Medicine and Health Sciences Commons^™

The Development And Evaluation Of Nurse-Created Video Modules To Encourage Healthy Behaviors Among Women With Polycystic Ovarian Syndrome (Pcos), Rebecca Akers

Doctoral Projects

Problem Statement: Women with PCOS have a higher prevalence of overweight and obesity, a problem that is directly linked with many of the symptoms and long-term health problems experienced by these individuals. Research studies indicate that lifestyle modifications, including dietary changes and increased physical activity aimed at promoting weight loss, are often the initial approach to treatment, but many women fail to adopt those health-promoting behaviors, which may be due to insufficient teaching and support provided by healthcare professionals.

Purpose: Utilize Pender’s Health Promotion Model to develop and evaluate a set of educational video modules focused on encouraging women with …

Implementing Low-Dose Ct Scans To Screen For Lung Cancer In The Primary Care Setting, Monifa Ri'ana Beal

Doctoral Projects

Lung cancer is the leading cause of cancer-related death in both men and women in the United States. By the end of 2023, lung cancer will have been diagnosed in approximately 238,000 Americans and claimed the lives of about 127,000 of those that are diagnosed.(American Cancer Society, 2023) Currently lung cancer accounts for more deaths among Americans than breast, prostate, and colon cancers combined (Centers for Disease Control and Prevention [CDC], 2019). Despite being one of the most preventable cancers in the world, lung cancer continues to be the leading cause of cancer-related death among Americans and more so in …

Preventing Diabetes Through Prediabetes Screening And Treatment In Primary Care, Dewona Beal

Doctoral Projects

Diabetes is an epidemic in the United States. There are three types of diabetes: type 1, 2, and gestational diabetes. Type 2 diabetes mellitus (T2DM) is the most common type of diabetes. This type of diabetes can be prevented or delayed. In persons with T2DM, the body cannot use insulin well to keep blood glucose within normal limits. Several factors, including genetics, lifestyle such as poor diet and physical inactivity, obesity, insulin resistance, hormones, and certain medications, can cause it. A precursor to T2DM is prediabetes. Prediabetes is when blood sugar levels are elevated but not elevated enough to be …

A Quality Improvement Project On Blood Pressure Measurement: Are We Failing Our Patients?, Michael Baker

Doctoral Projects

Despite billions of dollars invested in research, education, and equipment, high blood pressure remains a significant contributor to mortality rates across the globe. According to the Centers for Disease Control (2019), hypertension was listed as a primary or contributing cause of over a half-million deaths in the United States (Centers for Disease Control [CDC], 2021). Without regard to race, gender, background, or socioeconomic level, this “silent killer” the Mississippi State Department of Health estimated that over 700,000 Mississippi adults were diagnosed with high blood pressure and thousands more at an increased risk each year (MSDH, 2019). Failure to identify and …

Early Identification Of Barriers To Medication Adherence In The Elderly Population Through The Use Of A Modified Screening Tool, Miranda Joyner, Blake Meranto

Doctoral Projects

Medication nonadherence (MNA) is a major contributor to hospitalizations and accounts for billions of dollars spent every year on health care. Despite medications being prescribed in nearly 75% of healthcare interactions, it is estimated that 33 to 50% of Americans do not take their medications as prescribed, if at all (Bartlett Ellis et al., 2020; Kleinsinger, 2018). The COM-B (Capability, Opportunity, Motivation, Behavior) Model used in this DNP project suggests that an individual must have the capability, opportunity, and motivation to enact a certain behavior, and should any of these areas be lacking, the behavior is unlikely to occur. This …

Examining The Effectiveness Of Physical Activity Patient Education In Improving Hba1c, Nadieh Samiaei

Doctoral Projects

Regular physical activity plays an important role in maintaining good health and managing and reducing HbA1c among type 2 diabetes patients. The goal of this study is to examine the effectiveness of physical activity in reducing the HbA1c among the type 2 diabetes patients of a local community health center in San Leandro, California. A quasi-experimental, pretest-posttest single site design project was conducted among a sample of 24 patients who had type 2 diabetes. The participants were selected to attend regular patient education classes promoting physical activity, diet, and lifestyle change as a measure of controlling diabetes. A paired sample …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

