Evidence Based Management Of Herpes Zoster Ophthalmicus, Mikkel Buckmier Rn

Nursing Capstones

No abstract provided.

Point-Of-Care Reminders To Prompt Provider Adherence With Diabetes Care Guidelines For Adults, Eric E. Spohn

Evidence-Based Practice Project Reports

Diabetes is a complex, chronic illness, and a leading cause of morbidity and mortality (ODPHP, 2019). Gaps in diabetes care exist between clinical guidelines and interventions provided in the clinical setting (ADA, 2015; Chauhan et al., 2017; Renders et al., 2001; Worswick et al., 2013). Improved diabetes management strategies and interventions among healthcare providers are essential to close the quality gap. The purpose of this evidenced-based practice (EBP) project was to prompt providers to adhere to diabetes care guidelines using a paper point-of-care reminder over a 12-week period. Provider performance rates covering four specific guidelines were measured: HbA1c, microalbuminuria, diabetic …

Availability Of & Access To Prenatal Care & The Effects On Maternal & Infant Mortality Rates: A Comparison Of Central American Countries, Costa Rica & Guatemala, Joanne Danae Youngblood

Theses and Dissertations

Costa Rica and Guatemala share similarities in history, culture, and a relatively congruous geopolitical philosophy. Yet despite these superficial parallels, access to prenatal care between the two countries is shockingly disparate. Costa Rican women have better access to prenatal care and both the maternal and infant mortality rates are comparable to more developed countries with significantly higher rates of economic development and higher spending on healthcare per capita. In juxtaposition, the lack of prenatal care within Guatemala’s health care system is a prime example of a country’s failure to implement protections and policies that promote and elevate the level of …

Improving The Process Of Making Preoperative Home-Medication Recommendations, Andrew Standefer

Doctor of Nursing Practice Projects

Improving the Process of Making Preoperative Home-Medication Recommendations

Many patients presenting for surgery have a list of prescribed medications they take daily to treat various comorbidities. Even though prescription drugs may offer patients therapeutic benefits during the perioperative period, they may also cause adverse effects when used in conjunction with anesthesia during surgery (Marley, Calabrese, & Thompson, 2014). Therefore, identification of medications for the preoperative patient to take or withhold is necessary.

Research indicates that clinicians often make inappropriate decisions regarding preoperative medication management in settings where no guideline exists (Renew, Bolton, Alvarado, & De Ruyter, 2015; Symons & McMurry, …

Implementation Of Crisis Checklist For Local Anesthetic Systemic Toxicity (Last) In The Parturient Patient, Annelise Contino

Doctor of Nursing Practice Projects

The chief anesthesiologist at a large hospital in Illinois requested education and a checklist on the treatment of Local Anesthetic Systemic Toxicity for the medical team involved in the care of parturient patients. The implementation of The Stanford Anesthesia Cognitive Aid Group checklist for LAST and an educational session was completed for all staff involved in the care of the parturient patient. A PowerPoint presentation was utilized to educate on the early recognition and treatment of LAST. The presentation was implemented at the obstetrics department staff meetings and the monthly anesthesia department meeting. A pretest was completed prior to education …

Crna To Cvicu Rn: Implementation Of A Standardized Patient Handoff Checklist For Post-Surgical Heart Patients, Ashley Mcgrath

Doctor of Nursing Practice Projects

Patient handoffs occur when the information and responsibility of the patient is transferred from one health professional to another. Ineffective communication during the critical postoperative phase of the transfer of care (TOC) has been associated with extended hospital stays, increased healthcare costs and patient dissatisfaction. In 2007, the Joint Commission National Patient Safety Goals proclaimed the importance of a standardized handoff process for effective handoffs. The purpose of this quality improvement doctoral project was to assess if the utilization of a standardized TOC checklist from the operating room to the cardiac intensive care unit (CVICU) for post-heart patients improved communication …

Dnp Project: Improving No-Show Rates In Primary Care, Mai-Linh T. Nguyen, Sarah M. Kuzara

