Nursing Commons^™

Family Nurse Practitioner Student Competencies In Integrated Psychiatric Healthcare, Mark Manning

Doctor of Nursing Practice Final Manuscripts

Title: Practicum to Practice: Family Nurse Practitioner Student Competencies in Integrated Psychiatric Mental Healthcare.

Background: Major Depressive Disorder (MDD) is a widespread and costly diagnosis that affects nearly 16 million people annually and costs the United States nearly $83 Billion. Primary care providers such as Family Nurse Practitioners (FNP) play a crucial role in screening for health problems, preventing, and managing illness. Opportunities exist to integrate psychiatric mental healthcare into FNP curriculum and clinical practicums to better prepare providers to identify and screen for depression.

Purpose: The purpose of this evidenced-based practice project is to evaluate FNP student competencies …

Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph

Doctor of Nursing Practice Final Manuscripts

Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. …

An Evaluation Of The Treatment Modality And Management Of Acute And Chronic Low Back Pain Individuals In Rural Southeast Kansas, Michele R. Carey

Doctor of Nursing Practice Scholarly Project

Roughly 25 million American adults experience pain, and 23 million others withstand severe assiduous pain that is disabling and results in decrease work productivity, loss of quality of life and diminished health (Meldrum, 2016). Treatment of pain, including chronic and acute low back pain includes a multidisciplinary approach merging cognitive-behavioral, psychological and physical therapies, respite, pain coping management and self-hypnosis (Meldrum, 2016). In 1999, pharmaceutical companies reassured physicians that opioid pain relievers were not addictive, and the prescribing rate began to increase (NIH, 2017). The quantity of opioids being prescribed has quadrupled since 1999 which has led to an increase …

The Effect Of Algorithm Implementation In The Family Practice Setting On The Pain And Recovery Of Acute Low Back Pain Patients, Joan Caito

Evidence-Based Practice Project Reports

Nearly $86 billion is spent annually in healthcare costs for Americans with low back pain (Lee, McAuley, Hübscher, Allen, Kamper, Moseley, 2016). Additionally, the burden on the economy due to loss in productivity incurs approximately $114 billion dollars of lost revenue annually (Lee et. al., 2016). Patients with an acute low back injury inadequately treated may become a chronic issue. Only 50% of patients who experience back pain symptoms for 12 months will return to work (Petit, Fouquet, & Roquelaure, 2015). The purpose of this project will be to implement an evidence-based algorithm to standardize acute low back pain care …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

Doctor of Nursing Practice Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

Perceived Health: A Grounded Theory Study On How Young Black Men Process Their Health, Layla L. Qaabidh

Dissertations, Theses, and Capstone Projects

This dissertation explored the perceptions young, Black men have regarding their health. It also sought to understand behaviors young, Black men engage in to maintain their health.

Sexually Transmitted Infection Risk Reduction For College Students, Mary Kathryn Dowling

Doctoral Projects

University students have been assessed through many sexual health lenses, but there is a paucity of research on the sexual health of community college students. This population may provide good access to at-risk youth, and opportunity to reverse steep climbs in sexually transmitted infection (STI) rates. This research project pilot tests a theory-based intervention employing social facilitation to reduce STI risk among college students. Fifty students were recruited from Human Sexuality courses to participate in a 60-minute workshop. Pre- and post-testing measured for change in STI knowledge, attitude towards safer sex, and self-efficacy for engaging in safer sex practices.

A …

The Effectiveness Of Insulin Pump Therapy After Transition From Multiple Daily Insulin Injections In Type 1 Diabetes, Sima Sapkota

Doctoral Projects

The population of patients who have been diagnosed with diabetes mellitus (Type 1 or Type 2) has been increasing in the United States. Patients with type 1 diabetes may receive insulin through delivery via insulin pump therapy (IPT) or multiple daily insulin injections (MDII). In addition to requiring insulin, other management regimens have included frequent blood glucose monitoring, checking laboratory values hemoglobin A1c (A1C), maintaining normal body mass index (BMI), keeping a balanced diet, carbohydrate counting, and exercise. The purpose of the study was to compare the retrospective data of A1C and BMI of patients with type 1 diabetes after …

Development And Validation Of A Silhouette Scale To Measure African-American Mothers’ Perception Of The Body Size Of Their Two To Four Year Old Children, Joan Buckley

