Nursing Commons^™

Outpatient Medication Error Improvement, Savannah M. Klinginsmith

Master's Projects and Capstones

Patient Safety Initiative -Improving Medication Administration (Outpatient Care)

SPECIFIC AIM: We aim to Improve the medication administration process and involve all staff within 6 months

In the microsystem consisting of 14 family practice and urgent care clinics, there is not a standard process based on evidence based practices for medication administration. With and estimated of 400-600 medications (immunizations included) being administered per day, without a standard of care protocol, the risk for medication errors is evident.

Objectives and changes anticipated based on implementation of the project is to engage staff in support for improving medication administration standard of care based …

The Design And Implementation Of A Grief Support Program In A Faith-Based Setting, Susan Mortell

Doctor of Nursing Practice (DNP) Projects

Although grief itself is not a pathological condition, adequate support before and after loss can prevent grief becoming unresolved or complicated. Complicated grief (CG) is often diagnosed when severe bereavement symptoms persist over six months following a loss, and it affects an estimated 3-25% of the general population (Fujisawa, Kato, Miyashita, Nakajima, Ito, & Kim, 2010). Complicated grief can result in longstanding psychological issues such as depression and substance abuse.

One group that is at particular risk for CG is older lesbian, gay, bisexual and transgender (LGBT) individuals. This population is significantly represented in Most Holy Redeemer Catholic Church (MHR) …

Implementing An Evidence Based Foot Assessment Protocol For Use By Nurses Caring For Adult Diabetic Patients Seeking Care In The Thanh Nhan Hospital Endocrinology Department, Amy Ly

Doctor of Nursing Practice (DNP) Projects

The purpose of this primary care nursing practice improvement project was to implement a diabetic evidence-based protocol for use by nurses caring for adult patients seeking care in the Thanh Nhan Hospital Endocrinology Department (TNH/ED) in Ha Noi, Vietnam.

Prior to project implementation, physicians performed all patient foot assessments. No standardized foot assessment tool existed.

The author made an on-site visit to the clinic to assess current practice. The author then recommended expanding nursing practice by using an evidence-based assessment tool. The author conceived an implementation approach, then designed, developed and presented the plan via an Internet-delivered fully interactive Virtual …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Evidence-Based Change In Practice: Development And Implementation Of Type Ii Diabetic Flow Sheet, Kathryn Grimleybaker

Doctor of Nursing Practice (DNP) Projects

Ten percent of the National Health Service annual budget goes to treat complications from diabetes (Lancet, 2010). The American Diabetes Association® (ADA, 2013) estimated that diabetics in the United States incur $176 billion annually in direct medical costs for treatment with hospitalization being the main component of the expenditures. California has the largest population of diabetics and the highest annual cost at $27.6 billion (ADA, 2013). The Healthcare Cost and Utilization Project (HCUP, 2008) found that the average cost of hospitalization in 2008 for a patient with diabetes was $10,937 in contrast to $8,746 for a patient without diabetes. The …

Good Intentions?: A Consideration Of Short-Term, Medical Mission Trips, Kayla M. Steele

Mahurin Honors College Capstone Experience/Thesis Projects

I review the current trend of international volunteer travel with a focus on advantages and disadvantages of short-term (1-2 week) medical volunteer trips and how cross-cultural communication can influence the effectiveness of volunteers. Advantages include making health care available to populations who normally do not have access to care. Disadvantages to trips include a lack of follow-up care and community dependence on outside aid. To increase the effectiveness of these trips, it is recommended that volunteers coordinate with full-time health care workers in target communities and utilize pre-departure training.

