Medicine and Health Sciences Commons^™

Reducing 30-Day Heart Failure Hospital Readmissions Through The Implementation Of A Telehealth Education And Screening Program, Madison Geib, Jo Loomis, Maria (Dupi) Gomez Cogan

Doctor of Nursing Practice (DNP) Projects

Heart Failure (HF) is a difficult disease to manage. It requires knowledge on weight monitoring, diet, exercise, medications, and symptom management. With this difficulty, there is a high incidence of HF patient readmissions into the hospital, especially in the first 30-days after discharge, showing that patients are not well equipped to manage their HF on their own at home. A review of the available literature found that some of the most common reasons for readmission include poor discharge planning, a lack of continuation of care, as well as a lack of education and adherence to their medications (Mathew & Thukha, …

Early Sepsis Recognition: Improving Sepsis Education In A Medical-Surgical/Telemetry Unit, Kathileen Tran

Master's Projects and Capstones

Problem: This quality improvement project aimed to increase sepsis education and bundle compliance within the medical-surgical/telemetry unit to improve sepsis mortality and morbidity rates.

Context: A microsystem assessment was completed by Clinical Nurse Leader (CNL) students in the medical-surgical/telemetry unit at Hospital X located in the San Francisco Bay Area. This microsystem cares for patients diagnosed with sepsis, congestive heart failure (CHF), electrolyte imbalance, and alcohol withdrawal.

Interventions: Due to time constraints, an intervention was not implemented; however, the students provided recommendations for interventions to the leadership team for follow up. The recommended interventions encompass implementing sepsis protocol reference cards, …

Educating Nursing Staff On Evidence-Based Maternal Positioning To Promote Fetal Descent During The First And Second Stages Of Labor, Daniela Gonzalez Acosta

Master's Projects and Capstones

This project aims to educate labor and delivery nurses on evidence-based maternal labor positions that promote fetal descent in the first and second stages of labor. In a labor and delivery unit in the San Francisco Bay Area Silicon Valley region, there is a gap in nurse knowledge relating to labor positions. Evidence supports upright and flexible sacrum positions, along with frequent repositioning promotes shorter labor duration, decreased vaginal tearing, and decreased rate of cesarean section deliveries.

A quality improvement project was conducted through education implementation using evidence-based practices utilizing a PDSA cycle for a semester. Educational content was created …

Early Sepsis Recognition Saves Lives:Optimizing Sepsis Care In A Medical-Surgical Telemetry Unit, Genevieve Kales

Master's Projects and Capstones

Abstract

Problem: This Quality Improvement project aims to improve sepsis bundle education to reduce mortality and morbidity rates related to septicemia in a Medical-Surgical Telemetry Unit at a San Francisco Bay Area Hospital, Hospital Z.

Context: The Quality Improvement project occurred in a Medical-Surgical Telemetry unit at Hospital Z. This Unit is a 32 beds unit with an increased mortality and mobility rate with decreased sepsis bundle compliance.

Intervention: Collect active and passive observational data in the microsystem. Data collection was conducted through anonymous self-administered questionnaires to the registered nurses on the unit. No intervention was implemented at this time. …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Spencer Forest

Master's Projects and Capstones

Problem: This quality improvement project aims to increase SEP-1 sepsis bundle compliance among nursing staff at a 16-bed emergency department through targeted continual staff education on sepsis screening and best practices. Currently, the unit is experiencing cases of sepsis fallout and is not meeting the 90% threshold on three treatment metrics as defined by the institutional sepsis bundle time goals. Bundle compliance that adheres to the time goals decreases incidences of sepsis fallout and overall days in the hospital, while increasing positive patient health outcomes.

