Medicine and Health Sciences Commons^™

Implementation Of The Generalized Anxiety Disorder 7-Item (Gad-7) Screening Tool In A Mental Health Outpatient Clinic, Ella Bosunglan Gang

Doctoral Dissertations and Projects

Purpose: The prevalent disorder known as generalized anxiety disorder (GAD) can have various negative consequences. GAD harms individuals, families, communities, and society as a whole. People with GAD frequently experience a crippling decrease in their physical and mental health. When generalized anxiety disorders are combined with the pressures of pre-existing medical conditions, the quality of life can be significantly impacted. GAD severely impairs social and functional functioning, resulting in frequent clinic appointments, doctor shopping, emergency room visits, high costs from family and employer treatment, and increased costs for global healthcare spending. Proper diagnosis is essential to effective treatment, and a …

Comparing Student Perceptions In Traditional And Online Anatomy & Physiology Courses At The Community College Level, Benjamin Curtis Wright

Doctoral Dissertations and Projects

This paper is intended to compare student perceptions of learning environments within anatomy & physiology I and II courses at the community college level. Literature suggests that student perceptions vary depending on the learning environment. The purpose of this study stems from very little research within science courses. Students participating in the research will be grouped into two categories based on the type, of course, they are completing: A traditional face-to-face course or a distance education course. All learning materials within the courses are identical. The Distance Education Learning Environments Survey (DELES) will be used to gather data on student …

Impacts Of Telemonitoring On Weight Obesity In African Americans, Miranda Bessem Mbutambe

Doctoral Dissertations and Projects

Obesity has become a complex public health issue among African Americans over the last few decades, due to the health risks it poses to this population. Obesity exposes African Americans to a variety of chronic diseases, including, but not limited to, diabetes and cardiovascular diseases. Owing to the complexity inherent in obesity, healthcare practitioners have developed various strategies and interventions to manage weight among vulnerable populations. In this regard, telemonitoring, a continuous or non-continuous process that allows medical practitioners to remotely monitor, collect, and interpret data necessary for medical follow-up and, if necessary, make medical decisions regarding the health state …

Best Strategies To Address Burnout Among Healthcare Professionals: An Integrative Review, Kimberly Ann Delbo

Doctoral Dissertations and Projects

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy …

Implementation Of A Medical Emergency Chain Of Command Protocol In The School Setting, Vikki Shannon Brannon

Doctoral Dissertations and Projects

Medical emergencies occur every day in school settings across America. School nurses have a vital role in providing care for individuals experiencing a medical emergency and leading a multidisciplinary team during a medical emergency event. Since incidences of medical emergencies are commonplace, it is standard to have protocols and guidelines for these events. To address this concern, an evidence-based practice project was implemented in a rural school district in North Georgia. The pilot project was developed and implemented to assess the effectiveness of implementing a “Medical Emergency Chain of Command Protocol.” The protocol was developed to improve the effectiveness and …

How Does The Use Of Telemonitoring In Adult Patients With Uncontrolled Hypertension Improve Blood Pressure Control? An Integrative Review, Lucie Bakop

Doctoral Dissertations and Projects

Hypertension is an evolving problem worldwide and it constitutes a great risk for cardiovascular diseases. Despite the research and new drugs on the market to manage high blood pressure, hypertension remains the leading cause of disability-adjusted life and death worldwide. With many people suffering from hypertension around the world, and the burden of uncontrolled hypertension, it is imperative to find an intervention that can improve blood pressure control. To better target uncontrolled hypertension, the conventional method of management of high blood pressure based on in-person visits has shown some limitations and it must be combined with a contemporary approach that …

The Importance Of Pediatric Provider Awareness Of Social Determinants Of Health And The Impact On Health Outcomes: An Integrative Review, Whitney Lenelle Dowd

Doctoral Dissertations and Projects

Social determinants of health have become a global concern over the past several years. Efforts to reduce negative health outcomes related to social determinants of health are of high priority. Awareness of this issue by providers, especially pediatric providers, must be considered to help combat this major concern. A researcher seeks through an integrative review to determine provider perspective on social determinants of health, impact of social determinants of health on outcomes, and ways of integrating social determinants into prescriptive practice. The integrative review will inform stakeholders about the importance of pediatric provider assessment of social determinants of health and …

