Nursing Commons^™

Exploring The Use Of Telehealth In A School-Based Health Center, Kourtney Chapman, Mia Rhodes, Jordan Smith

Doctor of Nursing Practice Projects

The benefits of remote telehealth assessment kits and their use in school-based settings were explored in this Quality Improvement project. The primary goal was to examine rural school-based settings and explore options to fulfill healthcare care gaps. A secondary objective was to explore telehealth systems and identify one that provided thorough diagnostic evaluation abilities. A tertiary objective was to educate potential users of the identified system and assess the perceived ease of use and practicality. A cohort of 58 doctoral candidates and 11 staff members from a local school district were educated on the advantages of using telehealth and received …

Hepatitis C Screening, Confirmation, And Referral Improvement Project, Maria E. Mcmahon

Doctor of Nursing Practice Scholarly Projects

Hepatitis C is an illness caused by the blood-borne Hepatitis C virus (HCV), and usually becomes a chronic condition. Left untreated, HCV can lead to severe liver disease and liver failure. Newer treatments are effective and well tolerated, but most people with chronic HCV are not accessing treatment due to several factors that will be discussed. The primary objectives of this quality improvement project were to improve the treatment cascade, provide education to providers and patients, and facilitate screening, virus confirmation, and referral to treatment, in a Federally Qualified Health Center.

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Childhood Obesity Within The Lens Of Racism, Nancy T. Browne, Eric A. Hodges, Leigh Small, Julia A. Snethen, Marilyn Frenn, Sharon Y. Irving, Bonnie Gance-Cleveland, Cindy Smith Greenberg

College of Nursing Faculty Research and Publications

Despite decades of research and a multitude of prevention and treatment efforts, childhood obesity in the United States continues to affect nearly 1 in 5 (19.3%) children, with significantly higher rates among Black, Indigenous, and People of Colour communities. This narrative review presents social foundations of structural racism that exacerbate inequity and disparity in the context of childhood obesity. The National Institute of Minority Health and Health Disparities' Research Framework guides the explication of structurally racist mechanisms that influence health disparities and contribute to childhood obesity: biologic and genetic, health behaviours, chronic toxic stress, the built environment, race and cultural …

Beliefs About Safe Traffic Behaviors Among Male High School Students In Hamadan, Iran: A Qualitative Study Based On The Theory Of Planned Behavior, Vahid Ranaei, Alireza Sahab Jahanlu, Laleh Hassani, Ghodratollah Roshanaei, Kristin Haglund, Jagnoor Jagnoor, Forouzan Rezapur Shahkolaei

College of Nursing Faculty Research and Publications

Road traffic injuries are public health challenges with heavy economic and social burdens. Road traffic injuries are common in developing countries and occur disproportionately with adolescents. This study aimed to elicit beliefs about traffic behaviors based on the theory of planned behavior among male high school students in Hamadan, Iran. We used a constructivist-interpretive qualitative design with directional content analysis. Interviews were conducted with 19 adolescent males in Hamadan, Iran. Analysis revealed that theory of planned behavior fit well to explain how perceptions, attitudes, and beliefs influenced traffic behaviors. Perceived subjective norms in the forms of parental encouragement, traffic rules …

More Than A Meme: The Dunning-Kruger Effect As An Opportunity For Positive Change In Nursing Education, Cynthia Sherraden Bradley, Kristina Dreifuerst, Brandon Kyle Johnson, Ann Loomis

College of Nursing Faculty Research and Publications

The Dunning–Kruger Effect (DKE) describes the cognitive bias in which novices tend to overestimate performance or competence while experts tend to underestimate. Those who are lacking in competence do not have the skills to accurately recognize deficient performance. Subjective assessment is used widely in simulation learning and in nursing curricula, yet often without expert feedback and reflective discussions, which can result in mistakes being overlooked and encoded, which could subsequently result in clinical errors. The prevalence of DKE should not be interpreted solely as a deprecation of the use of subjective measures, but rather as an indicator of the need …

Economic Impression Of On-Farm Research For Sustainable Crop Production, Milk Yield, And Livelihood Options In Semi-Arid Regions Of Central India, Sunil Kumar, Purushottam Sharma, Prabhu Govindasamy, Maharaj Singh, Sant Kumar, Hanamant M. Halli, Bishwa Bhaskar Choudhary, Muthukumar Bagavathiannan

