Nursing Commons^™

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement …

Intergenerational Hispanic Perceptions Of Childhood Obesity, Janelle Weiss

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Childhood obesity is on the rise in the United States especially among minority families. This study investigates how Hispanic parents perceive their child's weight based on years of acculturation, education level, age, child’s gender and 1^st or 2^nd generation status.

Objective: To assess if there are differences in perception between more acculturated Hispanic immigrants and their less acculturated counterparts.

Methods: Data were collected using the Child's Body Image Scale. Participants were asked to arrange the images based on a series of questions inquiring about their perception of their child and health in general. BMI's were then …

Utilizing Culturally Congruent Educational Interventions To Improve Native American Diabetic Outcomes, Laurie Ann Hamilton

Doctoral Projects

Native Americans suffer from diabetes type II at a proportionately higher rate than other populations. Management of diabetes in this population is problematic and compounded by multiple influences such as socioeconomic, cultural and linguistic variables. The purpose of this DNP project was to investigate cultural influences on Native American diabetic outcomes.

Do cultural influences act as barriers to diabetic medication, diet and education understanding? Would a Native American nurse applied education on medication, diet and exercise improve diabetic outcomes in a 3 month period?

A convenience sample of 6 Native American participants obtained at a primary care clinic were given …

Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Shawn E. Raymond

Medication cost is a major contributor for patient medication nonadherence. Take in the fact that a large population lives in poverty, many cannot afford to pay the retail prices associated with purchasing their medications. By incorporating wholesale medications into a charitable health clinic, the reduced cost of medications for treatment of both acute and chronic illnesses could be passed on to those in need thereby decreasing cost associated medication nonadherence. Nurse Practitioners in the state of Kansas are not afforded the privilege to purchase, repackage and distribute or resell wholesale …

Personal Protective Equipment Use For Patients With Clostridium Difficile, Mallory L. Compton

Scholars Week

In researching the literature on correct PPE by healthcare staff when a patient has C. diff. I have found that the policy on PPE for patients with C. diff at Baptist Health Paducah is compliant. The theoretical framework used for this research is that of Imogene King. Their policy is evidence based and is also cost effective when it comes to preventing the spread of infection from patient to patient. There is no need for change to this policy at this time because it is supported by evidence in the literature.

An Assessment Of The Human Papillomavirus Immunization Knowledge, Practices, And Prevention Among A Cohort Of Urban College Students, Nancy H. Busen Phd, Fnp-Bc, Aprn, Robert G. Hanks Phd, Rn, Fnp, Aprn, Eileen R. Giardino Phd, Rn, Aprn, Fnp, Stanley Cron Msph

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Human papillomavirus (HPV) is the most common sexually transmitted disease, yet little is known about the college-age knowledge and prevention practices related to HPV. Although sample vaccination rates mirrored national known vaccination rates, a majority of participants did not complete the three dose vaccine schedule. HPV knowledge was similar between males and females while males were more likely to engage in preventative practices. This information can help healthcare providers reinforce vaccination schedule and prevention practices.

Human Papilloma Virus-Related Cervical Dysplasia, Shaylyn D. Webster

Nursing Student Class Projects (Formerly MSN)

Among sexually active men and women, the human papilloma virus (HPV) is one of the most common sexually transmitted infections. With more than 200 different genotypes of HPV known, there are more than 500,000 cases each year in the United States alone (Lowy, 2016). The virus is associated with nearly all cervical cancers, anal cancers, vaginal cancers, penile cancers, and head and neck cancers (Jorge & Wright, 2016). In women, the virus is capable of causing slow cellular changes on the cervix, and this dysplasia is graded based on severity (Jorge & Wright, 2016).

The statistics related to the prevalence …

Perceptions Of Renal Disease Risk Among African Americans: A Review Of The Literature, Casey L. Migliore, Julie Barroso, Allison Vorderstrasse

Journal of Health Disparities Research and Practice

African Americans are disproportionately at risk for renal disease, especially those with type 2 diabetes (McDonough et al., 2011). Despite this disease disparity, the literature lacks research on renal disease awareness and risk perceptions among African Americans with type 2 diabetes. Therefore, a literature review guided by the Common Sense Model was conducted to review and synthesize the literature on African Americans’ awareness of renal disease and existing risk perceptions, capturing sociocultural factors in the African American community that could influence the development of those risk perceptions. The literature identified an overall lack of knowledge about renal disease risk factors, …