An Education Intervention Project In Community Clinics To Improve The Identification Of Patients With Pulmonary Alveolar Proteinosis And To Correctly Identify The Type Utilizing The Differential Diagnostic Algorithm, Catherine J. Poisson

Doctoral Dissertations and Projects

With over 7000 types, rare diseases affect 25-30 million Americans and contribute to over one trillion dollars in healthcare-related costs. Prescribers lack the knowledge to improve awareness, identification, and treatment of rare diseases. Pulmonary alveolar proteinosis is a rare disease in which patients present with symptoms such as dyspnea, fatigue, and respiratory infections. Diagnosis can take four to 92 months. A differential diagnostic algorithm published in the literature can guide clinicians in identifying the type of pulmonary alveolar proteinosis the patient has. In addition, if the clinicians perform a laboratory test called the granulocyte-macrophage autoantibody test, this test provides 100% …

Focused Group Meetings To Promote Job Satisfaction For Emergency Department Advanced Providers, Kendra Osei-Wusu

Doctoral Dissertations and Projects

Objective: Over the last few years, the pattern of increased burnout, operating under adverse environments, and being under- appreciated as led to a decrease in job satisfaction among emergency room providers(physicians, advanced practicing nurses, and physician assistants). Therefore, this scholarly project examined if small focused group discussions among emergency room providers will help combat poor job satisfaction scores and increase the well-being of the practitioners that keep the emergency room functioning. Methods: Using a quasi-experimental design, 10 providers that work in the emergency department at Lifebridge Health were randomly selected. Baseline well-being and job satisfaction rates were measured prior to …

Correlation Of Psychospiritual Factors And Suicide In The Military, Michael Odinaka Ugbor

Doctoral Dissertations and Projects

Military is a profession that requires stable mental state as a prerequisite for active military life. However, suicide rate among active members and veterans has significantly increased despite traditional measures such as psychotherapies, medications and government sponsored incentives. The purpose of this quantitative study was to examine the correlation of psychospiritual factors (spiritual, religious factors and psychological beliefs) and suicide risks among military members. Participants were 18 years or older and members of the United States military base stationed in Kentucky. Data collection involved the used a paper-based survey to measure spiritual and religious affiliations and activities, church attendance, prayer …

Implementation Of Provider Education Regarding Exercise As Adjunctive Treatment For Common Mental Health Diagnoses, Lauren Grace Martin

Doctoral Dissertations and Projects

Mental and physical health are inextricably linked. The advent of the Covid-19 pandemic reduced physical activity levels while worsening mental health symptoms. Pharmacological treatments are frequently used to treat mental health conditions; however, side effects can worsen metabolic issues. There is significant evidence that exercise can improve mental health conditions. The purpose of this project was to utilize provider education as an intervention to increase the use of exercise as an adjunctive treatment in the psychiatric treatment plan. This project was implemented at Nevada Mental Health, an outpatient behavioral health clinic in Las Vegas, Nevada. The investigator conducted a chart …

The Overlooked Care Plan- Nursing Mindset Related To Self-Care: An Integrative Review, Marie Mulford

Doctoral Dissertations and Projects

COVID-19 brought to light many things worldwide. One of the pressing issues was the increased rates of burnout, depression, and suicidal risk among nurses. This called for examining nurses’ work experiences and overall well-being during the Coronavirus pandemic. Furthermore, it was revealed that the nursing mindset regarding self-care was overlooked. This integrative review will inform stakeholders about the “overlooked care plan.” This review will be a call to action built on existing knowledge and facilitate policy for the nursing profession. Building upon nursing science, informative research, and facilitating policy initiatives, this review will serve as a call to action for …

Nursing Instructors Preparing Nursing Students To Cope With Distractions When Administering Medications: A Phenomenological Qualitative Study, Michael Thurman Frazier

Doctoral Dissertations and Projects

The purpose of this hermeneutic qualitative study was to discover and describe how nursing instructors teach nursing students to cope with interruptions and distractions while administering medication. The hermeneutic phenomenology approach is appropriate for discovering what nursing instructors teach their students about distraction in the classroom, simulation laboratory, and clinical setting. The study’s guiding theory was Kolb’s experiential learning theory. Nursing instructors from associate and bachelor’s degree programs from across the United States were recruited to participate in this study. The participants completed questionnaires about medication administration instruction, expanding on their answers in semi-structured, one-on-one interviews. All participants had the …

