Medicine and Health Sciences Commons^™

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Initiating Access To Palliative Care Earlier In Pediatric Oncology Patients, Anita Sharma

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Pediatric oncology patients should be referred to palliative care early but despite research indicating the clear benefits, there is still a delay in referring patients. One of the reasons include lack of understanding amongst providers on what palliative care is. Palliative care provides symptom management, emotional support and helps the patient and family with difficult decision making.

Objectives: This project aimed to increase the number of early referrals to palliative care. The Pediatric Palliative Care Screening Tool (PaPas) was utilized to help identify the triggers which should prompt the referral.

Methods: A chart review of patients diagnosed with …

Supporting Text And Data Analysis Across Campus From The Academic Library, Amy Kirchhoff, Hejin Shin Phd

Digital Initiatives Symposium

The ability to comprehend and communicate with text-based data is essential to future success in academics and employment, as evidenced in a recent survey from Bloomberg Research Services which shows that nearly 97% of survey respondents now use data analytics in their companies and 58% consider data and text mining a business analytics tool (https://www.sas.com/content/dam/SAS/bp_de/doc/studie/ba-st-the-current-state-of-business-analytics-2317022.pdf). This has fueled a substantial growth in text analysis research (involving the use of technology to analyze un- and semi-structured text data for valuable insights, trends, and patterns) across disciplines and a corresponding demand on academic libraries to support text analysis pedagogy and text analysis …

Technology And Mental Health Counseling, Hanna Cespedes, Elizabeth Robey, Tyler Wilkinson

Journal of Technology in Counselor Education and Supervision

The use of technology in the field of mental health has been an increasing interest of study and utilization in recent years, especially during and after the Covid 19 pandemic in which social distancing practices were encouraged to limit the spread of the virus. During this time, the use of technology for health-related appointments became vital as many offices shut down and/ or had limited in-person access. Furthermore, technology has already been integrated and researched significantly in other areas of the healthcare fields such as psychiatry and nursing. However, there is a lack of understanding of the role of technology …

Introduction To The Special Issue On Artificial Intelligence In Counselor Education And Supervision, Russell Fulmer, Wendell Callahan, Olivia Uwamahoro Williams

Journal of Technology in Counselor Education and Supervision

No abstract provided.

Counseling And Artificial Intelligence: Forging A Path Forward (Commentary), Russell Fulmer

Journal of Technology in Counselor Education and Supervision

The thesis of this editorial is twofold. First, counselors should work with Artificial Intelligence (AI), and AI should work with counseling. Second, counselors should increase their involvement with, essentially, all things AI. Counseling should forge a path forward with artificial intelligence. This editorial is a bit premature for pragmatists. Where is artificial intelligence (AI) in mental health? The answer is seemingly a paradox, everywhere yet nowhere. Everywhere, through AI subfields like machine learning, natural language processing applications, chatbots, and the myriad ways that large language models find correlations in data hidden from the human eye. Also, AI is nowhere to …

Using Ai-Supported Supervision In A University Telemental Health Training Clinic, Donna Sheperis, Shiri Sadeh-Sharvit

Journal of Technology in Counselor Education and Supervision

Artificial Intelligence (AI) technologies have the potential of transforming clinical education and supervision in university-based telemental health training clinics. AI can improve the accuracy of diagnoses, automate routine tasks, and personalize treatment plans, potentially enhancing the accessibility and quality of mental health care. In this paper, we describe why training clinics serve as an optimal setting to adopt innovation and share lessons from the field to inform future integrations of AI in clinical supervision. The lessons include support for case conceptualization, feedback on session quality, and automation of routine tasks such as sending standardized assessments and writing progress notes. However, …

Artificial Intelligence, Virtual Reality, And Augmented Reality In Counseling: Distinctions, Evidence, And Research Considerations, Sidney Shaw, Sophie Oswin, Yue Xi, Fallon Calandriello, Russell Fulmer

Journal of Technology in Counselor Education and Supervision

Technology is experiencing a growing presence in counseling and mental health, attracting attention from counselors, researchers, and the general public. This growth has the potential to change counseling practice, counselor education, and how users access mental health services. In this article we provide definitions of and distinctions between three common technologies that are used in the counseling field—Artificial Intelligence, Virtual Reality, and Augmented Reality. We also provide examples of the use of each technology, ethical implications, research support, and recommendations for future research.