Gram-Negative Bacteria And Sepsis, Christine D. Ridge

Nursing Student Class Projects (Formerly MSN)

Today’s medical world encompasses an environment in which gram-negative bacteria that once were defeated with common antibiotics, have now become resistant. Gram-negative bacteria like Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter, and Acinetobacter are pathogens that are an emerging threat causing sepsis due to multidrug-resistance (Pop-Vicas & Opal, 2014, p.189). The multidrug-resistance mechanisms of gram-negative bacteria coupled with a patient population commonly seen in hospital settings, that consist of immunocompromised adults due to advancing age, comorbidities (e.g. AIDS, history of transplants, diabetes, and chemotherapy), and immunotherapies, create an environment for advanced infection or sepsis to take place.

Complications of multidrug-resistant gram-negative bacteria …

Assessment Of Air Force Providers’ Adherence To Overweight And Obesity Guidelines, Dale Harrell

Doctor of Nursing Practice Scholarly Projects

Despite the existence of obesity treatment guidelines, Air Force healthcare providers may offer suboptimal weight management. The purpose of this quality improvement project is to assess adherence by healthcare practitioners with adult overweight and obesity guidelines before and after an educational session on the optimal management of the overweight or obese patient. Overweight or obese adults treated in Military Treatment Facilities (MTF) may not be properly identified and controlled, as providers may not be adhering to the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for the management of obesity.

Diabetes Self-Management Education (Dsme) Program For Glycemic Control, Jenilyn P. Peros

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this quality improvement project was to implement and evaluate the impact of Diabetes Self-Management Education (DSME) program with type 2 diabetes mellitus (DM) patients. The goals were to improve glycosylated hemoglobin (A1C) and improve patient satisfaction.

Methods: A quality improvement project using the Iowa model was implemented in a primary care setting in Southern California to provide DSME program for adults with type 2 diabetes. A nurse practitioner conducted three DSME group sessions, which were done for 90 minutes per session in a 4-month period. The American Association of Diabetes Educators (AADE) 7 self-care behavior …

Stress Management In A Corporate Setting, Erinn Gelakoska, Susan Instone

Doctor of Nursing Practice Final Manuscripts

Abstract

The purpose of this evidence-based project was to implement a sustainable stress management program in a corporate setting, utilizing company stress management resources. A three-step program was initiated to include a 30-minute stress education session, followed by a 30-minute one-on-one session with a nurse practitioner student utilizing aspects of motivational interviewing to develop a goal oriented stress management plan. An individual one-month follow up was also performed. Of the 30 employees who attended the educational session, 15 signed up for a one-on-one session. Eight out of the 15 employees completed the one-month follow up. Employees completed a pre and …

A Quality Improvement Project On Diagnosis And Management Of Asthma In A Private Pediatric Setting., Sosamma Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Although national guidelines exist for the diagnosis and management of asthma, general practice differs significantly from recommendations. Quality improvement methodology when implemented can narrow quality gaps.

Objective: The objective of the project was to create and implement a plan of action to address identified gaps in key clinical activities of asthma care among pediatric population in a private pediatric setting in Northern California

Methods: The project was centered on the use of Education in Quality Improvement for Pediatric Practice (EQIPP), a program of the American Academy of the Pediatrics. Both the pediatrician and the DNP student took this …

Development, Implementation And Evaluation Of A Screening Mammography Program, Christine Natan

Doctor of Nursing Practice (DNP) Projects

Breast cancer is a major public health concern in the United States and remains a priority for national women’s health centers, primary care practices and cancer control organizations such as the American Cancer Society (ACS). The cancer care continuum includes the spectrum of prevention/risk reduction, early detection, treatment, and living with the diagnosis. Currently there are no proven primary prevention options for women at average risk of developing breast cancer; therefore, secondary prevention interventions such as screening mammography and clinical breast examination (CBE) are required to reduce morbidity and mortality. This manuscript describes a Doctor of Nursing Practice (DNP) led …

Implementing The 5as Framework For Obesity Management, Jennifer C. Sassman

Doctor of Nursing Practice Final Manuscripts

This Doctor of Nursing Practice (DNP) pilot project strives to improve management of obesity by increasing provider knowledge and utilization of the 5As Framework which is an effective evidence-based intervention and a behavioral counseling tool. Pre-data including BMI and waist circumference were collected over one month. An educational in-service on the 5As was held for one primary care nurse practitioner. Post data was gathered over five months. Provider knowledge on the 5As was increased however, there was not an increase in identifying obesity. The 5As was used about 10% of time with obese patients. This pilot project can be expanded …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