Telemedicine Perception: An Identification And Evaluation Of Factors Contributing To The Use Of Telemedicine Services, Katherine Lewing

Doctoral Projects

A morbidity and mortality report made by the Centers for Disease Control (CDC) on the impact of telehealth services during the COVID-19 pandemic throughout 2020 noted several instances in which telemedicine tools had contributed to improved patient outcomes, including: increasing the availability of care to patients otherwise left with little access to health care, decreasing unnecessary patient visits, and reduced disease exposure to patients and staff directly at risk (CDC, 2020).

As the utilization of telemedicine becomes more important and prevalent in U.S. health care systems, it is important to recognize factors that inhibit patient usage. Factors such as inadequate …

Understanding The Effectiveness Of Diabetes Self-Management Education On Psychological Distress And Self-Care Activity Measures: A Focus On Latinx Community, Anita Khadka

Doctoral Projects

The psychological distress that people with diabetes experience makes them twice likely to have clinical depression. Diabetes self-management education and support is an effective strategy to improve psychological distress and increase self-care activity measures. However, there has been limited knowledge on the impact of formal diabetes self-management education and support DSME/S on psychological distress among minority populations such as Latinx. The primary objective of this study is to explore the impact of diabetes self-management education on psychological distress and self-care activity measures. This study also explores the impact of demographic variables of the Latinx respondents on psychological distress and self-care …

Improving Diagnosis And Treatment Of Prediabetes Among Primary Care Providers By Increasing Awareness Of Prediabetes Education, Sonia Walker

Doctoral Projects

Prediabetes is a precursor to diabetes and requires treatment most of the time. Prediabetes is a health condition characterized by high blood sugar levels, but it has not developed into type 2 diabetes mellitus (T2DM). According to the Centers for Disease Control and Prevention (CDC) recent estimates, about 88 million Americans have prediabetes (CDC, 2020). This project's main aims were to determine the effectiveness of implementing a structured prediabetes education intervention in diagnosing and screening prediabetes among primary care providers caring for African American females (AA) aged 30 to 60 years. Moreover, to evaluate the outcomes of implementing the educational …

Improve Primary Care Advanced Practice Nurse's Knowledge Of Depression By Educational Interventions And Treatment Recommendations, Dorothy Adams

Doctoral Projects

Poor medication adherence is one of the significant barriers to treatment for depression, often due to fears about side effects and insufficient knowledge among nurses. Educating primary care advanced practice nurses can help to improve understanding about symptoms of depression and the treatment recommendations. Education can help engage the primary care advanced practice nurses to improve patient understanding and thereby support better adherence measured as improved refill rates and follow-up reports. The refill rates will show if the patients under the primary care advanced practice nurses ‘care have been following the medications prescribed in the right frequency and dosage. The …

Decreasing Hospital Readmission With Post-Hospital Discharge Primary Care Clinic Appointments, David Snodgrass

Doctoral Projects

ABSTRACT

The Centers for Medicare and Medicaid Services (CMS) continue to apply costly financial penalties for hospital readmission. Hospital readmission can stem from multiple causes which can lead to poor health outcomes or increased healthcare financial costs. However, with the use of an implemented 14-day post-hospital follow-up appointment with a primary care provider, hospital readmission could be reduced, and patient care improved. The multiple factors that can lead to hospital readmission include non-adherence to medication, socioeconomic factors, patient-related factors, condition-related factors, or health system-related factors. Through the implementation of post-hospital discharge follow-up visits within 14 days of discharge, hospital readmissions …

Implications Of Educational Counseling On Prep Uptake In Msm At A Community Health Clinic, Thanh T. Dinh