Dissertations, Theses, and Capstone Projects

Background: In the United States (U.S.), the Center for Disease Control (2011 – 2014) reported that one-third of adults and 17% of children between the ages of two and nineteen are obese. Obesity in the U.S. is higher in the African-American groups comprising 13.2 % of the U.S. population. With the link between obesity and chronic diseases, such as, diabetes, heart disease, stroke, and some cancers there is a necessity to understand and reverse the consequences of obesity. There is a need to change the development of obesity/adiposity from childhood to adulthood in African-Americans. Exploring the parent’s awareness of …

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …

Impact Of Motivational Interviewing On Body Mass Index, Tajsier L. Thompson

Doctor of Nursing Practice Projects

Introduction

Being overweight and obese has become a common lifestyle. More than half of American adults are overweight and more than a quarter of overweight adults are obese. Despite this overwhelming statistic, weight-loss coaching by primary care providers is usually disregarded due to time constraints and lack of skills to motivate patients to reach weight-loss goals. Motivational interviewing (MI) focuses on helping people investigate and overcome ambivalence toward healthy lifestyle modifications by helping them to explore their weaknesses, strengths, and preferences in an effort to facilitate behavioral changes.

Objective

The primary objective of this project is to assess the effectiveness …

Pornography As A Public Health Issue: Promoting Violence And Exploitation Of Children, Youth, And Adults, Elisabeth Taylor

Dignity: A Journal of Analysis of Exploitation and Violence

The pornography industry is expanding exponentially as a result of ongoing technological advances. The ability to stream videos over the internet and the ubiquity of the smart phone have meant that pornography producers are able to use algorithms to target potential consumers, to cultivate new sexual tastes and to deliver content to a more diverse audience over mobile devices. The advent of virtual reality pornography with interactive sex toys and sex robots imbued with artificial intelligence promises to unleash a further step-change in the extent to which pornography influences ‘real-world’ sexual culture. The critical analysis of pornography undertaken over decades …

Anesthesia "Hand Off" Process For Patients At High Risk For Obstructive Sleep Apnea, Terry Yeager

Student Scholar Showcase

No abstract provided.

Culturally Sensitive Diabetic Group Education, Kelly Marie Flores

Doctoral Projects

This study assessed the effectiveness of a culturally sensitive type 2 diabetes group education program delivered to Hispanic women in Merced County. Design: A pre-test post-test design. Purposeful sampling was used. Fifteen Hispanic women from a Merced County outpatient clinic were invited to participate in a culturally relevant group education workshop over a 6-week period. Four (N=4) women accepted the invitation, completed the educational workshop, and participated in the assessments. Topics discussed in the education sessions included: (1) diabetic diet, (2) exercise, (3) blood sugar monitoring, (4) medication, and (5) preventative health. A knowledge check was completed by …

Enhancing Elderly Advance Care Planning Experience At A Primary Care Clinic, Oi Shan Wong

Doctoral Projects

The purpose of the project was to examine if the identification of readiness for an advance care planning (ACP) discussion of elderly participants would enhance the outcomes of participants' satisfaction, improve the likelihood of having an ACP discussion and increase the completion rates of an advance directive (AD) document after an office visit.

Forty-four elderly participants, who met the selection criteria, were recruited from a primary clinic in Northern California from October 1, 2017 to December 31, 2017 (Female, n =28). All participants were randomly assigned to either an intervention group (n= 22) or a control group ( …

Parental Knowledge And Perceptions Of Hpv Vaccines Among Korean American Parents, Veronica Ross, Serik Tursunaliev

Grace Peterson Nursing Research Colloquium

Abstract

Title: Parental Knowledge and Perceptions of HPV Vaccines among Korean American Parents

Author: Young-Me Lee

Affiliation: School of Nursing, DePaul University, Chicago

Background: Given significant concerns about HPV infection, lower immunization rates, and higher cervical cancer risks facing KAs, limited attention has been paid to the specific concerns of KA parents and barriers that underlie parental reluctance to vaccinate their children.

