On Breast Stemness And Nucleotide Excision Repair In Breast Cancer Stem Cells In Novel Human Model Systems, Omar Ibrahim

Student Theses, Dissertations and Capstones

Precocious puberty, measured by thelarche or menarche, is a well-established breast cancer risk factor. Using a unique and patented tissue engineering system we established cell lines from 48 primary cultures of normal breast tissue from reduction mammoplasties and used them as an in vitro model of thelarche, quantifying episphere formation and ductal differentiation. Differential ductal formation was observed based on ancestry. In light of African American (AA) precocious thelarche both in vivo and as we observed in vitro, we hypothesized that AA women would exhibit an increased proportion of breast stem cells, with greater potency for differentiation. Five AA cell …

Exploring Incivility Among Nursing And Health Science Students: A Descriptive Study, Diane Louise Smith

Student Theses, Dissertations and Capstones

Incivility has infiltrated our institutions of higher learning as well as the world of nursing. All too familiar in nursing is the phrase “eating their young,” which aptly describes how nurses treat other nurses, even though they should be nurturing and caring professionals.

The investigator explored nursing and health science students’ perceptions of student and faculty uncivil behaviors within the academic environment, seeking the levels and frequency of the problem. Bandura’s social learning theory presents a sound theoretical framework for this dissertation. The research methodology consisted of a quantitative descriptive approach. The Incivility in Higher Education-Revised (IHE-R) Survey was used …

Correctional Nurses: Adult Opioid Dependence Referral Process, Christine Hilary Edmund

Student Theses, Dissertations and Capstones

Background: Correctional nurses make up a large part of the corrections workforce and have increasing responsibility for making decisions about patient care in the opioid dependent incarcerated patients. The National Commission on Correctional Health Care (NCCHC) has intoxication and withdrawal standards that advocate individuals entering a correctional facility under the influence or undergoing withdrawal from opioids have their therapy continued, or a plan for appropriate referral for treatment. The NCCHC standard that incarcerated opioid dependent inmates have their therapy continued or a plan for appropriate referral for treatment is not adhered to consistently, as the current process lacks organization. Purpose: …

Prevalence Of Vitreomacular Traction In Patients 40 Years Of Age And Older, Julie Rodman

Student Theses, Dissertations and Capstones

Vitreomacular traction (VMT) is a condition characterized by an incomplete posterior vitreous detachment resulting in traction on the macula and decreased visual acuity. The process of vitreomacular traction can lead to a number of maculopathies including cystoid macular edema, epiretinal membranes, and macular holes. VMT is more common in patients over 40 years of age; however no population-based studies documenting the prevalence of VMT in this age group has been published. Purpose: The current study was undertaken to evaluate the prevalence of vitreomacular traction syndrome in the population aged above 40. Clinical examination does not adequately illustrate the extent of …

Ocular Sensory Dominance And Viewing Distance, Karen Squier

Student Theses, Dissertations and Capstones

Abstract Purpose: It is not clear as to whether sensory dominance is affected by test distance. Jiang et al previously reported that that the sensory dominant eyes may be affected by refractive error; however this study was done at a near distance only (60 cm). In this study, we investigated the effect of two different test distances (near, 60 cm vs distance, 6 meters) on the laterality of ocular dominance. Methods: Ocular sensory dominance was quantified in 60 subjects with a technique that involves the dichoptic presentation of a Mondrian noise and a Gabor patch. The threshold to detect the …

Comparison Of Three Clinical Tests Of Accommodation To Hofstetter's Norms To Guide Diagnosis And Treatment, Marc Brian Taub

Student Theses, Dissertations and Capstones

Purpose. It has been documented previously that the push up (PU) and pull away (PA) methods overestimate accommodative amplitude (AA), while the minus lens-to-blur (MLB) method underestimates it. It also has been shown that the PU and PA methods produce similar results. We sought to compare data obtained from these three clinically used methods to determine AA in children and young adults with base-line normative data predicted by Hofstetter.

