Nursing Commons^™

The Youthful Pandemic, Brook Sahlemariam

Nursing | Senior Theses

This paper attempts to examine the neurological, physical, and societal effects of e-cigarette use among youth and young-adults in North America. Furthermore, the paper investigates the parallels between e-cigarette users, tobacco users, and dual users in regard to behavioral patterns, reasons for use, and age of initiation.

Apneic Oxygenation: An Adjunctive Therapy For Laryngoscopy During Anesthesia Induction, Yaro Hoffman

Doctoral Projects

Endotracheal intubation is an essential component within the skill set of anesthesia providers. Rapid arterial desaturation remains a primary risk factor during laryngoscopy and intubation. The risk for hypoxemia exists because during endotracheal intubation, patients are apneic or hypo-ventilating (Wong et al., 2017). Apneic oxygenation (AO) has been advocated to attenuate hypoxemia during endotracheal intubation (Pavlov et al., 2017).

The aim of this project was to assess for any knowledge deficits regarding AO among anesthesia providers and assess the willingness of these providers to include AO into their current practice. The project investigator conducted an education session involving the …

Using Collaborative Objective Simulation Clinical Evaluation With Undergraduate Nursing Students And Nurse Anesthesia Students Labor Epidural Placement In An Active Labor Patient, Chaka K. Jackson, Aisha Pierre

Doctoral Projects

Developing interdisciplinary teamwork and patient communication skills are essential for the student registered nurse anesthetist (SRNA) to provide quality patient care when administering epidural anesthesia. The synthesis of the evidence revealed limited available information on simulation use for SRNA epidural administration and collaboration. This doctoral project examined the effectiveness of learning through traditional simulation to enhance communication and collaboration between the Bachelor of Science in Nursing (BSN) and the Nurse Anesthesia Program (NAP) students. The BSN and NAP students were provided with a simulation environment to care for a laboring patient while improving patient safety and quality outcomes. The project …

A Best Practice Recommendation: Decreasing Perioperative Fentanyl Used Through The Utilization Of Dexmedetomidine Prior To Surgical Incision, Shelby Harriel, Amy Houck

Doctoral Projects

Upon anesthesia induction, patients often receive fentanyl, an opioid medication that is linked to addiction, dependence, morbidity, and mortality (Stanley, 2014). The goal of this practice recommendation was to propose an alternative way of managing pain and the increased sympathetic response in the perioperative setting, specifically during the induction phase, through evaluating published research. A possible substitute for fentanyl is a drug called dexmedetomidine (Precedex™). Through a comparison of pharmacology, indications, risks, and benefits, one can conclude that if Precedex™ is given prior to induction, in the place of large doses of fentanyl, it can potentially achieve a smoother intraoperative …

Improving Door To Transfer Times For St Segment Elevation Myocardial Infarction In Small Emergency Departments: A Quality Performance Improvement Project, Amber Ryals

Doctoral Projects

Heart disease is a leading cause of death in the United States (Centers for Disease Control [CDC], 2020). ST-elevation myocardial infarctions are around 38% of all coronary syndrome patients that present to the emergency department (Akbar et al., 2020). Smaller, outlying facilities can be at a disadvantage due to the lack of readily available specialties and services, such as a cardiac catheterization laboratory, which has the potential to cause a delay in inpatient care. With standardized cardiac protocols in place at many facilities, initial identification and treatment of myocardial infarctions are begun long before a patient enters a facility, often …

Educating Student Registered Nurse Anesthetist On Malignant Hyperthermia Using An Objective Structured Clinical Examination, Ednita Street Fountain, Faith Sherman

Doctoral Projects

Malignant hyperthermia (MH) is a low-frequency, high-impact event that many student registered nurse anesthetists (SRNA) may be unprepared to manage due to limited exposure in clinical practice (Hackl et al., 1990). Lack of preparation for dealing with such low frequency, high impact events can lead to unfortunate adverse events resulting in death (Hackl et al., 1990). Thus, students should be are prepared to handle these situations if an event should occur.

