Nursing Commons^™

Influence Of Depression And Interpersonal Support On Adherence To Antiretroviral Therapy Among People Living With Hiv, Jerry John Nutor, Akua O. Gyamerah, Robert Kaba Alhassan, Henry Ofori Duah, Rachel G.A. Thompson, Natalie Wilson, Orlando Harris, Jose Gutierrez, Thomas J. Hoffmann, Monica Getahun, Glenn-Milo Santos

College of Nursing Faculty Research and Publications

Background

Poor adherence and under-utilization of antiretroviral therapy (ART) services have been major setbacks to achieving 95-95-95 policy goals in Sub-Saharan Africa. Social support and mental health challenges may serve as barriers to accessing and adhering to ART but are under-studied in low-income countries. The purpose of this study was to examine the association of interpersonal support and depression scores with adherence to ART among persons living with HIV (PLWH) in the Volta region of Ghana.

Methods

We conducted a cross-sectional survey among 181 PLWH 18 years or older who receive care at an ART clinic between November 2021 and …

Carboplasty, A Minimally Invasive Procedure For Knee Osteoarthritis: Surgical Technique And Clinical Evidence, Antonio Madrazo-Ibarra, David A. Kolin, Tracey Hunter, Joseph A. Ogyaadu, Henry Ofori Duah, Henry O. Tutu, Anthony Bandoh, Prudence Nutsuklo, Kwadwo Boachie-Adjei, Kaitlin M. Carroll, Amoli Vad, Eric Zhao, Vijay B. Vad

College of Nursing Faculty Research and Publications

Knee osteoarthritis affects ~16% of adults in the world and is considered one of the most incapacitating diseases. Despite the advances in scientific knowledge and biological treatments in the field of orthopedics, available nonsurgical treatments for knee osteoarthritis are limited and still ineffective in delaying or stopping the progression of arthritis. Biologics such as platelet-rich plasma, bone marrow aspirate, and progenitor cells have emerged as potential treatments for osteoarthritis; however, the results are still not as expected. Carboplasty is a new treatment that involves the application of bone marrow aspirate into the bone-cartilage interface and intra-articularly, with the intention of …

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

The Factors Associated With Caesarean Section At A Rural Hospital In Southwestern Uganda: A Cross-Sectional Study, Lilian Nuwabaine, Mathius Amperiize, Patience Annet Nakalega

School of Nursing & Midwifery, East Africa

Background

Globally, the overall prevalence of caesarean section (CS) is estimated at 18.6%, with 27% in high-income countries and 6% in low- and middle-income countries. There is an increase in trends of CS in Uganda from 8.5% in 2012 to 11% in 2016. No studies have been carried out to account for the high rates of CS at Kisiizi Hospital in Uganda. This study determined the proportion and factors associated with CS delivery at a rural hospital in southwestern Uganda.

Methods

This was a cross-sectional study of 321 immediate postnatal women in a rural hospital in southwestern Uganda. A structured …

Association Between Early Prostacyclin Therapy And Extracorporeal Life Support Use In Patients With Congenital Diaphragmatic Hernia, Akila B Ramaraj, Samuel E Rice-Townsend, Carrie L Foster, Delphine Yung, Emma O Jackson, Ashley H Ebanks, Matthew T Harting, Rebecca A Stark, Congenital Diaphragmatic Hernia Study Group

Faculty, Staff and Student Publications

IMPORTANCE: Prostacyclin (PGI2) is a therapeutic option to treat congenital diaphragmatic hernia (CDH)-associated pulmonary hypertension in neonates. Its use may decrease the need for extracorporeal life support (ECLS).

OBJECTIVE: To evaluate the association of early PGI2 therapy with ECLS use and outcomes among patients with CDH.

