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Articles 1 - 30 of 30
Full-Text Articles in Medicine and Health Sciences
The Lived Experience Of Practical Nursing Faculty Who Have Transitioned To A Concept-Based Curriculum As Required By The North Carolina Nursing Curriculum Revision Project, Lora Poole Bartlett
The Lived Experience Of Practical Nursing Faculty Who Have Transitioned To A Concept-Based Curriculum As Required By The North Carolina Nursing Curriculum Revision Project, Lora Poole Bartlett
Doctoral Dissertations and Projects
The purpose of this hermeneutic phenomenological qualitative study was to understand the lived experience of practical nursing (PN) faculty who have transitioned from a systems-based curriculum to a concept-based curriculum (CBC) as required by the North Carolina nursing revision project. In recent years, nursing education transformation has been a topic of interest among government organizations, the healthcare system, nursing leaders and organizations, and faculty of nursing programs. However, literature specifically on how faculty perceive and transition into these new innovative methods of teaching is minimal. The participants in the study were PN faculty employed by North Carolina community colleges and …
Increasing Asymptomatic Chlamydia Screening In The Ed, Mikyung Kim
Increasing Asymptomatic Chlamydia Screening In The Ed, Mikyung Kim
Doctoral Dissertations and Projects
The Centers for Disease Control and Prevention (CDC) recommends chlamydia screening in young women and others who are at risk based on scientific evidence related to the effectiveness of screening to prevent chlamydial infection. Female patients may visit the emergency department (ED) with symptoms such as urethritis, abdominal pain, or vaginal spotting. For men, most complaints are urinary problems, discharge from the penis, and testicular pain. However, most infected patients are never symptomatic and have no abnormal physical findings. Therefore, the question that spurred this project was, “Why aren’t asymptomatic patients screened more often?” Furthermore, “Why are the CDC screening …
Reducing Emergency Department Length-Of-Stay And Overcrowding Through Team Triage, Kirsten Gisela Sizemore
Reducing Emergency Department Length-Of-Stay And Overcrowding Through Team Triage, Kirsten Gisela Sizemore
Doctoral Dissertations and Projects
Emergency department (ED) overcrowding is an internationally studied phenomenon linked to adverse patient outcomes, including death. Early medical screening exams (MSE) may prevent morbidity and mortality. Yet, EDs struggle to evaluate, treat, and discharge patients within recommended and nationally monitored benchmark times. This evidence-based scholarly project explored if stationing an advanced practice provider (APP) in triage would improve door-provider-times, length-of-stay (LOS), and the left without being seen (LWBS) rate at a medical center ED in the southeastern United States. A pre- and post-intervention design compared benchmark times after a provider triaged alongside the registered nurse (RN) during times of high …
The Use Of Patient Diaries In The Cvicu To Prevent Post-Intensive Care Syndrome And Improve Family Satisfaction With Care, Denise M. Goodberlet
The Use Of Patient Diaries In The Cvicu To Prevent Post-Intensive Care Syndrome And Improve Family Satisfaction With Care, Denise M. Goodberlet
Doctoral Dissertations and Projects
Patients in the ICU are at risk for adverse physiological and psychological symptoms including anxiety, depression and confusion common with post intensive care syndrome. The presence of these symptoms is correlated with poor satisfaction with care and decreased quality of life. This creates stress for patients as well as the families of these patients. This evidence-based practice (EBP) project sought to answer the clinical question: For patients and families in the cardiovascular intensive care unit (CVICU), can participating in an intensive care diary program, when compared to standard of care, decrease the symptoms and incidence of post-intensive care syndrome in …
Teachback: The Implementation Of The Teach-Back Method To Improve Patient Satisfaction With Care Transitions, Elizabeth M. Breton
Teachback: The Implementation Of The Teach-Back Method To Improve Patient Satisfaction With Care Transitions, Elizabeth M. Breton
Doctoral Dissertations and Projects
Patient education at discharge from the hospital is an essential element to continuation of care and management of chronic health issues. While many elements may contribute to patient satisfaction with discharge education, use of the teach-back method has been found to improve retention of discharge instruction, as well as increase patient confidence in chronic disease management and self-care at the time of discharge. Patient satisfaction with discharge education is a notable component of hospital reimbursement by national standards, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) results. Following education of nursing staff participating in …
