Nursing Commons^™

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

A Systematic Review Of Complimentary Therapies To Treat Symptoms Of Post-Traumatic Stress Disorder In The Aftermath Of Domestic Abuse, Jordan A. Meeks, Saida Byrami

Senior Honors Projects, 2010-2019

Objectives: Explore the impact of intimate partner violence (IPV) on the health of female survivors. Identify complementary therapies that alleviate symptoms of psychological health impacts of IPV on women’s health.

Method: An exhaustive search of published, peer reviewed literature on complementary therapies and IPV was conducted. Databases included PubMed and CINAHL. Each article reviewed was published between the years of 2002 and 2016. The initial search produced 112 articles, abstracts of all studies were reviewed and studies were included if they addressed; a) complementary and alternative therapies, b) post-traumatic stress disorder, anxiety, and depression and, c) the impact of IPV …

The Development, Implementation, And Evaluation Of A Transgender Health Resource Bundle, Lovejeet Kaur

Doctor of Nursing Practice (DNP) Projects

Transgender populations experience disproportionate social and health disparities that can negatively impact quality of life. Healthcare barriers due to gender based discrimination and lack of medical insurance and culturally competent providers contribute to low levels of access to preventative health care screenings, resulting in sub-optimal health outcomes. The unique health circumstances of transgender individuals have been understudied in the literature. As a result clinicians are often under-informed of their specific health maintenance needs and screening guidelines. To help address this disparity, a Doctor of Nursing Practice (DNP) student at the University of San Francisco facilitated the collaborative assessment, development, implementation …

Lactation Clinic: Improving Patient Lactation Support, Iana Johnson

Master's Projects and Capstones

Despite the numerous health benefits and recommendations that breastfeeding is the optimal method for nourishing infants, many still choose other ways to feed their babies during the first year of life. This project considers the initiation and future implementation of a Lactation Clinic as an additional patient support service provided in the inpatient and outpatient settings. A Failure Modes and Effects Analysis (FMEA) was conducted in an effort to evaluate and eliminate “what could go wrong” before such an establishment becomes operational. The Risk Priority Numbers (RPNs) from the analysis reveal the lack of use (RPN 50) and streamlining (RPN …

Ihss: Repackaging Consumer Information, Deloras N. Puran

Master's Projects and Capstones

Currently, qualified Californians with disabilities and aging individuals can receive consumer-directed care through the IHSS program. Despite the strong demand for the program, new consumers are still struggling to begin their service after enrollment.

This study assisted San Francisco In Home Supportive Services Public Authority to understand how new consumers can navigate the IHSS program services after enrollment. Focus group and semi-structured in-depth interviews were conducted to gather feedback from consumers regarding what type of information would they need after enrollment, and how would they want to receive the information. Based on the feedback, written and virtual deliverables were designed …

Kinder Ready: Exploring The Role Of Technology In Promoting School Readiness Among Low-Income Parents In A Clinic-Based Setting, Brenda Lu

Master's Projects and Capstones

The Stanford Pediatric Advocacy Program advocates to improve the health status of children in Silicon Valley and the surrounding community. This summer, I worked on a project called Kinder Ready, with the goal of evaluating the feasibility of technology use in promoting school readiness in children ages zero to five. We used a variety of qualitative research methods, including focus groups, one-on-one interviews, and surveys to collect feedback from the community on what their children need to transition into schools. Our local participatory research approach has paved the way for many new partnerships with local organizations, while strengthening existing ones. …

Reducing Annual Emergency Department Visits Through Improved Asthma Discharge Teaching, Alvin R. Walters

Master's Projects and Capstones

Asthma is the most common pediatric condition in the United States, and a child's home environment plays an impactful role in the triggering of asthma exacerbations (Harper et al., 2015). Current emergency department (ED) ideology focuses on symptoms management, with little time spent on education, and virtually no attention paid to the home environment. Evidence shows that programs which incorporate home environmental assessments into asthma patient education produce a reduction in annual ED visits, fewer missed school days, decreased use of rescue medications, and improvements in quality of life (Gruber K.J., et al, 2016, Hollenbach J.P. & Cloutier M.M., 2015, …

