Nursing Commons^™

Nurse Practitioner Student Confidence And Competence In Common Women's Health Diagnostic Procedures, Jessica Cowan

Dissertations

Problem: In areas with limited health resources, such as Guatemala, cost-effective and reliable methods for sexually transmitted infection and cervical cancer screenings are needed. The purpose of this Quality Improvement (QI) project was to develop standardized training in Vaginal Wet Mount (VWM) preparation and cervical cancer screening using Visual Inspection with Acetic Acid (VIA) for Nurse Practitioner students who traveled to Guatemala for a week-long global immersion experience.

Methods: This was a QI project with a prospective descriptive design utilizing a purposive sample of 10 University of Missouri-St. Louis Nurse Practitioner students who traveled to Guatemala on medical mission trip …

Screening For Delirium In The Emergency Department, Melissa Minks

Dissertations

Abstract

Delirium is a problem for many older adults who are acutely ill. Delirium often comes on suddenly, can be severe, and is often difficult to diagnose, especially in the presence of dementia. Missed delirium has a mortality rate of 30.8% and costs millions. What is the purpose of this study?

Methods The 4A’s Test screening instrument was implemented and evaluated in the Emergency Department of a rural Midwestern hospital from May 1, 2019 through August 31, 2019.

Results There were 122 participants in the study with 61 in each cohort. In 2018, three (5%) were diagnosed with delirium without …

A Strategic Plan To Thread Genomics Competencies Into Undergraduate Curriculum, Holly Mathis

Dissertations

Problem: Genomics in undergraduate nursing education has experienced slow adoption in the United States. Various approaches have been proposed but do not address barriers to successful implementation.

Methods: A strategic plan was developed to increase the amount of genetics and genomic content in the curriculum of an undergraduate nursing program. A gap analysis was performed on the curriculum revealing a paucity of content. A SWOT analysis informed the strategic plan, which included a faculty education program using the ANA/ISONG’s Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines and Outcome Indicators (2^nd ed.) (2009) as a foundation.

Results: Faculty …

Utilizing Wellness Champions As A Faith-Based Initiative For Mental Health Promotion, Tracy M. Webster Cooley

Dissertations

Abstract

Purpose: This program evaluation project evaluated the effectiveness of mental health training and support provided to wellness champions affiliated with a behavioral health organization. This project sought to gain a better understanding of how clergy and laypersons acting as wellness champions in predominately African-American faith-based organizations perceive they create an atmosphere to decrease stigma and increase mental health promotion and wellness when receiving education and training on mental health.

Methods: A descriptive project using a program evaluation design to evaluate the effectiveness of the training of 122 wellness champions from faith-based organizations received from a behavioral health organization …

Evaluation Of Sleep Hygiene Checklist For Delirium In An Intensive Care Unit, Ying Wei

Dissertations

Abstract

Problem: Delirium is a severe complication brought on by sleep deprivation that could increase mortality and prolong intensive care unit (ICU) stays in critically ill patients. This project aimed to develop and implement a sleep hygiene checklist to decrease the incidence of delirium in a Medical Intensive Care Unit (MICU).

Methods: This study used a pre-post design to compare the incidence of delirium pre-and post-implementation of the sleep hygiene checklist. Forty-four patients and thirty-six patients were recruited for the pre-and post-intervention groups, respectively.

Results: The result of this study demonstrated use of a sleep hygiene checklist could decrease the …

The Effects Of High Dose Intravenous Vitamin C In Cancer Patients, Bankole Aluko

Dissertations

Problem: Currently used standard treatments (Chemotherapy, radiation) in cancer patients are generally accompanied with side effects, which may include pain, nausea, vomiting, fatigue, and chemotherapy-induced peripheral neuropathy (CIPN) during and after completion of treatments. High dose IV C may improve the anti-cancer action of chemotherapeutic agents by reducing side effects of fatigue, pain, nausea and vomiting and boosting immune cell functioning, and inhibiting angiogenesis (Mikirova, Casciari, & Hunninghake, 2019).The purpose of this quality improvement project was to explore whether high dose intravenous vitamin C (IV C) prevented major side effects that frequently occur with standard treatments in cancer patients and …

Impact Of The Hester Davis Fall Risk Scale On Inpatient Falls, Amelia Payne

Dissertations

Problem: During a three month period in 2018, a rural acute care facility experienced a fall rate of 3.4 falls per 1,000 patient days. The aim of this clinical scholarship project was to implement the Hester Davis Fall Risk Scale (HDFRS) for adult inpatients in a rural acute care facility.