Communicating The Value Contributions Of Pathology And Laboratory Medicine (Palm) To Healthcare Administrators, Evidence Of Value From A Multiple Cases Study, Susan K. Edralin

Doctoral Dissertations and Projects

Hospital administrators were interviewed to explore their perceptions of the strategic alignment of PaLM value-based activities (VBAs). Hospital based PaLM leaders were interviewed to explore their communication of the VBAs. This study identified a misalignment between the assessments utilized by healthcare administrators for PaLM services and the value contributions of laboratorians. PaLM leaders offered insight into the laboratory’s value chain. Three themes emerged from the data: PaLM VBAs, PaLM communication efforts, and PaLM VBA strategic alignment. Together these findings suggest that hospital laboratorians offer untapped value in healthcare, and hospital administrators failing to recognize this value miss opportunities to improve …

Certified Nursing Assistant Turnover In The Long-Term Care Facility Industry, Michael Leroy Gregory

Doctoral Dissertations and Projects

Employee turnover in long-term care facilities results in increased operational costs and a reduction in the quality of care delivered. The purpose of this correlational study was to investigate the relationships between employee turnover intention of certified nursing assistants working in long-term care facilities and employee compensation, engagement, job satisfaction, motivation, perceived work stress during the COVID-19 pandemic, and work environment. The population of interest consisted of CNAs over the age of 17, with at least two years of experience working in the central Texas long-term care industry. Herzberg’s motivation-hygiene theory served as the theoretical framework underpinning this study. Multiple …

What Screening Schedule Or Algorithm Has Shown To Be Beneficial In Early Identification Of Perinatal Depression: An Integrative Review, Olivia Grace Hull

Doctoral Dissertations and Projects

Within the health care industry, mental illness has become a growing national concern, especially within the realm of obstetric care. As a vulnerable population, pregnant and postpartum women require appropriate screening and treatment for depression as warranted. Within the United States, there is an increasing concern around undiagnosed and untreated perinatal depression because of the lack of adequate screening and treatment plans. Perinatal depression that remains unrecognized contributes not only to long-lasting effects on the women, but also to adverse developmental effects in infants and an overall burden on the family unit. In addition, perinatal depression is associated with various …

Best Practices For Implementing Critical Care Orientation Programs For Newly Graduated Nurses After Reduced Hands-On Clinical Experience Due To The Covid-19 Pandemic: An Integrative Review, Anne-Marie Hinish

Doctoral Dissertations and Projects

The academic-practice gap has been described in the literature for years. Poorly implemented transition to practice can negatively impact patient outcomes, newly graduated nurses, and the nursing profession. Abbreviated prelicensure clinical experiences due to the COVID-19 pandemic have exacerbated the academic-practice gap’s impact on new nurse confidence, competence, safety, and retention. This integrative literature review aimed to identify best practices for developing and implementing a standardized new graduate nurse orientation program in the critical care setting that addresses and supports the transition from student to practitioner in an era of reduced hands-on clinical experiences due to the COVID-19 pandemic. Evidence …

Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infection (Pandas): A Qualitative Study Of Parental Perceptions Of Factors In Remission, Janice Diane Weddle

Doctoral Dissertations and Projects

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) starts as the child’s body has an inappropriate reaction to the immune response for streptococcal infection. PANDAS is characterized by the sudden onset of neuropsychiatric disorders, including obsessive-compulsive disorder (OCD), anxiety, chorea movements, and tics. Previous research has drawn conflicting conclusions on PANDAS treatment efficacy and long-term treatment outcomes leaving remission rates unclear. The purpose of this qualitative phenomenological case study was to explore parents’ perceptions of factors related to PANDAS remission. Parents of children diagnosed with PANDAS were recruited through Facebook PANDAS support groups and the National Institute of Mental …

The Overlooked Mission-Transitional Care Programs For Veterans In Civilian Settings: An Integrative Review, Cynthia Louise Gonzales