Doctor of Nursing Practice Projects

Abstract

This paper explores the factors that contribute to no-show rates in the primary care setting and effective interventions to improve no-show rates. The average no-show rate in the primary care setting is 23%, (Dantas, Fleck, Olivaria, & Humacher 2018). In 2018, the no-show rate at the WeCare Clinic was 50-60%. A literature review was conducted to gather information regarding why patients choose to no-show their appointments, the common causes of high no-show rates, and effective interventions found to decrease no-show rates. We investigated the primary causes of a high no-show rate at the WeCare Clinic by interviewing staff and …

Improving Health Insurance Literacy Within Our Community Through The Use Of Local Libraries, Bonnie Gregg, Jenny Lieu

Doctor of Nursing Practice Projects

Low health literacy is associated with a poorer ability to understand medical information leading to disparities among all ages. Communities play a role in supporting efforts to improve health literacy. Libraries are trusted institutes that offer an environment for all members of the community and serve as places of lifelong learning. A needs assessment approach determined a gap in knowledge regarding health literacy and insurance, specifically the Affordable Care Act (ACA). This project was an exploratory, community improvement project. Information was presented in educational sessions at two local libraries. Participants were also given an informative brochure to accompany the presentation. …

Hepatitis C Screening Protocol In A Rural Primary Care Setting, Katie C. Wollerman, Mackenzie M. Bowers

Doctor of Nursing Practice Projects

Current evidence indicates a need for Hepatitis C Virus (HCV) screening, as the virus can lead to complications if not detected early. Screening is determined by population-based risks, behavioral-based risks, and healthcare-based risks. After criteria are met, patients can be screened by a venous laboratory test. A gap existed in a rural primary healthcare clinic, as providers were not following Centers for Disease Control and Prevention (CDC) or U.S. Preventative Services Task Force (USPSTF) recommendations to screen patients. An HCV screening protocol was developed and implemented in this healthcare facility. The providers opted to only implement screening for population-based risk …

Implementation Of Supplemental Oral Anticoagulant Education To Promote Medication Adherence, Blake Cory

Doctor of Nursing Practice Projects

Proper adherence regarding high-risk medications such as oral anticoagulants (OAC) is essential for reducing the incidence of adverse events such as thrombosis or major bleeding when dosages are missed or inappropriately administered.

The goal of this project was to reduce these events by supplementing current educational practices at a metropolitan cardiac electrophysiology office with new medication education protocols, the development of specific medication informational handouts, and provider training. Providers and staff were provided with medication specific education for Vitamin K Antagonists (VKA) such as warfarin and Non-Vitamin K Agonists (NOACs) such as dabigatran, rivaroxaban, and apixaban for those patients initiating …

The Development Of A Pain Medication Management Protocol, Kirstie Mcgrath, Jane M. Brown, Shannon D. Walle

Doctor of Nursing Practice Projects

Implementation of an organization-wide pain management policy incorporates a multifaceted team approach that could lead to improved patient outcomes. The absence of a standardized opioid prescribing policy within a healthcare organization has led to individual departments adopting their own guidelines. Management of an individual patient’s pain medication is often met with reluctance from providers when a patient is transferred from another department leaving the patient with inadequate care.

Improving Caregiver Health Literacy Of Pediatric Febrile Illness: A Patient Care Initiative, Rebecca T. Shipley

DNP Final Reports

Background: Pediatric fever, though typically harmless and incredibly common, can cause substantial fear and anxiety for caregivers unfamiliar with how to manage or treat this condition at home. Studies evaluating pediatric emergency department (ED) rates have repeatedly found fever to be a leading reason for clinical evaluation. Local EDs record percentages as high as 40% of pediatric patients seek evaluation primarily for fever. Purpose: Provide educational resources for high-risk populations to reference at home regarding fever so that avoidable ED visits decreased and caregiver knowledge of fever improved. Methods: An educational program was implemented at a pediatric primary care clinic …

The Relationahips Between Health Behaviors Of Women And Health Locus Of Control Among Black Caribbean Women And Black American Women With Hypertension, Camelle Charles