Methods. Ninety healthy subjects (mean 11.7 years, range: 6-36 and 50F/40M), split into two groups, children (mean 9.8 years, range: 6-13 and 38F/22M) and young adults (mean 25.5 years, range: 21-36 …

The Lived Experience In Relation To The Educational Needs Of Nurses Caring For Induced Hypothermia Patients, Marie Regina Hankinson

Student Theses, Dissertations and Capstones

Background: Ongoing educational development is essential to ensure the effectiveness of professional nurses’ learning experiences. Understanding the ways in which workplace learning occurs is fundamental to enabling nurse educators to deliver that knowledge. Induced hypothermia was introduced as a new treatment modality in 2005 and education surrounding the care of the hypothermia patient is lacking in the literature. Purpose: The purpose of this study is to illuminate how nurses learn new knowledge in the clinical setting. Theoretical Framework: The learning theory chosen for this study is the three dimensions of learning by Illeris (2004). Methods: Semistructured interviews were conducted with …

Transition To Practice Experience: The Impact On Newly Licensed Rn Performance, Patricia P. Lawson

Student Theses, Dissertations and Capstones

This quantitative non-experimental descriptive correlational design sought to answer the question if there was a difference in newly licensed RN (NLRN) performance at one-year post hire after participation in a nurse residency program that offers a formalized curriculum that extends throughout the entire year, one that offers a formalized curriculum that does not extend throughout the entire year, or one that does not provide a formalized curriculum. The study utilized the Six Dimension Scale of Nursing Performance (SDNP) and evaluated NLRN performance on six subscales: leadership, critical care, teaching/collaboration, planning/evaluation, interpersonal relations/communication, and professional development at one-year post hire. Benner’s …

Professional Nursing Value Development In Nursing Students Who Participate In International Service Learning, Heather Ferrillo-Diiulio

Student Theses, Dissertations and Capstones

Background: International Service Learning (ISL) is becoming widely used in nursing education as a means to provide global learning opportunities. Concrete outcomes for these experiences have not been clearly supported in previous research. Determining if ISL experience facilitate the development of Professional Nursing Values (PNV) can support the use of ISL as a viable pedagogy. Purpose: The purpose of the study was to determine if there were a difference in PNV development in students who participate in ISL as part of their clinical experiences compared to those who do not. The hypothesis was that there was a difference in the …

Factors That Predit Levels Of Sleepiness Of Advanced Practice Nursing Students, Deana Shevit Goldin

Student Theses, Dissertations and Capstones

Background: Due to arduous demands of graduate education, advanced practice nursing (APN) students who are classified as adult learners are at risk for suffering sleep deprivation. Factors contributing to sleep deprivation include stress, expected academic challenges, and everyday life stressors. Purpose: This study investigated if APN students’ grade-point average (GPA), gender, and employment status predicted levels of daytime sleepiness. Theoretical Framework. The psychological well-being model selected for this study was consistent with the theory that sleep is a resource essential to well-being; adequate sleep is the resource needed to optimally manage stressful life demands. Methods. Bivariate and multiple regression were …

Cancer-Related Fatigue Clinical Guideline And Protocol For Hospitalized Oncology Patients: A Quality Improvement Project, Sulotte Valcin Amilcar

Student Theses, Dissertations and Capstones

Background: Cancer-related fatigue is one of the most common symptom experienced by cancer patients throughout their cancer trajectory. However, very little effort has been made within many oncology practices to assess this clinical problem and to provide timely nursing interventions to reduce its impact. While there have been tremendous advancements in the treatments of the disease aspects of cancer in term of medicine and advanced technology, basic assessment of related physiological concerns, such as fatigue, have not seen the same progress. Purpose: The purpose of this quality improvement project was to develop an evidence-based cancer-related fatigue assessment guideline and a …

Chemotherapy Side Effects At Home: A Nursing Impact, Gwendolyn E. Saint-Clarke

Student Theses, Dissertations and Capstones

Background: Approximately 32% of all lymphoma patients experience immunocompromised severe avoidable side effects of nadir at home after discharge postchemotherapy. The certified oncology nurses employed at a large metropolitan hospital in Atlanta, Georgia, lack standardized discharge guidelines that include regulatory organizations’ recommendations to assist patients/families with at-home self-management of the avoidable side effects. Purpose: The purpose of this quality improvement project was to utilize the institution’s existing postchemotherapy discharge protocol to assess certified oncology nurses’ knowledge of severe avoidable side effects of nadir; modify the existing healthcare institution’s postchemotherapy discharge protocol to reflect standardized practice for promoting clinical practice continuity …

Evidence-Based Diabetic Discharge Guideline: A Standardized Initiative To Promote Nurses' Adherence, Marjorie V. Scarlett

