Nursing Commons^™

Empathy In Aging, Morgan Kranz, James Charles Arendt

Honors Theses

Empathy in Agingis a project exploring how to show compassion for the inevitable aging process. This form of care is physical and mental. The concept for this work comes from my time working as a nursing assistantin a nursing home. Through my experiences, this project explores what I took away through observation and interaction

Fat For Life: The Development Of A Low-Carbohydrate High-Fat Dietary Toolkit For Type 2 Diabetes In Rural Southeast Kansas, Curtis Beall

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to identify the feasibility of a low-carbohydrate high-fat (LCHF) diet in less affluent type 2 diabetics in rural Southeast Kansas, specifically, Crawford County. The author assessed this through the identification of the resources offered in Crawford County, and ultimately, the development of an LCHF dietary toolkit utilizing these resources. The toolkit offers an array of LCHF resources including compliant foods, grocery prices, shopping lists, phone applications, books, internet websites and blogs, accountability forums, and fitness centers. Upon completion of the dietary toolkit a select few healthcare providers directly involved with diabetes in Crawford County …

A Pre And Post Survey To Evaluate Patient Perception Of Group Diabetes Self-Management Education In Rural Health Clinics, Stormy Carter

Doctor of Nursing Practice Scholarly Project

Diabetes is a significant clinical issue in the primary care setting. Providers struggle to overcome barriers to facilitate therapeutic interventions for populations served. The specific aim of this study was to assess group diabetes self-management education from a patient perspective. Evaluation of diabetes knowledge and confidence of diabetes management was conducted in rural primary care clinics. This study utilized a one-group pretest-posttest design to patients receiving group diabetes self-management education in Southeast Kansas rural primary care clinics by a certified diabetes educator. The surveyed population included individual’s ages 18-65 with prediabetes, type 1, or type 2 diabetes who received DSME …

Increasing Human Papillomavirus Vaccination Among Adolescents Through Parent Targeted Cancer-Prevention Education, Shannon Duncan

Doctor of Nursing Practice Scholarly Project

INCREASING HUMAN PAPILLOMAVIRUS VACCINATION AMONG ADOLESCENTS THROUGH PARENT TARGETED CANCER-PREVENTION EDUCATION

An Abstract of the Scholarly Project by

Shannon Leigh Duncan

The purpose of this study was to determine if parent targeted HPV education emphasizing the cancer-prevention benefits of vaccination increased initiation of the Gardasil 9 series among adolescents attending Pittsburg Community Middle School (PCMS). This project was completed in conjunction with the Southeast Kansas Community Health Center (SEK CHC) and consisted of providing HPV and Gardasil 9 education to the parents/legal guardians of the students enrolled at PCMS one week prior and during the 2018 parent-teacher conference sessions. An …

Increasing Providers' Intent To Perform E-Cigarette Screening In The Adolescent Population, Andrea Hight

Doctor of Nursing Practice Scholarly Project

Youth e-cigarette use has increased significantly in recent years. E-cigarette use has many negative health effects supported by the literature including increased risk of respiratory infections, nicotine addiction, and the potential for cancer. E-cigarette screening creates an opportunity for patient education and counseling, as well as potentially decreases e-cigarette use. However, healthcare providers do not regularly screen adolescents for e-cigarette use. According to previous studies, the main barrier to e-cigarette screening is healthcare providers’ knowledge regarding e-cigarette health effects. This project sought to increase healthcare providers’ intent to screen for e-cigarette use in the adolescent population, through the provision of …

Autism Screening Knowledge And Practice In Southeast Kansas, Briana M. Laforge

Doctor of Nursing Practice Scholarly Project

Autism spectrum disorder (ASD) is classified as a neurodevelopmental disorder characterized by delays in social communication and interaction as well as restricted repetitive behaviors, interest, and activities. According to the most recent reports from the CDC (2018), it is estimated that 1 in 68 children are diagnosed with some form of ASD in the United States. Research has shown that early identification and intervention can significantly improve outcomes in those individuals diagnosed. As a result of this research, the American Academy of Pediatrics (AAP) has recommended routine screening on all children for ASD at the age of 18 months and …

