Challenges Experienced By Newly Qualified Nurse-Midwives Transitioning To Practice In Selected Midwifery Settings In Northern Malawi, Mathews Brave Mtegha, Elizabeth Chodzaza, Ellen Chirwa, Fatch Welcome Kalembo, Maggie Zgambo

Research outputs 2022 to 2026

Background: Literature shows that newly qualified nurse-midwives face challenges integrating into the workforce during their transition period from education to practice. However, little is known about the needs and challenges of Malawian nurse-midwives during their transition from education to practice. The aim of the study was to explore the transition experiences of newly qualified nurse-midwives working in selected midwifery units in Northern Malawi. Methodology: A qualitative descriptive approach was used. Data were collected through in-depth interviews using semi-structured interview guides from a purposive sample of 19 participants (13 newly qualified nurse-midwives and 6 key informants). The researchers developed two interview …

The Discovery Of Data-Driven Temporal Dietary Patterns And A Validation Of Their Description Using Energy And Time Cut-Offs, Luotao Lin, Jiaqi Guo, Yitao Li, Saul Gelfand, Edward Delp, Anindya Bhadra, Elizabeth Richards, Erin Hennessy, Heather A. Eicher-Miller

School of Nursing Faculty Publications

Objectives

Data-driven methods were recently applied to create temporal dietary patterns (TDPs) incorporating timing and amount of energy intake over 24-hours; their relationships to obesity were determined. However, description of the data-driven TDPs using energy and time cut-offs were not validated against obesity. Aims were to (1) create data-driven TDPs, describe pattern characteristics using energy and time cut-offs, and determine relationships to BMI and waist circumference (WC); (2) assess the concurrent validity of TDPs derived using the cut-offs by determining relationships with BMI and WC. Methods

Amount and timing of energy intake from the first day 24-hour dietary recall of …

The Lived Experiences Of Middle Eastern Immigrant Women During Their Cancer Survivorship Journey: A Phenomenological Study, Enam Alsrayheen, Khaldoun Aldiabat, Catherine Aquino-Russell

The Qualitative Report

The number of Middle Eastern immigrant women (MEIW) living in Canada has significantly increased. However, this group of women is underrepresented in health research and there is a gap in knowledge of their cancer survivorship experiences in Canada. This phenomenological qualitative approach was employed to uncover the meaning of the lived experiences of MEIW during their cancer survivorship journey (CSJ). Data were collected through unstructured interviews and one written description from three MEIW. The participants' perspectives of cancer risk factors were believed to be the cause of their cancer, and their CSJ was fear-inducing and anxiety-provoking. There appears to be …

Implementing A Courtesy Call System To Increase Patient Satisfaction, Tessa Garcia

Master's Projects and Capstones

Abstract

Problem: An assessment of a home health microsystem found a decrease of patient satisfaction using Home Health Consumer of Healthcare Providers and Systems (HHCAHPS) survey scoring. Low HHCAHPS scores equivalate to poor quality care, which has a negative impact on patients and the organization itself.

Context: The setting for this project was a home health department microsystem in Northern, California serving a 400-patient population. The project was implemented within the quality department of the home health organization.

Interventions: Evidence shows that implementation of a courtesy call check-in improves satisfaction and patient outcomes. A courtesy call check-in was implemented to …

Exploring The Self-Care Practices And Needs Of Entry-Level Nursing Students: A Pilot Project, Nancy Armstrong, Kristin M. Reid, Dana Todd

Faculty & Staff Research and Creative Activity

Self-care is often lacking in nursing students worldwide. The objectives for this study were to discover the current self-care practices of one group of entry level undergraduate nursing students, the students’ understanding of self-care, and the students’ preferences for self-care interventions aimed at improving self-care. Quantitative and quantitative measures were used to measure the students’ current self-care practices, needs, and recommendations for interventions to be used in future semesters to improve nursing student self-care. The students were found to generally be deficient in areas related to nutrition, obtaining healthcare information or guidance, pacing themselves to avoid exhaustion, and performing relaxation …

Implementing And Evaluating A Mentorship Program For New Graduate Nurses In A Medical-Surgical Unit: A Quality Improvement Pilot, Nicholas Dull, Jennifer Jakobe, Carol Reichel, Sonja Meiers

Nursing DNP Projects

The purpose of this quality improvement project was to pilot and test the acceptability of implementing an eight-week voluntary evidence-based mentorship program for new graduate nurses within a medical-surgical unit. This project was guided by the Iowa Model of Evidence-Based Practice and an adaptation of the Academy of Medical Surgical Nurses Mentoring Program. Nurse leaders may want to consider creative ways to incentivize mentees and involve them in tailoring mentoring programs during the final phases of the orientation program.

