Nursing Commons^™

The Experience Of Non-English Speaking Hispanic Patients During Kidney Transplant Evaluation, Ana Ivette Merced-Castro

Walden Dissertations and Doctoral Studies

There has been an increase in the incidence of Hispanics being diagnosed with end stage renal disease (ESRD), which has evolved from the rise in type 2 diabetes and hypertension. However, Hispanics and African American people are less likely to receive kidney transplants than non-Hispanic White individuals, and many Hispanics referred for transplants often do not complete the evaluation process due to its complexities. The purpose of this qualitative narrative descriptive study, guided by the socioeconomic model, was to explore the lived experiences of non-English-speaking Hispanic patients during the kidney transplant evaluation process. Six participants were recruited for the individual …

Effect Of Clean Closing Trays In Enhanced Recovery After Surgery Protocol On Surgical Site Infection Rates In Colorectal Surgeries, Elizabeth Carlson, Shelli Bergeron, Scarlett B. Hao, Kristin Lemarbe, Nora Laban, Diana Lee, Bradley Krasnick, Harry Wasvary

Conference Presentation Abstracts

Reducing surgical site infections (SSIs) after colorectal surgeries remains a key quality improvement target. The summative effect of multiple pre-, intra-, and post-operative interventions bundled as part of Enhanced Recovery After Surgery (ERAS) programs have been shown to effectively reduce SSIs, however the individual impact of each intervention has not been well-studied. This study evaluates the impact of clean closing tray use on the rate of SSIs in colorectal surgeries.

What Is The Impact Of An Education Program Designed To Remove The Healthcare Professional As A Barrier To Care For The Transgender And Gender Diverse Community?, Richard D. Dansereau

Doctoral Projects

Healthcare disparities disproportionately affect transgender and gender-diverse (TGD) individuals, often due to implicit biases among healthcare providers. This study examines the impact of an educational intervention designed to address these biases and improve care for TGD patients. Using the Biased Care Model as a guiding framework, the intervention targeted three critical phases of bias: pre-visit assumptions, in-visit interactions, and post-visit decisions. Conducted in the intensive care unit of a mid-sized hospital in Northern California, the study employed a pretest-posttest quasi-experimental design involving multidisciplinary healthcare workers. Participants completed a modified Jefferson Scale of Empathy survey to assess changes in cognitive and …

Online Multimedia Education Effect On Breast Health Knowledge And Self-Efficacy, Brooke D. Hancock, Elizabeth Frankle, Jennifer Cera, Leeza Struwe, Mackenzie Koch

Doctor of Nursing Practice Projects: College of Nursing

Objective: To evaluate comprehension and retention of breast health and BSE by providing evidence-based education via a website. The researchers aimed to measure knowledge of breast health, self-efficacy of performing breast health promotion, and usability of the interventional website.

Design: A single group efficacy trial was used.

Setting: The study was conducted in two outpatient clinics in Nebraska that provided well women health care.

Participants: A convenience sample of 100 women were enrolled

Methods: Breast health knowledge was assessed with the Breast Health Assessment (BHA) and consisted of 3 subscales. The Champions Health Belief Model Scale (CHBM) assessed BSE self-efficacy …

Implementation Of An Adolescent Women’S Health And Wellness Education Program, Lauren Acker, Laynee Conner, Jennifer Cera

Doctor of Nursing Practice Projects: College of Nursing

Objectives: The goal of this research study was to provide scientific evidence supporting the importance and effectiveness of implementing a women’s health and wellness education course and its effect on (1) adolescent knowledge of sexual health and hygiene, (2) self-efficacy in menstrual management, and (3) self-empowerment in managing their own reproductive health.

Design: This was a mixed methods pilot study utilizing a pre/post-test single intervention efficacy trial. Quantitative and qualitative data were obtained.