An objective structured clinical examination (OSCE) is a structured method used to assess certain skills and underpinning knowledge required for practice (Harden & Gleeson, 1979). Students are allowed to …

Ultrasound-Guided Peripheral Venous Access: An Objective Structured Clinical Examination (Osce), Christopher Smith

Doctoral Projects

Intravenous (IV) access is essential to anesthetic practice as it allows the provider to administer fluids, sedative agents, and resuscitation medications. There is, however, a large subset of patients in which IV access can be difficult to obtain due to confounding factors such as preexisting disease, body habitus, and volume status (Sabado & Pittiruti, 2019). Bedside ultrasonography is an effective tool that can be used to gain IV access in these difficult patient populations. The downside to this technology is that there is a learning curve associated with its use, and proper training in ultrasound-guided venous access techniques is crucial …

Using Empathic Design Principles To Improve Surgical Nursing Efficiency, Roberta Sutton

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

Improving efficiency to increase operating room utilization, improve turnaround time, and first case on time starts, is a goal of hospitals to increase surgical case volume. Increasing case volumes improves the hospitals bottom line by increasing reimbursement. In addition, improving the utilization will improve patient and caregiver satisfaction, show less wasted time between cases, and allowing for more timely starts. In the hospital that this study was be performed, located in Atlanta, Georgia, there is a need to improve these metrics which will improve the bottom line of the facility. This study addressed inefficiencies in processes, job duties, and preparation …

Developing An Interdisciplinary Team Checklist To Assess Readiness For Appropriate Medical Removal Of Central Venous Catheter (Cvc), Miranda Harper

Doctoral Projects

Healthcare-associated infections are not a new concept in health care. Many different health-care-associated infections have been established over the years including but not limited to healthcare-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bacterial infection. While these infections are common in healthcare facilities, the rates of these infections are still prevalent in hospitals across the United States. This DNP project focused on central line-associated bacterial infections.

An interdisciplinary team checklist to assess readiness for appropriate medical removal of central venous catheter (CVC) was developed to assess intensive care unit patients for early appropriate medical CVC removal. The interdisciplinary team …

Effect Of A Self-Care And Self-Awareness Education Program On Resilience To Burnout And Depression In Clinically Experienced Nursing Students, Andrew Taylor

Undergraduate Honors Theses

The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these …

How Do Pregnant Women Perceive The Role Of The Midwife In Thailand? A Descriptive Study, Sudjit Liblub, Lyn Gum, Maryam Bazargan

Journal of Asian Midwives (JAM)

Background: Midwives are globally recognised as health professionals who specialise in caring for childbearing women with a vital role in maternal and neonatal health care. Despite the midwifery profession being an autonomous profession, there are many struggles to attain recognition within its formal scope of practice in some countries.
Objective: This study was undertaken to explore the views of pregnant women in Thailand regarding the role of midwifes and their selection of intrapartum care providers in order to understand their perceptions about giving birth with a midwife for normal pregnancies.
Design and setting: An online descriptive survey collected the views …

The Exploration Of The Long-Term Effects Of Stroke Patients In The Icu, Hannah Smith

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Hospitalization in the Intensive Care Unit (ICU) has been shown to have poorer long-term effects in stroke patients from the time of admission up to one year of discharge. Throughout the world, people suffer from the complications of having a stroke and being in the ICU. Increased mortality rate, dysphagia, poor speech, loss of mental status, and decreased muscle movement are found in stroke patients who received treatment in the ICU. The poorer long-term effects in stroke patients receiving treatment in the ICU may be caused by the type of stroke, comorbidities, or mental status at admission. The long-term effects …

A Quality Improvement Project To Facilitate A Human Trafficking Screening Protocol At A Maternal Resource Center, Jessica Mcdow

Doctor of Nursing Practice

Human trafficking is a global, criminal industry that negatively impacts the health of victims. Most U.S. victims of human trafficking are young females. Many female sex trafficking victims will seek health care services for unplanned pregnancies and sexually transmitted infections. Healthcare professionals fail to identify human trafficking victims due to lack of standardized screening. The aim of the project was to initiate a sustainable, standardized human trafficking screening protocol at a Maternal Resource Center in order to improve human trafficking identification.