Effectiveness And Feasibility Of In-Office Versus Smartphone Text-Delivered Nutrition Education In The College Setting: A Mixed-Methods Pilot Study, Jordan Rose, Deepika Goyal, Mary Ellen Wilkosz, Anita Catlin

Doctoral Projects

Often, being away from home for the first time, coupled with limited knowledge regarding healthy eating behaviors, leads to poor food choices and an increased risk of obesity among college-aged young adults. These college students are prone to high-calorie diets and limited physical activity, putting them at risk for obesity, a physiologically, psychologically, and financially costly epidemic in the United States. College students use their cellular phones over eight and a half hours a day and cell phones are their primary means of information consumption outside of the classroom, suggesting that the phones would be a useful tool to provide …

The Influence Of Birth Weight On Body Mass Index In Young Children In Northwest Arkansas, Margaret Frame

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Body Mass Index (BMI) is a screening tool to measure body fat that is calculated based on the height, weight, age, and gender of a child. Being overweight as a child is defined as having a BMI between the 85^th and 95^th percentiles. Obesity is defined as having a BMI at or above the 95^th percentile (“Basics About Childhood Obesity,” 2012). Having a high BMI comes with an increased risk of multiple co-morbidities, both physical and psychosocial (Pulgarón, 2013). Birth weight has been presumed to play a role in the prevalence of obesity in children. The purpose …

Development And Evaluation Of A Chronic Care Management Toolkit, Heidi Hongxin He

Doctoral Projects

Currently, little research is available on the topic of Chronic Care Management (CCM) service and its impact on patient health outcomes, largely because the service was recently introduced by Medicare in January 2015. The purpose of this Doctor in Nursing Practice (DNP) project is to create a Chronic Care Management (CCM) Toolkit specific to an established pulmonology practice based in a Central California community. This quality improvement pilot project also included an evaluation of the newly developed CCM Toolkit designed for this project. The evaluation was accomplished by surveying CCM care team members in this pulmonary practice (an internal group), …

Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy

Doctoral Projects

This descriptive study examined undiagnosed depression in the elderly and how it affects the elderly from retaining healthcare education. It is estimated by 2029, 20% of the United States population will be age 65 and older (Colby & Ortman, 2014). Depression in the elderly who have chronic diseases, is estimated to be undiagnosed up to 40% (Chaoyang et al., 2009). A hallmark symptom of depression is the inability to concentrate. It is unknown if undiagnosed depression will affect the older adult from retaining pertinent healthcare education. The 30 point Geriatric Depression Scale (GDS) was administered to a class of elderly …

How To Start A Nurse Practitioner Faculty Managed Clinic: Missing Components?, Johnna Edmunds

Doctoral Projects

A serious need exists for improved access to primary care for vulnerable populations. Nurse Practitioner Faculty Managed Clinics (NPFMC) can help to alleviate this problem. The purpose of this qualitative, descriptive study was to identify and examine the beginning components necessary for implementing this inter-professional collaboration. A comprehensive literature review identified the absence of these components, which were then revealed through the interviews with founders of NPFMCs. Prior to the interviews two manuals were reviewed about the process of starting a free clinic. Questions were explored relating to the participants’ experiences in starting a NPFMC. Review of the manuals was …

Using Focus Groups To Identify Ways To Reduce Infant Mortality In Kalamazoo, Leah Dries

Honors Theses

Study goals were to explore maternal perceptions of possible ways to reduce infant mortality in Kalamazoo County, with specific regards to the infant mortality rates of non-Hispanic African American babies versus non-Hispanic Caucasian babies. Two focus groups were conducted of voluntary, anonymous, participants from the YWCA domestic violence shelter and clients of home visiting services provided by the Kalamazoo County Department of Health and Community Services. The focus groups were guided allowing women to voice their opinions about ways to prevent infant mortality in Kalamazoo. Women were also asked to respond to the goals created by a community planning committee …

Effect Of Dietary Self-Monitoring In Caucasian And African-American Women, Julianne Tondreau

DNP Projects

Purpose: The purpose of the study is 1) to assess the effect of dietary self-monitoring on weight loss in a population of Caucasian and African-American women and men; and 2) to determine if there is a difference in African Americans’ and Caucasians’ use of self-monitoring in weight loss.