Setting: The setting included two different sites including one outpatient ambulatory obstetrics/gynecology clinic and one community outreach center. Both sites were located within a midwestern metropolitan …

Covid-19 And Related Adverse Neurological Complications, Hannah A. Wasson

Honors Thesis

Abstract

The COVID-19 pandemic changed the world drastically, and its impact was monumental. COVID-19 or SARS-CoV-2, or severe acute respiratory syndrome, was the virus responsible for causing such mayhem. This contagious virus can enter the body via different routes, live on surfaces for hours, and be transmitted through the air, increasing infection risk. Once it enters the body, it can trick the body into replicating the virus. From this reaction within the body, signs and symptoms follow. While the name indicates a respiratory illness, the virus can inflict injury on other parts of the body. Due to the organ systems …

Evaluation Of An External Urinary Device Protocol And Practices In Hospitalized Female Patients: A Quality Improvement Project At A Rural Midwestern Hospital, Melissa Leibnitz, Ashley Causa, Susana Lopez

Doctor of Nursing Practice Projects: College of Nursing

Aims and Objectives- 1: Describe and measure current implementation and management practices of the PureWick™. 2: Describe and measure current outcomes in the use of the PureWick™ device including mobility scores, skin breakdown, Braden scores, moisture-associated dermatitis, CAUTIs, PAUTIs, hospital LOS, HAIs and HPIs. 3: Measure the survey results from staff regarding the current PureWick™ practices. 4: Propose recommendations for an improved EB protocol for the PureWick^TM.

Background: Currently, the PureWick^TM device has been utilized by facilities as an alternative to indwelling urinary catheters in an effort to reduce the incidence of CAUTI. Since the introduction …

Universal Adolescent Depression Screening And Implications For Identification Of Adolescent Depression And Mental Health Referrals, Cherry Cooper, Juan Zhou Powell

Doctor of Nursing Practice Projects: College of Nursing

Background: Throughout the United States, mental health concerns have been steadily increasing, which has created a significant impact for caregivers, overburdened healthcare facilities, and patients. In fact, a large number of those experiencing mental health issues are unidentified and thus more likely to experience mental health crises, suicidal ideation, or suicide attempts. Rural adolescents are significantly more vulnerable than their urban counterparts related to disparities in both mental health services and preventative screening. Coordination with a critical access hospital (CAH) emergency department revealed that there was no universal adolescent depression screening in place, and patients were potentially going undiagnosed and …

Program Evaluation Of The Behavioral Interventions Monitoring Assessment System-2 For High School Students In Rural Nebraska, Laura Burnett, Lakin Braman

Doctor of Nursing Practice Projects: College of Nursing

Behavioral and mental health issues among adolescents in rural areas often go unrecognized due to limited access to screening and intervention. This study evaluated the efficacy of the BIMAS- 2 tool in identifying at-risk high school students in a rural Nebraska high school. Methods: A retrospective cohort program evaluation was conducted over two years with 263 students in grades 9-12. The BIMAS-2 assessment was administered electronically each semester, followed by in-person mental health interviews. Descriptive statistics and Pearson chi-square tests assessed the tool’s sensitivity, specificity, and predictive value. Results: The BIMAS-2 demonstrated high sensitivity (100%) and specificity (96.15%), with a …

Enhancing Nurse Confidence In Labor Pain Management And Respectful Maternity Care Through Implementation Of The Coping With Labor Algorithm, Diane Johnson, Amy Murlowski

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to implement the Coping with Labor Algorithm in the labor and delivery setting and study its impact on nurse self-efficacy and on birthing persons’ experiences.

Design: A quasi-experimental pre- and post-design was used for this project.

Setting: The project was conducted in a maternity unit with six labor beds located in the Midwest.

Methods: This project was conducted over twelve weeks. Twenty-five registered nurses were provided in-person education, access to educational materials, and training on how to use the Coping with Labor Algorithm. A pre-test was administered before the unit implementation of the …

Yoga Therapy For Psychological Safety In Healthcare Staff, Kristen Fabiszewski

Doctoral Projects

Establishing a culture of psychological safety is a necessary foundation for creating a High Reliability Organization. Healthcare professionals must practice emotional self-regulation to maintain equanimity and facilitate positive communications with their colleagues. This can be exceptionally challenging when increasing numbers of healthcare professionals are experiencing burnout. Using the framework of Polyvagal Theory, yoga practices have been demonstrated to support emotional self-regulation and reduce symptoms of burnout. The purpose of this project was to implement yoga therapy to increase the perception of psychological safety in healthcare staff. Veterans Affairs Long Beach Healthcare System (VALBHS) staff invited to attend one 45minute yoga …

Knowledge, Skills, And Barriers To Palliative Care Referrals By Oncology Providers, Audra Meador, Bailey Waldron