DESIGN, SETTING, AND PARTICIPANTS: This was a cohort study from the CDH Study Group (CDHSG) registry of patients born from January 2007 to December 2019. Patients were from 88 different tertiary pediatric referral centers worldwide that contributed data to the CDHSG. Patients were included in the study if they were admitted within the first …

Mitigating Risks To Improve Hypertension Medication Adherence In A Medically Vulnerable Population, Donna Hales-Teat

Doctor of Nursing Practice Projects

This project assessed the effect of an evidence-based medication adherence intervention on adherence rates at a Northern Indiana clinic led by a sole nurse practitioner, receptionist, and continuous rotation of graduate nursing students from several nursing programs in the Northern Indiana area. Patient education and comprehension were poor in terms of understanding disease process, treatment options, and disease management that led to poor communication with the medical provider. The process and steps in which patients matriculate through was described by Johnson’s (2002) Medication Adherence Model (MAM) with concepts of purposeful action, pattern behavior, and feedback; these helped to construct, steer, …

Getting A Grip On Safewards: The Cross Impact Of Clinical Supervision And Safewards Model On Clinical Practice, Jennifer Hamilton, Amanda Cole, Richard Bostwick, Irene Ngune

Research outputs 2022 to 2026

The Safewards model is used across various mental health settings to reduce incidents of conflict and containment and its efficacy in reducing the use of seclusion and restraint, improving patients' experiences of care, and enhancing safety within clinical settings is well documented (Bowers, Journal of Psychiatric & Mental Health Nursing, 21, 2014, 499). However, there are barriers to successful implementation, including level of staff buy-in (Baumgardt et al., Frontiers in Psychiatry, 10, 2019, 340; Price et al., Mental Health Practice, 19, 2016, 14). This mixed-method study assessed the impact of adopting a Safewards model within a clinical supervision framework in …

Benefits Of Using An Upright Laboring Position As Compared To Supine In The Second Stage Of Labor And The Impact On The Use Of Assisted Devices, Chelsey Cook

Master of Science in Nursing Family Nurse Practitioner

Abstract: This paper explores the conclusion that women and their infants are at an increased risk for harm when assisted devices are used during the second stage of labor. Traditional practices involving a supine position during pushing have been associated with an elevated likelihood of assisted delivery, necessitating interventions such as forceps, vacuum extraction, or episiotomy. However, emerging evidence suggests that adopting an upright position during labor may help decrease the need for these interventions and positively impact maternal and fetal outcomes.

Although comprehensive research on this topic is limited, the available evidence supports the benefits of an upright position …

Fostering Resilience In Children Of United States Navy Seals Using A Social Media Platform, Riley Walker

Doctor of Nursing Practice Final Manuscripts

Background: Having resilience helps children overcome, cope, and manage stressors that they encounter throughout life and provides intrinsically protective factors to help a child thrive in the face of adversity.

Local problem: Children of United States Navy Sea, Air, and Land Operators (SEALs) face consistent stress as their parent is away from home more than 240 days per year doing high-risk training exercises.

Methods: Resilience education to mothers of children whose fathers are United States Navy SEALs delivered virtually on a social media platform. Pre- and post- intervention surveys using the Likert scale were conducted to measure the mothers’ understanding …

Nurse-Led Post Stroke Depression Screening (Psd) For Patients With Acute Stroke Using Patient Health Questionnaire-9 (Phq9), Stefan Panov

Doctor of Nursing Practice Final Manuscripts

Introduction: This Evidence-Based Practice Doctor of Nursing Practice project aimed to implement a nurse-led post-stroke depression (PSD) screening using Patient Health Queastionnaire-9 (PHQ-9) in a 12-bed progressive care neuro-stroke unit at a tertiary care hospital. The first goal of this project was to detect stroke patients at risk for depression who met specific inclusion criteria. The second goal was to provide depression education, initiate social work and medical referrals, and start pharmacological treatment to reduce the medical and socioeconomic burden associated with untreated PSD before discharge from the hospital.