Purpose: The purpose of this study was to examine Korean-Americans parents’ level of knowledge of the HPV vaccine, explore their perceptions of the HPV vaccination for their children, and identify the difference in parental knowledge and perceptions of …

Exploring Reasons For Opting Out Of Hpv Vaccination Among Patients And Health Care Providers, Megan Masters

Grace Peterson Nursing Research Colloquium

Background: Human Papillomavirus (HPV) is a virus that can infect both males and females, potentially causing genital warts, vaginal, cervical, anal, and vulvar cancers. According to CDC guidelines, the HPV vaccine can be given to boys and girls age 9 to 26 (CDC, 2017). Although cases of HPV have dropped as the number of HPV vaccinations rise, vaccine rates are still far below the Health People 2020 target of 80% coverage. With current rates of 49.5% coverage in females, and 37.5% in males through 2017, it is evident that current routes of vaccine education are not adequate (CDC, 2017).

Objective: …

The Influence Of African Immigrants’ Beliefs On Health-Seeking Behaviors: An Integrative Literature Review, Omolara Alao-Aboko

Grace Peterson Nursing Research Colloquium

Abstract

Background: Africans hold many beliefs and engage in various practices that shape their health in their countries of origin. African immigrant population in the United States had the fastest immigrant growth rate between the years 2000-2013, increasing by 41% (Anderson, 2017). However, not much is known about how their beliefs impact health-seeking behaviors after immigrating into the U.S.

Objective: The purpose of this study was to explore and discover the influences of African immigrants’ beliefs on their health-seeking behaviors.

Method: Whitemore & Knafl (2005) was used as a guide for this literature review. A database search …

Exploring The Need Of Hpv Education Programs In Korean American Communities, Emilia Mondragón, Young-Me Lee

Grace Peterson Nursing Research Colloquium

Aim: 1) To identify cultural influences and other barriers affecting HPV vaccination decisions, 2) To identify educational methods that can deliver HPV related information to Korean American (KA) parents effectively

Background: Given significant concerns about HPV infection, lower immunization rates, and higher cervical cancer risks facing Korean Americans, it is imperative to better understand the barriers to vaccination. Currently, there is no HPV-focused education program that considers the linguistic and cultural barriers of the KA community. Additionally, there is a lack of effective educational content and methods available to reach KA parents.

Methods: An exploratory, qualitative design was conducted. Content …

Influence Of Supportive Care On Chemotherapy Patients' Self-Care Behaviour And Satisfaction: A Pilot Study Conducted In Karachi, Pakistan, Salima Shams, Adnan Jabbar, Kashmira Nanji, Rafat Jan, Ambreen Tharani

School of Nursing & Midwifery

Background and aim: Cancer is a daunting illness affecting a vast number of people globally. During the illness trajectory, cancer patients suffer from physical and/or psychosocial issues. These physical and psychosocial issues demand conscious actions by patients to maintain their well-being. Hence, the objective of the pilot study was to evaluate the level of self-care behaviors and satisfaction in women suffering from cancer after exposure to supportive care (education and mind diversion activities) delivered via a patient help group program.
Methods: The study was conducted at the chemotherapy day care unit of one of the tertiary care hospitals …

Diabetes Disparities In African Americans: A Cry For Help To Primary Care Providers, Pandora Goode

Journal of Health Disparities Research and Practice

Diabetes is a national public health problem. Low socioeconomic status influence access to quality care for African Americans with Diabetes who must rely on government assisted insurance or are uninsured. Inadequate access and poor quality care for African Americans contributes to increased morbidity and negative health outcomes. This manuscript will examine the existence of diabetes disparities in African Americans pertaining to the role of low socioeconomic status, access, and poor quality care, and suggest some practical strategies for reducing diabetes disparities in this population.

What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler

Nursing & Health Sciences Research Journal

No abstract provided.

Orthopedic Nurse Practitioner As A Subspecialty: A Case Study, Debra M. Palmer

Dissertations

Purpose: The overall purpose of this study was to describe the ONP role by exploring how and why NPs are utilized in orthopedic health care settings. Two problems associated with the evolving ONP role were addressed: the concomitant decrease in the supply of and increased demand for orthopedic patient care services and the nursing profession’s unmet challenge to keep pace with that increased demand and protection of the public and nursing profession through credentialing of ONPs and programs providing certification and training for ONPs.

