Nursing Commons^™

Self-Reported Professional Competencies Of Rn-To-Bsn Students, Nicole Thompson

Honors Theses

Groundbreaking research by Aiken et al. (2003) and subsequent researchers has determined increased educational preparation and Bachelor of Science in Nursing (BSN) degree obtainment of Registered Nurses (RNs) to be associated with improved patient safety and outcomes. Other organizations, such as the World Health Organization (WHO), have demonstrated professional competency to be an important indicator of quality nursing care. The purpose of this study was to evaluate self-reported professional competency of RN-to-BSN students at the point of graduation in order to investigate the added value of baccalaureate degree obtainment to the actual nursing practice of RN-to-BSN program graduates. The Nurse …

An Evaluation Of A Care Conference Model And Improvement In The Transition Process For Medically Complex Pediatric Patients Between Inpatient And Outpatient Care, Tamara Van Kampen

Doctoral Projects

Medically complex and/or fragile pediatric patients are high utilizers of health care dollars. This population represents less than one percent of the general pediatric population, yet they account for more than 30% of pediatric healthcare costs. These patients tend to have longer lengths of stay in the hospital, high readmission rates, and lower healthcare satisfaction scores. They also have multiple transitions between inpatient and outpatient care which increases the opportunity for medical errors. Research has shown that care conferences attended by key stakeholders tend to reduce readmissions and healthcare utilization while improving satisfaction rates and patient outcomes. Research also shows …

Prenatal Opioid Exposure And Intermittent Hypoxemia In Preterm Infants: A Retrospective Assessment, Elie G. Abu Jawdeh, Philip M. Westgate, Amrita Pant, Audra L. Stacy, Divya Mamilla, Aayush Gabrani, Abhijit R. Patwardhan, Henrietta S. Bada, Peter J. Giannone

Pediatrics Faculty Publications

Introduction: Intermittent hypoxemia (IH) is defined as episodic drops in oxygen saturation (SpO₂). Preterm infants are at increased risk for IH due to their immature respiratory control/apnea of prematurity. The clinical relevance of IH is a relatively new observation with rising evidence linking IH to neonatal morbidities and long-term impairment. Hence, assessing factors that influence IH in preterm infants is imperative. Given the epidemic of opioid misuse in the USA, there is an urgent need to understand the impact of prenatal opioid exposure on neonatal outcomes. Hence, we wanted to assess the relationship between isolated prenatal opioid exposure …

Individualized Glycemic Targets For The Elderly Residing In Long Term Care Facilities, Abegail Hubberd

Doctor of Nursing Practice

Of people age 65 and older residing in a long-term care facility, 1 in 4 has Type 2 diabetes (Smide & Nygren, 2013). Care and management of this population is a challenge for nurses and other providers. Results of a needs assessment in a local long-term care facility identified deficiencies in the provision of evidence-based Type 2 diabetes care for this target population. American Diabetes Association Guidelines (2017) recommend application of individualized HbA1c targets for the elderly residing in long-term care facilities, especially for those with compromises in clinical and functional status. This two prong quality improvement project strove to …

Critical Appraisal Tools And Reporting Guidelines For Evidence-Based Practice, Robin Buccheri, Claire Olivia Sharifi

Gleeson Library Faculty and Staff Research and Scholarship

Background: Nurses engaged in evidence-based practice (EBP) have two important sets of tools: Critical appraisal tools and reporting guidelines. Critical appraisal tools facilitate the appraisal process and guide a consumer of evidence through an objective, analytical, evaluation process. Reporting guidelines, checklists of items that should be included in a publication or report, ensure that the project or guidelines are reported on with clarity, completeness, and transparency. Purpose The primary purpose of this paper is to help nurses understand the difference between critical appraisal tools and reporting guidelines. A secondary purpose is to help nurses locate the appropriate tool for the …

Improving Vaccination Rates In Adults With Type Ii Diabetes In A Family Practice Setting: An Evidence-Based Quality Improvement Project, Ronda Gottlieb

