Nursing Commons^™

A Structured Weight Loss Program To Combat Obesity In Women, Tara English

Walden Dissertations and Doctoral Studies

Rates of obesity and the associated comorbidities continue to increase for women in the United States. Despite information available, efforts at weight loss are often unsuccessful because women lack integral knowledge of how to approach the various components essential for weight loss. This doctoral project was created to address the practice question of whether obesity can be reduced through a step-wise weight loss program that identifies essential elements to reduce weight in menopausal age women. Guided by the information-motivation-behavioral skills model, this project led 17 volunteer participants from a Northwest, Florida primary care clinic through 6 weeks of protocols supplemented …

The Evaluation Of A Breast Cancer Screening Decision Aid In The Community Setting., Kimberly Gibbons

DNP Scholarly Projects

Breast cancer screening (BCS) has been recommended to women by healthcare providers as well as professional organizations and non-profit awareness organizations for over four decades. Recently, attention is being paid to quantification of the actual benefits and harms of BCS with mammography. The harms include overdiagnosis, overtreatment and mandate of mammography screening that may not be in alignment with the individual values and preferences of women ages 40-69. This evidence translation project developed a resource for practice that was evaluated by community participants for alignment with personal value and preference-based educational needs about BCS. This project piloted a clinical practice …

Reduction Of Antipsychotic Use In Patients With Dementia Residing In Nursing Homes, Marysarah Frank

DNP Scholarly Projects

Abstract

Residents of nursing homes diagnosed with dementia have long been treated with psychotropic drugs for the symptoms of behavioral disturbances that are frequently associated with major neurocognitive disease. Specifically, the antipsychotic drugs have been widely used in this population. Despite a lack of evidence, antipsychotic rates have shown up to 25% of dementia patients in nursing homes (NH) are prescribed these drugs. This off-label use is not FDA approved for behavioral symptoms of dementia and the drugs have been given a black box warning related to the risk of serious and potentially irreversible side effects and even an increased …

Decreasing Duration Of Mechanical Restraint Episodes By Increasing Registered Nurse Assessment And Surveillance In An Acute Psychiatric Hospital, Diane Allen

DNP Scholarly Projects

Background

Application of mechanical restraints is a high-risk emergency measure that requires psychiatric intensive care in order to assure patient safety and expedite release at the earliest opportunity. While current regulations require that trained staff continuously observe restrained individuals, assessment by a registered nurse is required only once an hour. This project builds on research that demonstrated a regulatory change requiring more frequent registered nurse assessments led to decreased duration of mechanical restraint episodes in an acute psychiatric hospital.

Purpose

The purpose of this project was to implement and evaluate a practice change that required increased frequency of registered nurse …

Implementation Of A Physical Activity Group At A Community Mental Health Center: A Pilot Quality Improvement Project To Reduce Depressive Symptoms In Adolescents With Major Depressive Disorder, Nancy Gallagher

DNP Scholarly Projects

Major Depressive Disorder is a debilitating illness that affects millions of Americans, including adolescents. The majority of adolescents with Major Depressive Disorder (MDD) do not receive treatment. There may be a variety of reasons for this including stigma, access to care, and potential adverse reactions. People suffering from MDD are known to be at high risk for suicide. Lack of treatments adds the risk of suicide for adolescents with MDD. Identifying and implementing treatment options that are more acceptable and accessible are of the utmost importance. Although there is limited research regarding exercise/physical activity, depressive symptoms, and adolescents with MDD, …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

College Student Sleep, Christine S. Gipson, Susan Bartos

Nursing Faculty Publications and Presentations

A position paper on college student sleeping habits.

