Nursing Commons^™

Outcomes Of Directly Observed Therapy In People Living With Hiv Who Experience Homelessness And Substance Use Disorder, Mara C. Clawson

Doctor of Nursing Practice (DNP) Projects

Background: Antiretroviral directly observed therapy, in which nurses or other allied health professionals provide patients with daily medication, is an evidence-based solution for viral load suppression in people living with HIV who experience homelessness. Purpose: This quality improvement project aimed to assess the outcomes of antiretroviral directly observed therapy at one urban clinic caring for people living with human immunodeficiency virus who experience homelessness and substance use disorder. Methods: Data was collected from the electronic health record for the antiretroviral directly observed therapy patient cohort (n = 33); 10 of them were surveyed. Fisher exact tests determined nonrandom associations between …

Vaccination Inequities Among Children 12-23 Months In India: An Analysis Of Inter-State Differences, Octavia K. Goodman, Abram L. Wagner, Dakota Riopelle, Joseph L. Mathew, Matthew L. Boulton

Community & Environmental Health Faculty Publications

Background

Previous research has shown that socioeconomic and demographic risk factors in children are additive and lead to increasingly negative impacts on vaccination coverage. The goal of this study is to examine if different combinations of four risk factors (infant sex, birth order, maternal education level, and family wealth status) vary by state among children 12-23 months in India and to determine the impact of ≥ 1 risk factor on differences in state vaccination rates.

Methods

Using data from the National Family Health Survey (NFHS) conducted in India between 2005 and 2006 (NFHS-3) and 2015-2016 (NFHS-4), full vaccination of children …

Application Of A Secondary Opioid Risk Tool In The Management Of Patients On Opioids In The Adult Pain Management Clinic: A Quality Improvement Project, Monica Kastanaras

DNP Projects

Introduction—Significance and Background: Aggressive opioid prescription practices play the biggest role in opioid-related behaviors and contribute to an epidemic of abuse. If started on long-term opioid therapy without screening, patients who are high risk for opioid abuse could overdose on their prescribed opioids. Current practice does not follow guidelines on monitoring opioid misuse behaviors utilizing a secondary screening tool for patients on long-term therapy.

Purpose: The purpose of this project is to help clinicians identify whether a patient, currently on long-term opioid therapy, may be exhibiting aberrant behaviors associated with misuse of opioid medications, using the Current Opioid Misuse Measure …

Community-Based Tuberculosis Contact Management: Caregiver Experience And Factors Promoting Adherence To Preventive Therapy., Micaela Sandoval, Godwin Mtetwa, Tara Devezin, Debrah Vambe, Joyce Sibanda, Gloria S Dube, Thandeka Dlamini-Simelane, Bhekumusa Lukhele, Anna M Mandalakas, Alexander Kay

Journal Articles

Delivery of tuberculosis preventive therapy (TPT) for children with household exposure to tuberculosis is a globally supported intervention to reduce the impact of tuberculosis disease (TB) in vulnerable children; however, it is sub-optimally implemented in most high-burden settings. As part of a community-based household contact management program, we evaluated predictors of adherence to community based TPT in children and performed qualitative assessments of caregiver experiences. The Vikela Ekhaya (Protect the Home) project was a community-based household contact management program implemented between 2019 and 2020 in the Hhohho Region of Eswatini. At home visits, contact management teams screened children for TB, …

A Qualitative Exploration Of The Use Of Service Dogs In Veterans With Post Traumatic Stress Disorder And Traumatic Brain Injury, Jennifer Shiroff, Kathy Gray, Gabrielle Santulli, Stephen Didonato, Jacqueline O'Rourke Fulford

College of Nursing Faculty Papers & Presentations

Objective

This qualitative research was conducted to add to the body of knowledge that supports the benefits of service dogs (SDs), as a tertiary treatment modality, to veterans with post‐traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI).

Methods

This grounded theory research design utilized open‐ended, semi‐structured interviews with veterans (n = 10) who were using SDs as a treatment modality for PTSD and/or TBI. Transcripts were analyzed using NVivo qualitative software until data saturation was achieved.

Results

Results from the data analysis identified 4 major themes with concurrent subthemes. The most prominent themes were functional status, impact of …

Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux

MSN Capstone Projects

Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …

Resilience And Prenatal Mental Health In Pakistan: A Qualitative Inquiry, Shireen Shehzad, David Arthur, An-Sofie Van Parys, Nicole Letourneau, Gail Wagnild, Shahirose Sadrudin Premji, Nargis Asad, Olivier Degomme

School of Nursing & Midwifery

Background: Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention.
Methods: The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A …

Depression Awareness Programs For Adolescents: A Scoping Review, Kincharska N. Freeman Msn, Aprn, Fnp-C, Cnor, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

The purpose of this DNP project is to determine if receiving school-based depression awareness education affects the depression scores of adolescents between 10 and 19 years of age.