Background: Globally, stroke is a prominent cause of death and disability. …

Wound Care For Unhoused Youth, Diana Altman, Monse Villasenor, Grace Fry, Maddy Johnson, Matthew Messenger

Nursing Leadership in Community Engagement Projects

Wound Care For Unhoused Youth

Introduction

We partnered with a non-profit organization designed to serve the unhoused youth, ages 18-25, who have a day program as well as an overnight shelter. They have 30 beds and reserve 20 of those beds for individuals who are “residents,” who commit to staying for several nights and work towards finding more permanent options. The other 10 beds are for individuals to use for a single night, but these are not always guaranteed, you must sign up to save a spot. The day program has various activities ranging from painting to resume workshops and …

Women’S Shelter Health Needs Assessment, Asmait Woldu, Kelly Dona, Anna Frediani, Andrea Herrejon-Duran

Nursing Leadership in Community Engagement Projects

Women’s Shelter Health Needs Assessment

Introduction

Homelessness is currently one of the biggest societal issues in the United States and evidence indicates it is increasing, particularly for women (McGeough et al., 2020). A group of nursing students from Seattle Pacific University teamed up with a women’s homeless shelter in a Metropolitan city. The agency provides shelter and warm meals as well as laundry, toiletries, bus tickets and more. But even with the resources that they do provide, the residents have other needs that are not fully met, particularly with regard to their health. This is due in large to a …

Self Management Programs And Its Effects On Blood Pressure, Thao Vo

Master of Science in Nursing Family Nurse Practitioner

No abstract provided.

Amniotic Fluid Embolism Diagnosis & Treatment Pathway, Jeremy May

Doctor of Nursing Practice Projects

Access to care in rural areas can prove difficult for any patient, but especially for the expecting mother. Healthcare providers in these rural settings often lack the staffing and experience to effectively recognize and treat rare obstetric emergencies. Amniotic fluid embolism (AFE) is a rare medical emergency that requires healthcare providers to rapidly diagnose, monitor, and treat the sequela of resulting symptoms in the obstetric patient. After a literature review, a teaching session was developed and implemented as part of the annual training for 20 nursing staff at a small 50-bed rural hospital in central California. An 8-question pre-test was …

Group-Based Interventions Using A Low-Fat Diabetes Diet To Improve Self-Efficacy And Hba1c Levels In African American Type 2 Diabetics, Linda Baker-Bynum

Doctor of Nursing Practice Projects

Background and Problem

Type two diabetes mellitus (T2DM) is a chronic medical condition of impaired glucose metabolism that has significantly impacted the health of Americans. According to Centers for Disease Control and Prevention (CDC), T2DM is the seventh leading cause of death making up over 270,000 deaths in 2017 (CDC, 2020a). There are noted disparities among African Americans who are disproportionately affected by T2DM more than Caucasians. African Americans account for 13% of the population in the United States of which 11.7% are diagnosed with T2DM as compared to Caucasians who make up 76.3% of the population of which 7.5% …

Resources To Promote Senior Independence, Amanda Anderson, Sheree Mae Cacal, Sophia Gallego, Madyson Grant, Lola Wallace

Nursing Leadership in Community Engagement Projects

Resources to Promote Senior Independence

Introduction

Our group of five students from Seattle Pacific University's Lydia Green nursing program assessed the community of an independent senior apartment complex that provides affordable housing for adults aged 65+ in the Seattle area run under Sustainable Housing for Ageless Generations (SHAG). This assignment is for our leadership project and occurred over an 8-week period. During this time, we applied the nursing process to assess, diagnose, plan, and implement an intervention specific to a population's needs. The community faced issues of resource access, exacerbated by the population's low income and age. Our focus was …

Supportive Resources For Unhoused Individuals & Families, Grace Felder, Jordyn Henson, Kial Neang, Nasha Phansangiam, Taylee Thain

Nursing Leadership in Community Engagement Projects

Introduction

Since 2016 King County’s unsheltered homeless individuals have increased by 24% and families experiencing homelessness have increased by 26% (National Alliance to End Homelessness, 2021). In the past 5 years, homelessness has risen by 10% in King County alone (NAEH, 2021). Our agency was an emergency family shelter located in King County that “ensures that no child sleeps outside by centering equity and opportunity for women and families” (Mary’s Place Seattle, n.d.-a). This facility has 5 other family center facilities that provide shelter and resources. Since 1999, our agency with its 6 facilities have aided thousands of women and …

Death Cafés As A Strategy To Foster Compassionate Communities: Contributions For Death And Grief Literacy