Doctor of Nursing Practice

The purpose of this evidenced-based quality improvement project is to implement processes to facilitate providers’ adherence to the American Diabetes Association (2017), American Association of Clinical Endocrinologist (2015), and American College of Endocrinology (2015) immunization guidelines for adults with type II diabetes. Presently, diabetes is the 7th leading cause of death in the United States contributing to serious complications throughout the body as a result of poor glucose control. Adults with diabetes are at increased susceptibility to infectious disease because of hyperglycemia, poor glucose control, and decreased immunity. A protocol was created using The Four Pillars Transformation Program ™ to …

Improving Trauma Activation Guideline Adherence In A Level Iii Emergency Department, Jesus Valdez

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase appropriate use of trauma activation guidelines by nurses in a level III emergency department. Care provided by a multidisciplinary trauma team is paramount for the severely injured patient, as this may facilitate rapid diagnosis and treatment. Trauma related mortality can be significantly decreased through the care provided. Trauma patients require specialized care at a precise time often called the “golden hour” to help prevent death or disability. Almost 30 Texans die every day from trauma related injuries, which averages to 10,000 people each year. Trauma is the leading cause of …

Increasing Provider Awareness Of Patient Health Literacy Needs For Dental Screenings Among Patients With Diabetes In A Rural Health Clinic, Diana M. Solis

Doctor of Nursing Practice

The purpose of this project was to increase provider awareness of health literacy needs for recommended dental screenings among patients with diabetes in a rural clinic setting. Over 35% of adults in the United States are considered to have low literacy levels (Agency for Healthcare Research and Quality, 2015). Low health literacy levels have an impact on patient outcomes due to decrease compliance with recommended treatment plans and preventive health screenings. Patients with diabetes have a trifold increase of developing oral infections such as periodontal disease, fungal infections, and xerostomia (Kudiyirickal & Pappachan, 2015). Healthcare providers acknowledging a patient’s health …

The Use Of Culturally Sensitive Education On Organ Donation And Its Impact On Attitudes And Willingness To Donate Organs, James Winters

Doctoral Projects

In regards to transplantation, ethnic minorities are disproportionately affected by the donor shortage. The high morbidity rates and decreased willingness to donate commonplace among these demographics has created a devastating imbalance. Increasing minority donor presence will make the allocation process more favorable for minority candidates. The current study entailed the provision of a culturally sensitive educational intervention to sixty-five (n=65) students at the University of Southern Mississippi. Surveys were administered pre/post intervention to assess knowledge and attitudes towards donation. Pre-intervention data reflected findings from prior research, post-intervention data showed that the intervention was able to mitigate these findings and that …

Improving Discharge Planning Using The Re-Engineered Discharge (Red) Program, Sterling L. Roberts, Leslie C. Moore, Brian Jack

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

The 12-actionable items of the Re-Engineered Discharge Program (RED) are equipped to address essential areas to prevent hospital re-visits. Evidence supports the use of nurses to complete these essential components of hospital interventions. The aims of this project were to: 1) assess nurses’ readiness to learn prior to receiving education on the RED Program, and 2) measure the utilization of the RED discharge process from patient chart reviews following an educational intervention focused on the RED 12-actionable items. Participants (N = 69) scored high M = 219.8 (SD 23.7) on the Self-Directed Learning Readiness – Adult Scale, indicating the nurses …

High School Seniors' Educational Experience Lnfluencing The Decision To Pursue A Career In Nursing, Ryan L. Rowe

Dissertations

Many high school students interested in nursing as an occupation choose to engage in a Career and Technical Education (CTE) program and subsequently progress through the exploration stage of Super’s Career Development Theory in a succinct, deliberate, and intentional manner. While CTE continues to serve as an educational option for many high school students interested in nursing, its value as a means for students to crystallize, specify, and implement the choice to pursue the high-wage, high-skill, and high-demand career of nursing is not understood to the extent possible. CTE is regularly overlooked as a viable educational option by high school …

Increasing The Adherence To Updated Clinical Practice Guidelines For Tb Screening Among Hiv Patients Entering A Congregate Setting Utilizing A Clinical Reminder, Domingo Lopez

Doctor of Nursing Practice

Purpose: The purpose of this Doctor of Nursing Practice project was to update an existing tuberculosis policy for screening HIV-positive individuals entering a south Texas jail to meet current evidence-based guidelines and increase the adherence of jail staff to the updated screening process.