Noninvasive Ventilation Protocol Development, Janise Pierce Tinsman
Noninvasive Ventilation Protocol Development, Janise Pierce Tinsman
Doctoral Dissertations and Projects
Endotracheal intubation results in many serious complications including regurgitation, vocal cord paralysis, and death. Noninvasive ventilation using bi-level positive airway pressure has been shown to provide the necessary support without intubation and is also associated with better outcomes if trialed prior to endotracheal intubation. A noninvasive ventilation protocol was applied in a rural acute care facility. Results: The average length of stay for acute respiratory failure decreased from 5.32 to 4.44 days, while intubations fell from 41.9% to zero, and mortality fell from 9.7% to zero during the pilot period. Five cases met criteria for noninvasive ventilation, and three received …
Improving Patient Satisfaction With Quietness At Night: An Integrative Review, Victoria Rondez Squier
Improving Patient Satisfaction With Quietness At Night: An Integrative Review, Victoria Rondez Squier
Doctoral Dissertations and Projects
Despite the efforts to improve the environment of care in hospital settings by noise reducing interventions, building redesigns, and quiet hours, research maintains patients continue to report noise is problematic across all specialties in acute care settings. Patient satisfaction correlates to their perception of quality care and hospitals are economically impacted by their feedback on hospital rating surveys. Stagnant Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results across the country indicate “Quiet at Night” is in need of attention to be prioritized, as it continues to be the lowest scoring line item on hospital rating surveys since …
Back To The Basics With Environmental Hygiene, Shanna D. Stowe
Back To The Basics With Environmental Hygiene, Shanna D. Stowe
Doctoral Dissertations and Projects
Environmental hygiene is fundamental in preventing the transmission of pathogens that can cause health care-associated infections (HAIs). Inanimate surfaces within the patient’s environment are defined as high-touch surfaces and include areas such as bedrails, tray tables, call lights, telephones, any equipment that is attached to the patient, and the computer on wheels. HAIs develop during hospitalization and occur within 48 to 72 hours of admission or within 10 days after hospital discharge (CDC, 2014; Collins, 2008). HAIs increase the morbidity, mortality, and hospital expenditures; and critically ill patients are at greater risk for HAIs because of their compromised immune systems, …
The Benefits Of Early Referral To Palliative Care For End Stage Renal Disease (Esrd) On Dialysis, Omolola Akinmadelo
The Benefits Of Early Referral To Palliative Care For End Stage Renal Disease (Esrd) On Dialysis, Omolola Akinmadelo
Doctoral Dissertations and Projects
Palliative care provides outstanding holistic nursing for the management of undesirable symptoms and suffering related to chronic illness disease processes such as end stage renal disease. When palliative care services are initiated early in course of a chronic illness, they improve the quality of care and life and reduce stress for patients and their families. While palliative care is slowly being recognized as the most effective means of improving quality of life and care in the management of chronic illness, most health care staff and providers are not aware of the full benefits of palliative care in the management of …
Using Teamstepps® To Improve Interprofessional Collaboration In The Outpatient Psychiatric Care Setting, Amy Michele Wadsworth
Using Teamstepps® To Improve Interprofessional Collaboration In The Outpatient Psychiatric Care Setting, Amy Michele Wadsworth
Doctoral Dissertations and Projects
The AACN has identified in their QSEN competencies that collaborative teamwork and patient-centered care are two qualities that skilled nurses must exhibit to provide high-quality care. The IOM has made a call to action that healthcare professionals must exhibit patient-centered care in interdisciplinary team settings to achieve high-quality care. At a community resource program in the mid-Atlantic region, a recent qualitative job satisfaction survey revealed that employees identified issues with interprofessional collaboration and a lack of teamwork at the facility. Using the Iowa Model, this EBP project involves the use of a cohort study with a pretest-posttest design, where the …