Healthcare Workers On A Rotating Schedule Experiencing Burnout, Sunni Holland, Isabelle Boria, Samantha Hamblen

Non-Thesis Student Work

In addressing the burnout symptoms seen in a healthcare workers and how their shift time intensifies those symptoms, we ask the following evidence-based PICOT question: In (P) healthcare workers within the first five years of employment, is there evidence that suggests (I) rotating between night and day shifts compared to (C) a fixed schedule impacts the (O) presence of burnout symptoms? Healthcare professionals work shifts to cover the full 24 hours of care required for patients. The majority of workers will work 12 hour shifts in either the day or night hours. In workers that rotate between the shifts it …

Improving Retention Rates Of New Graduate Nurses, Rebekah B. Littlefield, Courtney Kelsey, Sophia Howrey

Non-Thesis Student Work

The purpose of this project is to explore if pairing (P) new grad nurses (I) with a similar personality nurse preceptor (C) as compared to a randomly assigned nurse preceptor (O) improves retention rates (T) over a 24-month period? Nursing has been recognized as a highly stressful profession that can lead to early career burnout. New nurses have reported an intention to leave the profession due to high-stress levels from unrealistic career expectations. Studies have shown that having a supported, planned, and consistent residency program for new nurses will increase retention of the nurses at the beginning of their careers. …

Altop (Alternatives To Opioids), Fall 2022, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

In this issue:

• New Principal Investigator (PI) ALTOP Grant
• 2021-2022 Graduating Class
• ANEW HRSA 2022-2023 Awardees
• Students Quality Improvement Projects
• April 9th, 2022, Preceptor Workshop Photos
• New Clinical Partner: The Bridgeport Rescue Mission/ Sage Health Care
• Save the Date: Annual DNP Colloquium

Utilization Of Creativity-Based Interventions To Combat Nursing Burnout, Heather J. Webb, Pamela Burhoe, Ryan Johnson, Brenna Milliken

Non-Thesis Student Work

In addressing the potential for a creative writing practice to serve as an effective intervention against nurse burnout, we ask the following research question: In RNs who have practiced between 2-10 years, does participation in a creative writing program decrease burnout symptoms compared to nurses who do not participate within a time frame of one year. Burnout syndrome is a collective term that encompasses many subcategories that result in negative attitudes towards patients and coworkers, as well as increased turnover rates. Burnout syndrome was already a significant concern before the COVID-19 pandemic because of the high demand and stress of …

Factors Influencing Utilisation Of Services Provided By Community Midwives And Their Non-Retention In District Thatta, Pakistan: A Qualitative Study Protocol, Bakhtawar M Hanif Khowaja, Anam Shahil Feroz, Sarah Saleem

Department of Obstetrics & Gynaecology

Introduction: Drawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to provide skilled birth attendance to pregnant women living in rural areas. Despite a large investment in CMW programme, the availability of community midwives in rural areas following their training is a constant struggle. The concerns related to the training, support and acceptability of community midwives need to be studied in order to identify gaps in the provision of skilled maternal and newborn healthcare. Therefore, this study aims to explore …

Implementing Universal Depression Screening In A College Health Clinic, Marilyn J. Grabau

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: College students are at high risk for depression, and this carries a considerable burden. The American College Health Association supports depression screening on college campuses recognizing that early identification leads to better outcomes.

LOCAL PROBLEM: The project site is a public university located in New England. The college campus health center incorporates medical and counseling services. From August 2019 to December of 2019, 67% of students seen in the counseling center described depressed mood as the presenting concern. Currently there is no routine depression screening in place.

METHODS: This QI project implemented universal depression screening at the student health …

Using The Whole School, Whole Child, Whole Community Approach To Improve An Urban Early Learning Center Students’ Social, Emotional, And Physical Health And Wellness, Joelle Chateauneuf

Doctor of Nursing Practice Scholarly Projects

Background: Integrating school-based health education and models of healthy lifestyles in early childhood provides a foundation for lifelong health learning. Many chronic may be prevented or mitigated through early childhood health education. Early learning centers (ELCs) may be a perfect setting to enable young children to achieve their full potential.

Problem: In Boston, Massachusetts, there are differences in health experience across population groups. Children of color and lower socioeconomic challenges experience higher rates of chronic conditions.