Pandas: How To Recognize And Intervene, Trevor Brackney, Blaine Winters

Student Works

This research paper delves into pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS). PANDAS causes rapid psychiatric changes in children ages 3 to puberty. These changes are most often obsessive-compulsive disorder (OCD) and/or tics, however, anxiety, agitation, mood disorder, depression, oppositional defiance disorder, attention-deficit hyperactivity disorder, hallucinations, memory/cognitive deficits, enuresis, and sleep disturbances have also been noted. Present-day estimations of PANDAS cases would likely prove to be understated if awareness of PANDAS increased (Centner, 2021). The purpose of this paper is to disseminate awareness and data of a disease that has gone relatively unnoticed in American medicine since being defined …

The Overlooked Mission-Transitional Care Programs For Veterans In Civilian Settings: An Integrative Review, Cynthia Louise Gonzales

Doctoral Dissertations and Projects

The number of veterans within the United States continues to increase. With the addition of healthcare laws, veterans can seek care within the Veterans Health Administration (VHA) and civilian settings. The collaboration among multiple healthcare providers must ensure veterans are provided safe and efficient care when transitioning from provider to provider. Transitional care programs (TCPs) are effective strategies to ensure that veterans receive safe and efficient healthcare. The VHA employs interventions across their healthcare settings to facilitate optimal care. A variety of TCPs were discovered during the review. Most TCPs were used in VHA settings, which revealed an opportunity to …

An Icu-Specific Pressure Injury Risk Assessment Tool To Improve Outcomes, Solange Flore Kamdem

Doctoral Dissertations and Projects

Aim: To use an ICU-specific pressure injury (PI) risk assessment scale to promptly identify the risk for PIs in critically ill patients and promptly implement the appropriate PI prevention interventions to decrease the incidence rate of pressure injuries over 11 weeks.

Background: The risk of developing PIs is 3.8 times higher in the ICU patients than in other patient populations. The state of illness and or treatments increase their odds of developing hospital-acquired pressure injuries (HAPIs). The Braden scale currently in use may not identify the risk early enough to provide preventive interventions. An ICU-specific tool is needed to screen …

The Impact Of Increased Interdisciplinary Communication On Hospital Admission Rates In The Geriatric Population: An Integrative Review, Molly K. Langston

Doctoral Dissertations and Projects

The medical complexity of geriatric residents puts them at an increased risk of hospital readmissions related to coronary artery disease, myocardial infarction, chronic obstructive pulmonary disease, and diabetes, along with other chronic diseases. Geriatric residents of assisted living, skilled nursing, and memory care facilities should hold a particular interest to stakeholders, as the simple intervention of increasing early communication and correspondence regarding chronic diseases can have a great impact on quality improvement outcomes as well as financial burden of the institution. Additionally, interdisciplinary communication can be individualized to meet the needs of each geriatric resident in order to reduce the …

Advancing Treatment For Opioid Use Disorder In A Rural Emergency Department, Jill M. Wabbel

Doctor of Nursing Practice (DNP) Projects

Background: The opioid epidemic escalated in the United States due to the availability of prescription opioids, heroin, and synthetic opioids like fentanyl. Unfortunately, access to treatment is not always accessible, especially in rural communities with limited resources.

Local Problem: Tehama County is a rural county in northern California with limited access to treatment for opioid use disorder. The local Emergency Department (ED) and primary care-based Medication-Assisted Treatment (MAT) clinic collaborated to increase access. However, services remain under-actualized due to limited understanding of MAT best practices, stigma related to substance use within the ED culture, and poor articulation between the ED …

Impact Of Self-Care Techniques On Nurse Burnout, Macie Mayrell

MSN Capstone Projects

Nurse burnout is a serious, widespread problem in the healthcare arena. Registered nurses need to understand the importance of self-care to prevent or alleviate nurse burnout. An Evidence-Based Practice Benchmark Study implements a relaxation room on a nursing unit to encourage and promote self-care among acute care nurses.

Improving Donor Bank Milk Administration Workflow In The Neonatal Intensive Care Unit, Davelyn M. Moffit

Master's Projects and Capstones

_Abstract

Problem: Improvement in the donor bank milk (DBM) administration workflows is required to reduce documentation errors and discrepancies. Increased awareness of errors and their impact on quality, safety, and risk management is imperative to optimize clinical, operational, and financial outcomes, as well as a hospital’s reputation.

Context: Research shows human milk is beneficial to the growth of premature and medically-diagnosed term infants. Regulatory agencies recommend standards and guidelines to handle human milk and to monitor compliance and safety practices of healthcare organizations.

Intervention: An audit tool and process map were created to internally monitor the current process for DBM …

Critical Access Hospital Nurses' Qualitative Reports Of Major Obstacles In End-Of-Life Care, Con K. Newman

Theses and Dissertations

Background: Critical Care Nurses have previously noted obstacles in caring for dying patients. Obstacles noted by nurses working in more urban settings have been reported. What is not known is the obstacles to providing end-of-life (EOL) care as perceived by nurses working in Critical Access Hospitals (CAHs). Objective: To determine the stories/experiences related to obstacles in providing EOL care as reported by nurses working in CAHs. Methods: This was an exploratory, cross-sectional study. Previous quantitative data has been reported. Documentation of the qualitative stories/experiences of nurses working in CAHs related to obstacles to providing EOL care for dying patients and …

The Global Network Socioeconomic Status Index As A Predictor Of Stillbirths, Perinatal Mortality, And Neonatal Mortality In Rural Communities In Low And Lower Middle Income Country Sites Of The Global Network For Women's And Children's Health Research, Archana B. Patel, Carla M. Bann, Cherryl S. Kolhe, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sarah Saleem

Community Health Sciences

Background: Globally, socioeconomic status (SES) is an important health determinant across a range of health conditions and diseases. However, measuring SES within low- and middle-income countries (LMICs) can be particularly challenging given the variation and diversity of LMIC populations.
Objective: The current study investigates whether maternal SES as assessed by the newly developed Global Network-SES Index is associated with pregnancy outcomes (stillbirths, perinatal mortality, and neonatal mortality) in six LMICs: Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan, and Zambia.
Methods: The analysis included data from 87,923 women enrolled in the Maternal and Newborn Health Registry of the NICHD-funded …

Teaching Time: Postoperative Urinary Catheter Care In The Preoperative Setting Before Surgery, Lynn Utecht

Master's Projects and Capstones

Abstract

Problem: Patients who have same day surgery often have little or no recall of the postoperative home care instructions when delivered in the aftercare area. The number of instructions that are required for home care, combined with medications given for pain and nausea as well as anesthesia, can make recall of these instructions difficult. The purpose of this quality improvement project was to provide the postoperative instructions for post prostatectomy patients discharged with an indwelling urinary catheter in the pre-operative area before the patient underwent surgery to decrease the length of time the patient spent in the recovery unit. …

Environmental And Occupational Health Risks: Educating Undergraduate Student Nurses For Best Practice, Dorinda A. Mercado

DNP Qualifying Manuscripts

The environments we inhabit, whether homes, schools, workplaces, or the communities that envelop them, are replete with ubiquitous health risks that we routinely ignore to avoid analysis paralysis from worries. Environmental risks are hidden in food, drink, household and personal care products, furniture, and building materials; chemical hazards and physical residues of modern living contaminate air, water, and soil. Occupational hazards are prevalent in workplaces as diverse as agriculture, highways, and hospitals. A recent study by the Centers for Disease Control and Prevention (2022) found that out of 2,310 urine samples taken from a group of Americans from the United …

Trends In Health Outcomes Before And After Long Term Care Federal Regulations Limited Antipsychotic Medication Use: A Secondary Data Analysis, Karen Robson

Electronic Theses and Dissertations

Trends in resident falls did not significantly change, although trends in serious injury from falls declined ten years after regulations restricted antipsychotic medications in long-term care facilities. Trends in functional and continence status worsened after the regulations were implemented.

The Purple Heart And Suicidal Behaviors In Post-9/11 U.S. Army Combat Veterans With A Traumatic Brain Injury: A Mixed Methods Study, Jayna Moceri-Brooks

Electronic Theses and Dissertations

Military suicide rates remain high, despite years of targeted efforts to prevent suicide. Specifically, Army Combat Veterans who sustained a traumatic brain injury (TBI) while deployed in support of the Global War on Terrorism are at the highest risk for suicide. This dissertation highlights possible causes for suicidal behaviors within this unique group and provides specific military suicide prevention recommendations. The dissertation is organized into three publishable manuscripts: The first manuscript (Chapter 1) is a mixed-methods dissertation research proposal written according to the National Institute of Health proposal guidelines. The second manuscript (Chapter 2) is an integrative review of the …

Determinants Of Reproductive Freedom Among Israeli Women Ages 18-50: A Mixed Methods Study, Abby Kra-Friedman

Electronic Theses and Dissertations

Introduction: Reproductive freedom is a social determinant of health (SDOH) that reduces health disparities and increases health equity. Through the National Health Insurance Plan, Israeli women can access a range of contraceptive methods. Scant data on Israeli women limits development of policies and interventions to meet international benchmarks for reproductive freedom. The purpose of this dissertation study is to synthesize current international multidisciplinary literature using the capability approach for reproductive freedom, explore determinants of reproductive freedom among Israeli women ages 18-50 using Nussbaum's capability approach, and make recommendations for nursing research, practice, and theory.

Methodology: Using Whittemore and …

The Eat Sleep Console Approach: An Evaluation Of Impact, Outcomes And Continuation Of Care, Stefanie Disilvio

Doctor of Nursing Practice (DNP) Manuscripts

Neonatal Opioid Withdrawal Syndrome (NOWS), a subgroup of Neonatal Abstinence Syndrome (NAS), is a constellation of postnatal symptoms that occurs due to the abrupt cessation of intrauterine opioid exposure. Historically, these infants have been evaluated and treated by the Finnegan Neonatal Abstinence Scoring Tool (FNAST) (Appendix A). Recent evidence supports the use of the Eat Sleep Console Approach (ESC) (Appendix B) as an alternative to the FNAST. The ESC model focuses on the comfort and care of these infants by maximizing nonpharmacologic methods and increasing family involvement in the treatment of their infant. The purpose of this project was to …

Improving Measurements And Self-Management Skills Of Cardiovascular Disease By Incorporating A Healthy Lifestyle In Hispanic Adults: A Promotoras Led Program, Kelly Llewellyn

Doctor of Nursing Practice (DNP) Manuscripts

Hispanic community members face unique challenges related to language barriers, culture, access to care, and trust in healthcare providers. Hispanic community members have a higher incidence of cardiovascular diseases and diabetes than their non-Hispanic counterparts. Hispanic males were most likely to die of cardiovascular disease in 2017 (CDC, n.d.a), and for females, death from cardiovascular disease was only second to cancer (CDC, n.d.b.). Hispanics are 70% more likely to be diagnosed with diabetes than non-Hispanics (Office of Minority Health, nd.) Promotoras are trusted members of the Hispanic community who can assist healthcare providers in providing disease prevention education and self-management …

Enhancing Elementary School Educators And Staffs Behavioral Classroom Management Strategies To Support Children Affected By Trauma Through Utilization Of Trauma-Informed Care (Tic) And Social-Emotional Learning (Sel) Modalities: A Quality Improvement Project, Kerstin Burt

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background: The fundamental ACE study asked more than 17,000 adults about their childhood trauma exposure and how it has impacted their health as an adult. The study found a link between ACE exposure and a higher likelihood of experiencing adverse emotional and physical outcomes (Felitti et al., 1998).

Problem: Educators and staff encounter children affected by trauma and are untrained in trauma-informed care approaches, known as the “Four R’s” (SAMHSA, 2014b).