Sepsis Education Utilizing ‘Sepsis Alert’ Checklist To Support The Adherence Of Early Management Bundle In The Emergency Department, Jean Jun
Doctoral Dissertations and Projects
Early recognition and timely management of sepsis is a priority within hospitals due to its direct impact on patients’ outcomes. It is critical for healthcare providers to be educated and aware of the signs and symptoms of sepsis. The emergency department (ED) is the forefront of the hospital where majority of patients with sepsis are assessed and either discharged or admitted into the hospital. Therefore, it is critical for ED nurses to be educated in the early signs of sepsis and follow evidence-based practice guidelines when managing these patients. The project leader implemented a sepsis education intervention aimed at clinical …
Significance Of Capnography In Pediatric Post Anesthesia Care, Deborah Renee Whitley
Significance Of Capnography In Pediatric Post Anesthesia Care, Deborah Renee Whitley
Doctoral Dissertations and Projects
Updated clinical guidelines and professional practice standards for pediatric post-anesthesia care call for the use of capnography until the patient is awake. The purpose of this project was to champion the implementation of capnography in the pediatric post-anesthesia care unit at the project site. Monitoring capnography in addition to pulse oximetry for all pediatric post-anesthesia patients until awake was the practice change implemented. Capnography led to an increase in the number of appropriate respiratory-related nursing care interventions provided, earlier response to changes in respiratory status, and a decrease in the pediatric post-anesthesia care unit length of stay. The implications for …
Centeringpregnancy: Perceptions Of Providers And Staff In A Private Ob Practice, Allison F. Mills
Centeringpregnancy: Perceptions Of Providers And Staff In A Private Ob Practice, Allison F. Mills
Doctoral Dissertations and Projects
Traditional prenatal care has been the stalwart of care in the United States since the 1920s; however, a new model of care is emerging: group-style prenatal care. This model of care has been well-documented within literature as having notable maternal and fetal outcomes, including increased patient satisfaction, decreased preterm birth rates, increased breastfeeding rates, and increased patient compliance, to name only a few. With such remarkable outcomes, it begs the question of why the group prenatal care model is not more widely utilized. This project aimed to determine if increasing the knowledge of healthcare providers in a private obstetrics practice …
Evaluation Of Patient Education To Facilitate Advance Directives Completion With Dialysis Patients, Xuesi Liu
Evaluation Of Patient Education To Facilitate Advance Directives Completion With Dialysis Patients, Xuesi Liu
Doctoral Dissertations and Projects
Completion of advance directives (ADs) is an important part of identifying a patient’s treatment preferences. Lack of patient understanding regarding the scope and importance of advance directives is a common barrier to AD completion. This project reports on the effectiveness of a patient education intervention in facilitating patient understanding in an outpatient dialysis facility in rural Virginia. Thirty patients were selected by convenience sampling to participate in a 10-minute verbal presentation based on a brochure entitled “Advance Care Planning: Tips from the National Institute on Aging” and completed two short questionnaires, one before and one after the education session. Patients …
Mobile-Based Technology App Used To Improve Self-Care Management Of Patients With Type 2 Diabetes Mellitus, Fred Allen Smith Jr
Mobile-Based Technology App Used To Improve Self-Care Management Of Patients With Type 2 Diabetes Mellitus, Fred Allen Smith Jr
Doctoral Dissertations and Projects
Billions of dollars are spent on diabetes in healthcare each year. Patients with lower socio-economic-status tend to have poor glycemic control, higher associated diabetic complications, and higher associated mortality rates. In underserved patients with type 2 diabetes, does utilization of a Diabetes app, compared to previous self-care management and clinic education, lower the Hemoglobin A1c over a 3-month period? A 3-month scholarly project was conducted in a small rural town in Virginia with an average median income around $17,000. N=21 were selected for the scholarly project. Inclusive criteria consisted of adults aged 19-70 years with a diagnosis of type 2 …
The Implementation Of The Teach-Back Method In Dash Diet Education To Improve Blood Pressure Control In Patients With Hypertension And Low Health Literacy, Patrice Helen Spencer