The International Journal of Ecopsychology (IJE)

The death-positive movement, the most recent manifestation of the death awareness movement, contends that modern society is suffering from a “death taboo” and that people should talk more openly about death. This movement is striving to shift the dialogue about (and place of) death and dying into community spaces. Death literacy is defined as a set of skills and knowledge enabling people to learn about, understand, and act on end-of-life and death-care options. People and groups with a high level of death literacy have a context-specific comprehension of the death system and can more easily adapt to it, becoming better …

Nurse Practitioner's Perspectives On Human Trafficking In The Emergency Department; A Narrative Inquiry, Ann Gerhart

Dissertations

Background: Human trafficking (HT) is a global and domestic concern that impacts individuals, families, and communities. Over the last ten years, HT has become a significant public health concern intersecting with the health care community in various settings. HT abuse and oppression have both short- and long-term health consequences. Approximately 50 to 88% of trafficked individuals visit a health care provider, and 63% of those visits are evaluated in the emergency department (ED). Nurse practitioners (NPs) working in the ED interact with HT individuals but have not been represented in recent research scholarship.

Purpose: The purpose of this qualitative …

A Pilot Project For Tuberculosis Education In College Students, Sarah Williams

Doctor of Nursing Practice Final Manuscripts

Background: San Diego’s Tuberculosis (TB) incidence is more than double the national rate. The majority of cases of active TB are due to the progression of latent TB infection (LTBI).

Objectives: This evidence-based practice (EBP) project aimed to increase knowledge, awareness, and improve attitudes and practices regarding TB among college students.

Participants: Twenty Community College Students in San Diego participated in the project.

Methods: Students attended an in-person educational session. A pre-post knowledge, attitudes and practices (KAP) questionnaire measured the impact.

Results: The intervention improved knowledge and attitudes. The average post-intervention TB knowledge score was 95.8% compared to 57% …

Exercise As A Prescription For Patients With Depressive Disorders: A Quality Improvement Project, Sydney Roscoe, Rachelle Pace

Doctor of Nursing Practice Final Manuscripts

Purpose: The aim of this Doctor of Nursing Practice project was to increase exercise counseling rates in the treatment of depression by (1) implementing a focused educational training program and (2) understanding factors that impacted utilization of the practice change.

Background: Approximately 280 million individuals suffer globally from depressive disorders. Depression remains the fourth leading cause of disabilities, significantly contributing toward the global burden of disease by increasing morbidity and mortality risk. Psychopharmacology and psychotherapy are current gold standards of treatment; however, providers often overlook the significant role exercise serves in reducing depressive symptoms and severity, as it remains underutilized. …

Measuring The Effectiveness Of Antidepressant Treatment By Implementing Beck's Depression Inventory (Bdi), Azeem Anjum

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project integrates a structured periodic depression evaluation follow-up protocol for patients diagnosed with Major Depressive Disorder who have been prescribed antidepressant(s) at an outpatient mental health clinic. The purpose of this DNP project is to standardize the method of treatment progression monitoring to improve the timeliness of change detection and subsequent treatment adjustments using the Beck Depression Inventory (BDI) Scale.

Background: According to the World Health Organization (WHO), MDD is one of the most common mental health conditions affecting approximately 280 million people globally and 17.5 million adults in the United States. (WHO, 2021). The economic …

Church-Based Hypertension Education: An Alternative Solution To Hypertension Management In The African American Community, Nicole Tofi Rice

Doctor of Nursing Practice Final Manuscripts

Purpose: The objective of this evidence-based project is to explore a church-based hypertension education program as an alternative solution to providing hypertension education to the African American community. The desired goals of this project are: (a) to assess the current levels of adherence to antihypertensive therapy among members of a local African American church, using the Hill-Bone Compliance to High Blood Pressure Therapy Scale, and (b) to conduct a literature review exploring policy options encouraging the implementation of a church-based hypertension education program.