Background and Significance: In 2015, over 700,000 people were jailed in the United States with over 20,000 being HIV-positive. Tuberculosis is highly contagious and spreads through the air. HIV is a virus that targets the immune system. HIV-positive people are 17-22 times more likely to contract tuberculosis. The current screening process at the jail showed a low …

Implementing Evidence-Based Opioid Prescription Practices In A Primary Care Setting, Cyril Gaiennie

Doctor of Nursing Practice

The use and misuse of opioid pain medication has reached epidemic proportions in the United States. More than 16,000 people die each year due to the misuse or abuse of prescription opioid medications, which is more than from heroin, cocaine, and benzodiazepines combined. The purpose of this evidence-based practice project is to establish processes enabling a primary care clinic to implement and adhere to the 2016 Centers for Disease Control’s guidelines for opioid prescription practices in the primary care setting. A retrospective chart review conducted prior to implementation of the guidelines demonstrated that four of six of the CDC’s recommendations …

A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker

Doctor of Nursing Practice

The purpose of this project was to improve statin therapy adherence among diabetic patients aged 65 and older treated at a small family practice clinic in western San Antonio. Additionally, the project aimed to decrease LDL cholesterol (LDL-C) levels in this patient population as recommended to 70 mg/dl or less. Diabetic patients are more likely to die from a cardiac event than patients without diabetes. Statin therapy is an important factor in lowering cholesterol, which reduces the patient’s risk for atherosclerosis. Educating patients aged 65 and older about the role of statin therapy in preventing cardiovascular events, stroke, and vascular …

Increasing Depression Screenings In Adults With Advanced Non-Surgical Heart Failure Using 2013 Accf/Aha Recommendations And Healthy People 2020 Target Goals, Valerie Valencia

Doctor of Nursing Practice

The purpose of this evidence-based practice project was to increase depression screenings in adults with non-surgical advanced heart failure using reliable and valid tools, 2013 American College of Cardiology Foundation/American Heart Association recommendations, and Healthy People 2020 Target Goals as a method to identify and facilitate appropriate mental health referral, patient education, and follow-up for depressive symptoms. Interventions took place June 5, 2017, through August 10, 2017. This intervention project involving 246 adults with advanced heart failure demonstrated that an evidence-based intervention for depression screenings increased the number of patients screened from 5% to 44%. At project completion, 65% of …

Interventions To Increase Diabetes Self-Management Education Referral And Attendance, Genevieve Talamantez

Doctor of Nursing Practice

Despite the proven benefits of diabetes self-management education (DSME), referral and attendance remains suboptimal. DSME has the ability to encourage self-care behavior, improve clinical outcomes, and improve quality of life in a cost-effective manner. The American Diabetes Association recommends that all people with diabetes receive DSME in order to facilitate the knowledge, skills, and ability necessary for diabetic self-care. The Office of Disease Prevention and Health Promotion, Healthy People 2020, set a national diabetic patient education attendance target goal of 62.5% for adults. The purpose of this quality improvement project is to increase referral and attendance to DSME in type-2 …

A Quality Improvement Initiative To Increase Hypertension Treatment Adherence Among Hispanic Patients With Limited English Proficiency, Barbara Chavez

Doctor of Nursing Practice

The purpose of this project was to improve hypertension (HTN) treatment adherence among limited English proficient Hispanic patients with uncontrolled HTN. Limited English Proficiency (LEP) significantly reduces HTN control among Hispanics by diminishing their understanding of HTN diagnosis, treatment adherence, and complications. A language sensitive education session focusing on antihypertensive medications, reduced sodium intake, and appointment keeping was implemented among LEP Hispanic patients 21 to 85 years of age, with uncontrolled HTN, receiving care at a federally funded south San Antonio clinic. The Hill-Bone Compliance to High Blood Pressure Therapy Scale was utilized to measure adherence in the following domains: …

A Quality Improvement Project To Increase Eye Care Screenings And Recommendations For Patients With Type Ii Diabetes Mellitus, Amber Ojeda