Purpose: This quality improvement (Q.I.) project aimed to respond to the trauma-informed care (TIC) and social-emotional learning (SEL) gaps among educators and staff at a private elementary school …

Program Evaluation Of A New Initiative In An Interdisciplinary Pediatric Concussion Clinic: Active Rehabilitation Following Sports Concussion, Kelly Gettig

Doctor of Nursing Practice (DNP) Manuscripts

Mild traumatic brain injury (mTBI) or concussion is a growing public health concern in adolescents, and early interventions should target persistent symptoms that can impact learning, behavior, and emotions. The past decade has brought increased awareness, identification, and reporting of concussion and an accompanying explosion of quality research on the management of concussion. The overwhelming theme that has emerged is active rehabilitation which challenges the long-standing recommendation of rest and restriction.

This comprehensive program evaluation has focused on a new initiative in a pediatric interdisciplinary brain injury clinic, including an analysis of the impact of active rehabilitation on athlete concussion …

Cultural Care Needs Of Spanish Speaking Parents With Limited English Proficiency Whose Children Are Hospitalized: An Ethnonursing Study, Jennifer Stephen

Electronic Theses and Dissertations

Purpose: Parents’ inability to speak English proficiently is associated with communication barriers in the care process of their children, social determinants of health, and poor child health outcomes. Research exploring perspectives of Spanish speaking parents with limited English proficiency (SSP-LEP) whose children are hospitalized in the context of culture is lacking in the literature. The purpose of this study was to explore the cultural experiences, values, and beliefs of SSP-LEP, of Mexican origin, whose children were hospitalized and understand nurses’ role in providing culturally congruent care.

Design and Methods: Leininger’s qualitative, ethnonursing method was used for this study. The Theory …

Exploring Cultural Values, Beliefs, And Perceptions Of Human Papillomavirus Vaccine Acceptance In African American Men, Rashida Henderson

Electronic Theses and Dissertations

Introduction: African American (AA) /Black men have a higher rate of anal and rectal HPV-associated cancer, which the HPV vaccine can prevent. Purpose: This study aimed to understand the cultural values, perceptions, and beliefs of the HPV vaccine in African American/Black Men. Method: Through a focused ethnography, a semi-structured guide was utilized to interview 24 AA men. Inclusion criteria included identifying as AA/Black, aged 18-30 years, born and living in the United States, identify and born as male, and able to understand, read, and write English. Results: Through Leininger’s Four Phases of Analysis, three themes emerged: 1) lack of knowledge …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Is Trauma Informed Care Practiced In Public Std Clinics In New York State, Antonia Brewer

Electronic Theses and Dissertations

Introduction: Sexually transmitted diseases (STDs) are increasing in the United States and often result in long-term adverse health outcomes. New York State (NYS) local health departments (LHDs) provide public STD clinics for high risk populations also found to have high rates of violence. This study examined if/how trauma informed care (TIC) is implemented in these settings. The study sample were LHD STD Program Directors in NYS.

Method: A convergent parallel mixed methods study design was used which included an online survey and follow up interviews. Survey data were analyzed using univariate statistics and conventional content analysis was used to analyze …

Hospital Nursing Factors Associated With Decreased Odds Of Mortality In Older Adult Medicare Surgical Patients With Depression, Aparna Kumar, Douglas Sloane, Linda Aiken, Matthew Mchugh

College of Nursing Faculty Papers & Presentations

Background: Depression is common, costly, and has deleterious effects in older adult surgical patients. Little research exists examining older adult surgical patient outcomes and depression and the potential for nursing factors to affect these outcomes. The purpose of this study was to determine the relationship between hospital nursing resources, 30-day mortality; and the impact of depression on this relationship.

Methods: This was a retrospective cohort study employing a national nurse survey, hospital data, and Medicare claims data from 2006-2007. The sample included: 296,561 older adult patients, aged 65-90, who had general, orthopedic, or vascular surgery in acute care general hospitals …

Implementing A Clinical Decision Algorithm To Improve Fluid Resuscitation In Sepsis, Teresa Wavra

2022 Southern California Nursing Research Conference

Stabilizing hemodynamics using intravenous fluid and vasopressor support are essential therapies used to restore tissue perfusion in patients with sepsis. The project site noted poor compliance with the Surviving Sepsis Campaign recommendations for fluid resuscitation and vasopressor support in patients with refractory hypotension. The purpose of this quality improvement project was to determine if or to what degree the implementation of Douglas et al.’s clinical decision algorithm to guide fluid resuscitation impacted the number of patients who required mechanical ventilation when compared to current practice among adult patients with sepsis hypotension and shock in a community hospital in urban California …