Medicine and Health Sciences Commons^™

Clinical Nurse Manager Fatigue And Its Personal And Professional Impacts, Carlene Galanopulo

Walden Dissertations and Doctoral Studies

Workplace fatigue has been empirically linked with errors, injuries, and chronic health issues that negatively impact the healthcare worker, patients, and staff with whom that person comes in contact, as well as the organization for which that person works. The experience of fatigue in clinical nurse managers (CNMs) has been understudied. The purpose of this study was to understand the individual experience of fatigue and its professional and personal impacts as more fully described by CNMs. The research question that guided this study involved the professional and personal impact of fatigue as described by CNMs. The occupational fatigue in nursing …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

Assessing The Influence Of Education And The Diet Readiness Test On Self-Efficacy, Motivation And Resilience In Overweight Women, Ijeoma Iwu

Doctor of Nursing Practice Final Manuscripts

Purpose

The purpose of this evidence-based project is to assess motivation for weight loss and resilience to make lasting changes with weight management. The Diet Readiness Test (DRT) Questionnaire is a behaviorally based assessment tool used to evaluate psychological status prior to or during a weight-loss management program based on patients’ attitudes toward diet and exercise. The goal of using this survey was to identify predictive factors of successful weight changes for practitioners to implement into their approach to tackling obesity.

Background

One of the rising crises both in the United States and globally has been the topic of obesity. …

Lived Experiences Of Quality Of Life Among Makonde Immigrants In Kenya During And After The Covid-19 Pandemic, Shem Migosi Kenyanya

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic affected Makonde immigrants’ health and quality of life around the world more than any other previous event. This descriptive qualitative study aimed to contribute knowledge and understanding of the lived experiences of Makonde immigrants and their health and quality of life during and after the COVID-19 pandemic. Shye’s systematic quality of life model served as the theoretical basis for the study, along with Wilson and Cleary’s conceptual model of health quality of life. Semi-structured interviews were conducted with ten participants recruited through social media and flyers posted in Kilifi and Kwale counties. Subjects were interviewed face-to-face and …

Improving Adherence Rates To Postpartum Screening Of Diabetes In Women With Gestational Diabetes Mellitus: An Evidence-Based Project, Alicia Hernandez Punsalan

Doctor of Nursing Practice Final Manuscripts

Background: Women with a history of gestational diabetes mellitus are at increased risk of developing type 2 diabetes mellitus. Approximately 6%–10% of pregnancies in the United States are complicated by gestational diabetes mellitus, yet postpartum diabetes screening rates are low nationwide.

Purpose: This project focused on implementing a multi-modal reminder system to increase adherence to postpartum diabetes screening, or the 2-hour oral glucose tolerance test, for women with a history of gestational diabetes mellitus in the 4-12 weeks postpartum period.

Evidence-Based Practice Change: The multi-modal reminder system was comprised of an educational session for the staff reviewing current clinical guidelines …

“Shoes Enthused”: The Application Of An Evidence-Based Practice Podiatry Consultation And Footwear Education In Older Adults Living With Diabetes, Alissa Kathleena Gray, Razel Bacuetes Milo

Doctor of Nursing Practice Final Manuscripts

Background: Poorly fitted footwear contributes to falls in older adults living with diabetes, a population that experiences a baseline increased risk for falls in the presence of diabetic peripheral neuropathy. Despite this, baseline data reveals that 72% of older adults wear poorly fitted shoes with suboptimal shoe features¹.

Purpose of Project: Adhering to current evidence-based practice guidelines, the two goals of this project were to educate older adults with diabetes on the characteristics of properly fitted footwear and to increase access to properly fitted shoes via a podiatry consultation. Subsequently, the increased number of optimal footwear will decrease …

Screening For Adverse Childhood Experiences In An Adult Intensive Outpatient Therapy Program: A Pilot Project, Kristen Curry

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to pilot the implementation of the Adverse Childhood Experiences (ACEs) Questionnaire for Adults during admission to an intensive outpatient program (IOP) to identify clients who have experienced ACEs and provide risk-reduction measures to mitigate risks of ACE-related long-term health consequences. The study site is a Southern California-based large healthcare organization that provides outpatient intensive therapy programs which employ a variety of clinicians, to provide mental health care to clients across the lifespan.