Living With Hypertension: Experiences Of Black Men Related To Their Perceptions Of The Clinical Encounter At Diagnosis, Glenda Mccartney Feild

Doctoral Dissertations

Introduction: In the U.S., hypertension (HTN) is the most common primary diagnosis and HTN related illnesses are the number one cause of death. Being a member of the Black population increases the risk for developing HTN. Black males are reported to develop HTN earlier in life and have a high incidence of undiagnosed, untreated, and uncontrolled HTN. Sociocultural and gender barriers influence this population’s perceptions of medical experiences, which affects their participation in health-promoting behaviors such as eating a healthy diet, engaging in regular physical activity, avoiding tobacco, limiting alcohol consumption, and decreasing stress.

Purpose: The purpose of this study …

Increasing Hpv Vaccination Rates Using Social Marketing Strategies, Sharon Wilson Catledge

Doctoral Projects

The human papillomavirus (HPV) is the most common sexually-transmitted infection (STI). Approximately 20 million Americans between the ages of 15 and 49 years currently have HPV with > 6.2 million new HPV infections estimated to occur each year. Yet, HPV vaccination rates remain relatively low. More than 40 strains of HPV are transmitted through genital contact during vaginal, anal, or oral sex and can infect males and females. In addition to causing genital warts, HPV is associated with cervical, vulvar, vaginal, anus, penile, and oropharyngeal cancers. In women, the most prominent type of cancer is cervical with > 12,000 diagnoses each year …

Evaluating The Perceptions Of Quality Of Life In Informal Caregivers Caring For Hospice Patients, Rashandra Fisher Laws

Doctoral Projects

Maintaining or improving quality of life for informal caregivers is important as they endure the burden of providing care to terminally ill loved ones on a daily basis. Caregivers are at a greater risk for depression, deteriorating physical health, financial difficulties, and premature death than demographically similar non-caregivers (Demiris et al., 2010). The goal of this capstone project was to determine the effectiveness of the creativity, optimism, planning, and expert information (COPE) intervention, which address specific needs of the family and caregiver.

Twenty informal caregivers completed the Quality of Life (QoL) Index tool, which measured their perceptions of five different …

A Partnership To Enhance Community Health Education For Rn To Bsn Students., Cathy Abell, Lori Alexander, Tonya Bragg-Underwood

Nursing Faculty Publications

This article shares a unique model of collaboration between a school of nursing and a community business to offer an on-site occupational health clinical experience for RN to BSN students. This activity could be easily replicated by others to provide a learning opportunity for nursing students. Hospitals remain the primary site of employment for nurses. However, with health care reform nurses are exploring many new opportunities including many settings in the community (Black, 2014). Incorporating community health into nursing curriculum is a necessity; however, providing meaningful clinical experiences can be a challenge for faculty. To meet students' learning needs, faculty …

Determining Patient Activation Levels Among Patients Who Are Receiving Rehabilitation Services In A Rehabilitation Or Long-Term Care Facility, Danielle S. Vittatoe

Undergraduate Honors Theses

Research shows that one of the major contributors for an extended stay in a long-term care facility is lack of knowledge regarding goals for rehabilitation after being discharged from an acute care facility. It is important to determine patients’ levels of engagement because individuals who are actively involved in discharge planning and rehabilitation goals are able to manage their ongoing care more effectively, which results in increased quality of life. The data was collected using a survey method and the instrument used was the Patient Activation Measure or PAM which is a highly accurate and reliable tool. The 22 question …

Coronary Heart Disease Prevention With A Focus On Diet Modifications In Female College Students At A Local Community College, Traci N. Spitzmiller

Master of Science in Nursing Evidence-Based Practice Projects

In the United States, cardiovascular disease is the number one cause of death in women. The most common and deadly form of cardiovascular disease is coronary heart disease (CHD). Many coronary heart preventive education awareness programs focus on the adult women population (40 years old >). By that time, many previous lifestyle choices such as poor dietary choices have contributed to the development of risk factors for developing CHD. Young college women (18-24 years old) have the ability to implement healthy diet choices, which in turn will help to decrease their risk for CHD development. Sinclair Community College is located …