Context: A microsystem assessment was completed along with a staff gap survey to determine areas …

Bridging The Gap: Educating Medical-Surgical Unit Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Meara J. Matthews

Master's Projects and Capstones

Problem: Sepsis is a life-threatening response to infection that remains one of the leading causes of death worldwide. Based off results obtained from a pre-education survey of nurses on a medical-surgical unit in a large hospital organization, there is an opportunity to increase knowledge and confidence level regarding sepsis and care of septic patients so that nurses are prepared to detect sepsis early and intervention can begin.

Context: The project is being conducted in a medical-surgical unit at a large hospital organization in Northern California. The data from the survey includes 17 nurses on the unit who completed the pre-education …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Amanda H. Tran

Master's Projects and Capstones

Problem: According to a pre-survey collected, approximately six percent of medical-surgical nurses report expert knowledge with the “Inpatient Handoff Sepsis Bundle Checklist,” a checklist that details interventions to be taken when a patient is diagnosed with sepsis. About thirty-five percent of these nurses also report expert confidence levels in caring for sepsis patients. Therefore, there is an opportunity to provide education so that nurses may confidently and competently care for sepsis patients.

Context: A medical-surgical unit at Hospital A affiliated with a large, non-profit, integrated healthcare system located in the San Francisco Bay Area.

Intervention: Create an educational handout to …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Jillian J. Abinader

Master's Projects and Capstones

Problem: A sepsis protocol and bundle has been implemented in an urban Emergency Department to help screen patients and treat sepsis efficiently and effectively. The benchmarks from the bundle are not being met consistently every month and are below the targeted 90%.

Context: A microsystem assessment and a gap survey sent out to nurses, helped determine that there is room to improve nurses’ knowledge and confidence about sepsis and the sepsis bundle workflow. Sepsis is one of the most expensive and burdensome conditions in U.S. hospitals. Literature supports staff education to improve sepsis bundle compliance.

Intervention: A video was created …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Christopher N. Guinto

Master's Projects and Capstones

Problem: Results from a voluntarily anonymous pre-survey about sepsis revealed that a majority of the seventeen nurses assessed themselves below an "expert knowledge '' level. The survey results present an opportunity to improve the nurses’ knowledge and confidence in nursing response and improve patient outcomes with sepsis.

Context: The quality improvement (QI) project was conducted on a medical-surgical unit in a large Northern California hospital.

Intervention: A QI team initiated evidenced-based practice research and created an educational sepsis handout for nurses to increase sepsis knowledge and confidence.

Measures: The self-assessment pre-survey would be compared to the responses from the post-survey. …

Implementing Ethics Education For Nurse Managers, Mona L. Lateyice, Rachel E. Marzec

Doctor of Nursing Practice Scholarly Projects

Background: Every day, nurses are faced with making decisions for patient care and may come across complicated ethical decisions. Ethical practice is essential in every health care organization in providing care and how they conduct themselves (ANA, 2015). Nurse managers are responsible for ensuring ethical standards are met by nursing staff.

Problem: Nurse managers are faced with ethical problems more than fifty percent of their work time (Aitamaa, 2019). There are studies that show nurse managers and nurses have difficulty solving ethical problems because they lack understanding of ethical principles (Huang, et al., 2020). Evidence shows nurses are deficient in …

How To Be An Anti-Racist Educator: A Book Review Through An Educational Perspective, Maria Cristina F. Soares, Melanie Morales

Journal of Multicultural Affairs

The authors reviewed the book How to be an Antiracist by Ibram X. Kendi (2019) while reflecting on how Kendi’s brilliant dismantlement of racism and discrimination would help educators become conscious of how racism operates in our society, their schools, and their communities. Kendi’s book could motivate teachers to self-reflect on intrinsic feelings and misconceptions about race and culture built over time, allowing them to adopt new attitudes towards their students and school community. The authors considered the need to reevaluate systemic racism in schools as research has, for instance, found evidence of discriminatory practices towards African American boys (Gregory …