Provider Awareness Associated With Lifestyle Interventions And Adult Obesity, Reilly Tackett

Doctor of Nursing Practice Scholarly Project

The obesity epidemic cannot be solved through a single solution. A complex problem like obesity requires an intricately designed approach, comprised of both behavioral and environmental changes (Centers for Disease Control, 2015). Obese adults who attempt to alter their lifestyles often experience barriers to success. One such barrier is a provider who may be unfamiliar with evidence-based lifestyle interventions. Research suggests large variances both in provider knowledge levels and practice recommendations associated with adult obesity. This study’s purpose was; to determine if provider recommendations reflected clinical practice guidelines (CPG) associated with adult obesity, to measure current levels of provider knowledge, …

Knowledge And Attitudes Of Registered Nurses On Palliative Care, Amy Marpu

Doctor of Nursing Practice Scholarly Project

The purpose of this DNP scholarly project (SP) was to evaluate the knowledge and attitudes of registered nurses (RN) regarding palliative care (PC) before and after an educational presentation. This SP strived to answer these questions: What is the current knowledge in RNs of PC and end of life (EOL) patients before and after the education presentation? What is the anxiety level RNs feel regarding medication administration and symptom management in PC and EOL patients before and after the educational presentation?

A multimethodology, cross-sectional study design was used. The participants were currently enrolled in the RN-BSN program at PSU. These …

The Usability And Acceptability Of An Electronic Clinical Decision Support Tool For Antibiotic Selection For Common Pediatric Infections In Outpatient Rural Healthcare Clinics, Samantha Simpson

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to determine the potential role, usability and acceptability of an electronic clinical decision support tool (ECDST) for optimizing antibiotic prescribing practices for pediatric patients in outpatient rural healthcare clinics. Providers working with pediatric patients at Community Health Center of Southeast Kansas were asked to use the ECDST to complete two case studies. Following completion of the case studies, participants completed two standardized surveys regarding usability and mental workload of the ECDST. The ECDST used in this project was found to require a low mental demand, have a high usability value, and was accepted as …

Exploring Maternal Factors Linked To Weight Status In Salvadorian Infants, Carmen M. Kiraly, Melanie Turk, Melissa Kalarchian, Cheryl Shaffer

Electronic Theses and Dissertations

Background: Obesity rates in the US have risen dramatically, especially among Hispanic adults and children. Because of the high prevalence of overweight and obesity in Latino children by preschool age, it is prudent to examine maternal factors potentially linked to weight status during an infant’s first year of life. The literature on risk factors of child obesity has focused primarily on children of Mexican descent, and little research exists for other Latino populations, such as Salvadorans. Objective: To investigate maternal physiologic and infant feeding factors associated with infant overweight and/or obesity in a sample of Salvadoran mother-infant dyads. Methods: A …

The Lived Experience Of Recovery Following Transoral Robotic Surgery (Tors) For Head And Neck Cancer, Katharine Mahalik

Electronic Theses and Dissertations

Abstract

Ongoing advances in minimally invasive surgical techniques, such as transoral robotic surgery (TORS), has enabled select patients with head and neck cancer to receive treatment that results in less disfigurement and dysfunction compared with traditional approaches. While TORS research has focused mainly on functional surgical outcomes, a need exists to understand recovery following TORS from the patient perspective. A hermeneutic phenomenological approach was used to recruit patients who had recently undergone TORS at a major academic health system in northeastern US. Data were collected using audio-recorded telephone interviews and field notes and analyzed concurrently. Participants included 17 HNCS (12 …

Hepatitis C Treatment In High Risk Patients: Implementation Of A Successful Community Focused Program, Annie Pedlar, Jodie Sandhu Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Projects

Background: The city of San Francisco boasts a high rate of hepatitis C infection (HCV) among IV drug users indicating the need for a hepatitis C treatment program. It is estimated that over two-thirds of people who are actively infected with HCV are IV drug users (EndHepCSF, 2017), and in 2017 the San Francisco Department of Public Health (SFDPH) estimated that there are 22,500 active people who inject drugs (PWID) in SF (SFDPH, 2017). With the presence of a wide population of IV drug users in SF there is an identified need for intervention to treat this high-risk patient …