Background: Despite medical advances aimed towards prevention and effective treatment, the African American community remains disproportionately affected …

Are You In Control Of Your Diabetes? Providing 1:1 Diabetic Self-Management Education To Adults With Type Ii Diabetes Mellitus In An Outpatient Clinic In An Underserved Community, Joe Gonzales

Doctor of Nursing Practice Final Manuscripts

Non-insulin-dependent diabetes mellitus (DM) is a complicated multisystem disease that accounts for over 20% of health care spending in the United States (Hildebrand et al., 2019). Uncontrolled DM can lead to heart disease, stroke, blindness, amputations, and peripheral artery disease. The literature supports the use of practice guidelines to improve patient outcomes with diabetes self-management education (DSME) and pharmacological interventions.

The purpose of this evidence-based project was to improve hemoglobin A1c (HgbA1c) levels by introducing the 2021 American Diabetes Association (ADA) Standards of Care guideline to improve diabetes self-management in a largely underserved adult Latino community. The intervention included a …

Improving Patient Self-Efficacy, Readiness, And Completion Of Advance Care Planning Documents Using Prepare Documents And Advance Care Planning Group Referral, Marie Vassiliadis

Doctor of Nursing Practice Final Manuscripts

Advance Care Planning (ACP) is an ongoing discussion about medical decision making between a provider, patient, and support person. ACP can also include legal documentation in the form of an advance directive (AD). Nationally, only 36.7% of adults complete any form of AD for end-of-life care. Recently, ACP has become an important quality metric that many organizations are prioritizing. The purpose of this evidence-based project is to improve ACP readiness, self-efficacy, and documentation among patients at an internal medicine clinic using the PREPARE program and referral to an ACP group meeting. PREPARE for Your Care is an online program aimed …

Managing Menopausal Symptoms Through Exercise And Dietary Changes, Ae Rah Kang

Doctor of Nursing Practice Final Manuscripts

Background: The most critical aging stage for women is the menopausal transition period, which causes various symptoms such as hot flashes, night sweats, sleeping disturbance, and mood swings that lower women's quality of life. Menopausal symptoms that are not managed can exacerbate severe medical conditions such as cardiovascular disease, bone illnesses, neurological diseases, and psychosocial problems. As the first non-pharmacological treatment for menopausal syndrome, several studies have shown that regular exercise and diet control can potentially improve menopausal symptoms and the quality of life.

Purpose: This project aimed to examine the effect of improving the quality of life by reducing …

Implementation Of An Evidenced Based Peripheral Artery Disease Screening Protocol In An Outpatient Internal Medicine Clinic, Sarah Lee Bolanos

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidenced based project was to implement an evidenced based peripheral artery disease screening protocol in an outpatient internal medicine clinic serving adult patients with multiple co-morbidities. This clinic inconsistently screened patients for PAD using the ankle-brachial index (ABI).

Methods: During a three-month period, 50 patients were screened using current American Heart Association and American College of Cardiology (AHA/ACC) screening guidelines for PAD using the Ankle-Brachial Index (ABI) and the Edinburgh Claudication Questionnaire (ECQ).

Results: Out of the 50 patients screened for PAD, only one patient (2%) had a normal ABI score (1.0-1.4) and was categorized …

Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar

Doctor of Nursing Practice Final Manuscripts

Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and …

Implementation Of The Columbia-Suicide Severity Rating Scale At An Outpatient Mental Health Practice To Increase Provider Confidence In Identifying Suicide Risk, Lauren Reed

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) as part of routine patient assessment at an outpatient mental health practice to increase the likelihood of identifying clients at risk for suicidal behavior and increase provider confidence in screening for suicidal behavior. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians, including psychiatric-mental health nurse practitioners, to provide mental health care to clients across the lifespan.

Background: Approximately 57% of individuals who die by suicide had at least one contact with …

Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante

Doctor of Nursing Practice Final Manuscripts

Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. In the United States, DS occurs in one out of every 700 births. Children with DS have an increased risk of developing serious health conditions. In the military health system, children with DS face many barriers such as frequent relocations and poor access to specialty care. Primary care providers (PCPs) do not consistently follow published guidelines for health supervision.

Purpose: This project aims to improve the care for pediatric patients with DS in the military health system by increasing the knowledge and confidence of PCPs.

Methodology: An educational program …