Doctor of Nursing Practice

Type 2 diabetes affects more than 90 million people and is a major cause of reduced vision and blindness in the United States (Lu et al., 2016). Without proper preventative measures, T2D damages the microvascular within the retina causing diabetic retinopathy (Lima, Cavalieri, Lima, Nazorio, & Lim, 2016). Despite the success of early detection and the availability of diabetic retinopathy screenings, many people diagnosed with T2D do not complete the recommended routine eye exam (Lu et al., 2016). Healthy People 2020’s (HP2020) (2016) target goal for annual dilated eye exams for patients with T2D is 58%. At baseline, only 2% …

Improving Hpv Vaccination Series Initiation Rates And Compliance Among Indigent Women In South Texas, Ages 19-26, Through Provider Recommendation And Additional Clinic Funding: A Quality Improvement Project, Lacey Cudd

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase human papillomavirus vaccination series initiation rates among indigent women, ages 19-26, at a clinic in South Texas. The human papillomavirus is a sexually transmitted infection that has been associated with multiple types of cancers. Each year, approximately 6.2 million cases of the human papillomavirus infection are diagnosed; as many as 75% of all new infections occur among females 18-26 years of age. The human papillomavirus vaccination has a high efficacy in regards to cancer prevention, preventing as many as 76% of cancers with only one dose. The project included educating …

Implementation Of A Parental Notification System For The Improvement Of Well-Child Care Delivery, Frances Narvaiz

Doctor of Nursing Practice

This quality improvement project aimed to improve routine well-child exam rates in accordance with the American Academy of Pediatrics and Texas Health Steps recommendations through the implementation of a parental notification system. Missed well-child appointments impact health care by disturbing continuity of care and complicating preventive care services. Implementation of the parental notification system during June 2017 to August 2017 consisted of 100 patients from birth to 18 years of age for scheduled well-child visits in a pediatric clinic with a large Hispanic and Medicaid population. Interventions consisted of staff training, reminder phone calls 24 to 48 hours prior to …

Increasing The Vaccination Rates Of Adolescent Males 11 To 18 Years Of Age In An Urban Pediatric Clinic: A Quality Improvement Project, Victoria Fadare

Doctor of Nursing Practice

Purpose: The purpose of this quality improvement project was to determine if an evidence-based educational toolkit and an electronic reminder system would increase the rate of HPV vaccination among male adolescents, age 11-18 years old in an urban pediatric clinic. Background & Significance: HPV is one of the most commonly reported sexually transmitted infections in the United States. The safety and efficacy of the HPV vaccine have been established and approved for both males and females. Despite recommendations, vaccination rates among adolescent males remain lower compared to females. Methods: An evidenced-based educational toolkit from the CDC along with an electronic …

Improving Early Child Developmental Screenings In A Primary Care Setting: A Quality Improvement Project, Marlischa Jackson

Doctor of Nursing Practice

A dramatic growth of physical, motor, cognitive, communication, emotional, and social development will occur during the 3 years of life. Of children ages 3-17 years of age, 13% have some type of developmental or behavioral condition that goes undiagnosed before the age of 10. Children with multiple health and social risk factors, or those with chronic health disorders, are at greater risk to develop early child delays or disabilities. In the U. S., developmental screenings are only completed 21% of the time during well-child visits. Therefore, the purpose of this quality improvement project was to increase the adherence of health …

Evidence-Based Discharge Education Guidelines To Improve Adherence To Self-Care And Decrease 30-Day Readmissions For Older Heart Failure Patients, Lisette Melton

Doctor of Nursing Practice

Heart failure is a complex, debilitating, chronic disease characterized by high mortality and frequent hospital readmissions. Heart failure affects 5.7 million people in the United States with 670,000 new patients diagnosed each year. Patients are most vulnerable during the transition from the acute care setting to home. Limited patient knowledge on symptom recognition leads to detrimental outcomes for the patients; therefore, discharge education is paramount for decreasing readmissions. The national benchmark for 30-day readmission is 27%. The purpose of this quality improvement project was to improve compliance with the 2013 American Heart Association guidelines through discharge education by Telemetry staff …

The Development Of A Wayfinding Smart Phone Application As A Large Healthcare Facility Investment Opportunity, Jessie Fortson Marshall

Doctoral Projects

Health care is a continually growing field. New hospitals are constantly being built, while older facilities are experiencing renovation and expansion. With this growth comes a set of difficulties for patients as they try to navigate through large, multi-building facilities. Most large facilities have multiple parking garages, numerous buildings, and medical towers with an unending number of floors. Patients are forced to rely on directional signage to find their destination that is often insufficient. Attempting to navigate through large facilities is often overwhelming for visitors leading to frustration and stress.