Effects Of An Alcohol And Std Educational Intervention On Alcohol And Std Knowledge, Alcohol Expectancies, And Beliefs On Negative Consequences Of Sexual And Drinking Behaviors In College Athletes, Kimberly Van Ness

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

College students have increased susceptibility towards alcohol use and high-risk behaviors which remains a concern across U.S. college campuses. A subgroup of the college student population with higher rates of alcohol consumption, binge drinking, and alcohol-related consequences including high-risk sexual behaviors is college athletes. It is of importance that college athletes are knowledgeable of responsible alcohol use, healthy sexual behaviors, and the risk of negative sexual consequences that can occur with alcohol use. The purpose of this study is to assess alcohol and STD knowledge, alcohol expectancies on sexual vulnerability and coercion, and beliefs on negative consequences of sexual and …

The Effect Of Meditation On Stroke-Survivor Resilience: Secondary Analysis Of Existing Data, Mary Love

Dissertations and Theses (Open Access)

Purpose: To test the effect of meditation on resilience of community-dwelling stroke survivors, and to identify resilience predictor variables in these survivors.

Methods: Sub-study with secondary analysis of existing data from the parent study, MEditatioN for post stroke Depression (MEND). Paired samples t-test was used to evaluate the effect of meditation on resilience of stroke-survivors (n=20) in the intervention group. Bivariate analysis and general linear modeling (GLM) were used to identify demographic, clinical, and psychological predictor variables of baseline resilience for all stroke survivors (n=34).

Results: The increase in stroke-survivor resilience scores from baseline (mean 3.46, SD=.81) to intervention completion …

A Multifaceted Approach To Antibiotic Stewardship In The Outpatient Clinical Setting For Bronchitis, Elizabeth A. Weaver

Evidence-Based Practice Project Reports

Antimicrobial resistance is a world-wide health crisis (Infectious Disease Society of America [IDSA], 2016; World Health Organization [WHO], 2017) expedited by the overuse/inappropriate use of antibiotics. In the outpatient setting it has been determined that approximately 60% of antibiotic therapies are prescribed (Centers for Disease Control and Prevention [CDC], 2016). Antibiotic stewardship is the coordinated effort to improve the use of antibiotic therapies, minimize misdiagnosis and delayed diagnosis and select appropriate antibiotic drug regimens (IDSA, 2016). The purpose of this evidence-based practice project was to evaluate the effects of an antibiotic stewardship program (presentation, survey collection, bimonthly e-mail reminders, patient …

Use Of Smartphone Application To Facilitate Weight Loss And Promote Accountability In Obese And Overweight Patients, Angela M. Turner

Evidence-Based Practice Project Reports

In 2015, the U.S. Department of Health and Human Services published a National Health and Nutrition Survey (NHANES) on obesity from 2011 through 2014. From the survey, it was determined that the prevalence of obesity in the U.S. was 36% in adults and 17% in young adults/children (Ogden et al., 2015). Lifestyle modifications including moderation of caloric intake and increased exercise have been shown to be effective for both prevention and treatment of obesity. The purpose of this evidence-based practice (EBP) project involved the design, administration, and evaluation of a technology-assisted weight loss intervention to address the health problem of …

Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean

Evidence-Based Practice Project Reports

Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …

The Effects Of Learning Mindfulness Based Stress Reduction On Psychosocial Variables And Hba1c In Adolescents With Type 1 Diabetes, Denise Van Sant - Smith

Electronic Theses and Dissertations

ABSTRACT

THE PHYSIOLOGICAL AND PSYCHOSOCIAL EFFECTS OF AN ONLINE MINDFULNESS BASED STRESS REDUCTION INTERVENTION ON ADOLESCENTS WITH TYPE 1 DIABETES

By

Denise E. Van Sant – Smith

Date: 4-5-2019

Dissertation Supervised by Linda Goodfellow, PhD, RN, FAAN

Background: Stress has been shown to increase glucose levels through a sympathetic physiological response resulting in a release of chemicals such as adrenalin and cortisol, a response which results in an even greater need for insulin. Adolescents with Type 1 Diabetes may not be able to change or decrease the amount of stress in their lives but they may be able to …