The Effects Of A Brief Mindfulness-Based Meditation Intervention On Chronic Pain, Jolena B. Allred

Nursing Theses and Capstone Projects

As the number of individuals suffering with chronic pain escalates, management is shifting from pain specialists to primary care providers. Nurse practitioners are becoming increasingly responsible for the management of this complex patient population. Analgesics, primarily opioids, have been the standard of chronic pain management with a resulting national crisis related to overuse, improper use, and illegal use of these substances. Mindfulness-based meditation has gained increasing interest and acceptance by both the individuals suffering with chronic pain and the providers managing those who suffer, however, limited investigation is available related to brief interventions provided at point-of-care. This Capstone Project evaluated …

Enhancing Vegetable Intake In Infants And Toddlers Through Parental Complementary Feeding Education, Sophia Testa

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This research project investigated the outcomes of educating parents of infants between the ages of 6 months and 12 months on the importance of including vegetables in complementary feedings on the infant’s vegetable consumption. The efficiency of teaching was measured by comparing physical measurements and quantity of vegetables consumed by infants whose parents received education with the same data from infants whose parents did not receive education on inclusion of vegetable in complementary feedings. The results found contributed to Dr. Shreve’s research on childhood obesity in the Northwest Arkansas population and to the knowledge of parental education with regard to …

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 …

The Relationships Between Health Literacy, Self-Efficacy And Readiness For Change To Health Promotion Behaviors In Urban Black Women, Millie Hepburn

Seton Hall University Dissertations and Theses (ETDs)

Problem: Black women have been shown to experience higher rates of morbidity and mortality as a result of stroke, cardiovascular disease, hypertension, diabetes and overweight or obesity than women of other races/ethnicities. The ability to avert certain health problems, such as cardiovascular disease, hypertension, diabetes, stroke and overweight or obesity is known to be directly related to active engagement in health promotion behaviors, yet Black women are consistently less likely to engage in these behaviors than are white women. Improved understanding of the various factors that impact individual health promotion behaviors to reduce risk, such as health literacy, self-efficacy and …

Tuning "The System": An Evaluation Or Restorative Practices In San Lorenzo School District, Amber White

Master's Projects and Capstones

In 2013, The Director of Student Support Services for the San Lorenzo Unified School District (SLZUSD) implemented a Restorative Practices program in an effort to improve relationships on campus and decrease suspension and expulsion rates in SLZUSD. The Directors push for RP was fueled by the passing of Assembly Bill 1729 (AB-1729), when the California Education Code changed to allow for alternative disciplinary actions. States nationwide have passed bills similar to AB-1729 and allowed schools to use alternative punitive practices. Despite good natured intentions there were many faculty members who did not respond with enthusiasm and there has since been …

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

Implementing Change To Decrease The Emergency Department Visits For Pediatric Clients Referred To Mental Health Services, Diane Sandoval

Master's Projects and Capstones

The purpose of this clinical nurse leader (CNL) internship project is to implement an improvement intervention to decrease emergency department visits or psychiatric emergency services visit rates for pediatric clients receiving mental health services through the ambulatory clinic. The goal is to increase client safety by preventing harm to themselves or others and improving quality of care provided through timely nursing telephone triage. The project is taking place in a county run pediatric ambulatory clinic. We will participate in a shared leadership team to make recommendations for improvement at the microsystem level. Team members include the charge nurse, clinic manager, …

Intranasal Naloxone Adminstration Education, Natalie O. Levchenko

Master's Projects and Capstones

The Clinical Nurse Leader project focused on the provision of education on intranasal naloxone administration to healthcare providers in Lake County in order to educate patients, their families, peers, and members of their social network. Fatal opioid overdose rates from prescribed or illicit opioids are four times greater in Lake County than California. The setting is Lake County, California, with a population of 65, 000, a radius of 1,300 square miles, and an annual per capita income of $21,000, with 24.3 % living in poverty. The CNL project focused on the Clinical Nurse Leader elements: Systems Analyst/Risk Anticipator, Outcomes Manager, …

Issues In Patient Information Transmission: Standardizing Home Health Admission, Philippa Thomas

Master's Projects and Capstones

When 84 patients, current and former, complained about lack of information during the intake process within five months period, a uniform "Patient Screening Tool" (Appendix L) was developed to improve the admissions process to this home health agency. Intake staff is responsible for receiving accurate information from the referral sources, confirming qualifications to receive services, and initiating education about services to the patient. While the population served has a wide range in age, diagnoses, discharge settings and cultures, the majority are over 65, frail, homebound and are returning home after hospital, SNF or rehabilitation settings.