A Mixed Methods Sequential Explanatory Study Of Male Farmers' Health Beliefs, Attitudes And Practices In Rural Kerry, Chrystal O'Brien

Theses

Aim/Background: Beliefs and attitudes about health directly and indirectly influence concomitant behaviours, practices and health outcomes. In Ireland, male farmers are experiencing a disproportionate burden of ill health in preventable lifestyle diseases, yet there is a lack of behavioural research in relation to male farmers and their health. Therefore, the purpose of this study was to examine the health beliefs, attitudes and practices of male farmers in rural Kerry, and to explore healthcare professionals' insights of male farmers' health beliefs, attitudes and practices.

Methodology: The study adopted a mixed methods design. Phase one of the study involved structured interviews with …

A Bi-Level Heuristic Solution For The Nurse Scheduling Problem Based On Shift-Swapping, Ahmed Youssef, Samah Senbel

School of Computer Science & Engineering Faculty Publications

This paper presents a new heuristic solution to the well-known Nurse Scheduling Problem (NSP). The NSP has a lot of constraints to satisfy. Some are mandatory and specified by the hospital administration, these are known as hard constraints. Some constraints are put by the nurses themselves to produce a comfortable schedule for themselves, and these are known as soft constraints. Our solution is based on the practice of shift swapping done by nurses after they receive an unsatisfactory schedule. The constraints are arranged in order of importance. Our technique works on two levels, first we generate a schedule that satisfies …

The Headache Champion Program, Courtney Wellman, Kristin Allender

Posters

BACKGROUND

Approximately 10% of school age children suffer from migraines, making migraines one of the top five health problems experienced by youth today

School nurses often are the first healthcare provider seen by youth with migraine; visits to the school nurse for headaches amounted to one-third of the enrolled student population in a large local school district. (see reference)

Empowering school nurses through education and resources to identify and manage migraines therefore may have significant benefits to children with migraines and their families.

OBJECTIVE

To improve migraine care in the community through establishing a headache specialist mentorship program for select …

Peer Accountability Improves Performance For Daily Chg Bathing To Reduce Clabsis, Sara Crawford, Stacy Pennington, Jeremy Affolter, Kathlyn Baharaeen, Paul N. Bauer, Tara Benton, Shekinah Hensley, Tiffany Mullen, Michelle Waddell

Posters

No abstract provided.

Medication Education In The Pediatric Rheumatology Clinic, Ashley M. Cooper, Julia G. Harris

Posters

No abstract provided.

Decreasing Cardiac Arrests In The Pediatric Intensive Care Unit, Jeremy Affolter, Kathlyn Baharaeen, Mari Hanson, Lisa Laddish, Amy Bohm, Lindsey Bradbury, Megan Mcghee, Anne Leroy, Hannah Cunningham, Michelle Waddell, Tiffany Mullen, Kimberly Lucas, William Douglas, Angel Pope, Marita Thompson, Paul N. Bauer, Erica Molitor-Kirsch, Tara Benton, Laura Miller-Smith

Posters

No abstract provided.

The Identification Of The Role And Competencies Of The Graduate Nurse In Recognising And Responding To The Deteriorating Patient In An Acute Ward Environment: A Mixed Methods Study, Steven Hardman

Theses

The identification of the role and competencies of the graduate nurse in recognising and responding to the deteriorating patient in an acute ward environment: A mixed method study. Patients’ physiological condition can be unstable for prolonged periods before transfer to critical care units. Thus, it is imperative that ward based nurses are able to recognise, respond and initially manage patients with a deteriorating condition. Unfortunately, warning signs of physiological decline are often missed, or ignored by both experienced and newly graduated registered nurses. Complex systems and processes to recognise and respond to clinical deterioration have been developed to try to …

Nursing Home Infection Control Program Characteristics, Cms Citations, And Implementation Of Antibiotic Stewardship Policies: A National Study., Patricia W. Stone, Carolyn T.A. Herzig, Mansi Agarwal, Monika Pogorzelska-Maziarz, Andrew W. Dick