Knowledge And Acceptance Of Hpv And The Hpv Vaccine In Young Men And Their Intention To Be Vaccinated, Brenda Renee Jasper

USF Tampa Graduate Theses and Dissertations

Sexually active young men are at high risk of contracting HPV and developing genital warts and penile/anal cancers. They contribute significantly to the incidence of HPV in women. The HPV vaccine, Gardasil, was approved in 2009 for use in preventing HPV 6 and 11 in young males ages 9 to 26. Knowledge and awareness of the virus and the vaccine is limited among young men. Promoting education and prevention measures regarding HPV and reducing personal risks to HPV is significant in narrowing the gap between acquisition of the HPV virus and cancer sequelae. A correlational design utilizing cross-sectional survey methodology …

Menopause, Rurality, And Obesity In Rural African American Women, Colleen Kilgore

FIU Electronic Theses and Dissertations

In the US, one in every eight deaths is due to an obesity-related chronic health condition (ORCHC). More than half of African American women (AAW) 20 years old or older are obese or morbidly obese, as are 63% of menopausal AAW. Many have ORCHC that increase their morbidity and mortality and increase health care costs. In 2013, 42.6 percent of AAs living in South Carolina (SC) were obese. The purpose of this cross-sectional study was to identify the cognitive, behavioral, biological, and demographic factors that influence health outcomes (BMI, and ORCHC) of AAW living in rural SC. A sample of …

Technology Use In Patient Education: A Review Of The Literature, Jaime Mccabe, Kate Weinberg

Nursing Student Work

No abstract provided.

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

Electronic Thesis and Dissertation Repository

Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …

Evaluating The Student Health Needs At Dalton State College, Cheryl W. Owens

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

The incidence of chronic diseases in college students mirrors that of older adults. Yet despite the enactment of the Affordable Care Act (ACA), college student continue to have difficulty accessing medical care. Many have no insurance, limited transportation and inadequate finances during college to obtain medical care. While college health centers may improve access to care, smaller colleges often do not have the financial and personnel resources to provide student health services. Even in colleges that provide student health services, the focuses are primarily on sexual health, mental health, violence, and substance abuse. Prevention and treatment of chronic diseases services …

Global Burden Of Tuberculosis, Diana Moses

Nursing Student Class Projects (Formerly MSN)

Tuberculosis (TB) is a major health concern not only in the United States, but in the entire world. TB is an airborne communicable infection which has affected human beings from immemorial times, evidenced by TB being found in the skeletal remains of ancient mummies (Gough & Kaufman, 2011). There are many patho physiological events in TB that concern the entire body, especially the respiratory and immunological systems. According to Knechel, TB prevalence is rising due to the increased number of patients infected with HIV, bacterial resistance to medications, increased international travel and immigration from countries with high prevalence of TB, …

Ebola: Protecting Healthcare Workers, Martha Mccoy

Nursing Student Class Projects (Formerly MSN)

Ebola is a hemorrhagic disease that has been seen throughout Liberia, but because of international travel it is spreading. Gilsdorf, Morgan and Leitmeyer (2012) researched air travel and reported that, “In 2010, 5.04 billion passengers arrived and departed from 1318 airports worldwide… and travel to and from Africa almost doubled between 1995 and 2005.” (p.1471). In the last few months there have been cases of Ebola reported in Spain and the United States linked to travel. These are recent developments because as of July, 2014 the Center for Disease Control and Prevention (CDC) reported “to date there are no cases …

Ebola Pandemic, Lurajean Cravens

Nursing Student Class Projects (Formerly MSN)

Ebolavirus, or Ebola Virus Disease (EVD), is of the filovirus family causing hemorrhagic fever first discovered in the African country of Zaire in 1976 (Turner, 2014; Hampton, 2014) and has gained global concern and attention since the recent epidemic outbreak in West Africa. There are five known species of Ebola: Zaire, Sudan, Ivory Coast, Bundibugyo and Reston, based on the region of origination. The Zaire species has been identified as the strain responsible for the current outbreak in West Africa, and has spread to Liberia, Sierra Leone, Nigeria and Senegal (Centers for Disease Control and Prevention,2014; Gostin, Lucey & Phelan, …