Data were collected through evidence …

A Feasibility Study Of Just-In-Time Asthma Self-Management Intervention, Phillip Charles Scruggs

Masters Theses

Quality asthma care requires not only an initial diagnosis, but long term follow up care and education on long term control. Preventable symptoms continue to reduce the quality of life for chronic asthma sufferers and place an unnecessary burden on emergency services and the health care system at large. A mobile health (mHealth) solution is proposed to effectively improve outcomes for patients while ultimately reducing the overall burden of mismanagement on the healthcare system as a whole. The Just-in-Time Asthma Self- Management and Intervention (JASMIN) system provides a way for a patient or user to track, self-manage, and interact with …

Alcohol Withdrawal Syndrome, Sharon F. Ali

Nursing Theses and Capstone Projects

Alcohol withdrawal syndrome (AWS) is a very serious problem that may affect the patient when admitted inpatient for a traumatic or non-traumatic diagnosis. Chronic Alcohol consumption in moderation may put the patient at risk for delirium tremens which is the most severe form of alcohol withdrawal. Management of alcohol withdrawal in acutely ill hospitalized patients is challenging for healthcare providers (Riddle, Bush, Tittle, & Dilkhush, 2010). Signs and symptoms of AWS are caused primarily by neurophysiologic changes in the brain, which may be mild to severe, and may develop within 6-72 hours after abstaining from alcohol. Mild symptoms of withdrawal …

Youth Empowerment For Environmental Justice, Mattie B. Brickle

Ed.D. Dissertations in Practice

Woodsmoke pollution is an environmental justice issue for youth living in certain Pacific Northwest cities. Little is understood about how youth may be empowered to address woodsmoke issues in their communities. In this study, I examined youth empowerment in a citizen science study on woodsmoke, using Photovoice methodology. Ten diverse youth collected and analyzed indoor air samples and photos, then presented their findings to the community and policy makers. Entrance and exit surveys revealed an increased sense of empowerment to take action on woodsmoke pollution. Youth also expressed increased optimism and a resolve to become scientists and to combat environmental …

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 …

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 …

Evaluation Of A Smoke And Tobacco-Free Initiative In A Student Wellness Center, Angelito Dela Cruz

Doctor of Nursing Practice Final Manuscripts

Background

Tobacco use remains a leading cause of preventable disease and death in the U.S. Nearly all tobacco users begin using tobacco by 26 years of age. In a Southwest university, 9% of students smoke tobacco. This project evaluated a university-wide tobacco-free initiative by reviewing students’ use of tobacco cessation services following a tobacco-free policy implementation. This project also reviewed students’ tobacco use following campus tobacco cessation counseling.

Methods

A smoke and tobacco-free campus policy was implemented in August 2015. The Student Wellness Center provided free tobacco cessation services to all students. Each tobacco cessation counseling session lasted a minimum …

Increasing The Awareness Of Trauma Informed Care In The School Setting: Giving Practitioners The Tools To Actively Participate In Trauma Related Care, Rebekah L. Sypniewski

Doctor of Nursing Practice (DNP) Projects

Of the approximately 15 million children and adolescents who have a mental health disorders that are interfering with their functioning, a mere 25% seek medical advice or treatment (Melnyk, Kelly, & Lusk, 2014). Furthermore, two thirds of youth report experience at least one traumatic event by age 16 (Suarez, Belcher, Briggs, & Titus, 2012). School health practitioners have regular contact with children and adolescents as they typically attend school five days a week, nine months out of the year. The consistent presence of the relationship between the practitioner and student creates an ideal environment for discussing the sensitive topics necessary …