College of Nursing Faculty Research and Publications

Farming system research (FSR) is on-farm research that brings cutting-edge agricultural technologies to growers to enhance farm production, family income, and livelihood status. In 2007, an on-farm study was started on FSR in central India, and the effect was assessed after 5 yr (2012–2013) of implementation by comparing adopters and nonadopters of FSR-based promoted technologies. Further, in 2018–2019, the status of adoption of introduced technologies was also assessed. The study revealed that improved practices such as pre-sowing irrigation, high-yielding varieties, and crop protection measures collectively improved the system productivity of the adopters by 28%; the improved productivity was mainly due …

Helping Nurses Identify And Report Sentinel Injuries Of Child Abuse In Infants, Elizabeth Cleek, Joan P. Totka, Lynn K. Sheets, Joshua P. Mersky, Kristin Haglund

College of Nursing Faculty Research and Publications

Sentinel injuries (SIs) are some of the earliest and most readily identifiable red flags of child abuse. SIs are unexpected bruising or intra-oral injuries in pre-mobile infants and highly correlated with child abuse. However, SIs are not always recognized and reported as red flags of child abuse. Infants are left at risk for continued harm when SIs are not identified and reported. Although increasing nurses' knowledge of SIs is important, child abuse researchers and behavioral theorists have identified that knowledge alone does not predict nurses' behaviors when identifying and reporting suspected child abuse. Other predictors may include implicit biases, interpersonal …

A Cohort Comparison Study On Women In Threatened Preterm Labor Given Nifedipine Or Nifedipine And Salbutamol Tocolysis In Air Medical Retrieval, Breeanna Spring Walsh, Fergus W. Gardiner, Dianne Bloxsome, David Ford, Brennen W. Mills, Simon M. Laws

Research outputs 2022 to 2026

Objective: Women with threatened preterm labor in remote Australia often require tocolysis in the prevention of in-flight birth during air medical retrieval. However, debate exists over the tocolytic choice. Methods: A retrospective analysis was undertaken on data containing women who required air medical retrieval for threatened preterm labor within Western Australia between the years 2013 and 2018. Results: A total number of 236 air medical retrievals were deemed suitable for inclusion; 141 received nifedipine, and 95 women received salbutamol + nifedipine. Tocolytic efficaciousness was reported in 151 cases, proportionally more (P < .05) from the women who received salbutamol + nifedipine (n = 68, 71.6%) compared with the women who received nifedipine only (n = 83, 58.9%). Those receiving salbutamol + nifedipine were more likely to suffer maternal tachycardia (n = 87 [91.6%] vs. n = 62 [44.0%]), fetal tachycardia (n = 26 [27.4%] vs. n = 13 [9.2%]), nausea (n = 17 [17.9] vs. n = 5 [3.55%]), and vomiting (n = 12 [12.6%] vs. n = 2 [1.4%]). Three women who received salbutamol + nifedipine had serious side effects including echocardiographic changes, chest pain, and metabolic and lactic acidosis. Conclusion: Salbutamol + nifedipine tocolysis was proven to be more effective than nifedipine only. Although salbutamol + nifedipine had increased temporary side effects, most were nonsevere and managed in-flight.

Knowledge Of The Effect Of Synthetic Proteins On The Overall Health In Lebanese Adults: A Cross-Sectional Study, Zeina Al Shoufi, Alaa Al Bardan, Ahmad Shishnieh, Rami Asaad, Hiba Deek

BAU Journal - Health and Wellbeing

The aim of the study was to assess the knowledge of gym attendees on the effects of protein shakes on their health. A descriptive cross-sectional study involving a self-administered questionnaire was undertaken. Data were collected through a self-administered questionnaire in two ways. First method was googled form links which was sent out to acquaintances on social media (WhatsApp, Facebook, Instagram and Twitter) in both English and Arabic language. In addition, questionnaire was printed and distributed to four different gyms in Beirut. The coaches of the gyms took charge of distributing and completing the questionnaire. Reminders were issued every 2 days …

The Effect Of Frequently Wearing Face Masks During The Covid- 19 Pandemic On The Development Of Acne In Adults: A Crosssectional Descriptive Study, Rawan Taleb, Rayyan Jad, Rayan Salem, Noor Lababidi, Nourhan Awassa, Hadi Atchan, Hiba Deek