Background: Adverse Childhood Experiences (ACEs) are potentially traumatic events including neglect, abuse, and certain forms of …

School Stock Albuterol, Trish Reyes

Doctor of Nursing Practice Final Manuscripts

SCHOOL STOCK BRONCHODILATOR INHALER POLICY FOR IMMMEDITE ACCESS IN SCHOOLS

Introduction: The purpose of this evidence- based practice DNP project was to do a systematic review, examine stock inhaler policies in school districts, and provide policy recommendations for school districts to implement the Stock Albuterol Access law. The Stock Albuterol law enacted in January 2024 would allow schools to provide an Albuterol inhaler on hand for a student experiencing respiratory distress. Albuterol inhalers provided by school personnel can be lifesaving, control asthma symptoms, have better health outcomes, increase the quality of life, and decrease Emergency and Urgent Care visits, and …

Implementing A Naloxone Training And Opioid Overdose Prevention Program At A Residential Addiction Treatment Center, Martha Plack

Doctor of Nursing Practice Final Manuscripts

Introduction: Amidst the escalating opioid overdose crisis in the United States, it is imperative to deploy effective harm-reduction strategies. This Doctor of Nursing Practice (DNP) project involved the development, implementation, and evaluation of a Naloxone Training and Opioid Overdose Prevention Program delivered to clients at a residential addiction treatment center. The primary objective of this project was to determine if the educational intervention led to an improvement in participants' knowledge and attitudes about opioid overdose and naloxone use.

Background: Overdose fatalities are a leading cause of injury-related death in the United States. The majority of fatal overdoses involve opioids. Unfortunately, …

Fall Reduction In The Home Setting For Older Adults: An Evidenced Based Practice Project, Alison Birnie

Doctor of Nursing Practice Final Manuscripts

Falls in the elderly over the age of 65 are the highest mechanism of injury in a Level II TraumaCenter in the SanGabriel Valley. In reviewing the data from 2021-2022, there were 20,653 patients over the age of 65 that arrived in the EmergencyDepartment, 12.3% of those patients had falls. The Senior Care Network is a service line of Huntington Hospital whose mission is to support the health and well-being of older adults living in and around Pasadena and the San Gabriel Valley. To meet this mission, the Multipurpose Senior Services Program (MSSP) supports community members 65 and older covered …

Care Of The Critically Ill Nontrauma Patient: Improving Emergency Department Readiness And Patient Care Through The Implementation Of A Dedicated Resuscitation Bay, Martha H. Buck Rn, Bsn, Tcrn

Doctor of Nursing Practice Final Manuscripts

Current best practice among emergency departments worldwide includes the maintenance of a dedicated resuscitation space. This practice allows for team members and equipment to be ready at a moment’s notice to provide care to a patient in need of lifesaving interventions. This evidence-based performance improvement project seeks to implement this standard of care in a busy, urban emergency department in Southern California.

Prior to this study, patients at this facility were placed in the next available care space, without the maintenance of a dedicated resuscitation area for critically ill patients. Survey data evaluating staff levels of perceived readiness to care …

Keep The Beat: Increase Sudden Cardiac Awareness And Improve Cardiac Arrest Bystander Intervention, Carley Garnica

Doctor of Nursing Practice Final Manuscripts

Background: Sudden cardiac arrest (SCA) is a rare but life-threatening condition where a person’s heart stops suddenly. It remains the leading cause of death on school campuses with chances of survival being less than 10%. Every minute without cardiopulmonary resuscitation (CPR) decreases survival by 10%. Poor outcomes are attributed to bystanders who are not prepared or are unwilling to take action in the event of a cardiac emergency. Therefore, bystanders play a crucial role in cardiac arrest.

Objectives: The purpose of this project was to educate high school students about SCA and Cardiac Chain of Survival, with the primary objective …

Increasing Patient Access To Mental Health Providers: Improving Depression And Anxiety Outcomes For African American Women Aged 18 Years Old And Older, Twanna Davis-Arnold, Farnaz Trasandes

Doctor of Nursing Practice Final Manuscripts

Increasing patient access to mental health providers: Improving depression and anxiety outcomes for African American women aged 18 years old and older.

Background: Depression and anxiety are growing health problems in the United States. In 2020/2021, there was a 36.4% to 41.5% increase in reported symptoms of depression and anxiety. Evidence has shown that African American women experience disproportionate increased risks and disparities in obtaining mental health care.

Purpose of Project: To improve access to African American or culturally competent mental health providers for adult African American women. Improving access to mental health care will lead to earlier diagnosis …

Education Program To Increase Compliance With Advance Directive Completion In A Primary Care Setting Among Filipino Americans, Genalin Paglingayen

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This evidence-based practice project aimed to provide an education program to Filipino Americans in their preferred language (English or Tagalog) to improve compliance with Advance Directive (AD) completion in a primary care setting. Educating them about AD empowers patients with their decision-making about their health in situations where they are incapacitated and unable to make sound decisions. Moreover, it will eliminate the decision-making problem for family members.