The Implementation Of The Teach-Back Method In Dash Diet Education To Improve Blood Pressure Control In Patients With Hypertension And Low Health Literacy, Patrice Helen Spencer
Doctoral Dissertations and Projects
Low health literacy is closely correlated with poorly-managed chronic disease conditions. Hypertension is a common chronic disease condition which can be better controlled through compliance with the dietary approaches to stop hypertension (DASH) diet; however, patients with low health literacy may have difficulty understanding the DASH diet without proper education. The teach-back method is an evidence-based education tool which can empower patients with low health literacy to better control the management of hypertension through adherence to the DASH diet. This is an evidence-based project which purposes to reveal the effectiveness of the teach-back method in providing DASH diet education in …
Reducing Central Line-Associated Bloodstream Infections In The Intensive Care Unit By Improving Compliance With Dressing Changes And Curos Caps Use, Jennifer Khaziga Kilel
Reducing Central Line-Associated Bloodstream Infections In The Intensive Care Unit By Improving Compliance With Dressing Changes And Curos Caps Use, Jennifer Khaziga Kilel
Doctoral Dissertations and Projects
Background: Reducing central line-associated bloodstream Infections (CLABSI) is a topic of global importance due to associated risk of sepsis, increased length of hospital stay, high healthcare cost, and increased morbidity and mortality among critically ill patients in the intensive care unit (ICU). The mortality rate of patients who acquire CLABSI 15-25% The cost of CLABSI treatment per event is greater than US $16,500. Central cine-associated Bloodstream Infections affect the organization’s national ranking in patient quality and safety as well as reimbursement from the Centers for Medicare and Medicaid (CMS). The aim of the quality improvement project was to improve the …
Culturally Appropriate Education In Managing Hypertension In African Americans, Kristina Jones
Culturally Appropriate Education In Managing Hypertension In African Americans, Kristina Jones
Doctoral Dissertations and Projects
Abstract The historical treatment of African Americans with events such as the Tuskegee experiment and Jim Crow laws combined with distrust of the healthcare system may be affecting health outcomes in African Americans with hypertension. Cultural appropriate education by a provider of the same race is a method that can be utilized to bridge the trust gap between African Americans and providers and assist African Americans in managing their hypertension. A community based culturally appropriate educational intervention by a provider of the same race was implemented over the course of eight weeks to assist African Americans with hypertension to improve …
An Educational Intervention To Raise Obesity Awareness, The Importance Of Follow-Up, And The Need To Utilize Recommended Strategies And Interventions Among Advanced Care Practitioners In A Sleep Center Setting, Cindy L. Thomas
Doctoral Dissertations and Projects
Obesity is a national epidemic that affects approximately 40% of adult Americans. A lack of advanced practitioner (AP) knowledge about obesity and follow-up may contribute to the obesity epidemic. Diagnosing obesity and beginning prompt weight loss (WL) management with the aim to prevent the development or progression of chronic illnesses associated with obesity is imperative. Research has shown that WL of 5% to 10% of initial body weight can reverse or reduce the onset of chronic illnesses. The purpose of this evidence-based practice (EBP) scholarly project was to raise the awareness of weight management resources among APs caring for patients …
Decreasing Caregiver Stress, Dexter Ramos
Decreasing Caregiver Stress, Dexter Ramos
Doctoral Dissertations and Projects
Stress is both critical and personal experience and has significant effects on caregivers’ physical, mental, and social well-being. The nature of caregiving and the responsibility to work and serve individuals at their illness conditions are very personal encounters that often result in adverse effects on the health and well-being of caregivers (Frederick, 2016). A decrease in stress experience can lead to the satisfaction of caregiver roles and improvement of patient’s quality of life (Choi, Jisun & Boyle, Diane, 2013; Yada, Nagata, & Inagaki, 2014). This scholarly project determined that evidence-based stress management interventions have decreased the perceived stress in caregivers. …
A Patient-Centered Medical Home Model For Improvement Of Healthcare For The Homeless Population: An Integrative Review, Dale Ellen Strickland
A Patient-Centered Medical Home Model For Improvement Of Healthcare For The Homeless Population: An Integrative Review, Dale Ellen Strickland