BAU Journal - Health and Wellbeing

The aim was to highlight the dermatological side effect “acne” of repetitive usage of face masks on the skin of adults living in Lebanon through a cross sectional descriptive study involving self-administered questionnaire. Following ethical and administration approval, the questionnaire in English language was generated on a link through Google forms. The link was disseminated through social media; Facebook, Instagram and to the WhatsApp groups of the research group who are nursing BS students at the Faculty of Health Sciences. A total of 305 completed the questionnaire. Data analysis was done via SPSS. The mean age of the study participants …

An Educational Intervention To Improve Nurses’ Knowledge And Self-Confidence: An Integrated Literature Review, Angela N. Ikeme

DNP Qualifying Manuscripts

Purpose: To provide educational intervention to improve the knowledge and self-confidence of nurses in ambulatory and urgent care clinics in detecting early deterioration, intervening, and evaluating changes in patient condition using a consistent assessment tool. A review of the organization policy indicated a process to call the medical alert response team (MAR). However, there was no established algorithm for nurses to escalate or implement interventions when they noticed a patient condition change. An informal survey of ten assistant nurse managers in the ambulatory and urgent care clinics asked about their calling process for MAR and what interventions are used yielded …

Evidenced-Based Practice Guideline Development: Selection Of Local Anesthetics And The Additive Dexamethasone In Brachial Plexus Blocks, Sabina Lamichhane Wagle

Doctor of Nursing Practice Scholarly Projects

Brachial plexus blocks (BPB) are a type of regional anesthesia that inhibits the sensory and motor function of the upper extremity. The efficacy of a BPB depends on the type and dose of local anesthetics (LA), as well as the use of any additive agent. The selection of LA depends on the type, concentration, and volume of LA. Certain additives, such as dexamethasone, when added to BPB, were shown to increase motor and sensory block duration.

A chart audit conducted by the pharmacy and anesthesia departments revealed a significant variability of clinical practice in the use of LA and additives …

Evaluating The Impact Of A Team-Based Model Of Primary Care On Provider Burnout And Patient Experience, Kimberly A. Moreland

Doctor of Nursing Practice Scholarly Projects

Background: To assure high quality, safe, affordable, and accessible health care, organizations are embarking on quality improvement initiatives to work toward the triple aim of patient satisfaction, improving the health of populations, and reducing the cost of care.

Description of the Problem: Primary care is the backbone of the health care system, but it is a challenging environment with high rates of clinician burnout. Clinician burnout undermines the ability of organizations to meet the triple aim. Innovative new care delivery models are needed that can meet the triple aim while also mitigating burnout.

Available Knowledge: A PRISMA review of the …

Medication Assisted Treatment In Opioid Use Disorder, Catherine Paradiso

Open Educational Resources

This lesson centers on Medication Assisted Treatment, one part of the harm reduction strategy used to combat the opioid epidemic. This lesson reviews the medications that are used, and which ones can be used in a primary care setting. There are sample discussion questions and brief scenarios associated with primary care and medication.

Implementation Of A Polypharmacy Deprescribing Protocol Among Older Adults In A Community-Based Care Organization, Johanne Cazeau

Doctor of Nursing Practice Scholarly Projects

Background: Polypharmacy, defined as the use of five or more medications, has the potential to increase morbidity, mortality and decrease quality of life. Older adults are disproportionately affected by polypharmacy. Decreasing polypharmacy could prevent morbidity and mortality while saving millions of dollars annually. The use of the ARMOR tool has been shown to decrease polypharmacy and the prescribing of inappropriate medications among the elderly.

Local problem: There is a high prevalence of polypharmacy among older adult patients at the managed care organization where this quality improvement project was implemented. Among a panel of 30 members, almost all (n=29) were taking …

Dnp Final Report: An Evidence-Based Hesi Exit Exam Remediation Plan, Nancy Mcclurg

DNP Final Reports

In a small East Texas associate degree nursing program, the average pass rate for the National Council of State Board exam fell and was below both national and state averages for three years. In an effort to identify students who may need extra preparation prior to taking the licensure exam, the college administers the HESI Exit Exam during the last semester of the program. For the last three years, between 28 and 37% of the senior class did not achieve a passing score on the exam. The project’s purpose was to evaluate the effect of a remediation plan which consisted …

Pediatric And Child Health Nursing: A Three-Phase Research Priority Setting Study In Western Australia, Evalotte Mörelius, Ailsa Munns, Stephanie Smith, Helen J. Nelson, Anne Mckenzie, Jade Ferullo, Fenella J. Gill

Research outputs 2022 to 2026

Purpose: Priority settings are important to plan and direct future research. The aim of this study was to identify the top ten pediatric and child health nursing research priorities from the perspectives of consumers, community, and healthcare professionals in Western Australia.