Available Knowledge: Search of literature showed that school-based healthy lifestyle interventions improve healthy behaviors and can be taught to children as young as preschool. …

Overcoming Barriers To Implement Depression Screening Post-Stroke, Cameron Haeseker, Erin Morgan, Eric Wilson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Background

One-third of all stroke survivors are expected to develop post-stroke depression, which is linked to lower quality of life, impaired recovery, increased risk of recurrence and an overall increase in mortality (Robinson & Jorge, 2015).

Objectives

Despite this link, outpatient clinics including the stroke clinic of focus do not consistently use a formal depression screen. Therefore, a pilot project utilizing the framework of the IOWA Model of Evidence Based Practice to implement this American Stroke Association recommended guideline may result in a permanent adoption of screening (Iowa Model Collaborative, 2017).

Purpose

The purpose of this evidence-based practice project …

Perioperative Protocol To Prevent Emergence Delirium In Patients With Post-Traumatic Stress Disorder, Audrianna Bustos, Roxanne Sambuca

DNP Scholarly Projects

Introduction: Ten percent of adults will experience post-traumatic stress disorder (PTSD) at some point during their lifetime, 50% of which remain untreated and undiagnosed. Perioperative management of the patient with PTSD may create significant challenges for the anesthesia provider. Patients with PTSD are more likely to experience emergence delirium (ED), which poses a significant safety threat to patients and staff. Screening for PTSD is routine in the veteran population but has not yet translated into common practice. To our knowledge, no protocol currently exists for anesthetic management of patients with PTSD. Routine screening for PTSD in the preoperative period and …

End The Stigma: Strategies To Improve Mental Health, Alexia M. Frantzeskakis

Honors Projects

The project discusses coping strategies that students can utilize to improve their mental health. A paper, along with five fliers that will be distributed to incoming freshmen were developed. Each flier discusses a different coping strategy on the following topics: physical activity, mindfulness, social media use, routines, and resources available to students in the community.

Increasing Opioid Abuse Screening In Primary Care Clinic: An Evidence-Based Quality Improvement Project, Carlos Milla

DNP Projects

Introduction

To address substance abuse multiple organizations recommend increase drug abuse screening as part of routine health care. CAGE AID is five-question tool used to screen for drug and alcohol use, answering yes to two or more questions indicates further assessment is advised. Unfortunately, most primary care centers do not use screen for substance abuse using validated instrument tools such as the CAGE-AID tool.

Purpose

The purpose of this evidence-based practice (EBP) project is to implement the CAGE-AID Substance abuse screening tool by nurse practitioners students in a family clinic located in Bridgeport in order to increase to number of …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Evaluating The Use Of Long-Acting Injectables As A Method To Improve Treatment Adherence In Patients With Schizophrenia: A Scoping Review, Britney Michelle Holton Msn, Fnp-Bc, Patricia Rena Jones-Purdy Msn, Cnrn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background Medication adherence is a major issue for patients suffering from schizophrenia and medication non-adherence can lead to psychiatric morbidity. Although long-acting injectable (LAI) antipsychotics have been shown to improve treatment adherence, most clinicians continue to rely on oral therapies to manage schizophrenia. This scoping review will assess evidence-based literature to determine the relationship between the use of LAIs and medication adherence in patients with schizophrenia.

Methods A literature review was conducted between August 2020 and January 2021 to find studies that have evaluated medication adherence with the use of long-acting injectables in patients with schizophrenia. Relevant literature initially selected …

Dnp Final Report: Adolescent Support For Healthy Living, Kristin S. Hudson

DNP Final Reports

Adolescents often make decisions that negatively impact their health and wellness. They do this for many reasons including impulsivity, underdeveloped communication and coping skills, feelings of invincibility, and a perceived lack of support. In adolescents, how does education and training related to risky behaviors compared to no education affect knowledge, skills, and understanding (KSU) of high-risk behaviors three months after instruction? Thirteen peer- reviewed articles were utilized in the body of evidence. A curriculum-based intervention was implemented. Outcomes include an overall increase in KSU in six key concepts including contraception, substances abuse, sexually transmitted diseases/infections, teen pregnancy, peer pressure, and …

Comparing The Effectiveness Of Perioperative Ketorolac To Opioids: A Scoping Review, Kruze T. Vanderford Bsn, Ccrn, Srna, Abbie E. Walter Bsn, Ccrn, Srna, Anastasiya V. Woodard Bsn, Ccrn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Abstract Purpose/Background Opioids are commonly administered in the perioperative period to manage surgical pain. However, the ongoing opioid epidemic in the United States makes it necessary to evaluate other modalities of pain management that do not cause respiratory depression, nausea, vomiting and addiction. Ketorolac is a nonsteroidal anti-inflammatory drug that can manage pain safely and effectively. This scoping review examines the available literature on the effectiveness and feasibility of using ketorolac to minimize perioperative opioid use.