Doctoral Dissertations and Projects

The number of veterans within the United States continues to increase. With the addition of healthcare laws, veterans can seek care within the Veterans Health Administration (VHA) and civilian settings. The collaboration among multiple healthcare providers must ensure veterans are provided safe and efficient care when transitioning from provider to provider. Transitional care programs (TCPs) are effective strategies to ensure that veterans receive safe and efficient healthcare. The VHA employs interventions across their healthcare settings to facilitate optimal care. A variety of TCPs were discovered during the review. Most TCPs were used in VHA settings, which revealed an opportunity to …

The Impact Of Increased Interdisciplinary Communication On Hospital Admission Rates In The Geriatric Population: An Integrative Review, Molly K. Langston

Doctoral Dissertations and Projects

The medical complexity of geriatric residents puts them at an increased risk of hospital readmissions related to coronary artery disease, myocardial infarction, chronic obstructive pulmonary disease, and diabetes, along with other chronic diseases. Geriatric residents of assisted living, skilled nursing, and memory care facilities should hold a particular interest to stakeholders, as the simple intervention of increasing early communication and correspondence regarding chronic diseases can have a great impact on quality improvement outcomes as well as financial burden of the institution. Additionally, interdisciplinary communication can be individualized to meet the needs of each geriatric resident in order to reduce the …

An Icu-Specific Pressure Injury Risk Assessment Tool To Improve Outcomes, Solange Flore Kamdem

Doctoral Dissertations and Projects

Aim: To use an ICU-specific pressure injury (PI) risk assessment scale to promptly identify the risk for PIs in critically ill patients and promptly implement the appropriate PI prevention interventions to decrease the incidence rate of pressure injuries over 11 weeks.

Background: The risk of developing PIs is 3.8 times higher in the ICU patients than in other patient populations. The state of illness and or treatments increase their odds of developing hospital-acquired pressure injuries (HAPIs). The Braden scale currently in use may not identify the risk early enough to provide preventive interventions. An ICU-specific tool is needed to screen …

Impact Of Emergency Department Triage Sepsis Screening Algorithm And Treatment Order Sets: An Integrative Review, Danielle Marie Tester

Doctoral Dissertations and Projects

Sepsis is a life-threatening condition that can lead to tissue damage, end-organ damage, and death if left untreated. The Centers for Disease Control and Prevention defines sepsis as a severe response to an infection. Sepsis is prominent health concerns worldwide, as it continues to be a leading cause of mortality despite having access to health care. This has impelled many health care organizations to improve sepsis-related care and sepsis outcomes by formulating core measures to improve patient care. The purpose of this integrative review is to discuss if initiation of an emergency department triage sepsis screening algorithm and treatment order …

Does Screening Of Patients In The Home Health Setting Prevent Sepsis Readmissions?, Heather Michelle Cook

Doctoral Dissertations and Projects

The purpose of this evidence-based project is to reduce 30-day readmission rates of patients diagnosed with septicemia by using a symptom screening tool in the home health setting. Sepsis is a life-threatening and costly healthcare burden. Through this project the home health department staff were educated on the pathology of sepsis, and the use of the adult sepsis screener to identify at risk patients early and manage their symptoms thereby reducing 30-day hospital readmission rates of patients diagnosed with sepsis.

The Use Of Self-Efficacy Evaluations, Self-Care Evaluations, And Motivational Interviewing To Improve Glycated Hemoglobin Values In Type 2 Diabetes Mellitus, Meredith Ann Kelley

Doctoral Dissertations and Projects

When improperly managed, type 2 diabetes mellitus is a serious and chronic health condition with far-reaching repercussions for individuals, families, and societies. In the United States, 34.2 million individuals live with diabetes, and 90%-95% have type 2 diabetes. While the United States healthcare system faces the monumental task of improving diabetic care outcomes and associated costs, publications have established that motivational interviewing (MI) can improve self-efficacy and associated self-care behaviors of type 2 diabetics, resulting in improved hemoglobin A1c values. Thus, this scholarly project’s intent was to track participant hemoglobin A1c values over three months, measure participant self-efficacy and self-care …

Provider Knowledge And Confidence With Implementing Pediatric Adverse Childhood Experiences (Aces) Screening Tool In An Alaskan Family Practice Clinic, Lisa Marie Wangberg