Design and methods: This study used an adapted James Lind Alliance Priority Setting Partnership design with three phases. 1) A planning workshop to inform a survey. 2) A survey using five open-ended-questions distributed between October 2020 and January 2021 through social media and healthcare professionals' emails. Responders' statements were analyzed with content analysis. 3) A consensus workshop to finalize …

Conducting Neonatal Intensive Care Unit Research During A Pandemic: Challenges And Lessons Learned, Marliese Dion Nist, Sharon G. Casavant, Robin B. Dail Phd, Rn, Faan, Kayla C. Everhart Phd, Rn, Stephanie Sealschott, Xiaomei S. Cong

Publications

Background The coronavirus pandemic disrupted normal clinical operations and research. Nurse scientists conducting research studies in the neonatal intensive care unit experienced significant challenges to continuing their research studies amid national lockdowns and hospital visitation restrictions. Objectives The purpose of this article is to describe the challenges encountered by nurse scientists conducting research studies in the neonatal intensive care unit during the pandemic, the creative solutions devised to overcome these barriers, and the lessons learned during this unprecedented time. Methods Using our pandemic area studies as exemplars, we highlight the barriers encountered in continuing our research in the intense environment …

A Multimodal Intervention For Weight Loss In Primary Care, Amber Smith

Evidence-Based Practice Project Reports

Obesity is a worsening pandemic that requires immediate action. It is recommended that primary care providers screen patients for obesity and provide multimodal behavioral interventions to their patients to treat and prevent obesity (USPSTF, 2018). The purpose of this evidenced-base practice (EBP) project is to implement a multimodal intervention for weight loss in adults within primary care. Five search engines were utilized, and 16 articles were ultimately selected as evidence. The evidence supported self-monitoring and close follow-up while in active weight loss. The Iowa Model for EBP to promote quality care was used as the framework to guide the project …

Dnp Final Report: Seal The Deal In Dementia Care, Christian D. Garrett

DNP Final Reports

Background: Individuals with dementia are often burdened with behavioral problems, which augment health care costs and burden of disease. Treatment of behavioral symptoms with pet therapy is acknowledged to be emotionally beneficial. Robotic pets have demonstrated similar promising effects without the undesirable outcomes of traditional pet therapy. Robotic pet therapy offers an effective replacement to traditional pet therapy.

Objective: The DNP scholarly project rigorously appraises the effectiveness of the SAR, PARO, an FDA approved biofeedback device, for non-pharmacological treatment of dementia-related symptoms.

Methods: An experimental design with repeated measures guided the study. Pre- and post- measures included reliable, valid tools …

Light Acupuncture And Five-Element Music Therapy For Nurses' Mental Health And Well-Being During And Post-Covid-19: Protocol For A Randomised Cross-Over Feasibility Study, Carol Chunfeng Wang, Johnny Lo, Rosemary Saunders, Esther Adama, Caroline Bulsara, Christopher Etherton-Beer, Angela Wei Hong Yang

Research outputs 2022 to 2026

INTRODUCTION: Australian nurses have experienced higher levels of anxiety during the COVID-19 pandemic compared with the prepandemic. This may have affected their long-term mental health and intention to stay in the profession resulting in a workforce shortage, which further impacts the health of the public. Management is urgently required to improve nurses' well-being. However, there is limited evidence available. The proposed clinical trial aims to evaluate the feasibility and therapeutic effects of using a combination of light acupuncture and five-element music therapy to improve nurses' mental health and well-being during and post-COVID-19. METHODS AND ANALYSIS: This randomised, single blinding, two-arm …

Integrative Music Therapy: A Healing Intervention For Children With Disabilities, Francesca N. Do

Theses and Graduate Projects

Children with developmental delays have barriers to accessing early interventions to help develop their childhood milestones. An accessible intervention considered a universal language to all cultures is integrative music therapy. Music therapy paired with in-home care can create a healing environment for children to learn developmental skills, initiate play, and express their emotions with the nurse’s guidance. An integrative music therapy educational program was developed using Jean Watson’s Theory of Human Caring as a theoretical framework for the pediatric nurses working in a rural Midwest home health care company. The goal of the educational program is to promote awareness of …

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.