Methods: Utilizing the Find, Organize, Clarify, Understand, Select- Plan, Do, Study, Act (FOCUS-PDSA) model, the HDFRS was implemented and evaluated using a pre and post design to determine its impact on falls per 1,000 patient days and falls with injury per 1,000 patient days. The method of evaluation was a …

Evaluation Of A Type 2 Diabetes Mellitus Care Coordination Program, Carrie Smith

Dissertations

Abstract

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing Diabetes Care Coordination (DCC) program at an urban clinic for clients with no health insurance in the Midwest. Diabetes related indicators of those enrolled in the DCC program and client reported barriers were documented over a 19 month period.

Sample: Clients included were 18 years and older, with no insurance, having the diagnosis of Type 2 diabetes mellitus, and were enrolled in the DCC program within the first six months of the program's initiation.

Methods: A retrospective chart review of 24 clients recording diabetes related outcome indicators …

Utilizing High Flow Oxygen Therapy In Infants With Bronchiolitis, Sarah Ulses

Dissertations

Problem Bronchiolitis is the leading diagnosis of hospitalizations for children under one-year. The purpose of this study was to evaluate the effectiveness of supportive high-flow oxygen (HFO) therapy for infant patients requiring more than 2L/min nasal cannula (NC).

Methods An observational, descriptive design with convenience sampling of infants aged one-year or less, hospitalized with bronchiolitis and requiring HFO therapy. Comparisons were done between 2019 when no HFO was allowed on the general unit and in 2020 when HFO was allowed.

Results Of 28 patients (N = 28), 13 (n = 13) were in the 2019 cohort and 15 …

In Post-Extubated Patients What Are The Preferred Methods Of Communication During Their Experience Of Endotracheal Intubation With Mechanical Ventilation, Lanette Dumas

USF Tampa Graduate Theses and Dissertations

To date, communication between mechanically intubated patients and nurses is laden with negative psychological and physiological impacts. Research has focused more on what patients want to communicate, and how nurses communicate with intubated patients. There is limited research identifying the communication methods preferred by these patients. The purpose of this study was to identify communication preferences of mechanically intubated patients using a phenomenological approach.

Semi-structured interviews were conducted with participants in their hospital rooms. The interview questions focused on the period of mechanical intubation when the participants were unable to speak. A total of 27 participants were interviewed at a …

Multidisciplinary Team Approach Effect On Pediatric Severe Asthma, Lila Kertz

Dissertations

Problem. Children with severe asthma are more likely to be non-adherent with their prescribed medications, often related to barriers. A holistic assessment of these patients has been suggested, but is not typically performed in most pediatric asthma clinics. The purpose of this project was to evaluate the effects of severe pediatric asthma clinic services designed to perform holistic assessments and provide comprehensive care.

Methods. An observational, descriptive design was used to evaluate the Severe Asthma Clinic for Kids (SACK) created in 2013 using a retrospective database review. A convenience sample of data collected on all children treated in the clinic …

Intimate Partner Violence Screening In Adolescent And Young Adult Females, Emily Myers

Dissertations

Abstract

Problem Adolescents and young adult females are at risk for experiencing intimate partner violence (IPV). Females aged 16- to 24-years of age experience IPV three times more likely than males. Universal screening for adolescent IPV is considered a gold standard for adolescent anticipatory guidance. The purpose of this quality improvement initiative was to evaluate the impact of an adolescent IPV screening instrument in an urban, Midwestern shelter for pregnant adolescent and young adult females.

Methods An observational, descriptive design. All adolescent and young adult females presenting for intake evaluation were screened for IPV using the Healthy Relationship Quiz over …

Mitigating Suicide Risk Post-Discharge From Inpatient Crisis Stabilization: Safety Planning Intervention, Leighia M. Mcghee

Dissertations

Abstract

Purpose: The purpose of this program evaluation is to evaluate the effectiveness of a newly implemented safety planning intervention (SPI) tool, comparing patient outcomes relating to suicide attempt rates, emergency department (ED) encounter rates, and inpatient rehospitalizations rates pre and post its integration to care in a suburban behavioral health hospital.