Implementation And Evaluation Of A Diabetic Education Program, Brianna Cole

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to help create and evaluate a diabetes education program that was accessible to diabetic patients over the age of 18. This project was conducted through Enhanced Healthcare of the Ozarks clinic with the guidance and approval of the American Diabetes Association. There is currently one other diabetic education program available in Northwest Arkansas. The theme of this project was to provide education in individual and group settings regarding medication use, emergency situations, nutritional choices, and self-management techniques. These patients learned meal planning strategies, proper nutrition choices, functions of the body, self-management techniques, emergent situation …

A Pre And Post Survey Of How Teaching Interventions Of Anticoagulant/Antiplatelet Medications Affect Patient Outcomes In The Primary Care Setting, Renee Roth

Doctor of Nursing Practice Scholarly Project

With the elderly population expanding in the United States, primary care providers are having to place more emphasis on managing multiple disease etiologies and medication modalities in the outpatient clinic setting. Patients and providers struggle to overcome educational communication barriers that facilitate proper medication adherence and monitoring. The specific aim of this study was to evaluate whether antiplatelet management education increased the patients’ knowledge of medication understanding and possible adverse outcomes. Evaluation of antiplatelet knowledge was conducted in a rural health clinic in Columbus, Kansas. The study utilized an individual pretest-posttest design to patients who received self-management and monitoring education …

Evaluating Equity: Examining Inclusionary Practices From Educational Organizations To Improve The Education Experience Of Lgbtqia+ Students, Jillian G. Torrento

Seton Hall University Dissertations and Theses (ETDs)

This qualitative study explored the ways in which education policy and practices within public schools are addressing the needs of minoritized populations with a particular focus on LGBTQIA+ students. This study first employed a document analysis to investigate the federal, state, and district-level equity practices that are mandated or elective in addressing the needs of marginalized populations and LGBTQIA+ students. Secondly, a critical discourse analysis was conducted to examine the specific language, word choices, and symbols found within the public documents that signify equitable practices pertaining to minoritized student populations and the LGBTQIA+ community. Ultimately, the goal of this study …

The Participation And Exploration Of Play For Children In Foster Care, Isabella J. Relph, Jazminne Orozco Arteaga

Spring 2023 Virtual OTD Capstone Symposium

This capstone project, The Participation and Exploration of Play for Children in Foster Care, was completed by a Doctor of Occupational Therapy candidate at the University of St. Augustine for Health Sciences. Project objectives develop an understanding of the occupational therapy involvement in foster care and how to improve current advocacy and educational efforts related to play. A literature review of play participation, engagement, and exploration was conducted in conjunction with analysis of environmental barriers, generalized background information on children in foster care, and the role of occupational therapy for children in foster care. Play is essential for the pediatric …

Perceptions Among Athletic Trainers’ Education In Treating Athletes With Attention Deficit Hyperactivity And Autism Disorders, Juliette Mueller, Audrey Wagstaff, Jennifer Walker

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

The purpose of this study was to investigate the education and preparedness of athletic trainers when caring for athletes with Attention.Deficit.Hyperactivity.Disorder (ADHD) and or Autism Spectrum Disorder (ASD).

Post-Partum Deprssion: An Educational Intervention For Nursing Staff In A Rural Hospital Obstetrics, Tonya Jewell

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Postpartum depression (PPD) is a type of depression that has occurred in women during pregnancy or after the delivery of a child. In the United States, approximately 13.2% of postpartum women were diagnosed with postpartum depression. Research indicated that early identification of PPD led to the best outcomes for postpartum mothers. Routine postpartum depression education and screening for postpartum depression did not exist in the perinatal unit at a Southeast Georgia rural hospital. Lack of nursing knowledge and skill were two barriers identified to screening patients for PPD and providing discharge education. The study provided an educational intervention to provide …

Increasing Education And Awareness Of Patients Who Identify As Transgender In Primary Care​, Cindy Wallace

Doctor of Nursing Practice Projects

Background. Lesbian, gay, bisexual, and individuals who identify as transgender and queer (LGBTQ) often experience negative healthcare encounters (Parameshwaran et al., 2017). According to the Williams Institute of Law (2022), there are 1.3 million adults who self-identify as transgender. This education project utilized a pre/post-test design to explore attitudes, practices, and knowledge of primary care providers when interfacing with individuals who identify as transgender in primary health care settings.