Advantages Of Early Utilization Of Palliative Care In The Pediatric Icu: A Scoping Review, Shelby Noel Cain Bsn, Rn, Cpn, Dana Pabalate Zimmerman Msn, Rn, Charis Elizabeth Oji Msn, Aprn, Cpnp-Pc/Ac, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Abstract Purpose/Background Despite the increased use of palliative care in adults, only a tiny percentage of children with life-limiting illnesses or life-threatening conditions receive palliative care before dying. Palliative care has low utilization, and consults are often made late in a child’s hospitalization or diagnosis. Palliative care remains underutilized among hospitalized pediatric patients resulting in unnecessary treatments, costly and lengthy hospitalizations, and deaths occurring in the intensive care unit (ICU) rather than at home. The purpose of this scoping review is to evaluate current literature to determine the use and effect of pediatric palliative care, specifically, whether consultation of palliative …

Improving Provider Adherence To Ada Clinical Practice Guidelines: A Qi Project In A Patient Centered Medical Home, David H. Kamp

Masters Projects

Background and purpose: Diabetes is the leading cause of kidney failure, lower limb amputations, and adult blindness. The American Diabetes Association recommends timely screenings to reduce complications. Flowsheets facilitate improved outcomes. The project implemented an electronic flowsheet to promote staff adherence to select screenings.

Methods: Screenings included foot exam, eye exam, glycohemoglobin, microalbumin creatinine ratio, lipid profile, and anti-hypertensive medication. Staff viewed the flowsheet to determine screening eligibility per ADA guidelines. Quantitative and qualitative data analyzed.

Results: Quantitative results: 40% improvement among medical assistants (MAs) completing foot exams and 75.53% improvement among providers ordering eye exams. No statistical significance among …

Increasing Physical Activity In Women With Obesity To Promote Weight Loss, Ashley N. Kohler

Evidence-Based Practice Project Reports

Obesity is a chronic disease associated with a multitude of lifelong chronic illnesses. Obesity impacts more than 42% of the United States population (CDC, 2021b). Physical inactivity is a major determinant of obesity (Muerer et al., 2019). The purpose of this evidence-based practice (EBP) project was to promote a greater reduction in body mass index (BMI) of the participants enrolled in an existing wellness program at the EBP practice site by increasing the physical activity level of the participants compared to standard protocol. The existing wellness program’s standard protocol included diet modifications, physical activity encouragement, and medication management. The EBP …

Exploring The Millennial Novice Nurses' Transition Experience In Hospital Setting: An Integrative Review, Carman Dean

Master of Science in Nursing Final Projects

The nursing shortage coupled with a high demand for healthcare services necessitates retention of the current workforce comprised of a majority of millennial generation nurses. This generational cohort has previously demonstrated a lower job commitment and job satisfaction as compared to prior generations as well as individual work preferences. The purpose of this integrative review was to evaluate and synthesize previous studies that capture the millennial novice nurse’s experience in the hospital setting and to answer the question, “What are the initial transition experiences of millennial generation novice nurses in the hospital setting?” An integrative review design was used to …

Using A Food Insecurity Screening Tool In The Nicu, Emily Coffman Bsn, Rn, Fatina Caldwell Bs, Bsn, Rn, Cpn, Cpen, Mackenzie Box Bsn, Rn, Uche Anani Md, Faap, Christin Fritz Md, Mph, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background: Infants admitted to the NICU are disproportionately born to low-income families. This, combined with unique financial challenges of their long-term stay, may predispose caregivers to food insecurity (FI). FI among caregivers has far reaching implications for the health of infants who are already vulnerable related to comorbidities from their NICU stay.

Methods: Using the Iowa model to successfully engage key stake holders and begin a small pilot study, a randomized preintervention chart audit was performed (n=30) to evaluate if FI was identified by NICU Social Worker (SW). The FI screening tool was administered by nursing to a separate group …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …