Medicine and Health Sciences Commons^™

Evaluation Of A Smoking Cessation Program In Primary Care, Yolanda Duncan-Watt

Dissertations

Abstract

Problem: The adult tobacco smoking rate exceeds 12.5%. The problem is the insufficient attention given to smoking cessation education in low socioeconomic status(SES) communities. There is a lack of access to and awareness of smoking cessation programs for low-income populations.

Methods: This quality improvement (QI) study will use a descriptive, observational approach. A retrospective medical record review will be conducted to determine the rate of individuals who got the smoking cessation intervention and the rate of those who successfully quit one month after the intervention. Data was collected throughout the spring of 2024, during primary care visits and phone …

Improving Nurse Response To Seizure Events In A Pediatric Epilepsy Monitoring Unit With Use Of A Standardized Process, Stacey Obst Paule

Dissertations

Problem: Nurses responding to seizure events in the pediatric epilepsy monitoring unit (EMU) should initiate a neurological exam in addition to managing seizure activity. When nurses respond to these events, however, there can be significant variability, which can result in diagnostic inaccuracy and adverse patient outcomes. The purpose of this project is to implement a nursing response checklist and neurological assessment guide to standardize the process of response to seizure events in the pediatric EMU.

Methods: This quality improvement (QI) project utilized a cohort study design. Standardized tools were placed in an accessible area outside patient rooms. Education was provided …

Implementation Of Skin-To-Skin Immediately Post C-Section: A Pilot Study, Miah Vernor

Dissertations

Skin-to-skin contact during the golden hour is a practice that has numerous health benefits following the delivery of a newborn. These benefits include a healthy transition to extrauterine state, initiation of breastfeeding, thermoregulation, and more. However, the mode of delivery affects how often this practice is done. Parents who deliver vaginally are routinely offered the opportunity to perform skin-to-skin immediately after delivery whereas birth parents who deliver by cesarean section are not always offered this same benefit due to various reasons. A quality improvement project was conducted on an 18-bed labor and delivery unit at a Midwest hospital. This project …

Implementation Of Skin-To-Skin Contact Immediately Post Cesarean Birth: A Quality Improvement Project, Sophia Cooke

Dissertations

Problem: Skin-to-skin contact implemented within the first hour of a newborn’s life improves health outcomes for both mother and infant. One of these health outcomes includes exclusive breastfeeding. The purpose of this quality improve project was to implement an infant securement device within the operating room after cesarean section births to decrease the time to initiate skin-to-skin contact and increase exclusive breastmilk feeding rates at discharge.

Methods: This study utilized a descriptive, observational design and was guided by the Plan-Do-Study-Act framework. A pre-test, post-test design was utilized to compared retrospective and prospective data. The retrospective data was collected to assess …

Evaluation Of The Grief Of Mothers Affected By Perinatal And Traumatic Loss, Landry Crabtree

Dissertations

Problem: The experience of a perinatal loss can be traumatic for mothers, and complicated grief reactions are common for those who have experienced a perinatal loss. An increase in perinatal loss resources is needed in the United States. The purpose of this program evaluation was to assess outcomes of a pilot perinatal loss support program on the grief of women who have experienced a perinatal loss.

Methods: This project was an evaluation of a perinatal loss support program that employed evidence-based strategies in both individual and group therapy sessions. A retrospective design was used, and data on perinatal …

Implementation Of Postnatal Depression Screening: A Pilot Study, Mollie Gulino

Dissertations

Abstract

Background: Postpartum depression (PPD) is a prevalent problem among women during their childbearing years, affecting approximately 1 in 7 women. Alarmingly, about 50% of PPD cases go undiagnosed and untreated, contributing to poor maternal outcomes, including suicide, which is a leading cause of maternal mortality in the United States.

Issue: Despite its prevalence and severe consequences, PPD often goes unrecognized due to inconsistent screening practices. Current guidelines vary by organization and lack consistent, evidence-based criteria.

Objective: This pilot program aimed to implement universal PPD screening with a validated tool at the six-week postpartum follow-up visit. The goal was to …

Implementation Of The Edinburgh Postpartum Depression Screening Tool For Postpartum Depression In A Midwest Primary Care Clinic, Makenzie Garrison

Dissertations

Problem: Postpartum depression is a prevalent health concern in postpartum women. Screening practices to identify postpartum depression are inconsistent. The purpose of this quality initiative is to determine if the implementation of the Edinburgh Postpartum Depression Screening Tool (EPDS) to screen for postpartum depression in the primary care setting increases the detection of postpartum depression in postpartum women from delivery to one year postpartum.

Methods: This quality improvement project utilizes a descriptive, observational design. A retrospective medical record review was utilized as well as a 12-week data collection period. Retrospective medical record reviews were conducted to assess the rate of …

Implementation Of Quantitative Blood Loss Following Cesarean Section Birth, Layna Victoria Schultz

Dissertations

Problems: Postpartum hemorrhage (PPH) is a significant problem due to potential harm and is a main contributor to maternal morbidity (ACOG, 2019). According to ACOG, of maternal deaths in the United States, 11% are caused by PPH and 54-93% of the deaths related to PPH could be prevented (ACOG, 2019). When institutions adopt quantitative blood loss (QBL) protocols for improved accuracy in blood measurement, PPH can be identified sooner, allowing for earlier intervention. Inaccurate estimation of obstetric blood loss by health care providers is a primary cause of delayed staff response to PPH (ACOG, 2019).

Methods: This quality improvement (QI) …

A Qualitative Study Exploring The Management & Implications Of Power Differentials Experienced By Pre-Licensed Supervisees In Clinical Supervision Settings, Joyti Jariwala

Dissertations

The focus in this qualitative study was to explore how power differentials in supervision create positive and negative experiences between licensed psychologists and pre-licensed doctoral students. The study results provide insight into how supervisees navigate these dynamics during supervision, which typically involves experiential learning environments in which trainees discuss progress, receive feedback, and enhance their skills. The theoretical framework grounding the study was social learning theory, which is based on the idea that individuals learn from modeling, observation, and imitation in a social context (Bandura, 1986). Reflexive thematic analysis was used to recognize similarities in findings gathered via two sets …

Infusing Values Into Written Exposure Therapy: A Comparison Study, Maegan Campbell

Dissertations

Written Exposure Therapy is a brief, efficacious intervention for the treatment of PTSD symptoms. The WET protocol calls for the infusion of values into therapeutic work, however, does not detail how to incorporate these values work into the highly scripted treatment. This study compared the standard WET protocol with WET infused with values. The study examined differences across the two conditions on seven variables (PTSD scores, depression scores, value importance and consistency, quality of life, psychological flexibility, customer satisfaction, and therapeutic alliance). The sample was largely homogenous in gender, ethnicity, sexuality, and reported index trauma. The sample was largely white …

Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

Reducing Maternal Morbidity From Peripartum Hemorrhage In Cesarean Delivery, Jennie Lee

Dissertations

Background/Purpose: Maternal hemorrhage is the second highest cause of direct maternal death and the leading cause of morbidity and mortality in the United States. This public health crisis is highlighted by the economic burden of over $30.8 million annually in the United States. The greatest tragedy in the review of maternal mortality is that 84% of pregnancy-related deaths were determined preventable. Identifying trends of factors that predispose women to hemorrhage can mitigate rates of severe maternal morbidity and mortality. This study describes relationships among demographic factors (maternal age, race, and ethnicity), clinical and physiologic factors, which include coexisting medical conditions …

Second Victim Syndrome: Nurses Suffering In Silence, Matthew Riehm

Dissertations

Medication errors are inherent in health care due to human fallibility and inherent systemic complexities. Nurses are often unjustly blamed after committing a medication error despite the multitude of contributing factors. Formal education and healthcare organizations focus on preventing medication errors, but little has been done to support nurses involved in these tragic incidents. Recent cases, including RaDonda Vaught and Kimberly Hiatt, demonstrated the victimization of nurses after committing medication errors that plague the healthcare system potentially causing profound psychological trauma, often known as Second Victim Syndrome, SVS. There is limited research on the phenomenon of SVS in nursing due …

Impact Of Social Determinants Of Health On Skill Of Involvement: Differences In First Year Adn And Bsn Nursing Students In Rural Oklahoma, Cynthia Brown

Dissertations

The impact of Social Determinants of Health (SDOH) on Skill of Involvement (SOI) has not been adequately studied in nursing education. The skill of involvement is defined by Benner (2022) as necessary to expert-level nursing and it brings humanity, meaningfulness, acute situational awareness, and rapid thinking required for strong clinical decision-making in crisis management of the deteriorating patient. It is important for nurse educators to understand how SDOH impacts SOI on nursing students in order to transform the delivery of nursing education. The purpose of this study was to determine the impact of SDOH on SOIs in first-year nursing students …

The Association Between Emotional Intelligence, Empathy, And Social Determinants Of Health Among Accelerated Bachelor Of Science In Nursing Students: A Multi-State Cross-Sectional Descriptive Study, Kwanza Thomas

Dissertations

This study investigated the association between emotional intelligence (managing and understanding), empathy, and social determinants of health (SDOH) among accelerated Bachelor of Science in Nursing (ABSN) students. Despite the exponential increase in ABSN programs in the United States, little is known about the association between these variables among this nursing student population. A cross-sectional, correlational descriptive design was used to survey 104 students completing ABSN programs in Georgia, Mississippi, Philadelphia, and Texas. Participants self-reported their socioeconomic and programmatic characteristics using a researcher-developed questionnaire. Emotional intelligence (managing and understanding) was measured using two instruments, including the Situational Test of Emotional Management …

Sharp Injuries And Splash Exposures Among Healthcare Workers In The United Arab Emirates, Ibtisam Aref Karkaz

Dissertations

Brief introduction: Occupational injuries, including sharps injuries and splash exposures, pose significant risks to healthcare workers worldwide. These incidents can lead to the transmission of bloodborne infections, resulting in substantial healthcare costs and workforce challenges. Aims: The present study aimed at investigating sharps injuries and splash exposures among healthcare workers in Abu Dhabi government hospitals. To achieve the aim, the study planned to determine the frequency of sharps injuries and splash exposures, and to identify their risk factors, applied preventive measures, and consequent occupational infections. Method: Secondary data from the available records of all sharp injuries and splash exposures reported …

Evaluating Effective Communication Of Baccalaureate Nursing Students, Christine Brockway

Dissertations

Brockway, Christine. Evaluating Effective Communication of Baccalaureate Nursing Students. Published Doctor of Philosophy dissertation, University of Northern Colorado, 2024. The purpose of this mixed methods study was to determine how communication evaluation by clinical faculty compared in a clinical setting versus a simulation setting for Bachelor of Science in Nursing (BSN) students. Fifty (50) BSN students from three different schools of nursing were scored using the Interprofessional Situation, Background, Assessment, Recommendation Nurse to Physician Rubric in both clinical and simulation settings by seven nursing faculty. Scoring for each student occurred in both settings during one semester. Following the evaluation, students …

"My Longest Relationship Is With Food": Exploring Eating Related Behaviors Throughout The Gender Identity Journey Of Transgender Males, Angeles Polett Coss

Dissertations

This study sought to explore how transgender adult males have navigated the development of their eating behaviors throughout their gender identity trajectory. While recent research has focused on gender identity development and protective factors of the transgender community, this study explored and examined elements regarding the eating related behaviors of transgender males. Interviews were conducted with six participants within the United States during semi structured virtual sessions; the age range of participants was 19 to 35. Results of this research revealed identity management, Sociopolitical discourse, identity management and inter-relational identity affirmations as inter-multicultural segments that connected with eating related behaviors …

Investigating The Role Of Diet In Modulating Neuroinflammation In Health And Disease, Rasa Valiauga