Doctor of Nursing Practice Projects: College of Nursing

Palliative Care is an evidence based and integrative aspect of cancer care that has demonstrated improved quality of life and diminished symptomology, however, barriers to referrals exist. With the growing interest in and demand for specialized healthcare services, more research on integration and referral practices surrounding palliative care is necessary. This study aimed to explore the knowledge, attitudes, perceptions, and barriers to referring cancer patients to outpatient palliative care at a teaching and research hospital. In one cancer center, 50 physicians, Advance Practice Providers, and nurse case managers responded to an electronic survey regarding interest and support for palliative care …

A Virtual Wellness Program To Enhance Well-Being For Pediatric Oncology Staff During The Covid-19 Pandemic, Karen Moody, Maria Swartz, Zachary Gresham, Martha Askins, Laura Cahalan, Pavilia Francis, Christine Geistkemper, Amy Heaton, Ruitao Lin, Melissa Melo, Alakh Rajan, Madeline Smith, Priti Tewari, Keyana R. Williams, Cheng-Han Yang, Rhonda Robert

Advances in Cancer Education and Quality Improvement

In response to the COVID-19 global health crisis and mandated social isolation, Pediatric leadership at MD Anderson Children’s Cancer Hospital was concerned for the psychological impact on its workforce and encouraged wellness programming. A grassroots wellness taskforce was assembled for the Division of Pediatrics. The task force’s primary mission was to promote the well-being of clinicians and non-clinical staff members through a broadly accessible, sustainable, and effective virtual wellness program. Guided by the Stanford Model for Professional Fulfillment, a virtual program entitled, “Weekly Wellness Webex” for Pediatrics staff was launched. Weekly Wellness Webex is a 1-hour live-streamed program with varied …

Strengthening Addiction Recovery In Adults Through Mindfulness, Sara Christenson

Theses and Graduate Projects

Addiction is a significant health issue that affects millions of people. Individuals experiencing addiction face challenges in their everyday lives which often results in health issues, financial and/or legal issues, and broken relationships with family and friends. Additionally, there are often many barriers to seeking treatment which ultimately prevents recovery from substance use disorder. Throughout history, addiction has often been misunderstood, however, it is now recognized as a chronic illness that permanently changes the way the brain functions. Mindfulness is an intervention that promotes a nonjudgmental, nonreactive awareness that can strengthen the recovery process by acceptance of the craving response …

The Impact Of Motivational Interviewing On African-American Men With Type 2 Diabetes Mellitus, Jamekia Kitchens

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

African-American men with type 2 diabetes face an immense health disparity in the United States, with alarming mortality rates compared to their counterparts. This pilot study examined the impact of motivational interviewing on African-American Men with type 2 diabetes mellitus. The researcher conducted motivational interview sessions using the components of the Diabetes Management Self-Efficacy Scale to guide the meetings. Pre- and post-confidence levels and pre- and post-hemoglobin A1c levels were collected and analyzed. After the completion of three motivational interview sessions, participants displayed significantly higher self-efficacy scores with significantly decreased A1c levels. The results suggest that motivational interviewing has a …

Psychoeducational Training For Community Health Workers To Improve Confidence In Providing Mental Health Services To Migrants, Nimota M. Akintoye

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

There is a higher prevalence of mental health illnesses among migrants. This minority group is faced with challenges in accessing healthcare due to poverty, stigmatization, and fear of discrimination. Research has shown that community health workers (CHWs) bridge the gap between the health and social service sectors and the patients by improving patient access to care and healthcare outcomes. A translational project was implemented to evaluate how psychoeducational training improved the CHWs’ confidence and knowledge level in providing mental health support to the patients and community members. Sister Calista Roy’s Adaptation Model was used to guide the study by incorporating …

Hospital Organizations’ Obligation To Promote Spiritual Well-Being Among Nurses: Development Of A Normative Ethical Argument, Michael Jordan

Electronic Theses and Dissertations

This dissertation presents an innovative strategy to promote the support of nurses' spirituality within hospital organizations. By focusing on the spiritual well-being of nurses by hospital organizations, with a natural extension into nursing schools, the approach aims to enhance nurse’s ability to protect their own spirituality, provide comprehensive spiritual care to patients, and increase nurse moral resilience. By investing in nurses' spirituality and spiritual growth, hospitals can potentially increase job satisfaction among nursing staff, improve patient care outcomes, and create a more holistic healing environment for both nurses and patients. As the nursing shortage continues and the number of nurses …

Household Point-Of-Use Faucet Filters For Lead Removal: Field Performance And User Experiences, Jeannie M. Purchase, Chantaly Villalona, Adrienne Katner, Kelsey Pieper, Marc Edwards