College of Nursing Faculty Papers & Presentations

Recently, the Centers for Medicare & Medicaid Services (CMS) final rule required that nursing homes (NHs) develop an infection control program that includes an antibiotic stewardship component and employs a trained infection preventionist (IP). The objectives of this study were to provide a baseline assessment of (1) NH facility and infection control program characteristics associated with having an infection control deficiency citation and (2) associations between IP training and the presence of antibiotic stewardship policies, controlling for NH characteristics. A cross-sectional survey of 2514 randomly sampled US NHs was conducted to assess IP training, staff turnover, and infection control program …

Resilience In Caregivers Of Partners With Young Onset Dementia: A Concept Analysis, Karie R. Kobiske, Abir K. Bekhet

College of Nursing Faculty Research and Publications

Introduction: Over 200,000 Americans diagnosed with young onset dementia (YOD), dementia diagnosed prior to age 65, are cared for by family members. This can be costly to caregivers’physical and psychological health. Some adapt well to the caregiver role and are said to be resilient. Aim/Question: This paper builds on current understanding of the concept of resilience and applies this to caregivers of partners diagnosed with YOD. Method: Concept analysis. Results: Resilient caregivers exhibit attributes including determination, flexibility, positive thinking, self-efficacy, resourcefulness, social support and spirituality. Discussion: YOD affects caregiver’s health. Much research has been done on interventions for dementia caregivers. …

Pomona Large Vessel Occlusion Screening Tool For Prehospital And Emergency Room Settings, Kessarin Panichpisal, Kenneth Nugent, Maharaj Singh, Richard Rovin, Reji P. Babygirija, Yogesh Moradiya, Karen Tse-Chang, Kimberly A. Jones, Katrina J. Woolfolk, Debbie Keasler, Bhupat Desai, Parinda Sakdanaraseth, Paphavee Sakdanaraseth, Alimohammad Moalem, Nazli Janjua

College of Nursing Faculty Research and Publications

Background: Early identification of patients with acute ischemic strokes due to large vessel occlusions (LVO) is critical. We propose a simple risk score model to predict LVO. Method: The proposed scale (Pomona Scale) ranges from 0 to 3 and includes 3 items: gaze deviation, expressive aphasia, and neglect. We reviewed a cohort of all acute stroke activation patients between February 2014 and January 2016. The predictive performance of the Pomona Scale was determined and compared with several National Institutes of Health Stroke Scale (NIHSS) cutoffs (≥4, ≥6, ≥8, and ≥10), the Los Angeles Motor Scale (LAMS), the Cincinnati Prehospital Stroke …

Feasibility And Pilot Testing Of A Mindfulness Intervention For Frail Older Adults And Individuals With Dementia, Christine R. Kovach, Crystal-Rae Waltons, Lisa Sattell, Kimberly Rosenau, Sandeep Gopalakrishnan

College of Nursing Faculty Research and Publications

Mindfulness interventions have been beneficial for healthy adults and individuals experiencing a stressful medical or mental health diagnosis. The purposes of the current study were to: (a) determine feasibility of mindfulness for older adults in long-term residential settings, and (b) examine differences in outcomes between a mindfulness and cognitive activity. The current study is the first mindfulness study to include individuals in moderate and severe stages of dementia, and included 36 individuals with a range of cognitive abilities. A crossover design was used, and the intervention was feasible for continued practice by individuals with cognitive impairment. Statistically significant short-term changes …

Initiating The Loeb Criteria In Long-Term Care, Janice Khauslender

Theses and Dissertations

Urinary tract infections are one of the most commonly reported infections in long-term care. Current practices often rely on non-specific symptoms, rather than specific genitourinary symptoms, to aid in the decision to obtain a urine culture. The literature does not support this practice due to the high prevalence of asymptomatic bacteriuria among long-term care patients, which does not have adverse outcomes when untreated. Antibiotics do not eradicate asymptomatic bacteriuria and place patients at risk of adverse reactions and increased risk of multi-drug resistant organisms. This clinical improvement project applied the Loeb criteria in two long-term care facilities to reduce the …