Methods A comprehensive literature review was performed between October 2020 and September 2021 utilizing five scholarly databases: GoogleScholar ™, PubMed, Ovid, Cochrane Library, and …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

Impact Of Ante- And Postnatal Depression Screening In Women With Hiv: A Scoping Review, Kimberly M. Grider Bsn, Rn, Pmh-Bc, Bao Chau Le Bsn, Rn, Blessing Okon Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Maternal depression has been identified as a strong predictor of poor prenatal care. Among pregnant women living with Human Immunodeficiency Virus (HIV), mental health-related factors such as depression could potentially undermine effective antiretroviral therapy (ART) adherence, increase mortality, and cause poor HIV viral suppression consequently impacting vertical transmission of HIV. This scoping review aims to identify existing knowledge regarding the impact of ante- and postnatal depression screening in women with HIV and to adduce the necessity for effective screening.

Methods A literature search was performed for studies with primary outcomes of depression screening within the context of ante- or …

Boarding Barriers For Psychiatric Patients In Emergency Departments, Emmeline B. Martin Bsn, Rn, Alison Rossano Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Objective To identify past or current literature about emergency department holds and psychiatric patients consisting of the evaluation of patient outcomes, satisfaction and equity of care. It is already known that shorter boarding times from the emergency department to a psychiatric unit have positive patient outcomes such as a decrease in readmissions, increase in patient satisfaction and efficiency in appropriate treatment.

Method A scoping review to analyze data by grouping articles into themes which included authors, date of publication, aims/purpose, methodology, sample, interventional details, and the key findings in each article. Excluded articles included those discussing COVID-19 and case management. …

A Scoping Review: Trauma Informed Care For Justice Involved Youth To Decrease Recidivism, Tamika Beecham, Marissa Gray, Shelby Husband, Diana Dedmon Dnp, Fnp, Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this scoping review was to address trauma-informed care, juvenile justice systems, and recidivism rates. The literature review conducted identified key research and analysis of effective trauma-informed treatment methodologies, referrals, and accessibility of care for justice-involved youth, and the rate change of recidivism related to trauma-informed treatment and interventions.

Background The high rates of recidivism in the juvenile court systems matched with the increased prevalence of psychological trauma in justice-involved youth represent the need for implementing trauma informed care. The scoping review analyzed the research implementing the intervention of trauma informed care to determine if it resulted …

Altop (Alternatives To Opiods) Newsletter, Spring 2022, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

In this issue:

• Southwest Community Health Center Quality Improvement Staff (QIS)
• FNP-DNP Student's Quality Improvement Project
• Paul L. Jones Scholarship Recipients
• SHU Alumni Kimberly Testo's AANP National Year Award
• Preceptors' Workshop CEU Credits

Factors Associated With Home Delivery In Rural Sindh, Pakistan: Results From The Global Network Birth Registry, Afreen Sadia, Shafaq Mahmood, Farnaz Naqvi, Seemab Naqvi, Zahid Soomro, Sarah Saleem

Community Health Sciences

Background: According to global estimates for 2017, nearly 295,000 maternal deaths occurred worldwide. Thus, approximately 810 women die every day due to pregnancy-related complications. This burden of maternal deaths in LMICs is primarily due to poor healthcare service utilization, as indicated by relatively low rates of institutional deliveries and skilled-birth attendance (SBA). We conducted this study with an aim to assess the factors associated with home delivery and its subsequent effect on the pregnancy outcome in rural Sindh, Pakistan.
Methods: Data for this study were taken from The Global Network's Maternal Newborn Health Registry (MNHR), which is a prospective, population-based …

Effects Of Nonpharmacological Interventions On Disruptive Vocalisation In Nursing Home Patients With Dementia-A Systematic Review, Saad Bilal Ahmed, Alfredo Obieta, Tamsin Santos, Saara Ahmad Muddasir, Joseph Elliot Ibrahim

Department of Biological & Biomedical Sciences

Background: Vocally disruptive behaviour is a common and difficult to treat condition in older residents with dementia. The aim of this systematic review is to evaluate the efficacy of nonpharmacological interventions in its management in persons with dementia residing in a nursing home.
Methodology: A systematic search was conducted using Ovid MEDLINE, CINAHL, and Cochrane databases and reference lists from relevant publications on various nonpharmacological approaches to manage vocally disruptive behaviour in nursing home residents. The method of appraisal was through the National Institutes of Health scoring for the Quality Assessment of controlled intervention studies. Inclusion criteria included residents of …