Review of the Literature: Previous studies demonstrated increased weight loss with dietary self-monitoring; however, these studies’ samples are 70-80% Caucasian women and cannot be generalized to African-Americans or men. Studies confirming the effectiveness of dietary intake self-monitoring in non-Caucasian women and men are needed.

Methodology: Using a cohort design with prospective and …

The Effect Of Reduced Carbohydrate Diet Education On Hemoglobin A1c In Patients With Type 2 Diabetes, Lauren Parker

Evidence-Based Practice Project Reports

Type 2 diabetes (T2D) is characteristically the result of modifiable risk factors, impacting the health and well being of all ethnic backgrounds across the lifespan. Research has indicated that despite the many risk factors associated with T2D, alterations in dietary macronutrient composition can lead to improvements in disease management and resultant complications. Therefore, the purpose of this evidence-based practice (EBP) project was to provide individuals with reduced carbohydrate (carb) diet education to promote greater glycemic control and reduce associated risk factors through macronutrient modification, specifically carb intake. An integration of the most current evidence obtained from the critically appraised literature …

Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso

Student Research Posters

According to the Annals of Family Medicine, the amount of babies born via cesarean section has increased from 4.5% in 1965 to 26.1% in 2002 and nearly 40% of all cesarean sections are repeats. After an extensive literature review, results showed that patients need to be educated about the risks and benefits of vaginal delivery and cesarean delivery. It was also found that there needs to be policy changes to decrease the amount of cesarean sections done and increase the labor and delivery support without using interventions. Further study should be focused on morbidity and mortality very low birth weight …

Ua61/1 Nursing Spirit, Volume 1, Neal Chambler, Dean, Mary Bennett, Director, Susan Megahee, Editor, Creative, Wku School Of Nursing

School of Nursing Publications

No abstract provided.

Is Dietary Intervention A Viable Method For Improving Outcomes In Adult Patients With Asthma?, Jennifer Grolimund

Senior Honors Theses

Asthma is a disease process characterized by episodic inflammation of the lower airway in response to various triggers. Those with asthma have trouble breathing effectively during an acute episode, making asthma a potentially life threatening condition. Standard medical treatment of asthma, including medications and environmental changes, can be effective at reducing or eliminating negative outcomes in patients with asthma. However, a holistic approach to patient care, including an examination of dietary influence, may also be useful for patients trying to manage the course of their illness. Variations in intake of individual nutrients or in total dietary patterns may play a …

Embryo Adoption As An Ethical Option For Couples Faced With Infertility, Rachel M. Walters

Senior Honors Theses

Embryo adoption takes embryos that are still forming and introduces them into the uterus of a woman with whom they do not share any genetic material. If pregnancy does ensue and continues without complications, the child that will be born will not share any genes with the woman who carried him or her. In addition, if the child is born to parents who already have other children, the children in the adoptive family will share no biological link to the newborn. Essentially, the child will have two families—a biological family and an adoptive family. This thesis will explore and discuss …

Exploring The Needs And Preferences For A Diabetes Self-Management Program In Hispanics Living In The Central Valley Of California, Emily Lane Kimble

Doctoral Projects

Diabetes mellitus type 2 is an ever increasing threat to the health of people living in the United States, especially those of Hispanic ethnicity. This ethnic group is disproportionately afflicted with the chronic condition and is also more likely than non-Hispanic whites to suffer from serious complications of diabetes. This project examines this growing problem among Hispanics living in the Central Valley of California by exploring how best to structure diabetes self-management education in a network of community health centers.

The Social Cognitive Theory provides a theoretical basis for investigation into motivation for diabetes self-management. This needs assessment specifically explored …

A Phenomenological Assessment Of Factors That Affect Medication Adherence Among Hypertensive Nigerian Immigrants, Beulah Iroegbu

Doctoral Projects

This qualitative study explored the perceptions that affect medication adherence among hypertensive Nigerian immigrants in Sacramento, California. The research questions focused on factors that influenced the adherence to hypertension medication; specifically, how the sample population explained the cause of hypertension and whether culture and religion impacted the cause and management of hypertension. A phenomenological approach was used to understand perceptions about medication adherence. A predefined group of 9 acted as a purposive sample and was given semi-structured individual interviews. Qualitative data analysis of the interviews was performed using Colaizzi's 7-step method. Results from the study found the cause of hypertension …