Depression Screening In The Primary Care Setting, Colleen Dostal, Stephanie Boerding

Doctor of Nursing Practice Projects

Recent data reveals that approximately 17.3 million adults in the US population experience an episode of depression each year. Unidentified and untreated depression has many consequences leading to a poor quality of life, direct and indirect healthcare cost-related increases, and an increase in medical comorbidities. The U.S. Preventative Services Task Force recommends that all adults be screened for depression. The PHQ-2 and PHQ-9 are the most widely accepted screening tools in the preliminary detection of depression. The purpose of this project was to educate health care professionals regarding depression and the implementation of a new depression screening protocol: A positive …

Managing Chronic Back Pain In A Rural Primary Care Setting, Cassandra Chambers, Kaitlin E. Behnken

Doctor of Nursing Practice Projects

Chronic back pain management is complex and is often challenging for Primary Care Providers (PCPs). Rural PCPs are managing chronic back pain despite limited training and availability of pain management specialists. Pharmacological interventions are often used to treat chronic back pain despite current evidence suggesting physical therapy and aquatic therapy are first-line treatments. A directory of local therapy facilities offering physical and aquatic therapy and a review of clinical practice guidelines (CPG) were provided to three PCPs in a rural clinic in the Midwest. Use of the directory and the CPG was intended to help decrease reliance on pharmacological options …

Ethical Considerations In Short Term Global Health Experiences, Sheri Compton-Mcbride

Doctor of Nursing Practice Projects

Academically sponsored, short-term experiences in global health care (STEGH) have increased in popularity and accessibility among students originating from high-income countries (HIC) and enrolled in medical and health care programs. The populations served have socioeconomic, cultural, and/or geographic barriers to healthcare. Establishment of goals, clarity of expectations, and ethical awareness of services being provided are essential to achieve mutually agreeable outcomes for all involved. The project was designed to increase the knowledge of undergraduate nursing students scheduled to embark on a short term experience in global health. Module development and dissemination of evidence regarding the ethics of care and cultural …

Implementation Of A Medication Near-Miss Reporting System, Jamie Deubel

Doctor of Nursing Practice Projects

Faculty from a state university nurse anesthesia program requested a system to track medication near-miss events among their students. After a literature review, and in collaboration with faculty stakeholders, an electronic medication near-miss reporting system was developed and activated. A Likert scale evaluation survey was designed and reviewed by experts. This medication near-miss survey was auto-populated for all students who utilized the system. Students were happy with the anonymity, ease of use, and time it took to report the near-miss. Faculty stakeholders were given an open-ended question survey and results indicated faculty were pleased with the data they received. After …

Introducing Enhanced Recovery After Surgery For Colorectal Procedures: Development Of An Enhanced Recovery After Surgery Protocol, Vincent Compton

Doctor of Nursing Practice Projects

Abstract

The prevalence of colorectal surgery is increasing due to the surgical demand of an aging population with various comorbidities (Ralph & Duff, 2017). Consequences include an increased burden on clinical and financial resources from perioperative costs, length of stay (LOS), complications, and readmissions (Nelson et al., 2016). Enhanced recovery programs were created to improve patient outcomes and decrease financial strain. Objectives of this practice project included researching current evidence-based literature to determine the effectiveness of ERAS implementation in open and laparoscopic colorectal procedures, developing a customized ERAS protocol, and introducing the pathway to members of anesthesia, pharmacy, and the …

Unraveling Sex Trafficking Through Screening And Referrals, Rebecca Sarabia

Doctor of Nursing Practice Projects

Abstract

Human trafficking is a form of modern-day slavery; sex trafficking is one form of human trafficking. Previous research has demonstrated that most trafficking victims encounter the healthcare system at some point during their trafficking experience. Patients who have been sex trafficked may experience profound psychological and physical trauma. Healthcare personnel are in key positions to screen for trafficking and to provide appropriate referrals; if an awareness of the problem exists. The purpose of this project was to increase OB/Gyn office staff confidence with sex trafficking screening and to complete appropriate referrals to address the identified needs. The project began …

Improving Acute Pain Management For Pediatric Patients: Development Of A Ketamine Infusion Protocol, Oksana Koeppen