Doctoral Projects

HIV pre-exposure prophylaxis (PrEP) medication is 99% effective at preventing HIV acquisition if used daily (CDC, 2020; FDA, 2019). Despite its effectiveness and wide availability, PrEP uptake and adherence remained low, especially among MSM of color (Bradley et al., 2019; Kuhns et al., 2017). Prior studies have shown that participants exposed to PrEP information, counseling, and education were more likely to show interest in PrEP and uptake of PrEP. Although various studies support the effectiveness of educational interventions in increasing PrEP uptake, it has not been widely implemented in the practice setting in communities that would benefit from it. The …

Full Practice Authority: Determining Readiness Among Nurse Practitioner Students In Mississippi, Betty Hoffman

Doctoral Projects

Full practice authority has been granted to nurse practitioners by many states. These practitioners are educated and trained as full primary providers of health care. Full practice authority for nurse practitioners is not granted in Mississippi, which currently ranks in the lowest positions for health care in the United States. The low ranking can be attributed to a lack of providers and access to services.

This project seeks to explore attitudes and understanding of nurse practitioner students in the State of Mississippi regarding full practice authority. A survey will be electronically distributed to determine what is already known and understood …

Increasing Knowledge Of Fibromyalgia Diagnostic Criteria Using A Screening Tool In Primary Care, Diane Morris

Doctoral Projects

ABSTRACT

Fibromyalgia (FM) is a chronic pain condition that is second only to osteoarthritis. Fibromyalgia dramatically impacts the quality of life, with its many symptoms requiring a multidisciplinary approach to treatment. The recommendation is that patients with fibromyalgia are treated in primary care, as are other chronic diagnoses such as hypertension and diabetes, with referrals to other disciplines as needed. However, some primary care providers may not recognize fibromyalgia as a valid diagnosis, have received inadequate formal training in fibromyalgia, and have limited awareness of diagnostic criteria.

According to the research, as many as 3 out of 4 people with …

Improving Adolescent Risk Assessment And Provider Follow-Up In Primary Care, Darby R. Disselkoen

Doctoral Projects

Purpose: The purpose of this quality improvement project was to improve preventive care for adolescent patients by implementing standardized, routine screening for risk-taking behaviors and improving provider response to identified risks using the Rapid Assessment for Adolescent Preventive Services tool and resources for providers to reference during discussions about risk.

Methods: Quality improvement methodology was utilized at a midwestern pediatric primary care office to implement a practice workflow for staff to follow during annual, adolescent wellchild exams beginning at age thirteen.

Results: Analysis of project results demonstrated a significant increase in routine screening for adolescent risk behaviors compared to the …

Evaluating The Clinical Impact Of Providing Home Blood Pressure Monitors To Patients With Elevated Or High Blood Pressure, Theresa La Guardia Asmus

Doctoral Projects

Many clinicians continue to diagnose hypertension based on office-based readings, despite the 2015 United States Preventive Services Task Force recommendation for the use of home or ambulatory blood pressure monitoring to confirm the diagnosis of hypertension prior to initiating treatment. Without obtaining blood pressure readings outside of the clinic environment, it is impossible to correctly diagnose hypertension, particularly regarding masked hypertension and white coat hypertension.

Stanford Health Care implemented a quality improvement project that provided patients with a home blood pressure device to monitor out of clinic blood pressure readings. The purpose of the project was to improve clinical care …

Nurse Practitioners’ Perceptions Of Telehealth Behaviors, Michelle Austin

Doctoral Projects

Problem: NP’s must be proficient in the behaviors that are required for a successful patient encounter to provide the full benefit of nurse practitioner (NP) telehealth. Consequently, it is imperative for NPs to understand telehealth etiquette behaviors which include the technical and non-technical skills that are necessary for an effective NP-patient patient telehealth encounter (Haney, Kott & Fowler, 2015). Telehealth has been incorporated into healthcare delivery and its use is expanding. In the United States, it is predicted to be used by seven million patients in 2020 (US Department of Health and Human Services, 2018). Appropriate access to health care …