This 10-week quality improvement project provided the staff and volunteers at a Maternal Resource Center with the necessary tools …

Pregnancy Bridge Program For Psychiatric Patients, Adam Barnett

Doctor of Nursing Practice

The National Institute of Mental Health (2017) estimates that 9.2 million people age 18 years and older are diagnosed with bipolar disorder in the United States. Research has shown pregnancies in women with mental health problems have higher rates of poor outcomes and complications (Epstein et al., 2014; Freeman, 2007; Rusner et al., 2016; Scrandis, 2017). Aim. The purpose of this scholarly project is to provide standardized patient education, increase urine human chorionic gonadotropin screening rates, and to set up a gynecologic care bridge for patients considering pregnancy and are diagnosed with bipolar disorder. Evidence. The Centers for …

Hpv Vaccination In Adults 18 Through 45: Reducing Missed Vaccination Opportunities In The Primary Care Setting, Ashley Hernandez

Doctor of Nursing Practice

HPV is the most prevalent sexually transmitted infection in the United States and is linked to six different types of cancer cell development. Prevention of infection from this virus could save hundreds of thousands of lives worldwide. An evidence-based quality improvement project was designed to increase the identification of HPV vaccination opportunities in the adult primary care setting to improve HPV vaccination rates. A protocol and patient eligibility algorithm were developed to align primary care practice with recently updated CDC guidelines. Interventions included clinic staff and provider education, designation of a vaccination champion, a flag within the patient chart to …

Improving Colorectal Cancer Screening And Testing In A Primary Care Clinic, Leslie Michelle Dubois

Doctor of Nursing Practice

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer-related deaths worldwide (World Health Organization, 2019a). In the United States, CRC was the fourth most common cancer in 2016 (Centers for Disease Control and Prevention, 2019a). The American Cancer Society (2020a) estimated that there will be 147,950 estimated new cases and 53,200 estimated deaths of CRC in the U.S. in 2020. The purpose of the project was to improve CRC screening completion rates and follow up referrals from 27.5% to 35% for adult patients, 50-75 years of age, within a family medicine clinic …

Patient-Centered Implementation Of Statin Therapy In Patients With Type 2 Diabetes, Giovanna P. Favarato

Doctor of Nursing Practice

Heart disease is the leading cause of morbidity and mortality in Americans with type 2 diabetes mellitus. The American Diabetes Association recommends statins and lifestyle modifications for all patients with type 2 diabetes mellitus for the prevention of atherosclerotic cardiovascular events. A patient-centered approach to primary prevention is encouraged, yet there are no specific instructions regarding implementation. The Statin Choice Decision Aid is a tool designed to facilitate shared decision-making between the patient and the provider in the clinical setting. The 2018 American College of Cardiology/American Heart Association guidelines for the primary prevention of atherosclerotic cardiovascular disease for patients with …

Implementation Of Comprehensive Foot Exams In Primary Care: A Quality Improvement Project, Dora Elia Trevino

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase performance and documentation of provider comprehensive foot exams (CFEs) by 50% among patients with Type 2 diabetes (T2DM) in a small clinic in the southwestern United States.