Theses & Dissertations

Background

Millions of Caribbean women have migrated to the United States, and a sizeable number of these women and Black American women suffer from hypertension and other cardiovascular health problems. This research showed the comparison of health behaviors of both groups of women and the difference in their health outcomes. Today, there are more migrants in the world than ever before; an estimated 272 million international migrants in 2019, which is an increase in 51 million since 2010 (United Nations, 2019) and Caribbean migrants are a substantial portion of this pool. Approximately 4.4 million Caribbean immigrants reside in the U.S. …

The Relationship Of Self-Efficacy And Clinical Reasoning Of Undergraduate Nursing Students, Amy G. Holder

Electronic Theses and Dissertations

Aim. This investigation aimed to discover if a there is a correlation between a student’s clinical reasoning self-efficacy and a student’s actual clinical reasoning ability. Also, this research sought to discover the connection between an undergraduate nurse’s self-efficacy of clinical reasoning and the locus of control of that student. Finally, this investigation sought to discover if perceived self-efficacy of clinical reasoning changed over time.

Background. The ability to successfully navigate the process of clinical reasoning is critical to providing safe, effective care for patients. For nurses, this process begins to develop in nursing school. Unfortunately, evidence suggests that newly graduated …

Forecasting The Essential Chemotherapy Needed For Treatment Of Children With Acute Lymphoblastic Leukemia In Low- And Middle-Income Countries, Brian T. Lewis

Theses and Dissertations (ETD)

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer, with contemporary therapy resulting in a 90% survival in high-income countries (HIC). However, an estimated 89% of the world’s children live in low- and middle-income countries (LMIC) where survival is much lower. Lack of access to essential chemotherapy contributes significantly to the decreased survival rates for LMIC, and inaccurate forecasting of chemotherapy needed may lead to stockouts or oversupply. This chapter describes a simple forecasting system with population and patient-based multipliers for each drug used in the treatment of pediatric ALL, thus estimating the essential chemotherapy quantities needed for a …

The Experiences And Well-Being Of Mexican Immigrant Women Living In Traditionally Non-Latinx Communities In Western North Carolina, Melinda Bogardus

Electronic Theses and Dissertations

North Carolina has, in recent decades, experienced significant growth in its Latinx, and more particularly Mexican immigrant population. As a traditionally non-Latinx state, or a state without a long-standing, large Latinx population, many communities and healthcare and service providers within North Carolina still lack knowledge, resources, and skills needed to serve and support Latinx immigrant populations well. Guided by interpretive description, this qualitative study on Mexican immigrant women in Western North Carolina sought to gain knowledge and understanding of what it is like for them to live in a traditionally non-Latinx region and how immigration has affected their well-being. Asking …

A Protocol Driven Stroke Code's Impact On Door-To-Needle Times, Jesse Osborne

Electronic Theses and Dissertations

Tissue plasminogen activator (tPA) is most effective the faster it is able to be administered to a patient that has been affected by stroke. A Stroke Code is a strategy that acute care facilities implement to reduce the time from diagnosing a stroke to administering tPA. The purpose of this study was to determine if the initiation of a Stroke Code in an acute care hospital reduces the door-to-needle time for patients affected by a stroke. In particular, does a Stroke Code reduce door-to-needle times. The research was conducted using data from April 1, 2014 to December 31, 2014 (pre-Stroke …

Increasing Nurses' Knowledge Of Advance Care Planning, Jocelyn K. Allen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Advance care planning (ACP) is a process that seeks to ensure patients receive medical care that is consistent with their values and preferences. The process has proven benefits for patients and their loved ones but is under-utilized in clinical practice. Nurses are capable of successfully supporting patients through ACP; however, they encounter barriers that prevent their engagement in the process. These barriers include a lack of knowledge regarding ACP, poor understanding of their role in the process, and a lack of confidence to embrace the practice.

The purpose of this DNP Project was to create an evidence-based educational intervention to …

Validity And Reliability Of The Antepartum Gastrointestinal Symptom Assessment Instrument, Lisa Hanson, Leona Vandevusse, Mauricio Garnier-Villarreal, Donna O. Mccarthy, Teresa Jerofke-Owen, Emily Malloy, Heidi Paquette

College of Nursing Faculty Research and Publications

Objective

To examine the psychometric properties of the nine-item Antepartum Gastrointestinal Symptom Assessment (AP-GI-SA) instrument.