Methods: A descriptive cohort design utilizing a retrospective chart review was completed over six months, three months pre, and three months post implementation of the SPI program. A convenience sample of inpatient charts was reviewed to assess the rate of suicide attempts, ED encounters frequencies, and hospitalization rates …

Compassion Fatigue And The Emergency Department, Alexandra Myers

Dissertations

Problem The emergency department (ED) is a high-stress environment. Nurses exposed to this stress for prolonged periods are subject to compassion fatigue (CF). The purpose of this quality improvement project was to identify and reduce the level of CF in ED nurses by implementing Real Time Transformative Response^© (RTR). RTR^© is a technique that uses combinations of neurofeedback response awareness, biofield therapy intervention, and clearing of unwanted energy.

Method A purposeful sample of ED nurses working at a moderately-sized, suburban, Midwestern hospital ED who were scheduled to work 24-hours or more per week completed a Professional Quality of …

The Crisis In Male Mental Health: A Call To Action, Demetrius Porsche, Salvatore J. Giorgianni

School of Nursing Faculty Publications

No abstract provided.

Coronavirus, Carla Bonczak

Nursing Student Class Projects (Formerly MSN)

Coronavirus (COVID-19) is a novel virus that began its virulent spread in China December 2019. Since that time, it has spread worldwide and has affected individuals, business, and educational systems, as well as day to day life. COVID-19 has become a national pandemic. COVID-19 is spread through airborne droplets produced by affected individual that may or may not be symptomatic. Individuals may experience fevers, dry cough, and difficulty breathing. While most individuals with COVID-19 may be able to recover at home, several are requiring hospitalization. If patients are hospitalized, they are placed into an isolation negative air flow room for …

Data Acquisition And Management Nur 570, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Techniques In Geospatial Analysis Nur 571, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Emerging Technologies In Gis Data Collection Nur 537, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Advanced Topics In Geospatial Visualization Nur 572, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Evaluation Of Pharmacist- Or Nurse-Driven Long-Acting Insulin Titration Protocol In Adult Primary Care Patients With Type 2 Diabetes, Ruth Manzi, Corinn Martineau, Carmine Laporta, Mary Muca, Samantha Marrier, Donald Medd, Jennifer Aronson

Journal of Maine Medical Center

INTRODUCTION

Studies have supported protocolized insulin titration to optimize insulin therapy. We implemented a long acting insulin titration (LAIT) protocol in a primary care setting to aid patients achieve optimal control of their diabetes. The purpose of the study was to evaluate the performance of the LAIT protocol.

METHODS

This retrospective analysis included patients ≥18 years with type 2 diabetes (T2D) and a hemoglobin A1c (A1C) >8% who were managed as outpatients at clinics within our health care system. We collected demographic and clinical data before and after a patient’s enrollment in the LAIT protocol. Our primary outcome measure was …

Infuse!_Volume 4_Number 1_2020, College Of Nursing

Infuse! College of Nursing Magazine

No abstract provided.

Guide Lines Vol. Ii, Issue 5 - July 2020, College Of Health And Human Services

GUIDE Lines

Periodic Newsletter of the Governors State University - University of Illinois, Chicago - Disparities Education Cancer research training and education project (The GUIDE Project).

Implementation Of A Central Line Bundle As A Quality Improvement Priority., H. Anthony Flood

Doctor of Nursing Practice Papers

Background: Central-line associated blood stream infections (CLABSI) are a major threat to patient morbidity and mortality. Kentucky Continue Care Hospital (KCCH), a long-term acute care hospital, experienced a significant increase in CLABSI in 2018; therefore, implementation of a central-line bundle to reduce CLABSI was identified as a quality improvement priority. Methods: This author used the Quality Improvement Model to plan, study, and evaluate the implementation of a central line bundle in KCCH following University of Louisville Institutional Review Board (ULIRB) approval, staff were educated on the new process and the audit tool using a self-study module over a 2-week period …