Theoretical Framework. This project was guided by Lewin’s Change Theory.

Methods. Primary care providers in an urban community health clinic received a pre and post-education survey. A teaching session was delivered …

Expansion Of Heart Failure Education From Hospital To Clinic, Abigail M. Fischer

Doctor of Nursing Practice Projects

Heart failure education is vital to the long-term management of this condition. Education recommendations for heart failure are given by the American Heart Association (AHA) and the American College of Cardiology (ACC). Recommendations include verbal instruction and written materials regarding the patient’s medication plan, recognition of symptoms, what to do when symptoms occur, and the importance of daily weights.

This project aimed to provide outpatient clinic providers and staff with resources and education necessary to educate heart failure patients. The project expanded use of an inpatient heart failure education packet for outpatient use. This was accomplished by conducting educational sessions …

Black Male Educator Shortage In The Mississippi Public School System: Impact, Challenges, And Intervention Strategies, Jilkiah Bryant

Honors Theses

The shortage of Black male educators in Mississippi's public school systems is a critical issue with far-reaching implications for the state's education system. Despite the state's sizable Black population, the percentage of Black male teachers remains disproportionately low, and there is little evidence of progress being made to address this issue. This paper examines the impact of the Black male educator shortage on Mississippi's education system, the challenges faced by Black male educators, and related intervention strategies to increase the number of Black male teachers in Mississippi's public school systems. Through a comprehensive literature review and interviews with Black male …

Brief Review: Kano Model In Healthcare, James Espinosa, David Ho, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Here we discuss the use of the Kano Model in the hypothetical example of a re-design of resident conference experience. Kano appreciated that there were a number of attributes to quality. These are discussed in this brief review.

Training Program For Occupational Therapists Working With Skilled Caregivers In Skilled Nursing Facilities, Lovegifty Dudero, Mai Huynh, Ridhee Patel

Occupational Therapy | MSOT Capstone Projects

Dementia impairs one’s ability to live independently and participate in everyday activities (CDC, 2019). Individuals with dementia (IwD) are often referred to skilled nursing facilities (SNFs) for around-the-clock care to receive support for their everyday challenges brought on by dementia symptoms. Although certified nursing assistants (CNAs) help IwD with everyday self-care tasks, they frequently lack specialized dementia care training. Consequently, CNAs experience low self-efficacy when providing care and managing challenging behaviors IwD may have. OTs have expertise and understanding regarding the stages of dementia and how the symptoms of dementia impact participation in daily occupations. OTs working in SNFs are …

Preoperative Pain Management Education And Narcotic Use: A Quality Improvement Project, Sarah Scheller

DNP Projects

Introduction: Comprehensive preoperative education is an important aspect of pain management and helps empower patients prior to their surgery. Evidence supports the use of a combination of the teach-back method, videos, and pamphlets to educate patients prior to their surgery. A quality improvement project was initiated for patients having total shoulder arthroplasty surgery with an orthopedic surgeon in Connecticut.

Methods: An educational video and handout were created, and preoperative education sessions using the teach-back methods were performed. Postoperative phone calls were placed at 24 and 72 hours to assess the patient’s use of narcotic pain medication, alternative pain management medication …

Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus

Doctoral Projects

Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …

Gender, Personality, And Cognitive Resilience Against Early-Life Disadvantage, Joseph L. Saenz, Sadaf Arefi Milani, Silvia Mejia-Arango

School of Medicine Publications

Objectives: Early-life disadvantage (ELD) relates to lower late-life cognition. However, personality factors, including having an internal locus of control (LOC) or a conscientious personality, relate to resilience and effective stress coping. We explore whether personality factors convey resilience against the negative effects of ELD on cognition, by gender, in Mexico.