Chagas Disease: A Dangerous Kiss, Stephen Maynard

Nursing Student Class Projects (Formerly MSN)

Parasitic infections are a common occurrence worldwide and are often more common in low income countries. While these infections are associated with poor compromised communities outside the United States these diseases effect people within the United States and are more common than realized. One specific parasitic infection infects its human host causing Chagas disease. Chagas disease is an infection that occurs from the parasite T. cruzi and was named for the Brazilian physician Carlos Chagas who discovered the disease in 1909 (CDC, 2014). According to the Centers for Disease Control (CDC, 2014), Chagas disease has been targeted as a priority …

Concept Clarification Of Grief In Mothers Of Children With An Addiction, Donna M. Zucker Rn, Phd, Faan, Kimberly Dion Msn, Rn, Roxanne P. Mckeever Msn, Rn

Donna M. Zucker

Aim: To report an analysis of the concept of grief in mothers of children with addiction. Background. The concept of grief in this context is poorly understood and often synonymously used with concepts depression, loss and chronic sorrow. In the US, the core concept grief has been recently revised by both NANDA and the DSM-V in efforts to better understand and characterize the concept. The plethora of literature on grief worldwide often characterizes grief as a response to a death. Design. Concept analysis. Data sources. Search terms ‘parental grief’ and ‘substance abuse’ yielded 30 articles. A second review using terms …

Hepatitis C Testing In The Birth Cohort 1945-1965. Have You Been Tested?, Donna M. Zucker Rn, Phd, Faan, Donald (Chip) E. Bailey Phd, Rn

Donna M. Zucker

No abstract provided.

Prevention Of Hiv Mother-To-Child-Transmission In Sub-Saharan Africa, Sidik Abdul-Mumuni

Master's Projects and Capstones

The transmission of HIV infection from an HIV-positive mother to her child during labor, pregnancy, breastfeeding or delivery is termed as mother-to-child HIV transmission (WHO, 2013 report on HIV). A range of 15-45% infection transmissions are possible when no intervention strategies are put into place. Globally, goals and initiatives have been set to combat this issue as well as speeding up the interventions and achieve possible transmission rates of levels less than 5% and total elimination of new infant HIV infections by 2015 (WHO, 2013 report on HIV). In 2011, 57% of pregnant women living with HIV in low and …

Food For Health: An Investigation Of Infant Feeding Practices, Breastfeeding Self-Efficacy, And Perceived Barriers And Facilitators, Jessica W. Smith

Electronic Thesis and Dissertation Repository

Exclusive breastfeeding is associated with numerous health benefits for both mother and child, and is recommended for the first 6 months of an infant’s life. The purpose of this prospective study was to examine, using a survey-based design, the breastfeeding practices, self-efficacy, and perceived barriers and facilitators of primiparous mothers in London, Ontario. A total of 71 women (M_age = 30.0, SD = 4.3) participated in the study. Women (breastfeeding and non-breastfeeding) were asked to complete online surveys at three time points: < 4 weeks postpartum, 3 months postpartum, and 6 months postpartum. Results indicated that rates of exclusive breastfeeding decreased over time, whereas partial and non-breastfeeding rates increased. Women in the exclusive breastfeeding category reported the greatest levels of breastfeeding self-efficacy at all time points. Lastly, participants identified a number of breastfeeding-related facilitators (e.g., partner support, community services) and barriers (e.g., insufficient milk supply, latching difficulties).