New technology has allowed a convenient solution to this problem …

The Relationship Between Bmi & Mandated Physical Education Requirements Of Elementary Schools, Kathryn Fairlamb

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The physical activity policies of elementary schools in Arkansas and correlations between physical activity requirements and body mass index have been studied. Examination of the policies at the individual school, district, or state level were noted. The statewide BMI database was consulted. Interviews with physical education teachers was conducted to assess policy implementation. Results may provide schools and policy makers with insight on future physical activity policies.

Development Of Evidence-Based Rapid Response Team Protocols For Treatment Of Deteriorating Adult Medical-Surgical Patients, Laura Pitts Darby

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

Acute care hospitals in the United States and across the world are experiencing substantial increases in acutely ill patient populations requiring multifaceted medical treatments and care. This increase in number of seriously ill patients is resulting in crowded critical care units and more acutely ill patients on general medical-surgical units. Several decades ago, Rapid Response Systems were introduced to help reduce the risk of adverse outcomes in patients presenting signs and symptoms of clinical deterioration on medical-surgical units. In patients displaying symptoms of rapid clinical deterioration, members of the Rapid Response Team are often required to begin immediate intervention and …

Openpediatrics: Integrating Technology Into Pediatric Healthcare Education, Marisa Albert

Senior Honors Projects

In contemporary times, the dissemination of knowledge across specialties has become convenient through the use of computer technology and the internet. Technology has been integrated into educational systems worldwide and has become invaluable in the advancement of healthcare. Nursing practice and education has utilized modern technology as a resource for continuing education such as through the use of online RN-BSN programs and sharing improvements in healthcare practice. A great part of a nursing student’s education is understanding the importance of a nurse’s professional commitment to lifelong learning by utilizing critical thinking skills to support evidence-based practice to improve standards of …

Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks

The Eleanor Mann School of Nursing Undergraduate Honors Theses

A child’s wellbeing is influenced by many factors related to the environment they are raised in. The purpose of this study was to investigate the relationship between a child’s social and economic factors and his or her health. A convenience sample of 588 2nd and 4th grade children was taken from three elementary schools in Springdale Independent School District. Health status was represented by calculations of each child’s body mass index (BMI) and number of days counted absent from school. Socioeconomic and demographic factors examined include the child’s grade level, gender, ethnicity, number of parents over the household, number of …

Modifiable Factors Impeding Nurses’ Willingness To Report In A Disaster, Kate Hutchison

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This research project investigates what modifiable factors impede nurses’ willingness to report to work during a disaster. The survey sample were nurses in the United States. Survey methodology was a snowball sampling initiated among nurses attending a PhD Program at the University of Texas at Tyler as well as the utilization of Facebook to recruit participants. The survey instrument determined likelihood of nurses reporting to work in various types of disasters and factors that may impede them from responding to such disasters. The online survey asked thirty-five “select all that apply” type questions and the results will be used to …

Simulation As A Multidisciplinary Team Approach In Health Care Programs In An Urban University Setting, Geraldine Fike, Dawn Blue, Guillermo Escalante, Phoebe (Yeon) S. Kim, Jose A. Munoz

Health Science and Human Ecology Faculty Publications

The poster provided here showcases results from a simulation study that began in the Spring Quarter of 2017 at CSU San Bernardino. The results presented here are based on four simulations conducted on campus in our nursing lab space. We incorporated the participation of 44 students in our study.

Patients are cared for by a nurse and multidisciplinary teams which may include physical therapists, social workers, and public health workers; however, students in health care programs usually will not experience necessary scenarios developing needed skills. Although needed skills are learned within the walls of the university they remain in a …