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 …

Implementing Change To Decrease The Re-Admission Rate For Clients Of A Care Transition Program, Aileen Tran

Master's Projects and Capstones

The clinical nurse leader (CNL) internship project’s purpose is to implement a change to decrease readmission for clients in a care transition program, thereby improving quality of life. This care transition program aids with the transition from hospital to home for adults. The microsystem is composed of public health nurses, volunteers, student interns, supervisors, and an administrative assistant. The aim statement for this change project is to improve patient safety by decreasing readmission rates by implementing an initial follow-up phone call within one day of discharge in 75% of the care transition clients by April 30, 2016. This project was …

The Experience Of Adult Children Cargiving For Aging Parents, Kimberly Conway

Seton Hall University Dissertations and Theses (ETDs)

Background: An estimated 35 million Americans are age 65 or older, and this population is expected to double within 25 years. When the normal progression of life for an aging person is interrupted, adult children are often suddenly faced with assuming care of their parent(s). Currently adult child caregivers of aging parents, work up to 100 hours per month at caregiving. Problem Statement: A limited body of empirical studies exists on the caregiving of aging parents exclusively by their adult children. Despite the amount of time dedicated to parental caregiving little is known about the experience of this exclusive caregiver …

Effect Of Using Culturally Sensitive Education In Increasing Mammogram Use And Breast Cancer Awareness: African Female Immigrants, Gertrude Mumba-Kaunda

Evidence-Based Practice Project Reports

Despite the advances in medical technology, breast cancer is the most common cancer among women and is the second leading cause of death in African-American and Caucasian women in the United States. Mammography has shown to be one of the best methods to reduce late detection of breast cancer. The American Cancer Society recommends monthly self-breast examination (SBE), clinical breast examinations every 3 years, and yearly mammography starting at the age of 40. Despite the recommendations, there is still significant disparity among different racial groups, when it comes to death rates, which can be attributed to low screening rates. The …

Physical Activity Levels And Related Factors In Midwestern Rural Hispanic Or Latino Adults, Alison K. Clevette

Theses & Dissertations

The purpose of this dissertation was to examine physical activity levels and specific intrapersonal, interpersonal and community physical environment factors that influence physical activity in Midwestern rural Hispanic or Latino adults. Instruments used in the study included: Self-Efficacy for Exercise Behaviors Survey, Social Support for Exercise Survey, Short Acculturation Scale for Hispanics (SASH), and Neighborhood Environment Walkability Scale (NEWS). Physical activity was measured by 7-Day Physical Activity Recall and ActiGraph^® accelerometer data. In the study of 54 participants, it was found that there was a very low level of physical activity. For example, 97% of the time was spent …

An Adult Pcv13 Vaccination Protocol In The Retail Healthcare Setting, Christine P. Duong

Doctor of Nursing Practice Final Manuscripts

Purpose – To establish an adult Pneumococcal (PCV13) vaccination protocol within a chain of retail healthcare clinics.

Background - Invasive Pneumococcal disease results in significant morbidity and mortality in patients ≥65 and those with immunocompromised status. Despite CDC recommendations, national PCV13 vaccination rates remain low in these populations. No adult PCV13 vaccination protocol existed in the project retail healthcare clinics.

Project Plan Process – An evidence-based PCV13 vaccination protocol based on the CDC guidelines using the Provus Discrepancy Evaluation Model as a framework was implemented. NPs were educated on indications for PCV13 vaccinations and a questionnaire to identify those patients …

The Effect Of Heart Failure Education On Knowledge And Readmission, Sara A. Golden

Evidence-Based Practice Project Reports

Heart Failure (HF) is a chronic progressive disease affecting over 5 million individuals with an expected increase in incidence as the population ages (Yehle & Plake, 2010). The costs associated with managing HF continue to increase and the Centers for Medicare and Medicaid Services (CMS) have attempted to identify ways to improve patient management of HF to reduce the revolving door of hospital readmissions and decrease expenditures. According to 2006 data, as many as one fourth of the Medicare beneficiaries discharged from acute care to skilled nursing facilities (SNF) were readmitted to the hospital within 30 days and the majority …