School of Public Health Faculty Publications

Lead certified point of use (POU) faucet filters were field tested in two Louisiana cities in a total of 21 occupied homes during normal use and in two unoccupied homes with very high risk of water lead (Pb) contamination. In an unoccupied home with a 28 m lead service line (LSL) with average lead of 17 μg/L in flushed water, treatment by POU filters generally produced water with < 5 μg/L Pb even when tested to 200% of rated capacity. In the unoccupied home with a disturbed LSL, the water had erratic influent particulate lead of 9-3053 μg/L, and the POUs did not consistently produce water with < 10 μg/L Pb despite very high percentage removals. When testing POUs in occupied homes known to occasionally have lead over 5 μg/L, POUs always reduced lead to < 1 μg/L. In addition, POUs were also effectively removing high levels of iron and manganese present in the water of one city, but this also caused clogging before reaching half of their rated capacity. Laboratory experiments confirmed POU susceptibility to iron clogging.

Using Video Education To Improve Patient Knowledge Of Cellular Therapy Side Effects: Cytokine Release Syndrome, Neurological Toxicities, & Prolonged Pancytopenia, Leslie Bennett

Doctoral Projects

This project evaluated the effectiveness of short educational videos on CAR T-cell therapy, cytokine release syndrome, neurological toxicities, and prolonged pancytopenia for blood cancer patients. At Stanford Health Care in California, in the ambulatory clinic of Blood and Marrow Transplantation and Cellular Therapy (BMT-CT), we obtained a convenience sample of individuals with multiple myeloma or lymphoma preparing for CAR T-cell therapy. A pre-and post-questionnaire assessed the patients' knowledge of CAR T-cell therapy and its side effects. Wilcoxon signed-rank tests were used to determine changes in knowledge. Thirteen patients enrolled, eight completed post-surveys, and four watched the videos. The median knowledge …

School Nurses' Role In Creating A Culture Of Preparation For Cardiac Emergencies, Dena L. Hinkle, Marisa A. Dressler, Katherine M. Miller, Shannon L. Beetz

Nursing Department Graduate Presentations/Conferences

Recent legislation in Illinois schools has focused on enhancing cardiac preparation in schools by establishing written emergency plans that are to be disseminated to employees within thirty days from the start of the school year. This web-based education tool was created as a centralized hub for employees to locate pertinent information regarding cardiac emergencies. The intent is to increase cardiac emergency preparedness in schools with access to evidence-based resources and content. The project began by performing a literature review to collect data on cardiac emergencies within the school, leading to the development of the web-based educational portal. The Cognitive Theory …

Improving Staff Knowledge And Patient Care Outcomes Through Targeted Educational Interventions On Diabetes Management In Home Health Agencies, Chikita Domonique Smith

Walden Dissertations and Doctoral Studies

No abstract provided.

Policy To Decrease Attrition Rates Amongst Mental Health Nurses, Ashley E. Burnett

Doctor of Nursing Practice Final Project Abstract

The high attrition rate among mental health nurses in the United States presents a critical challenge, leading to increased operational costs, workforce shortages, and compromised patient care. This policy proposal seeks to address the issue of mental health nurse turnover by offering a structured approach to enhancing job contentment and dealing with stress factors within the workplace. In line with the purpose of the study, quantitative and qualitative data from workforce surveys, peer-reviewed literature, and policy evaluations are combined to determine common retention strategies. Findings indicate that mentorship programs, competitive salaries, flexible scheduling, and workplace support systems significantly reduce burnout …

Healthcare Provider Comfort Surrounding Adverse Childhood Events (Aces), Cameo Culcasi

Doctoral Projects

Adverse Childhood Experiences (ACEs) are strongly linked to long-term health outcomes, yet discussions around ACEs in clinical settings remain inconsistent. This study investigates the comfort levels of healthcare providers in addressing ACEs with their patients, identifying barriers and facilitators to such conversations. Using a Quasi-experimental, single group, pretest-post test experimental design, we surveyed a diverse group of physicians, nurse practitioners, and physician assistants working in a primary care setting, providing ACE training, and an opportunity for learning reflection. Preliminary results indicate that while most providers acknowledge the importance of discussing ACEs, many report discomfort due to time constraints, lack of …

Associations Between Tiktok Use And Undergraduate Nursing Professional Identity, Parker M. Watts