The Mental Health Experience Among Parents Of Children With Autism, Thao Tran

Doctoral Projects

Parents of children diagnosed with autism spectrum disorder (ASD) face challenges, stress, and mental health issues than parents of children without autism. Mental health experience of parents in underserved communities are not adequately studied. This qualitative study used a phenomenological approach to understand the mental health experience of eight parent caregivers residing in San Joaquin Valley, California. All parents reported the journey was stressful but not all parents described the point when they received the diagnosis as being more stressful than before and after the ASD diagnosis. Parents’ responses to the semi-structured interview that assesses for the degree of ambiguous …

Implementation Of A Self-Care And Wellness Educational Program Addressing Job Stress Among Child Protective Service Workers, Natonya Murray

Doctoral Projects

Job stress attributed to secondary exposure to trauma and the high work demands put child protective service workers at high risk of developing physical and psychological health problems. The purpose of the project was to develop and implement a self-care and wellness educational program addressing job stress among child protective service workers (CPS) guided by Substance Abuse and Mental Health Science Administration’s (SAMSHA, n.d.b) educational toolkit, Promoting Staff Wellness and Preventing Vicarious Trauma and other Work Force Concerns, the Centers for Disease Control and Prevention’s (CDC, 2019c) section on Adverse Childhood Experiences, and the National Council for Community Behavioral …

Implementing Screening To Assess Readiness To Change In Overweight And Obese Patients At A Patient-Centered Medical Home, Jarrod Gant

Doctoral Projects

Obesity is at epidemic levels within the United States (U.S.), but the Southern U.S. has some of the most obese states. Mississippi (MS) is the most obese state in the country (Robert Wood Johnson Foundation, 2018). Factors such as diet, sedentary lifestyle, cultural influences, and socioeconomic status contribute to the state’s citizens being overweight and obese.

Contributing to the state’s obesity is the fact that MS has more people living in poverty than any other state (Center for American Progress [CAP], 2018). Lacking the ability to afford healthy foods and the ability to afford quality healthcare adds to the state’s …

Barriers In Hypertension Management Among Culturally Diverse Patients In An Urban Urgent Care Setting, Navpreet Kaur

Doctoral Projects

Hypertension is the leading cause of deaths related to cardiovascular disease conditions. A vast number of patients are not taking their medications as prescribed by the physicians. This non-adherence to hypertensive treatment plans results in increased numbers of cases of unstable blood pressure. Medication adherence will help to manage the controllable cardiovascular diseases and will automatically decrease the incidences of emergent cases in hospitals and urgent care clinics. It will further decrease the costs of diagnostic evaluations used during the emergent visits. This decreased patient load in the emergency rooms will improve quality patient care. The study timeframe of data …

Identifying Perceived Barriers To Primary Health Care Access In Rural, Medically Underserved Areas, Suzanne Hewitt

Doctoral Projects

Persons living in rural areas designated as having primary care provider shortages often lack access to timely and appropriate levels of care, frequently forcing them to forego care, delay treatment, or seek care in an emergency department for non-urgent complaints. This qualitative study reviewed evidence-based research and data generated from two focus groups sessions to generate a body of distinctive knowledge of the barriers to primary healthcare access as perceived by members of this rural, medically-underserved area of northern California. The theme that was identified, through conventional qualitative content analysis, as most prevalent among subjects was the inability to schedule …

Barriers In Health Care In Hmong Men And Women With Cardiac Diseases, Ying Thao

Doctoral Projects

Lauver’s theory of care seeking behaviors is applied to identify perceived barriers to accessing healthcare in Hmong men and women that may influence care seeking behaviors. The purpose of this study is to identify barriers in accessing health care among Hmong men and women ages 50 to 80 with cardiovascular heart disease (CHD) and risk factors for CHD (e.g., diabetes, hyperlipidemia, and hypertension). A quantitative descriptive analysis was used to look at demographic characteristics while a multiple regression analysis was used to statistically compare correlations between barriers to care, risk factors for CHD, sex, and access to health care. The …