Methods: Using the 2015 Mexican Health and Aging Study, we estimated expected cognition using multiple ELD markers to identify a subsample in the lowest quartile of expected cognition given ELD (n = 2,086). In this subsample, we estimated cross-sectional associations between personality and having above-median observed cognitive ability (n = …

The Influences Of The Public Health Care System And Education System On The Economic Growth Of Swaziland, Grace Greer

International and Global Studies Undergraduate Honors Theses

The Kingdom of Eswatini, also known as Swaziland, has one of the youngest populations in the world with over 70% of citizens being under the age of 18 years old. This creates a substantial opportunity for economic, social, and educational growth in a country previously plagued with diseases such as HIV/AIDS, poor health care infrastructure cutting off thousands from basic care, and an educational system with a very low attendance rate and an even lower graduation rate. By evaluating the root causes of such issues dating back to the colonial era there is an opportunity to reprioritize health care and …

Education, Beliefs, And Health Literacy Of Care Providers On Mouth Care Of Older Adults, Molly Lakin

Honors Program: Senior Projects (Public)

Oral health is important to one’s overall health and quality of life as it can lead to chronic illnesses such as cardiovascular disease, stroke, and neurodegenerative disorders (Haumschild et al. 2021). In long-term care facilities, it is important that dependent older adults are provided mouth care to maintain their oral health and decrease their chances of developing a chronic illness; however, there are barriers affecting the level, quality, and quantity of mouth care being provided in these facilities. A survey was developed to look at the education, beliefs, and health literacy of care providers on providing mouth care in hopes …

Uplifting An Invisible Population: How We Can Combine Psychology And Policy To Improve The Educational And Mental Health Outcomes Of Homeless Youth, Melissa Hamilton

Washington Semester Program

The goal of this thesis is to a) explain why homeless youth are frequently linked to poor mental health and education outcomes, and b) offer evidence-based suggestions that ought to be considered when developing any intervention aiming to improve the education and mental health of homeless youth. To accomplish this, prominent theories in both the psychology (ex: Maslow’s Hierarchy of Needs) and political science (ex: failed implementation of the McKinney-Vento Act) fields that pertain to student homelessness were reviewed, and a comparative analysis of existing intervention models was conducted. Three key trends were identified across successful homeless youth intervention models …

Medication Compliance And Decreases In Viral Load Status In Patients With Hiv, Tangela Woodland- Ballard

Doctor of Nursing Practice Projects

Background: The human immunodeficiency virus (HIV) epidemic has been a worldwide challenge for several decades. Proper medication adherence, following the Centers for Disease Control guidelines, has proven effective in decreasing patients’ viral load, thus improving their quality of life, and reducing the spread of the disease. The current literature identifies a lack of knowledge, support, and resources as barriers to medication compliance.

Purpose: To increase medication compliance among persons with HIV.

Methods: This evidence-based practice project utilized the Modified Morisky Scale to help minority HIV patients adhere to strict medication regimens. Repeated measures analysis of variance was conducted to …

A Scoping Literature Review Of Workforce Development Strategies To Increase Indigenous Birth Workers, Danielle A. Thies

Capstone Experience: Master of Public Health

Objective/Aim: To review the literature on workforce development to increase Indigenous birth workers to improve birth outcomes in Indigenous populations.

Design: A systematic scoping review.

Data Sources: The following databases were accessed: PubMED, Embase, and CINAHL. Support relating to key words and appropriate databases was provided by a university librarian.

Review Methods: Search terms across databases were sourced identifying a total of 152 papers. Title/abstract searches were screened against the inclusion/exclusion criteria, resulting in 55 papers reaching full-text review. Of the 55 papers reviewed, 26 were eligible for inclusion in the final review.

Results/Findings: Thematic …