High Fidelity Simulation Experience And Development Of Clinical Judgment: Recent Graduate Nurses’ Reflections, Martha Kay Lawrence

Theses and Dissertations

Introduction: Nurse faculty endeavor to educate future nurses who are able to effectively transition to competent practice after graduation. Shrinking clinical resources and shortages of qualified clinical faculty have contributed to the increasing utilization of high fidelity simulation (HFS) as a substitute for and enhancement of clinical practice in nursing education. The growing body of HFS research documents both student and faculty satisfaction and increased student self-confidence and self-efficacy. A significant gap in the literature is the lack of research on the translation of knowledge gained in HFS to practice. The aim of this research was to investigate recently graduated …

Addressing Challenges In Gaining Informed Consent For A Research Study Investigating Falls In People With Intellectual Disability, Portia Ho, Caroline Bulsara, Shane Patman, Jenny Downs, Anne-Marie Hill

Nursing Papers and Journal Articles

Background: People with intellectual disability encounter multiple barriers to accessing quality, evidence based health care which is detrimental to their quality of life (Qol) and mortality. Engaging people with intellectual disability when conducting research is vital to address these QoL issues. People with intellectual disability have the right to engage in research pertinent to them but at present, they are under-represented in research and there are limited methods available to ensure that people with intellectual disability are fully supported to provide informed consent. Therefore the aim of this paper is to describe an informed consent process and reflect on the …

Reversing The Spiral Of Fear, Sara Morris

ECU Posters

Introduction: The proposed poster aims to bring about discourse regarding current breech birth practices. Outlined within are factors which have contributed to the current state of breech birth, not only in Australia but on a global scale and highlights steps which have been taken by others and may be used in Western Australia (WA) to reverse the spiral of fear currently surrounding breech birth. There is currently no literature pertaining to the state of breech birth in WA.

The publication of the Term Breech Trial (TBT) in 2000, the lack of trust and the need to control the birthing environment, …

Perceptions Of The Nursing Faculty Shortage: A Case Study Of One College’S Adjunct Faculty’S Perception Of Doctoral Education, Donna Shaw

Theses and Dissertations

The problem addressed in this qualitative case study was the nurse faculty shortage and associated consequences of a shortage of nurses available to care for an aging population with multifaceted healthcare needs in a complex healthcare system. Because of the nurse faculty shortage, numerous qualified applicants are unable to enroll in nursing programs across the country. One of the key reasons for the nurse faculty shortage is a lack of nurse educators with doctorate degrees to fill the vacant positions. Adjunct nursing faculty were interviewed to ascertain their perceptions about the nurse faculty shortage and messages conveyed by full-time nurse …

Improving Office Workflow To Increase Developmental Screening Using The Ages And Stages Questionnaire (Asq-3) In A Primary Care Setting, Shelby L. Sikkila

Doctoral Projects

Background: It is estimated that 15% of children in the United States have at least one developmental delay, sadly, less than one-fifth of these children receive early intervention services before the age of three (Vitrikas, Savard, & Bucaj, 2017).

Objectives: Design, implement, and evaluate an evidence-based protocol to assist in timely referrals of identified children to intervention services in a pediatric primary care setting through staff education of the developmental screening tool ASQ-3.

Methods: Accurate assessment of current practice revealed the need for development and implementation of a protocol. Staff education was evaluated through pre and post-surveys. …

Home Exercise Therapy For The Treatment Of Knee Osteoarthritis, Kezia Nixon

Theses and Dissertations

Knee pain is the chief complaint of most osteoarthritis patients, and encourages them to seek medical attention. Unfortunately, pharmacological approaches to the treatment of knee osteoarthritis have been found to be inadequate. Given the prevalence and chronicity of osteoarthritic knee pain, there is an obvious need for treatments that can be provided for the course of the disease, with minimal adverse side effects. Exercise therapy has been found to significantly improve both pain and function among individuals with knee osteoarthritis. The primary objective of this quality improvement project was to investigate the effectiveness of a home-based therapeutic exercise program on …