A Retrospective Chart Review Pilot Study Of Fall Prevention Through A New And Innovative Care Model, Lydia Smith

Doctoral Projects

According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related mortality in the geriatric population, and they are the most common cause of brain injury and hip fracture. The prevalence for falls is 30% in patients over 65 in the United States who experience a fall annually, and the prevalence in dementia patients can be up to 80% annually; the consequences of falls can include injury, reduction in mobility, depression and decreased socialization with peers (CDC, 2015). The purpose of this retrospective chart review pilot study is to examine the number of falls …

Perceptions Of Adult Patients Accessing Telehealth In An Urban Medical Group, Katharine Shepherd West

Doctoral Projects

Problem: Although implementation of in-patient electronic healthcare records is nearly complete in the United States, this achievement has not translated into consumer-to-business telehealth in the primary care setting. Because there are few studies that describe how and why patients select telehealth, the aim of this study was to learn about perceptions of adult patients in an urban setting when telehealth options are available. Research questions included a) How do patients select any type of appointment? b) How do patients perceive and use telehealth options? c) How and when might telehealth be useful in the future?

Methods: A qualitative study design …

Does Preoperative Ostomy Education Decrease Anxiety In The New Ostomy Patient?, Michelle Suzann Harris

Doctoral Projects

Background: There are approximately 100,000 patients with new ileostomies and colostomies created in the United States each year. These patients have specialized needs that include acceptance of altered body image, psychological stress, learning of difficult tasks, and occasionally an ominous diagnosis leading to the need for surgery. In addition to pre-surgical stoma site marking on the abdomen, ostomy nurses have identified early education to be an important factor in long-term success and management of the patient . Early education and stoma site marking may assist with a better-situated stoma leading to fewer complications related to appliance adherence and leakage. …

Losing Weight And Improving A1c Level By Adding A 30-Minute Walk To Individuals' Daily Activities, Lobat Danehvar-Jahromi

Doctoral Projects

Overweight/obesity is a global health concern, as is the growing prevalence of type 2 diabetes mellitus. Health complications related to these two problems negatively affect individuals’ quality of life and the healthcare system. In the literature on controlling these two health issues and preventing their related health complications, few studies examine use of a simple and affordable method. This research investigated the possibility of improving BMI (body mass index) and lowering blood sugar level, as measured by A1c, by adding a 30-minute daily walk to individuals’ activities. Thirty patients classified as overweight or obese (BMI of 25-35) with type 2 …

Adult Attention Deficit/Hyperactivity Disorder Quality Improvement Project, Danielle Miller

Doctoral Projects

Adults with Attention Deficit Hyperactivity Disorder (ADHD) vary widely in their symptom presentation and functional deficits, which can make management in the primary care setting challenging for providers (Morstedt, Corbisiero, Bitto, & Stieglitz, 2015). Measurement-based care is common in the management of medical disease, however is rarely used as standard practice in treatment of psychiatric disorders (Waldrop & McGuinness, 2017). As a result, treatment for psychiatric conditions, such as ADHD, may vary widely among clinicians and may result suboptimal treatment and patient outcomes (Waldrop & McGuinness, 2017). The proposed solution was to introduce the use of a standardized measurement tool …

Actualizing Best Care Practices At A Psychiatric Treatment Center To Validate The Asset Of An On-Site Electrocardiogram, Pamela Metts

Doctoral Projects

Considerations to be contemplated in daily health delivery systems are complex and require varied approaches to deliver best-care processes that produce optimal patient outcomes. Specialty practice sites not only require the capability but also necessitate proficiency and dedication in meeting and exceeding essential healthcare competencies. A psychiatric treatment center specialty practice was the setting for this DNP project. The focus of this project included: (1) care resourcefulness, (2) safety initiatives, (3) increased privacy and confidentiality compliance, and (4) cost-efficiency measures.

Technology use beyond the security of the safety available within the treatment complex is a current policy at the psychiatric …