Re-Engineered Discharge Planning In A Rural Mississippi Hospital To Reduce 30 Day Readmission Rates Among Heart Failure Patients, Roxie Mae Hogan

Doctoral Projects

The hospital discharge is a complex process that involves interdisciplinary efforts to avoid readmissions and decrease health care costs. The purpose of this capstone project was to take a leadership role in translating evidence into practice by successfully preparing NWMRMC discharge planning stakeholders to adapt Project RED for use with HF patients admitted to NWMRMC.

A comprehensive systematic improvement plan, Project RED is designed to improve the work flow process through the use of timelines and strategies. Project RED supports discharge planning, helps to prevent readmission, and facilitates knowledge transfer that promotes sustainable changes. Re-Engineered Discharge Planning (RED), 6 step …

Vaccination Perceptions Of School Employees In A Rural School District, Janelle Macintosh, Karlen E. (Beth) Luthy, Renea L. Beckstrand, Lacey M. Eden, Jennifer Orton

Faculty Publications

Background: There continues to be a need for increases in adult vaccination rates, especially among those working in environments which may easily become communicable disease outbreak centers, such as school employees in the school environment. The purpose of this study was to evaluate why rural Utah school employees were non-compliant with the influenza and measles, mumps, and rubella (MMR) vaccines, as well as to identify their views on mandatory vaccination policies.

Methods: A questionnaire was distributed to all school employees in a rural Utah school district. Data analysis included frequencies and measures of central tendency and dispersion for quantitative items …

Don’T Diss The Reninjaza: A Case For Integrating Traditional Birthing Attendants Into The Allopathic System To Improve Prenatal Health In Rural Madagascar, Shenna Bannish

Independent Study Project (ISP) Collection

This project seeks to prove the practicality of using Reninjazas (traditional birthing attendants) in rural Madagascar to better prenatal care and diminish the maternal and infant mortality rates in this country. Prenatal care is of vital importance to expecting mothers. Without it, birth defects, complicated labor and delivery, miscommunications concerning fetal development, and even death can occur (Mayo Clinic, 2014). There is no doubt that the lack of adequate prenatal care in Madagascar contributes to its unfortunately high maternal and infant death statistics. While listed as “moderate” in terms of severity, the maternal and infant mortality rates in Madagascar are …

Five Dimensions Of Wellness And Predictors Of Cognitive Health Protection In Community Dwelling Older Adults: A Historical Collage Cohort Study, Kelley A. Strout Dr

Nursing Faculty Scholarship

Wellness is associated with cognitive health protection; however, findings are limited because they only examine variable(s) within one dimension of wellness. This research examined the association between multiple dimensions of wellness and cognition among aging adults. The sample included 5,605 male and female community-dwelling adults 60 years and older. Four dimensions of wellness demonstrated a statistically significant higher mean difference in cognitively healthy older adults compared to cognitively impaired older adults, F(4, 5,595) = 47.57, p < .001. Emotional wellness demonstrated the strongest association with cognitive health, followed by physical and spiritual wellness, F(5, 5,372) = 50.35, p < .001. Future research is needed to examine the cognitive protective benefits of wellness using longitudinal, prospective designs that control for the potential temporal relationship between wellness and cognition.DOI: 10.1177/0898010114540322

Accessing Healthcare: The Experience Of Individuals With Autism Spectrum Disorders In Maine, Alan Kurtz, Angie Schickle, Margaret Carr, Marnie Bragdon-Morneault, Susan Russell, Debra Rainey, Jill Downs, Nancy Cronin

Health and Well-Being

Previous research has revealed that children and adults with autism spectrum disorders (ASD) are significantly more likely to have both unmet healthcare needs than those with other disabilities. In addition, they are more likely to have difficulty accessing primary or specialized medical care. Minority status, living in a rural location, and low income can exacerbate these disparities. Other obstacles to effective healthcare for individuals with ASD include the following: (1) severity of symptoms associated with ASD; (2) lack of knowledge or skill by medical practitioners; (3) lack of access to comprehensive healthcare supports or a medical home; and (4) lack …