Artificial Intelligence For Mental Health Support During Covid-19: Experiences Of Graduate Counseling Students, Russell Fulmer, Eric T. Beeson, Carl Sheperis, Daniel Rosello, Rebecca Edelman

Journal of Technology in Counselor Education and Supervision

The purpose of this study was to examine how an AI chatbot could provide mental health support to counselors-in-training during the COVID-19 pandemic. The chatbot “Tess” was available to participants for two weeks. Participants responded to questions about their experience and the content of this qualitative data was analyzed. Themes emerged that focused on mental health during the pandemic, utility of the AI chatbot during the pandemic, and potential therapeutic use in general. Findings were mixed and suggest some skepticism among counseling students towards the use of an AI chatbot.

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Atrial Fibrillation Management In Hispanic Adults, Tania Borja

Dissertations

Background: Research has found atrial fibrillation (AF) to be the primary or a contributing cause of death on 183,321 death certificates, and an underlying cause of death for 26,535 Americans in 2019. Findings indicate an increased AF diagnosis in White people compared to racial and ethnic minorities, contrasting widespread findings of increased prevalence of cardiovascular disease and ischemic strokes in minorities. Significant disparities—by race and socioeconomic status in disease distribution and access to testing and lifesaving treatments—have been documented, specifically associated with social determinants of health (SDOH); i.e., the conditions in which people are born, grow, live, work, and age. …

Fostering Resilience In Children Of United States Navy Seals Using A Social Media Platform, Riley Walker

Doctor of Nursing Practice Final Manuscripts

Background: Having resilience helps children overcome, cope, and manage stressors that they encounter throughout life and provides intrinsically protective factors to help a child thrive in the face of adversity.

Local problem: Children of United States Navy Sea, Air, and Land Operators (SEALs) face consistent stress as their parent is away from home more than 240 days per year doing high-risk training exercises.

Methods: Resilience education to mothers of children whose fathers are United States Navy SEALs delivered virtually on a social media platform. Pre- and post- intervention surveys using the Likert scale were conducted to measure the mothers’ understanding …

Nurse-Led Post Stroke Depression Screening (Psd) For Patients With Acute Stroke Using Patient Health Questionnaire-9 (Phq9), Stefan Panov

Doctor of Nursing Practice Final Manuscripts

Introduction: This Evidence-Based Practice Doctor of Nursing Practice project aimed to implement a nurse-led post-stroke depression (PSD) screening using Patient Health Queastionnaire-9 (PHQ-9) in a 12-bed progressive care neuro-stroke unit at a tertiary care hospital. The first goal of this project was to detect stroke patients at risk for depression who met specific inclusion criteria. The second goal was to provide depression education, initiate social work and medical referrals, and start pharmacological treatment to reduce the medical and socioeconomic burden associated with untreated PSD before discharge from the hospital.

Background: Globally, stroke is a prominent cause of death and disability. …

Church-Based Hypertension Education: An Alternative Solution To Hypertension Management In The African American Community, Nicole Tofi Rice

Doctor of Nursing Practice Final Manuscripts

Purpose: The objective of this evidence-based project is to explore a church-based hypertension education program as an alternative solution to providing hypertension education to the African American community. The desired goals of this project are: (a) to assess the current levels of adherence to antihypertensive therapy among members of a local African American church, using the Hill-Bone Compliance to High Blood Pressure Therapy Scale, and (b) to conduct a literature review exploring policy options encouraging the implementation of a church-based hypertension education program.

Background: Despite medical advances aimed towards prevention and effective treatment, the African American community remains disproportionately affected …

Managing Menopausal Symptoms Through Exercise And Dietary Changes, Ae Rah Kang

Doctor of Nursing Practice Final Manuscripts

Background: The most critical aging stage for women is the menopausal transition period, which causes various symptoms such as hot flashes, night sweats, sleeping disturbance, and mood swings that lower women's quality of life. Menopausal symptoms that are not managed can exacerbate severe medical conditions such as cardiovascular disease, bone illnesses, neurological diseases, and psychosocial problems. As the first non-pharmacological treatment for menopausal syndrome, several studies have shown that regular exercise and diet control can potentially improve menopausal symptoms and the quality of life.