Student Theses, Dissertations and Capstones

Background: Diabetes mellitus (DM) affects more than 29.1 million Americans. Standardized clinical practice guidelines recommended by regulatory healthcare agencies are the standard of care for diabetic patients and must be adhered to by healthcare professionals providing care. Purpose: The purpose of this quality improvement project was to identify Centers for Medicare and Medicaid Services’, Joint Commission on Accreditation of Healthcare Organization’s, and other professional healthcare organizations’ guidelines for nurses’ knowledge of evidence-based discharge practices; determine level of nurses’ knowledge on evidence-based discharge practice process; develop a quality improvement plan, including development of an evidence-based guideline for diabetic discharge instructions; present …

Steroid-Induced Hyperglycemia In Patients With Malignancies: Healthcare Team Adaptation To A Paradigm Shift, Miriam Ingrid Silva

Student Theses, Dissertations and Capstones

Background: Caring for patients with malignancies and presenting hyperglycemia has been an ongoing problem that needed to be addressed. The Endocrinologist Society and the Joint British Diabetes Societies for Inpatient Care suggested a change in the process by which patients in this population are managed. Purpose: The purpose of this project was to implement evidence-based practice guidelines for managing steroid-induced hyperglycemia focusing on the interdisciplinary team and adaptation of nurses who care for patients with malignancies. Theoretical Framework: The theoretical framework selected for this project was Roy’s Adaptation Model. Methods: This project used a mixed method approach, with a triangulation …

Increasing Providers’ Adherence To Ordering Urine Microalbumin Tests, Florence Fadele

Student Theses, Dissertations and Capstones

Currently, a microalbumin urine test is an annual test for diabetic patients recommended by the American Diabetes Association, but primary care providers are not ordering the tests. This may be, in part, attributable to the fact that there are no guidelines for ordering microalbumin urine tests. The purpose of this capstone project was to assess providers' compliance in identifying the need for the microalbumin urine test for patients with diabetes, to develop evidence-based guidelines for monitoring and ordering microalbumin urine tests, and to evaluate providers' compliance. Rogers's theory of the diffusion of innovation provided the framework for this capstone project. …

Health Care Providers' Knowledge Of Childhood Obesity Within The Hispanic Community, Daysi Fardales

Student Theses, Dissertations and Capstones

Background: Recent studies indicate a rise in the prevalence of obesity in children of various age groups. Obesity was officially recognized as a disease by the American Medical Association (AMA) in June 2013. It has been acknowledged as a progressive epidemic public health crisis in the United States for the past 20 years. This is a health care concern that needs examination and the development of new and more effective prevention and treatment modalities for obesity in children. Environmental, hereditary, behavioral, and socioeconomic factors play a significant role in the prevalence of obesity (Rooney, Mathiason, & Schauberger, 2011). Childhood obesity …

Managing Diabetic A1c At A Primary Care Center: A Nurse Practitioner Perspective, Jacqueline Mcdonald

Student Theses, Dissertations and Capstones

Background: At a primary care center in Brooklyn, New York, approximately 27% of diabetic patients with abnormal Hgb A1C fail to return for follow-up appointments, as recommended by the Centers for Disease Control and Prevention (CDC). According to electronic medical records (EMR), healthcare providers demonstrated inconsistency in ordering and monitoring Hgb A1C and clinic follow-up appointments for patients.

Purpose: The purpose of this quality improvement project was to determine retrospectively the healthcare providers’ ordering, monitoring, and follow-up appointments for adult diabetic patients with abnormal Hgb A1Cs; to develop and implement astandardized process for healthcare providers to monitor and follow these …

Addressing Obstetric Health Care Providers' Nutritional Insight In The Low Socioeconomic Population, Nicole Theresa Marshall

Student Theses, Dissertations and Capstones

Background: During a woman's pregnant state, a diet that is adequate in nutrition is critical to the developing fetus, especially in the lower socioeconomic status population. The healthcare provider is charged with the acute fundamental awareness of this additional factor that can grossly impact pregnancy. Nutritional advice from the health care provider is one of many key points that contribute to the successful outcome of the pregnancy. Purpose: The purpose of this quality improvement project was to develop a standardized, evidence-based practice (EBP) protocol for the management of maternal nutrition, gestational weight gain, and physical activity for provider use at …