The project leader assessed clinic systems including the electronic health record (EHR) to identify means to increase CFE completion and documentation rate for patients with T2DM being seen for a chronic disease management (CDM) appointment. A process was created to incorporate a hardcopy CFE documentation form into the EHR and create a pop-up care reminder notification system. Staff and the provider were educated …

Incorporating Hiv Pre-Exposure Prophylaxis In Primary Care, Daniel Manesh

Doctor of Nursing Practice

In 2012, the Food and Drug Administration approved a combination medication named Truvada (tenofovir/emtricitabine) as a prophylactic treatment to prevent HIV transmission. Truvada is also known as pre-exposure prophylaxis (PREP). PREP is a one-pill-a-day regimen proven to be 99% effective against HIV-1 transmission from sex and intravenous drug injection when taken daily. The uptake of PREP remains low because primary care providers fail to identify patients who meet the requirements to start PREP and fail to prescribe PREP for patients at risk. The purpose of this quality improvement project was to increase the uptake of PREP in patients at risk …

Increasing Adherence To Measurement-Based Depression Management In Primary Care, Renad Saadat

Doctor of Nursing Practice

Background and Review of Literature. Approximately 11 million Americans 18 years or older experienced a severe symptom of depression leading to impairment in 2017. The severity of depressive symptoms is often miscalculated in primary care as measurement-based tools for the diagnosis and ongoing reassessment varies. Purpose. The purpose of the project was to increase provider adherence in using the patient health questionnaire-9 (PHQ-9) for ongoing evaluation of the severity of depressive symptoms in patients with depression at a primary care clinic in San Antonio, Texas. Objectives. The main objective of this Doctor of Nursing Practice project is …

Establishing A Structured Mentorship Program For Novice Advanced Practice Registered Nurses In The Veterans Health Care System, Rodney Duckett

Doctor of Nursing Practice

Background. Mentorship is an age-old strategy still widely sought after to increase integration into the workforce. Employers of new APRNs must be aware that newly graduated APRNs are inexperienced. To maximize the employers’ investment, training on proper integration should be a high priority. This Doctor of Nursing Practice (DNP) project addressed this quality improvement issue through the implementation of a structured mentorship program to improve the overall transitioning of newly hired APRNs in the Veterans Health Care System (VHCS). Problem. The VHCS lacks a formalized, structured mentorship program for newly graduated APRNs entering the VA System. Intervention. Seven APRN mentors …

Nursing Education Amidst Covid-19: Obstacles And Way Forward, Farida Bibi Mughal, Nasreen Rafiq, Bibi Hajira Irshad Ali

School of Nursing & Midwifery

No abstract provided.

Burden Of Care As Perceived By Informal Caregivers Of The Patients Receiving Chemotherapy In Tertiary Care Hospital Of Karachi, Pakistan, Asher Ghori, Rubina Barolia, Naghma Rizvi, Ghulam Qadir

School of Nursing & Midwifery

Background: Almost 32.5 million people are diagnosed with cancer annually. The huge number of cancer patients with deteriorating health renders a far greater number of informal caregivers bearing the burden of care in different forms and magnitude. The main purpose of the study was to explore the types of burden perceived by the informal caregivers and the factors associated with the caregiving burden.
Methods: A quantitative descriptive cross-sectional study design was adopted to answer the research questions from April to May 2016. Around 200 informal caregivers were recruited from one of the tertiary hospitals of Karachi, Pakistan. The modified ZBIS …

Evolving Nurse Leadership Role In 2020, Nasreen Rafiq, Farida Bibi Mughal

School of Nursing & Midwifery

No abstract provided.

The Impact Of A Digital Intervention On Perceived Stress, Resiliency, Social Support, And Intention To Leave Among Newly Licensed Nurses: A Randomized Controlled Trial, Lisa Concilio

Electronic Theses and Dissertations

The nursing shortage has been deemed a public health crisis with the turnover rate of newly licensed nurses (NLNs) growing (Robert Wood Johnson Foundation, 2014). One out of five NLNs are leaving the profession due to work dissatisfaction and feelings of inadequacy (National Academy of Medicine, 2017). NLN attrition during the first year of hire has been associated with feelings of overwhelming stress and decreased sense of support which negatively impact patient safety (Spence Laschinger et al., 2016). As seasoned nurses are attempting to retire amidst a nursing shortage (American Association of Colleges of Nursing, 2018), NLNs require more support …