Purpose: This project aimed to examine the effect of improving the quality of life by reducing …

Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante

Doctor of Nursing Practice Final Manuscripts

Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. In the United States, DS occurs in one out of every 700 births. Children with DS have an increased risk of developing serious health conditions. In the military health system, children with DS face many barriers such as frequent relocations and poor access to specialty care. Primary care providers (PCPs) do not consistently follow published guidelines for health supervision.

Purpose: This project aims to improve the care for pediatric patients with DS in the military health system by increasing the knowledge and confidence of PCPs.

Methodology: An educational program …

Evaluation Of Depression Screening Frequency In The Geriatric Population: A Pilot Project, Neha Bhagat

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to emphasize the importance and address the frequency of depression screenings for patients 65 years and older who reside at a nursing home. The first goal was to conduct a retrospective chart review of 18 patients residing at an assisted living facility (ALF) to determine whether a depression screening was completed two-four weeks after admission. The second goal was to educate ALF staff on evidenced-based practice of the importance and frequency of depression screenings for the elderly. The third goal was to increase ALF staff knowledge …

The Future Of Cognitive Dysfunction In Elderly Patients: A Clinical Perspective With Recommendations, Laura Taylor

Doctor of Nursing Practice Final Manuscripts

Background: The U.S. Census Bureau projects the number of Americans age 65 years and older will more than double between 2010 and 2050. The geriatric patient population will likely require the use of surgical services at a higher rate than ever before. To best care for the elderly undergoing procedures with anesthesia, it is imperative to follow the most up to date evidence to avoid post-operative complications, and more specifically post-operative cognitive dysfunction.

Purpose: The purpose of this DNP evidence-based practice project is to identify patients that are at high risk for post-operative cognitive dysfunction prior to undergoing anesthesia. Post-operative …

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

Advocating For Nurse Practitioner Independent Practice, Tamara Troyer Denlinger

Doctor of Nursing Practice Final Manuscripts

This project was an anonymous qualitative/quantitative survey of nurse practitioners in California to determine if passage of AB 890, which provides a pathway to independent practice, will result in more NPs choosing to practice independently after clinical hour requirements are met. Access to primary health care in California is projected to worsen over the next 10-15 years, particularly in rural areas, and an average of 44% of residents may be without enough access to care. Some areas in the state will be harder hit than others with Alpine, Calaveras, Glenn, and San Benito counties likely to be hardest hit by …

Implementation Of A Shared-Decision Making (Sdm) Approach In A Community Based Outpatient Mental Health Clinic, Alexa Vuylsteke

Doctor of Nursing Practice Final Manuscripts

Purposes/Aims: The purpose of this Doctor of Nursing Practice (DNP) project is to implement an evidence-based SDM approach in a culturally diverse community mental health clinic in order to increase patient-provider collaboration and improve patient autonomy and engagement in decision making processes of care in a mental health setting.

Rationale/Background: According to the Substance Abuse and Mental Health Services Administration (SAMHSA), shared decision-making (SDM) is a collaborative communication approach between patient and provider that aims to help people in treatment work together to have informed, meaningful discussions about their health care decisions. SDM is an evidence-based approach to encourage and …

Mantram For Mamas: A Pilot Study For Postpartum Women, Ritamarie Smedile

Dissertations

Objective: This pilot study launched an online Mantram Repetition Program (oMRP) using a virtual health portal that aimed to explore online portal accessibility, oMRP acceptance, and overall interface satisfaction among a sample of postpartum women.

Background: Postpartum depression remains one of the most common and severe childbirth complications, affecting more than 13% of women during the first three months after childbirth. Cognitive or behavioral talk therapy sessions and medication are the most frequently recommended treatments to alleviate symptoms. Although effective, women tend not to enroll or adhere to these modalities, suggesting they need alternative treatment plans. A possible alternative, mirroring …

A Pilot Project For Tuberculosis Education In College Students, Sarah Williams

Doctor of Nursing Practice Final Manuscripts

Background: San Diego’s Tuberculosis (TB) incidence is more than double the national rate. The majority of cases of active TB are due to the progression of latent TB infection (LTBI).

Objectives: This evidence-based practice (EBP) project aimed to increase knowledge, awareness, and improve attitudes and practices regarding TB among college students.

Participants: Twenty Community College Students in San Diego participated in the project.

Methods: Students attended an in-person educational session. A pre-post knowledge, attitudes and practices (KAP) questionnaire measured the impact.