Doctoral Dissertations and Projects

Adverse childhood experiences (ACEs) have been known to be associated with negative developmental and long-term health sequalae since Felitti and colleagues (1998) presented their groundbreaking research nearly a quarter of a century ago. Pediatric and primary care settings have been relatively slow to implement any type of ACEs screening at regular intervals such as at well-child exams (WCEs). A scholarly project implementation was used to present ACEs education and screening training to pediatric primary care providers in a small, private, rural family health care practice in Alaska. The goal of the project was to determine if providers felt more knowledgeable …

Analyzing The Relationship Between Non-Pharmacologic Interventions And Pregnancy-Induced Hypertension: An Integrative Review, Karen Ann Ellis

Doctoral Dissertations and Projects

Maternal and fetal health outcomes are threatened due to pregnancy-induced hypertension, which complicates nearly 6%–10% of pregnancies worldwide. This disease carries a high risk of maternal and fetal morbidity and mortality. Medications are commonly used to reduce blood pressure and physical consequences related to high blood pressure. However, the use of medications does not resolve the disease as there is no pharmacological cure. Current evidence demonstrates the detrimental long-term effects of pregnancy-induced hypertension and the increased risk of future cardiac disease. Close surveillance and effective treatment during pregnancy is needed to prevent serious complications. The aim of this integrative review …

Implementation Of A Flash Therapy Technique Pilot Program To Evaluate Well-Being In Bedside Nurses Caring For Patients With Covid-19, Rachel Faye Lakes

Doctoral Dissertations and Projects

The nursing shortage is no longer a crisis but an epidemic and it is being exacerbated by burnout and compassion fatigue. This burnout and compassion fatigue are stemming from a loss of resilience and inability to cope. The COVID-19 pandemic has further intensified these issues. A safe, efficient, and effective intervention is needed to help improve well-being and resiliency among healthcare workers. The purpose of this project was to implement a flash therapy technique pilot program to evaluate resiliency and well-being of healthcare professionals caring for patients with COVID-19. A pilot program consisting of two flash therapy sessions was implemented …

Revising An Order Set To Standardize The Workflow For The Outpatient Intravenous Diuretic Therapy Clinic In The Cardiac Cath Lab Holding Area, Mackenzie Trent Rasnake

Doctoral Dissertations and Projects

Heart failure (HF) is the leading cause of hospital admissions and readmissions. This produces costly hospital bills and detrimental effects on healthcare systems (Babar et al., 2020). It has been shown that intravenous (IV) diuretic therapy in the outpatient setting will reduce HF-related hospital readmissions (Abougergi et al., 2021). Outpatient IV diuretic therapy clinics are crucial for this reason. Revising an order set for the outpatient IV diuretic therapy clinic in the Cardiac Cath Lab holding area will reduce patient length of stay, improve nurse-provider communication, and increase patient and nurse satisfaction. Utilizing the Secure Chat feature within the electronic …

Walking To Improve Outcomes In Patients With Type Ii Diabetes, Kelley Leigh Sanders

Doctoral Dissertations and Projects

Walking is a simple, feasible, and effective exercise modality in which providers can instruct patients as a component of type II diabetic treatment plans. Many patients are overwhelmed when given instructions to exercise and therefore never begin. Lack of exercise contributes to poor glycemic control and adverse outcomes. Also, gym memberships can be expensive resulting in patients forgoing exercise altogether. The purpose of this DNP scholarly project was to conduct research outcomes which may enlighten providers to prescribe exercise interventions by providing evidence walking 45 minutes three times a week can improve glycemic control among type II diabetic patients. Also, …

The Effectiveness Of A Chart Audit And Education Intervention To Improve Rts Referral Rates And Confidence In Emergency Nurses Delivering Care To Patients Experiencing Perinatal Loss, Rachel Kathleen Tillas

Doctoral Dissertations and Projects

Perinatal loss is a significant event in a woman’s life that can have both physical and psychological impacts. Women with perinatal loss often seek care in emergency settings. Research shows that nurses working in emergency settings lack confidence in caring for this patient population, and women who seek care for perinatal loss in the emergency department are dissatisfied with their care. Resolve through sharing (RTS) is an evidence-based approach to bereavement care that offers resources and training to organizations and healthcare professionals. RTS can help bridge the education gap among emergency nurses caring for patients experiencing perinatal loss, be used …