Health Literacy, Illness Perception, And Diabetes Self-Management In Korean-Speaking Immigrants With Diabetes, Su Won Park

Nursing Dissertations - Archive

Type 2 diabetes mellitus (DM) is becoming an increasingly common disease with aging. As the prevalence of DM increases, the need for self-management is emphasized as a way to control DM and prevent its complications. According to the common-sense model, DM self-management is explained as an illness-related coping behavior that is affected by an individual's illness perception (IP). No studies were found that evaluated IP in Korean adults with DM in the United States, or that evaluated the association of health literacy (HL) with their IP and DM self-management. The purpose of this study was to examine the relationships between …

Smoking Cessation Within The Federal Employee Population, Brenda Ross Swilley

Nursing Dissertations - Archive

This article-based dissertation consists of two complete manuscripts related to smoking cessation within the federal employee population. In the first manuscript, the self-determination theory was described and evaluated using Walker and Avant’s criteria. A demonstration of how the theory has been used in previous research, as well as the application of the theory to federal employees who smoke was also presented in the article. There was no theoretical framework for administrators or clinicians to use when developing, implementing, or evaluating smoking cessation. Manuscript one addresses the need for a theoretical framework. As theory creates the foundations of nursing practice, occupational …

The Association Between Caffeine Intake And Cardiovascular Mortality: An Analysis Of The National Health And Nutrition Examination Survey (Nhanes) 1999-2014 Database, Juan Feng

Nursing Dissertations - Archive

Sixty-four percent of adults in America drink coffee daily and 71% of caffeine intake comes from coffee in the United States (US) diet. Cardiovascular disease (CVD) is the number one cause of death in the US. The purpose of this study was to examine the association between caffeine intake and CVD mortality in a nationally representative sample of the US civilian non-institutionalized population. The association between caffeine intake and CVD mortality among 21,938 participants (age ranging from 20 to 85 years) in the NHANES 1999-2014 database was examined by multivariate Cox’s proportional hazards regression model. Daily caffeine intake was assessed …

Roli I Infermierit Tek Fëmijët Me Hipertermi, Ariana Isufi

Theses and Dissertations

Ky studim është bërë për të njohur sa më mirë rëndësinë e kujdesit infermieror tek fëmijët me Hipertermi. Sigurisht, parandalimi është më i sigurti për një jetë të gjatë dhe të shëndetshme.

Hipertermia, megjithëse është një shenjë e sëmundjes që mund të vijë ose aktualisht është e paraqitur, ajo është shumë e diskutueshme nga ana e prindërve dhe gjithnjë e më shumë ka filluar të bëhet një problem serioz për popullatën.

Faktorët që ndikojnë në Hipotermi janë të shumtë dhe të ndryshëm që mund të ndikojnë në shfaqjen e saj te fëmijët, për të cilët do të diksutohet gjerë dhe …

Ndryshimet Psikologjike Te Pacientët Pas Diagnostikimit Me Kancer, Blerinë Terziu

Theses and Dissertations

Synimi kryesor i këtij punimi ishte që të kemi më shumë njohuri mbi ndryshimet psikologjike që ndodhin te pacientët pas diagnostikimit me sëmundjen e kancerit. Për të arritur këtë synim është përdorur metoda kuantitative si qasje kryesore metodologjike. Hulumtimi përfshinë një mostër prej 55 personave, 20 meshkuj dhe 35 femra. Pacientët vijnë nga vende të ndryshme të Kosovës dhe janë pacientë kryesisht të moshës së shtyrë. Rezultatet e këtij hulumtimi kanë treguar se femrat kanë tendencë të shfaqin më shumë ndjenja të përjetimit të situatës pas diagnostikimit me sëmundjen e kancerit si dhe janë më të lira për të komunikuar …