Honors Theses

Background. The global surge in social media usage prompts extensive research into its links with nursing professional identity. College-aged individuals who are in nursing school or are going to be in nursing school in the future must navigate their professional identity as they face heightened susceptibility to subjective opinions about the career of a nurse due to their frequent engagement with social media platforms. Among these platforms is that of TikTok, a platform of which has rapidly gained traction, especially among younger demographics. TikTok remains relatively underexplored in terms of its impact on nursing professional identity. This study seeks to …

Health Equity And Social Determinants Of Health Nurse Education, Jacqueline Arana Clements

Walden Dissertations and Doctoral Studies

The primary care setting provides integrated healthcare services where nurses address many healthcare needs, develop patient relationships, and practice in the context of family and community. To provide comprehensive care, nurses must complete a social determinants of health screening that addresses the social factors that impact clinical outcomes. In 2021, the National Academies of Sciences, Engineering, and Medicine published a nursing education strategy on educating nurses on social determinants of health. This project aimed to develop a staff education program to prepare primary care nurses on the concepts and terminology encompassing social determinants of health, identifying the severity of health …

Staff Education On Bias Awareness, Macbarbara Amaechi

Walden Dissertations and Doctoral Studies

The project was a staff education initiative focused on addressing a knowledge gap about bias for treatment of patients on controlled substances at the practice site. I aimed to fill this practice gap by developing an education program that delivered evidence-based methods to reduce bias. The practice-focused question was: Will a staff education project result in an increase in staff knowledge and awareness around implicit bias among patients who are taking controlled substances? The purpose of the project was to determine if a formal educational program could enhance the knowledge of the staff and decrease bias, which would lead to …

Staff Education To Standardize Handoff Communication Protocols: Enhancing Patient Safety, Delali Adjele Tetteh-Assiakoley

Walden Dissertations and Doctoral Studies

Summary This doctor of nursing practice (DNP) staff education project focused on providing a staff education program on standardized handoff communication protocols to enhance patient safety and communication efficiency and effectiveness of information exchange at the practicum site. The practice problem is the lack of consistency regarding handoff communication, which results in miscommunication, inefficiencies, and possible preventable patient harm. Under conditions of poor handoff communication, medical errors, delays in treatment, and adverse patient outcomes are well documented. The project sought to improve the nursing staff’s knowledge of standardized handoff tools through a structured education program guided by the following practice-focused …

Staff Education To Address Communication In Correctional Healthcare, Pamela Renee Bredy

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education initiative focused on enhancing staff knowledge of Situation Background Assessment Recommendations (SBAR) communication through structured educational intervention in correctional healthcare settings. The practice problem centered on significant deficiencies in standardized communication. The practice-focused question was, Will implementing staff education on SBAR communication increase staff knowledge and confidence? I aimed to enhance staff communication and knowledge through SBAR implementation using live sessions, hands-on practice, and reference materials.

Reducing Medical Supplies Waste By Managing Healthcare Resources In A Clinical Setting In The United States: Lessons Learned From The Covid-19 Pandemic, Chiatuogu Anna Ukaga

Walden Dissertations and Doctoral Studies

The gap in practice identified for my DNP capstone project is reducing medical supplies waste by managing healthcare resources in a clinic setting in the United States of America. The Organizational Change Process (OCP) Evaluation project assessed a tracking and exchange system to track the inventory of supplies used in different worksite clinics and their expiration dates. Knowledge of the expiration dates enabled exchange or shift to high-utilization areas before the supplies expired, thereby reducing waste, costs, and environmental pollution. The healthcare organization was a mix of ambulatory clinics and hospitals of varying scopes and sizes. The small clinics served …

Keep Me Upright, Joscelyn C. Zimmerman, Kamrie L. Peterson

Doctor of Nursing Practice Projects: College of Nursing

Background: As our society ages, falls have emerged as a leading cause of accidental injury and death globally, significantly impacting older adults’ quality of life (Matchar et al., 2017; WHO, 2021). The consequences of falls are profound, encompassing physical injuries, psychological distress, and substantial healthcare costs. In the U.S., Medicare spends approximately $31.3 billion annually on fall-related care (Gettel et al., 2020). These statistics underscore the need for standardized fall prevention strategies in primary care.

Purpose: This Doctor of Nursing Practice (DNP) project aimed to implement a standardized systems-level process change for fall risk screening and education during Medicare Annual …