Approach: This study employed a single-embedded case study research approach to answer the research questions and …

An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Chart Audit And Educational Provider Feedback Intervention To Improve Appropriate Use Of Spirometry In Patients With Chronic Obstructive Pulmonary Disease, Ruth Demetros

Doctoral Dissertations and Scholarly Projects

Despite being a GOLD guideline and having documented benefits, confirming a COPD diagnosis with spirometry is not routinely done. The purpose of this project was to increase patient referrals for spirometry to confirm COPD diagnosis. A quasi-experimental design was incorporated in a primary care office. A retrospective pre-intervention chart audit and two post-chart audits, 30-days apart, compared the frequency of documented spirometry to confirm a COPD diagnosis. An educational intervention with a pre and post-survey examined provider behavior intention to order spirometry to confirm a COPD diagnosis. The pre-chart audit revealed that 27/50 (54%) of patients had spirometry documented to …

Evaluating Impedance Monitoring To Reduce Hospital Readmissions For Patients With Heart Failure With Reduced Ejection Fraction: An Integrative Review, Abigail Newton

Doctoral Dissertations and Scholarly Projects

Congestive Heart Failure (HF) is a chronic progressive cardiac disorder with high mortality rates and is the number one reason for hospital readmission in the United States. More than 5 million Americans live with HF with more than 900,000 new diagnoses annually. The likelihood of developing HF increases with age making it the most common primary diagnosis for patients over age 65. HF has a significant impact on quality of life, with depression being a common comorbid condition. Thoracic impedance monitoring has shown to reduce exacerbations and hospitalizations in patients with HF. This project evaluated the literature related to impedance …

Implementation Of A Nurse Visit Model For Patients With Congestive Heart Failure In A Federally Qualified Health Center, Heather Brantley

Doctor of Nursing Practice Projects

Background: Chronic congestive heart failure is the primary cause for hospitalizations among people 65 and over in the United States, resulting in two-thirds of all heart failure costs .Congestive heart failure (CHF) continues to be one of the most prevalent and expensive chronic illnesses to treat throughout the world in a time when cost-effectiveness, improved quality, and care based on outcomes is a requirement . Chronic heart failure is the primary cause for hospitalizations among people 65 and over in the United States, resulting in two-thirds of all heart failure costs (Lambrinou, Kalogirou, Lamnisos, & Sourtzi, 2012). Traditional approaches …

Evidence-Based Guidelines And Protocol Implementation In A Primary Care Clinic To Improve Chronic Asthma Care, Jo E. Cote

Doctor of Nursing Practice Projects

The aim of this project was to pilot the implementation of evidence-based guidelines and protocols for chronic asthma care in a rural primary care clinic system. Asthma is under-diagnosed and under-treated, resulting in significant burden of disease. Achieving asthma control requires collaborative care between the patient and healthcare clinicians. Education on evidence-based guidelines was provided to healthcare clinicians. Effectiveness of education and integration of altered workflow was measured. Integration of evidence-based guidelines and protocols was demonstrated by clinicians. The results support expanding the project to the remaining five clinics in the clinic system.

Structural Stress And Otherness: How Do They Influence Psychological Stress?, Christine Dewilde

Theses and Dissertations

Background: The Theory of Cultural Distress offers a framework for understanding the potential outcomes in patients who do not receive care that incorporates their cultural beliefs (DeWilde & Burton, 2017).This study represents initial steps in researching the theory byexploring the layering of stressors that place the patient at risk for Cultural Distress. Methods: Utilized aCross-sectional descriptive correlational analysis of intersecting identities (Structural Stressors), ethnicity-related stressors (Otherness) and ethnic-identity (Otherness) to develop understanding of the potential effects of these variables on psychological stress. Independent variables included intersecting identities, perceived ethnic discrimination, concern for stereotype confirmation, own group conformity pressure, and …

Depression Screening And Care Management In Diabetes Patients At Rural Health Clinics In Primary Care: Quality Improvement, Marcy Doyle

DNP Scholarly Projects

Depression is one of the leading causes of disease and disability, often found in patients with long-term chronic physical conditions such as diabetes. Collaborative care, which includes care managers, has shown to improve depression outcomes in patients; usual care has been shown to be inadequate. This quality improvement project screened patients with diabetes for depression. Patients with an elevated depression screening score were provided care management support and rescreened every two weeks to evaluate depression symptoms. A small cohort of patients from two rural health clinics participated in the improvement project. The practices noted improvement in depression screening; patients who …