Breathing Easier: Indoor Air Quality Education Program., Sarah Kuner

Doctor of Nursing Practice Papers

Background: Exposure to indoor air pollutants increases the risk for poor health outcomes and health disparities among vulnerable groups such as children. The purpose of this evidence-based project was to implement an indoor air quality program that would: 1) improve caregiver awareness of indoor and outdoor environmental health exposures and 2) increase the intention to reduce exposures to indoor household pollutants. The target population included caregivers of preschool children, ages 3 to 5 years, who currently attend the Ohio Valley Education Cooperative. Methods: This project used a pre and post test study design that included two, virtual-learning modules that reviewed …

Current Recommendations For The Perioperative Management Of Patients On Buprenorphine: A Case Study, Coreen Tanner

Nurse Anesthesia Student Capstones

According to the US Department of Health and Human Services, more than 2 million Americans suffer from opioid use disorder (DHHS, 2020). Opioid maintenance therapy (OMT) for OUD has been shown to reduce the rates of inpatient hospitalization and overall opioid-related mortality (Quaye & Zhang, 2019). Buprenorphine is a partial mu receptor agonist and kappa receptor antagonist that is used frequently by patients on OMT. Beginning in 2010 annual prescriptions for buprenorphine products have increased dramatically (Lembke, Ottestad, & Schmiesing, 2019).

With the rising level of chronic pain and opioid use nationally, more and more patients taking buprenorphine are presenting …

Norepinephrine Use In Septic Patients Undergoing General Anesthesia, Lauren Reed

Nurse Anesthesia Student Capstones

Anesthesia providers are frequently confronted by the problem of caring for patients presenting with sepsis in the operating room. Sepsis is associated with high healthcare costs and a significant mortality rate despite advancements in the understanding of its complicated pathophysiology. The 2016 Surviving Sepsis Campaign recommends norepinephrine as the first-choice vasopressor in septic patients. Its mild beta-adrenergic effects, in addition to its alpha-adrenergic effects, make it an attractive agent for the vasoplegia and myocardial dysfunction associated with sepsis. Earlier achievement of adequate perfusion pressures, earlier lactate clearance, and higher in-hospital survival have all been associated with norepinephrine use in the …

Simulation To Reduce Medical Errors And Improve Patient Safety In Anesthesia, Matthew Leblanc

Nurse Anesthesia Student Capstones

Over the past two decades, simulation in medical education has been adopted by health education programs and established as a proven method of education for health care students and providers. Despite the addition of simulation to healthcare education, medical errors are ranked as the third leading cause of death in the United States. The purpose of this literature review is to investigate the translation of simulation education into increased patient safety and reduction of medical errors in anesthesia. Overall, the literature reviewed confirms that simulation can be used to reduce medical errors and improve patient safety. Additional correlational research between …

Dexmedetomidine Use And Various Techniques Of Administration To Reduce Emergence Delirium In Pediatric Surgical Patients Undergoing General Anesthesia With Volatile Agents, Sara K. Dusza

Nurse Anesthesia Student Capstones

This analysis of literature evaluated retrospective chart reviews and randomized controlled trials of school aged children undergoing surgical procedures necessitating general anesthesia with volatile inhalant anesthetic agents. These studies assessed and compared the efficacy of various routes and timing of administration of dexmedetomidine as a pre-medication to determine the most effective technique in reducing the incidence of postoperative emergence delirium (ED). ED presents as a transient, acute episode of delirium occurring during the transition from unconsciousness to complete wakefulness after general anesthesia with anesthetic gases. The results of this review suggested that pediatric patients treated with intranasal dexmedetomidine preoperatively experienced …

Treating Post-Dural Puncture Headaches: Sphenopalatine Block, Cosyntropin And Epidural Blood Patch, Amalia Zychowicz

Nurse Anesthesia Student Capstones

Post-dural puncture headache (PDPH) is a severe and debilitating complication that can occur following neuraxial anesthesia. Obstetric patients are at an increased risk for this complication due to their gender, young age, and widespread use of neuraxial anesthesia. A hallmark sign of PDPH is a postural headache that improves when lying down and worsens when sitting or standing. It requires prompt diagnosis and treatment due to its incapacitating effects. The gold-standard treatment for PDPH is an epidural blood patch (EBP). However, this is an invasive procedure with multiple contraindications and the potential for severe complications. Noninvasive, more conservative therapies such …