Doctor of Nursing Practice Projects

Multimodal analgesia is a recommended approach for acute pain management for adults and children (ASA, 2012; Chou et al., 2016). This approach is becoming a prominent modality in pain control strategies in the pediatric population. An intravenous anesthetic, ketamine, may be a useful adjunct for acute pain management in children. Development of a pediatric ketamine infusion protocol and its subsequent introduction to the key stakeholders at the host facility in central Illinois were the focus of this project. Research has demonstrated the effectiveness of low-dose intravenous ketamine in acute pain management when used as an adjunct to other medications (Asadi …

Clinical Guideline Based Interventions To Increase Smoking Cessation Success In Primary Care, Chloe Marth

Doctor of Nursing Practice Projects

Current evidence indicates that providers play an integral role and are most successful in improving cigarette smoking cessation rates through a combination of counseling, patient follow up, and pharmacotherapy. In order to address high smoking rates among patients at a primary care clinic in an urban community, the Five A’s model for smoking cessation (Ask, Advise, Assess, Assist, and Arrange) was initiated. During clinic visits, patients were asked about their smoking status. For those who stated they smoked cigarettes, further evaluation was conducted using the Fagerstrom Test for Nicotine Dependence and the patient’s willingness to quit was assessed. Five of …

Supraclavicular Blocks For The Treatment Of Distal Injuries In The Upper Extremity In The Emergency Department, Patrick O'Brien

Doctor of Nursing Practice Projects

Opioid addiction in the United States has increased, and interventions needs to be put into place to manage pain with fewer opioids. Alternatives like peripheral nerve blocks can be used to aid in pain management for acute injuries like ankle and wrist fractures. The purpose of this project is to develop and create a regional anesthesia protocol for acute upper and lower extremity fractures in the emergency department (ED) at Passavant Hospital in Jacksonville, Illinois, with the long-term goal of a reduction in opioid administration. An educational Power Point presentation was provided for the ED and the anesthesia personnel on …

Heart Failure Knowledge Among Cnas In A Skilled Nursing Facility: A Pilot Project, Amanda Mcdannald

Doctor of Nursing Practice Projects

Heart failure (HF) is one of the leading causes of hospitalization among patients over the age of 65 years. Many are transitioned to skilled nursing facilities (SNF) following hospital discharge. HF-specific SNF staff education was designed for early detection of changes and improved management of this patient population. Computer-based education modules and hands on skill demonstration stations were created to provide basic HF knowledge and specific guideline recommended care measures for the SNF environment. A pretest, post-test, and skill demonstration were implemented and included weight assessment, application of compression stockings, volume status monitoring, and low sodium diet recommendations. Pretest scores …

Utilizing Team-Based Care To Improve Rural Cardiovascular Care, Amanda Clouser, Kastin Engeling, Kris Rhodes

Doctor of Nursing Practice Projects

Cardiovascular morbidity and mortality are significantly higher among individuals living in rural areas compared to urban and suburban settings. Some contributing factors include financial limitations, education level, and limited access to cardiovascular specialty healthcare. Using a team-based cardiovascular care approach in rural communities, including both nurse practitioners and physicians, could help improve access to cardiovascular health services. The purpose of this project was to conduct a focus group interview to evaluate a team-based care approach to cardiovascular services implemented in a rural clinic located in a medically underserved area. Based on the results of the focus group interview, an evidence …

Improving Emergence And Awaken Time In The Obese Population: Development Of A Desflurane Protocol In The Obese Population, Nikki Watson

Doctor of Nursing Practice Projects

Studies have shown that obese patients are at an increased risk for apnea and aspiration during the postoperative period due to comorbidities associated with obesity (Nason, 2015). Complications such as apnea and aspiration can increase the length of stay in the post-operative care unit (PACU). Slower emergence further increases the risk for apnea and aspiration because of delayed return of protective reflexes (Brousseau, Dobson, & Milne, 2014). Evidence-based research has shown Desflurane to have the fastest wake-up times in obese patients when compared to Sevoflurane, Isoflurane, and Propofol (Juvin, Vadam, Malek, Dupont, Marmuse, & Desmonts, 2000). The goal of this …