Dissertations

An estimated 55 million people worldwide suffer from dementia, with the prevalence expected to drastically increase in the coming years as the population ages. Alzheimer’s disease (AD) is the most common form of dementia and the substantial burden associated with AD has been recognized as a growing public health issue. Despite significant advancements in uncovering the mechanisms which play a role in disease pathology, there is currently no cure or effective treatments. AD is highly complex and multifactorial, with accumulation of misfolded protein, oxidative stress, and inflammation among the numerous etiological processes implicated in disease pathogenesis. While genetic risk factors …

Adaptive Leadership: Nurse Executives Building Organizational Adaptive Capacity During Times Of Crisis, Challenge, And Change, Kristian Poitier

Dissertations

Purpose: The purpose of this exploratory phenomenological study was to identify and describe the strategies used by nurse executives in acute care hospitals to build an adaptive capacity based on the five key characteristics of adaptive leadership identified by Heifetz et al. (2009).

Methodology: This qualitative phenomenological study identified and described the perceived impact of adaptive leadership on building an organization’s adaptive capacity as perceived by nurse executives in acute care hospitals, for-profit and not-for-profit, with the title of chief nursing officer (CNO) or chief nurse executive (CNE) in Southeast, West, and North Florida. The researcher was part of a …

Mathematical Modeling For Dental Decay Prevention In Children And Adolescents, Mahdiyeh Soltaninejad

Dissertations

The high prevalence of dental caries among children and adolescents, especially those from lower socio-economic backgrounds, is a significant nationwide health concern. Early prevention, such as dental sealants and fluoride varnish (FV), is essential, but access to this care remains limited and disparate. In this research, a national dataset is utilized to assess sealants' reach and effectiveness in preventing tooth decay, particularly focusing on 2nd molars that emerge during early adolescence, a current gap in the knowledge base. FV is recommended to be delivered during medical well-child visits to children who are not seeing a dentist. Challenges and facilitators in …

Nursing Interventions For Psychosis And Other Mental Health Crises: A Hermeneutical Phenomenological Study Of Nurses’ Experiences, Christopher Jasensky

Dissertations

The nursing profession experiences caring for patients suffering psychosis and managing crises events in a way that is unique to all other healthcare providers. A gap in research and literature exists related to this phenomenon. The purpose of this study was to examine the lived experiences of nurses caring for patients experiencing psychosis or some other severe mental health issue. By analyzing the common expressions and behaviors of nurses in situations involving care of psychosis, the meaning of the care giving experience and thus, an understanding of the interactions involved with caregivers in psychosis was revealed. Participants provided experiential, firsthand …

Developmental Programming Of Normal Versus Metabolically Altered Pancreas In Rat: Effect Of Gestational Diabetes, Sanabil Ali Ahmed

Dissertations

Diabetes Mellitus (DM) is a chronic condition characterised by pancreatic β-cell dysfunction and consistently elevated blood glucose levels (hyperglycaemia), either due to the inability of the body to produce any or adequate amounts of insulin or the inability of the body to effectively utilise the produced insulin (i.e., insulin resistance). DM can be classified into 3 main types: Type 1 DM (T1DM), Type 2 DM (T2DM), and Gestational Diabetes Mellitus (GDM). GDM is defined as “hyperglycaemia that is first diagnosed during pregnancy with glucose levels below those considered diagnostic of overt diabetes outside of pregnancy”.

The mature pancreas is a …

Policymaker's Perspectives And Student Experiences Of Bullying At Schools In The Uae: A Mixed-Method Approach, Alfan Saghayir Alketbi

Dissertations

Bullying is a significant issue in schools worldwide, including Abu Dhabi, the UAE. This dissertation aims to explore the dynamics of school bullying and improve anti-bullying interventions through a mixed-method approach. The primary goal is to investigate current anti-bullying efforts in the UAE and develop a comprehensive framework for school-based bullying intervention, considering policymaker perspectives and student experiences.