Doctoral Dissertations and Projects
The homeless population is surrounded by many obstacles while trying to obtain the essentials of life including food, water, shelter, clothes, medical care, and safety. In many areas of the United States and other countries homelessness is becoming an increasing problem. Compared to standard healthcare, the Patient-Centered Medical Home Model is offering a better experience for homeless patients. This integrated review provides a selection of published studies and information on the homeless population and the beginning of the Patient-Centered Medical Home Model to improve access and healthcare to many homeless patients. As the model is accepted by more medical professionals, …
Raising Awareness Of Compassion Fatigue Among Healthcare Providers In The Coronary Care Unit, Keri Tifft
Raising Awareness Of Compassion Fatigue Among Healthcare Providers In The Coronary Care Unit, Keri Tifft
Doctoral Dissertations and Projects
Compassion fatigue is a pressing issue in critical care units across the healthcare field. There is a sincere desire by nurses to give the best care possible to each of their patients; however, many obligations split the nurse’s attention so they do not feel as if they are providing the best care to their patients. When nurses stop viewing their patients as humans and start viewing them as tasks, the compassion that the nursing profession prides itself on, is no longer there to the degree that is needed for quality care. Increasing awareness of compassion fatigue and teaching nurses and …
A Hepatitis C Screening Tool For An Uninsured Population, Kimberly Belle Babcock-Nobles
A Hepatitis C Screening Tool For An Uninsured Population, Kimberly Belle Babcock-Nobles
Doctoral Dissertations and Projects
Hepatitis C virus (HCV) is a public health epidemic effecting 3.5 million people in the United States alone. The uninsured, underserved residents of a rural county in North Carolina have limited access to screening and early detection for HCV. Through collective efforts, a free medical clinic partnered with a grant funded, nonprofit organization to provide free hepatitis C testing by use of a mobile medical unit. The aim of this study was to determine if use of an HCV screening tool would increase the number of patients screened for testing as compared retrospectively to the number of patients screened without …
Unleashing Top-Of-License Registered Nurse Practice: An Integrative Review, Michelle Dickerson
Unleashing Top-Of-License Registered Nurse Practice: An Integrative Review, Michelle Dickerson
Doctoral Dissertations and Projects
In light of a well-renowned report, “The Future of Nursing” released by the Institute of Medicine (2010), recommendations were suggested that nurses should practice at, and to, the full extent of their licensure, also referred to as top-of-license nursing practice. Transforming nursing care models coupled with strong leadership support is critical to fostering an environment where top-of-license practice can be fully achieved and sustained. This integrative review provides a compilation and synthesis of the available published evidence regarding the best practices for fostering environments conducive to top-of-license nursing practice. Results of these studies strongly supports the notion of nurses practicing …
A Phenomenological Study Of Graduated Nursing Student Athletes' Experiences Balancing Academics And Athletics, Robert E. Steed
A Phenomenological Study Of Graduated Nursing Student Athletes' Experiences Balancing Academics And Athletics, Robert E. Steed
Doctoral Dissertations and Projects
The purpose of this transcendental phenomenological study is to describe the lived experiences of eleven graduated nursing student athletes who completed traditional, four-year nursing programs while concurrently finishing four years of athletic eligibility in their respective sport at three private, Christian, Midwest universities and across three different competitive collegiate athletic divisions. The theories guiding this study are Tinto’s Theory of Individual Departure from Institutions of Higher Learning, Astin’s Theory of Student Involvement, and Lazarus and Folkman’s Transactional Model of Stress Response, as they relate to student athletes’ persistence to graduation and to nursing students who reportedly experience higher levels of …
Facilitating Transition To Practice For Millennial New Graduate Nurses, Tiffani Marie Wise
Facilitating Transition To Practice For Millennial New Graduate Nurses, Tiffani Marie Wise
Doctoral Dissertations and Projects