Background: An advance directive is a document that empowers patients to convey their wishes to their healthcare provider when they can no longer decide for themselves. Evidence suggested that …

Dm Education On Lifestyle Modification To Improve Dm Knowledge Retention And Self-Care Confidence, Jinyoung Sanchez

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based practice project was to provide diabetes education to improve diabetes knowledge and self-care confidence for patients with type 2 diabetes admitted to a tertiary hospital in San Diego. First, this study was to assess their DM knowledge and self-confidence before the education was provided. Second, based on the initial assessment and the education on lifestyle modification, 3 months of follow up was assessed to see if the education had been effective. Third, the study was to determine if the education also improved the self-confidence in managing diabetes on their own.

Background: Uncontrolled diabetes …

There’S An App For That: Reducing Stress In Peri- And Post-Menopausal Women, Roxane M. Brown, Bsn, Rn

Doctor of Nursing Practice Final Manuscripts

Introduction: This evidence-based Doctor of Nursing Practice project aimed to demonstrate the impact of Calm mobile application mindfulness activities on perceived stress levels in peri- and post-menopausal women ages 45 - 60 years old in a community setting.

Background: In 2020, 31.8 million women in the United States (U.S.) were between 45 and 60 years old. They are mothers, daughters, employees, and bosses, navigate intimate and social relationships, and are often caregivers. It can be a stressful stage of life. Meanwhile, these women experience menopausal changes, including hot flashes, mood changes, sleep disturbances, and cognitive difficulties. Peri- and post-menopausal women …

Personalized Text Message Reminders For Psychiatric Out Patients, Jusac Suryanata

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the use of personalized text message reminders to increase adherence to out-patient psychiatric visits and decrease the rate of no-show appointments. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians to provide mental health care to clients across the lifespan for a variety of patients throughout all socio-economic brackets.

Background: Approximately 23% of individuals who are scheduled with this provider result with a no-show appointment during the period of data mining. In general, psychiatric patients are most …

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 …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

The Interplay Of Gut Microbiota And Their Metabolites As Potential Regulators Of Resilience Or Susceptibility To Traumatic Stress In Male And Female Rats, Arax Tanelian

NYMC Student Theses and Dissertations

Exposure to traumatic stress is a major risk factor for the development of mood disorders in a subpopulation of individuals, while others remain resilient. Notably, women are twice as likely as men to develop affective disorders in the aftermath of trauma. The mechanisms and contributing factors that influence sex-related disparities in mood disorders and variations in resilience remain unclear. We hypothesized that sex-specific inter-individual differences in microbial composition, functionality, and metabolites would contribute to host resilience or susceptibility to stress-induced psychopathologies. In this study, we used single prolonged stress (SPS), an animal model of Post- Traumatic Stress Disorder (PTSD), to …

Evaluating The Implementation Of Biplane Ultrasound Probes For Guided Peripheral Intravenous Access In The Emergency Department, Ian Troupe

Doctor of Nursing Practice Final Manuscripts

Background: Single plane ultrasound (US) probes are currently standardized for initiating US guided peripheral intravenous (USGPIV) access for difficult intravenous access (DIVA) patients in the emergency department (ED). Emerging literature reveals the increased efficacy of biplane US probes for USGPIV access with an improved success rate of up to 36.6%.

Purpose of Project: Implement best practice recommendations by integrating one biplane US probe for USGPIV access at a Level 1 Trauma Center ED in Southern California after training ten registered nurses (RN) on its use. The project aimed to improve patient outcomes, department flow, RN education, and utilization …

Implementation Of Post-Operative Discharge Instructions To Outpatients In A Pre-Procedural Endoscopy Suite Prior To Sedation, Kalaya Valdez

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project is to improve overall patient satisfaction scores, patient safety and education retention postoperatively. The aim is to provide patients with the opportunity to review their discharge instructions and seek clarification prior to their procedure.

Background: Roughly 75 million endoscopies are conducted annually in the United States. The majority, 68%, are gastrointestinal endoscopies. Routine endoscopy procedures such as a colonoscopy or esophagogastroduodenoscopy utilize moderate sedation which is often a combination of midazolam and fentanyl. This combination reduces anxiety and discomfort during the procedure. The amnesic effects …

Knowledge, Health Beliefs, And Attitudes Toward Dementia Risk Reduction Among Rural Older Adults: A Qualitative Study, Jayanti Ray

Walden Dissertations and Doctoral Studies

Dementia, characterized by compromised memory, reasoning, and problem-solving, is one of the major health concerns for older adults in rural areas. Literature has indicated that there are gaps in knowledge about what older adults in rural communities know about dementia and its risk factors. The purpose of this qualitative study was to explore the knowledge, health beliefs, and attitudes toward dementia and its risk factors among older adults in rural areas. This study aimed to determine gaps in older adults’ knowledge of dementia and its risk factors and to identify their understanding of lifestyle factors and strategies that were likely …

Urgent Care Program Influences On An Integrated Health Care System, Craig H. Carter

Dissertations and Theses

The Veterans Health Administration (VHA) is the most extensive integrated health care delivery system in the world with over 20,000 physicians, 1,600 facilities, and more than 400,000 employees, caring for nine million veterans. The health care provided covers traditional outpatient and hospital-based services such as primary care, surgery, critical care, mental health, orthopedics, pharmacy, radiology, and physical therapy. Most VHA facilities offer additional medical and surgical specialties such as audiology, speech pathology, dermatology, dental, geriatrics, urology, oncology, podiatry, prosthetics, and vision care. Some of the more extensive VHA facilities offer advanced health care services, such as organ transplants and plastic …

Moving Forward With Ketamine Therapy: Ensuring Safety, Efficacy, And Accessibility In Depression Treatment, Julienne Desanto

Undergraduate Honors Theses

Ketamine, a medication long used in anesthesia, has emerged as a promising treatment for depression and other mental health disorders. Its rapid onset of action and mechanism, which differs from traditional antidepressants by targeting NMDA receptors, offers a novel approach to managing depressive symptoms. Despite its potential, ketamine's use outside anesthesia, particularly in off-label ketamine clinics, is fraught with regulatory, safety, and accessibility challenges. This paper explores the historical medical use of ketamine and its emerging role in mental health treatment. It compares the efficacies and administration routes of different forms of ketamine, including intravenous (IV) and intranasal (nasal spray) …

Analyzing The Cognitive Complexity Of The Questions On The Advanced Placement Computer Science Principles Exam, Lauren Zirpoli

Seton Hall University Dissertations and Theses (ETDs)

This convergent parallel mixed methods study with qualitative and quantitative content analysis was conducted to analyze and describe the cognitive complexity of the publicly released Advanced Placement Computer Science Principles Exam questions compared to the language of higher-order thinking found in research literature. Hess’ Cognitive Rigor Matrix was used to determine the frequency and percentage of questions categorized as higher-order thinking within each cell of the matrix. The qualitative method consisted of content analysis of the language of each question analyzed, followed by deductive coding, and culminated with categorizing the depth and type of thinking required on Hess’ Cognitive Rigor …

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 …

The Effect Of A Lactobacillus Containing Gel On The Clitoral Microbiome Of The Mare, Fiona E. Herzog

LSU Master's Theses

The equine lower reproductive tract harbors bacterial populations that serve as a reservoir for potential pathogens. Dysbiosis of urogenital sites may play a role in reproductive disease of the mare, including endometritis. Metagenetic studies have evaluated microbiomes in the uterus, vagina and placenta, while the clitoral microbiome has yet to be described. In this study, the following hypotheses were tested; 1) the clitoris harbors a unique microbiome, 2) topical Lactobacillus genus complex (LGC) probiotic will alter this microbiome, 3) acceptable per cycle pregnancy rates (PCPR) following probiotic application will be achieved. Reproductively normal mares (n=14) were selected, and clitoral fossa …

Lyme Disease In The Northeast: The Unintended Consequence Of Suburban Development, Hayden Neubert

Student Theses 2015-Present

This paper addresses the role of suburban development in the suburbs of the Northeastern United States in increasing human Lyme disease infection. Over the past 50 years, Lyme disease has become the most common vector-borne disease in the United States. In 2021, the two states with the most Lyme disease cases were New York and New Jersey, with a collective 6,524 cases, with Connecticut still representing 541 total cases. It is not a coincidence that case numbers are concentrated in suburban areas with high forest fragmentation. Chapter 1 of this essay analyzes how human land development disrupts bioregulatory ecosystem actors …

Exploring Attachment Through Clay-Based Therapy: A Parent-Child Community Engagement Project, Hilari Stahler

Expressive Therapies Capstone Theses

This research project explores the therapeutic potential of clay, particularly as a creative, sensory-rich process that facilitates access to pre-verbal memories. Grounded in attachment theory and the innovative approach to trauma healing by Cornelia Elbrecht, known as Trauma Healing at the Clay Field®, the study investigates clay's regressive and healing qualities. It examines how its smooth, skin-like texture can activate our implicit memories through sensory experiences. Utilizing a community engagement format, this study aimed to assess the effectiveness of parent-child clay field sessions in addressing intergenerational attachment trauma and unmet attachment needs. The research revealed that the unique properties of …