Assessment Of An Educational Intervention To Increase Knowledge And Intention To Take Hpv Vaccine And Cervical Cancer Screening In Nigeria, Chigozie Anastacia Nkwonta

Theses and Dissertations

Nigeria has some of the highest rates of cervical cancer morbidity and mortality in sub-Saharan Africa. Both the human papillomavirus vaccine (HPV) and cervical screening are effective prevention strategies against both HPV infection and cervical cancer. Lack of awareness, limited knowledge, limited decision-making agency, lack of spousal support and stigma are barriers to uptake of these preventive measures. Given patriarchal structures and norms through which men control family resources and dominate decisions, male involvement in initiatives aimed at improving sexual and reproductive health is necessary. Community-based health education is an effective intervention to improve knowledge and reduce stigma. The aim …

Sepsis Bundles: Impact On Mortality And Patient Outcomes, Sheila Ford

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

It is estimated that 24% of persons served by community mental health agencies have a co-occurring psychiatric and substance use disorder (COPSD). Up to 50% of persons with substance abuse have co-occurring post-traumatic stress disorder (co/PTSD). A failure remains in objectively identifying this population in everyday practice. At a community mental health agency serving rural East Texas, a new Screening-Into-Intake Procedure (SIIP) for adults initiating services was implemented using the Iowa Model for Evidence-Based Practice. Implemented in four stages, this SIIP incorporated both self- and observer-rated screening instruments to assist in identifying and provisionally diagnosing post-traumatic stress disorder (PTSD), COPSDs, …

Best Practices For Sepsis Patients: A Quality Improvement Project, Kevin Mark Smith Jr

Graduate Theses, Dissertations, and Problem Reports (ETD)

Sepsis is a complication caused by the overwhelming and life-threatening response of the body to an infection. Sepsis can lead to tissue damage, organ failure, and death (Center for Disease Control and Prevention, 2016). Sepsis is the leading cause of death in U.S. hospitals. Mortality from sepsis increases 8% for every hour that treatment is delayed. Each year, 258,000 people die from sepsis in the U.S. As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment (Sepsis Alliance, 2016). This project seeks to improve the ability of the transfer unit to screen patients, improve early …

Factors Associated With Behavioural Problems Among Children Receiving Anti-Epileptic Drugs, Aswathy K. L Ms, P A Mohammed Kunju Dr, S Mini Dr

Manipal Journal of Nursing and Health Sciences

Children on anti-epileptic drug (AED) therapy have many health problems. Children with epilepsy are at a high risk for poor psychosocial outcomes, even without evident co-morbidities. Apart from the episodic seizures, multiple socio-cultural factors affect their behaviour and health. Objective: Objective of the present study is to find out factors associated with behavioural problems among children receiving anti-epileptic drugs. Methodology: A cross-sectional design was used in the present study. Data were collected from 275 children between 6 to 12 years, who were diagnosed with seizure disorder and on AED for a minimum of six months. Children along with their mothers …

Effectiveness Of A Structured Teaching Program On Bonding Between Mothers With Mental Illness And Their Infants, Jisha Jose Ms, Prasanthi Nattala, Geetha Desai

Manipal Journal of Nursing and Health Sciences

Introduction: Mothers with mental illness have been described to display impaired bonding towards their infants. Objectives: This study assessed the bonding between mothers with mental illness and their infants and evaluated the effectiveness of a Structured Teaching Program on Mother-Infant Bonding to improve the bonding between mothers with mental illness and their infants. Methods: The study was carried out among mothers with mental illness admitted to a referral hospital. A one group pre-test post-test design was adopted. Twenty-five mothers who consented for the study were recruited through purposive sampling technique. The Structured Teaching Program (STP) was provided for 30 minutes …