Despite the growing nursing shortage and the dire need for a full nursing workforce, attrition rates among new graduate nurses (NGNs) continues to be of concern. One answer to the nursing shortage includes the next generation of nursing graduates: millennials. It is vital that nursing administrators and educators collaborate to develop a transition-to-practice process that meets the unique needs of millennial NGNs to increase job satisfaction, thereby increasing intent to stay in the profession. The MSPM was implemented in an NGN medical-surgical residency as a means of maintaining job satisfaction, perceptions of support, and intent to stay, among NGNs. A …
Increase In Pneumococcal Immunization In Adults Over 65 Years Of Age In A Federally Qualified Health Center, Mara J. Dominguez
Increase In Pneumococcal Immunization In Adults Over 65 Years Of Age In A Federally Qualified Health Center, Mara J. Dominguez
Doctoral Dissertations and Projects
Pneumococcal disease is a healthcare concern with increasing financial and societal burden for adults over the age of 65 years and their caretakers. The Center for Disease Control and Prevention (CDC) recommends the use of pneumococcal vaccines in this population as a preventive measure helping minimize the mortality and morbidity. This project aimed at increasing the rate of pneumococcal vaccines in a Federally Qualified Health Center (FQHC). The interventions implemented included the use of audit, feedback and provider educational intervention aimed at increasing the knowledge and the intent to change and improve their practice. The key results indicated an increase …
Addressing Health Literacy And Collaboration In Mobile Clinics Utilizing Teach-Back Methodology And Healthcare Provider Training, Mark Robert Drye
Addressing Health Literacy And Collaboration In Mobile Clinics Utilizing Teach-Back Methodology And Healthcare Provider Training, Mark Robert Drye
Doctoral Dissertations and Projects
Focused healthcare provider teaching was used to increase health literacy sensitive care and to improve interdisciplinary collaboration between providers in a mobile clinic setting that serves significantly underserved and socioeconomically challenged populations. The teach-back method was selected as one of the tools to help providers help their patients overcome health literacy challenges by increasing compliance and helping providers engage their patients in collaborative care. Multidisciplinary providers working in a large university clinic system in the southern United States (N = 20) were surveyed, provided focused training, and resurveyed to determine if provider practices addressing health literacy and interdisciplinary collaboration could …
Comparing The Causal Implications Of Clinical Unit Placements On Senior Bachelor Of Science In Nursing Students' Cognitive Decision-Making Processes, Shelley Layne Blackwood
Comparing The Causal Implications Of Clinical Unit Placements On Senior Bachelor Of Science In Nursing Students' Cognitive Decision-Making Processes, Shelley Layne Blackwood
Doctoral Dissertations and Projects
Evidence suggests that new nursing graduates entering the workforce struggle with decision making. Poor clinical decisions often lead to undesirable patient outcomes. Utilizing quantitative, causal-comparative, pretest-posttest design, this research explored the effect of four categories of clinical unit placements (specialty units, acute care, critical care, and emergency departments) on senior bachelor of science in nursing (BSN) students’ cognitive decision-making processes to explore which type of unit, if any, significantly changes nursing student cognitive processes while making decisions. A convenience sample of 30 senior BSN students from a private, faith-based university completed both a demographic survey and the Nurse Decision Making …
An Education Implementation Project In An Emergency Department To Increase Awareness And Referral For Trafficked Person Encounters, Stacey Lynn Alderman
An Education Implementation Project In An Emergency Department To Increase Awareness And Referral For Trafficked Person Encounters, Stacey Lynn Alderman
Doctoral Dissertations and Projects
Human trafficking impacts sufferers on a global scale with serious and lifelong health issues associated with the illegal practice. Interventions for these victims’ extensive health issues must ignite healthcare staff education and expert clinical interventions. Due to these health problems, healthcare staff function on the front lines to identify and help trafficked persons. This study focused on the scope of trafficking and health staff awareness, identification strategies to help recognize trafficked persons, techniques for interviewing, best practice strategies for intervention and referral, and new coding guidelines. During the intervention, health staff received a human trafficking pre-education questionnaire, a research supported …