Design

Single-group prospective design.

Setting

Urban prenatal clinic serving a diverse population.

Participants

Convenience sample of 45 pregnant women.

Methods

Participants completed the AP-GI-SA before a scheduled prenatal care appointment. We used Bayesian structural equation modeling to evaluate the construct validity of the scale and assessed known-groups validity. We assessed reliability through maximal reliability coefficient estimate and measured internal consistency with Cronbach’s alpha coefficient.

Results

Participants completed the instrument in 2 minutes or less. Construct validity was supported by confirmatory factor analysis (posterior predictive p …

Using The Engaging Parents In Education For Discharge (EPed) Ipad Application To Improve Parent Discharge Experience, Stacee M. Lerret, Norah L. Johnson, Michele Polfuss, Marianne E. Weiss, Karen Gralton, Carol Klingbeil, Cori A. Gibson, Mauricio Garnier-Villarreal, Sheikh Iqbal Ahamed, Riddhiman Adib, Rachel Unteutsch, Louis Pawela, Rosemary White-Traut, Kathleen J. Sawin

College of Nursing Faculty Research and Publications

Purpose

The purpose of this study was to evaluate the use of the Engaging Parents in Education for Discharge (ePED) iPad application on parent experiences of hospital discharge teaching and care coordination. Hypotheses were: parents exposed to discharge teaching using ePED will have 1) higher quality of discharge teaching and 2) better care coordination than parents exposed to usual discharge teaching. The secondary purpose examined group differences in the discharge teaching, care coordination, and 30-day readmissions for parents of children with and without a chronic condition.

Design/Methods

Using a quasi-experimental design, ePED was implemented on one …

Understanding The Importance Of Psychological Screenings For Patients Undergoing Elective, Invasive Cosmetic Surgery: A Literature Review, Jazmin N. Rush

Theses and Dissertations

All over the United States (U.S.), men and women alike are undergoing elective, invasive cosmetic surgery. Research has found there is an increasing number of patients choosing cosmetic surgery in hopes of alleviating psychological disorders such as body dysmorphic disorder and low self-esteem. The objective of this review is to analyze the literature available regarding cosmetic surgery and the psychological issues leading to the decision to undergo elective, invasive cosmetic surgery in order to understand and identify the possible benefits of psychological screenings. Information for this study was obtained from three electronic databases - Galileo, PubMed, and CINAHL. U.S. based …

Creating A Patient Handout For Venting Gastrostomy Catheter: A Quality Improvement Project, Sally A. Mathews

Doctor of Nursing Practice Projects

At the University of Texas MD Anderson Cancer Center (MDACC), approximately 200 patients undergo placement of a venting gastrostomy catheter annually (venting G-catheter). About 10% of these patients are later seen in the emergency room (ER) for complications related to venting G-catheters. These complications include leakage, infection, skin irritation, and dislocation that require interventions ranging from topical management to exchange of the catheter. The purpose of this project was to create an MDACC-designed patient education handout regarding the care of venting G-catheters as a means of improving patient care and reinforcing these concepts for clinical nurses, thus improving their knowledge. …

The Impact Of Intermittent Auscultation And Physiologic Labor Support Education For Nurses On Patient Satisfaction And Nurse Self-Efficacy, Heather N. Soper

Doctoral Dissertations and Projects

Knowledge and implementation of intermittent fetal auscultation (IA)and labor support mechanisms in the hospital setting are becoming a lost art. Nurses are well-trained on how to utilize technology and perform medical interventions for laboring patients, but are losing the confidence and skills necessary to promote normal, physiologic births for low-risk women. In order to address these concerns, an evidence-based practice project was piloted in a hospital in Virginia. Nurses were trained on the science, clinical application, and outcomes of both intermittent auscultation and continuous electronic fetal monitoring for low-risk women; education was also focused on labor support mechanisms and the …

Learning To Leave: Filipino Families And The Making Of The Global Filipino Nurse, Yasmin Y. Ortiga