Results: The intervention improved knowledge and attitudes. The average post-intervention TB knowledge score was 95.8% compared to 57% …

Measuring The Effectiveness Of Antidepressant Treatment By Implementing Beck's Depression Inventory (Bdi), Azeem Anjum

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project integrates a structured periodic depression evaluation follow-up protocol for patients diagnosed with Major Depressive Disorder who have been prescribed antidepressant(s) at an outpatient mental health clinic. The purpose of this DNP project is to standardize the method of treatment progression monitoring to improve the timeliness of change detection and subsequent treatment adjustments using the Beck Depression Inventory (BDI) Scale.

Background: According to the World Health Organization (WHO), MDD is one of the most common mental health conditions affecting approximately 280 million people globally and 17.5 million adults in the United States. (WHO, 2021). The economic …

Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar

Doctor of Nursing Practice Final Manuscripts

Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and …

Implementation Of An Evidenced Based Peripheral Artery Disease Screening Protocol In An Outpatient Internal Medicine Clinic, Sarah Lee Bolanos

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidenced based project was to implement an evidenced based peripheral artery disease screening protocol in an outpatient internal medicine clinic serving adult patients with multiple co-morbidities. This clinic inconsistently screened patients for PAD using the ankle-brachial index (ABI).

Methods: During a three-month period, 50 patients were screened using current American Heart Association and American College of Cardiology (AHA/ACC) screening guidelines for PAD using the Ankle-Brachial Index (ABI) and the Edinburgh Claudication Questionnaire (ECQ).

Results: Out of the 50 patients screened for PAD, only one patient (2%) had a normal ABI score (1.0-1.4) and was categorized …

Implementation Of The American Diabetes Association Pharmacological Approach For Adults With Type 2 Diabetes Mellitus With Cardiovascular Disease, Jose Cedillo

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice project is to improve the utilization of the 2022 ADA pharmacological approach for individuals with Type 2 Diabetic Mellitus (T2DM). The project implementation site was an outpatient clinic in Southern California with a large T2DM Hispanic population. The new ADA guidelines recommend selecting a glucagon-like peptide 1(GLP-1RA) and/or sodium-glucose cotransporter two inhibitors (SGLT-2) when clinically appropriate to reduce the risk of major cardiovascular events in T2DM patients.

Background: According to the American Diabetes Association, ASCVD is the leading cause of morbidity and mortality for adult individuals with T2DM. The use of …

Talking With Horses: Equine Assisted Activities To Promote Social Engagement In Individuals With Autism Spectrum Disorder, Amy Ezhaya

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The purpose of this evidenced-based project is to gather data on how therapeutic horseback riding (THR) facilitates social engagement in individuals with autism spectrum disorder (ASD). The project aims to provide alternative treatment options and disseminate information to providers on the importance of community partnerships.

Background: In 2020, it was estimated that 1 in 54 children had ASD, which is a 170% increase since 2000. Often, those diagnosed with ASD also experience co-occurring mental health diagnoses placing a large burden of care on our healthcare system. THR is a growing alternative treatment option and has been found …

Improving Nursing Student Retention: Early Identification Of Determinants Causing Attrition In Nursing Academic Programs, Tennille Gifford

Doctor of Nursing Practice Final Manuscripts

Introduction: Student success in higher education is a vital focus for the health of a community and the improvement of an individual’s life. It is equally detrimental if a student leaves an educational program without a degree. The purpose of this project was to improve the early identification of students at risk of attrition in a nursing program by using an electronic dashboard interfaced with a self-reporting student survey to identify determinants that are statistically significant factors for student attrition. Background: The current accreditation benchmark for nursing program completion is 70% for Bachelor of Science in Nursing degrees. Concordia St. …

The Impact Of The Family Nutrition And Physical Activity (Fnpa) Tool With Diet And Physical Education On Obesity Awareness And Body Mass Index (Bmi) Of Overweight Patients, Sheena Amos

Doctor of Nursing Practice Final Manuscripts

Purpose

This evidence-based practice project aims to apply the Family Nutrition and Physical Activity (FNPA) tool with diet and physical education to increase obesity awareness and decrease body mass index (BMI) among overweight parents in the community. The FNPA screening tool is a behaviorally based assessment designed to allow parents to evaluate obesogenic environments and practices that may predispose their children to become overweight. The first goal was to recruit parents in the community and utilize the FNPA tool to assess and better understand their diet and physical activity levels. The second goal was to increase obesity awareness among these …