The study includes a systematic scoping review, qualitative studies with policymakers, a SWOT analysis of Abu Dhabi's anti-bullying approaches, and a cross-sectional survey of students' perceptions, attitudes, and awareness in Al-Ain City. These methods provide an integrated view of bullying in the …

Longitudinal Evaluation Of Vitamin D Concentrations In Relation To The Onset Of Type 2 Diabetes In American Adults: A Secondary Data Analysis, Kathryn Michelle Schurr

Dissertations

Background: Prior research has suggested that low levels of Vitamin D may have negative effects on various biological functions, including Type 2 diabetes. The relationship between Vitamin D and the risk of Type 2 Diabetes has not yet been fully investigated. The objective of this research is to examine patients’ laboratory test data longitudinally to determine how vitamin D and other covariates of interest affect Type 2 diabetes status over time.

Methods: This study used retrospective data review from Quest Diagnostics from January 1, 2010, through December 31, 2022. Patients included in the study were required to have consecutive test …

Clinical Supervisors Competency And Readiness To Supervise Telehealth Practices, Myriam Buitrago

Dissertations

The growing effectiveness of telehealth as an alternative practice is gaining acceptance not only by professionals in the healthcare field but also by people who have benefited from this approach. New training and supervision practices are required to meet the new telehealth approach. Clinical supervision is a new profession identifying the competencies that define their best practices. However, telehealth is forcing us to evaluate and redefine them to meet the new telehealth requirements. This study used two assessments, the Supervisor competence self assessment and the supervisor evaluation and the Supervisor Competence Scale, to measure supervisors' self-evaluation of their performance as …

Professional Counselor's Experience Of Providing Clinical Services While Experiencing Adversity, Cambria Jovanna Mcdonald

Dissertations

The purpose of this study was to understand the lived experience of professional counselors who provided clinical services while undergoing personal adversity. Despite the common belief that counselors are more equipped to handle personal adversity, counselors experience adversity alike others. Interpretative phenomenological analysis was the methodology implemented. Participants in this study consisted of six licensed professional counselors working at various clinical sites who continued to provide counseling services while experiencing an adverse event. Adverse events included the death of a loved one, marital concerns, family crises, divorce, infertility issues, and complex parenting situations. Findings revealed that all participants reported a …

Verbal Abuse, Violence Prevention Climate, And Psychological Safety Among Pediatric Nurses, Donna Bigani

Dissertations

Purpose: The purpose of this study was to describe the relationships among demographic characteristics, verbal abuse, violence prevention climate, and team psychological safety.

Specific Aims: Specific aims were to describe: (1) demographic characteristics, verbal abuse, violence prevention climate, and the perception of team psychological safety by pediatric nurses; (2) relationships among select demographic characteristics, verbal abuse, violence prevention climate, and team psychological safety; and (3) the variance in team psychological safety accounted for by select demographic characteristics, verbal abuse, and violence prevention climate.

Background: Psychological safety is a key element for nursing practice and healthcare teams. Patient and employee safety …

Exploring The Relationships Between Health Literacy And Hba1c In A Rural Border Region, Stephen Jaime

Dissertations

Aims/Objectives: The purpose of this study was to describe the relationships between select sociodemographic and clinical characteristics, individual health literacy levels, and hemoglobin A1c (HbA1c) levels among Hispanic patients with diabetes living in a rural border region.

Background: The frequency of complications from diabetes can increase as HbA1c levels rise, causing the person with diabetes to be at greater risk for blindness, amputation, or renal failure. Unfortunately, people of Hispanic background are at higher risk of developing diabetes compared to non-Hispanic Whites. Many people living in rural towns that border Mexico are of Hispanic background, increasing their risk of developing …

Counseling And Mental Health Awareness In Higher Education Institutions: A Phenomenological Exploration Of Mental Health And How It Affects Degree Completion Among Black Undergraduate College Women, Shaquina D. White, Desirae N. Williams

Dissertations

The purpose of this qualitative study was to explore Black undergraduate women’s lived experiences with mental health management and pursuance of degree completion. This study used a phenomenological approach, guided by the following research questions: 1) What barriers are Black undergraduate college women facing regarding their accessibility to counseling services on their campus? and 2) How do Black undergraduate college women with mental health issues effectively manage stressful situations while pursuing and completing a college degree? The current literature that examined Black women’s utilization of counseling is limited, especially among Black women enrolled in college. This study aimed to fill …