Research Collection School of Social Sciences

This chapter investigates how this process of reconfiguring the “social” plays out in the context of the Philippines’ labor export system and pervasive culture of emigration. Focusing on the case of Filipino nursing graduates seeking to work overseas, this chapter discusses how the success of the Philippines’ labor-brokering process relies on individuals who can take on the responsibility of transforming themselves, mainly through education and training, into desirable workers for future employers. While the migration literature had largely framed emigration as an individual aspiration and project, this chapter demonstrates how families subsidize the Philippine state’s labor export system by taking …

Patient-Centered Emr Communication, Christi Lynn Camarena

Doctoral Projects

The electronic medical record (EMR) has become the standard in health care documentation. The EMR has been shown to improve the availability of medical records, provide tools to facilitate communication, and improve patient safety. Because of the absence of standardized training and EMR research, there is a gap in understanding the relationship between the EMR and the provider-patient relationship. The EMR requires the provider to use purposeful and deliberate patient-centered EMR communications behaviors to facilitate a meaningful, engaging, and educational dialogue with patients. These behaviors have been studied in physician populations and standardized tools have been developed to assist in …

Ntchs© Health Literacy Intervention Pilot Study, Genevieve Evenhouse

Doctoral Projects

This pilot study explored the effectiveness of a validated curriculum called, “Navigating the Health Care System” (NTHCSÓ) in improving the health literacy of high school-aged adolescents in response to the national call to promote knowledge and skills in all ages, and socio-economic and cultural groups to achieve healthier lives. Low health literacy has been shown to greatly affect the quality of lives, health outcomes, and health spending of individuals with and without health conditions across social demographics. High school-aged adolescents are the population of interest of this study due to their developmental milestones which allows for knowledge and skill building …

The Collaborative Health Objectives In Combatting The Effects Of Diabetic Peripheral Neuropathy (Choice): A Second Chance To Change Diabetic Destiny, Alishia A. Claibourn

Doctoral Projects

The Collaborative Health Objective in Combatting the Effects of Diabetic Peripheral Neuropathy (CHOICE); A Second Chance to Change Diabetic Destiny, is a research pilot study that will test the validity of The Diabetic Foot Book. Diabetic peripheral neuropathy (DPN) affects 60-70% of the diabetic population. The CHOICE project will use The Diabetic Foot Book, a patient education booklet, created explicitly for the DPN population. The goal of the pilot study is to evaluate the effectiveness of The Diabetic Foot Book to increase health literacy and affect behavior change in the DPN population.

Respiratory Distress Observation Scale Implementation For Comfort Care Patients In The Acute Care Setting, Marianne Wachalovsky

Doctoral Projects

One of the most common symptoms at the end of life is respiratory distress. Respiratory distress or dyspnea is a subjective symptom and therefore challenging to assess, especially when the patient is unable to communicate. Controlling symptoms depend on the knowledge and assessment skills of the clinicians and their willingness to administer the necessary pharmacological intervention. Assessment and treatment of this symptom presented a gap in the quality of care for the patients in the hospital of the author. An exhaustive literature review established that this existed also in other clinical settings and led to the Respiratory Distress Observation Scale …

Plant-Based Diet: How It Affects Health, Sarah Marsland

Senior Honors Projects

This research project aims to investigate the relationship between plant-based dieting and overall health, specifically the prevention and reversal of chronic disease. Two subjects committed to eating a plant-based diet comprised of primarily vegetables, fruits, whole grains and non-processed foods for six weeks. Before beginning, they were asked about their current health status, including a complete health history, and their knowledge of plant-based eating. Throughout the research period, the subjects shared what they were eating, challenges they faced, and any benefits they noticed. Upon completion of the diet, they answered questions about their experience. With this information, the researcher was …

Iatrophobia: How It Impacts Health, Jessica Newbury

Senior Honors Projects

According to Mara Hollander (2019), iatrophobia is “the fear of doctors, medical care, or the medical care system." The most severe cases of this fear only affect a small percentage of the population; however, many people, for a variety of reasons, reported that they disliked or felt uncomfortable seeking medical care. An anonymous survey was created and distributed to males and females between the ages of 18 to 75 to retrieve self-reported data regarding specific questions about doctor's visits and the healthcare system. The total sample consisted of 379 participants who voluntarily completed the assessment. Quantitative data was collected using …