Nursing Commons^™

Implementation Of The American College Of Cardiology And American Diabetes Association Clinical Practice Guidelines For Statin Therapy In Reducing Cardiovascular Risk Among Patients With Type 2 Diabetes, Edward Eloy Iruegas

Doctor of Nursing Practice

The incidence of type 2 diabetes has significantly increased over the past decade, making it a risk factor for cardiovascular disease (Banach et al., 2022). Individuals with type 2 diabetes are four times more likely to develop atherosclerotic cardiovascular disease, accounting for up to a 75% mortality rate. Despite this, the risk for atherosclerotic cardiovascular disease remains underestimated and undertreated in this population (Banach et al., 2022). The purpose of this project was to enhance adherence to the American College of Cardiology 2019 and the American Diabetes Association 2023 clinical practice guidelines regarding statin therapy for patients with type …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

Nurse-Physicians: From Nursing School To Practicing Physician, Tobias Fraedrich

Honors Scholar Theses

Nurse-physicians are healthcare professionals who have obtained both a nursing degree and a medical degree, transitioning from Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN) to a licensed physician, including Medical Doctor (MD), Doctor of Osteopathic Medicine (DO), or Naturopathic Doctor (ND). Research on this phenomenon conducted to date is limited to a single study. Some nonresearch sources indicate a small presence of this topic online. Yin’s (2018) descriptive, multiple-case study approach was employed to investigate the phenomenon using oral history interviews and a survey of the online platform YouTube as data sources. For the intention of pursuing this …

An Exploration Of Bedside Critical Care Nurses’ Attitudes Towards The Teleicu, Theresa Marie Drucker

Theses & Dissertations

Background

Acute care facilities are seeing an increased demand for critical care resources, given the increasing aging population with more complex health problems, retiring healthcare professionals, and subsequent decreasing supply of new expertise (Shahpori et al., 2011). Telehealth in the ICU is a valuable resource that some hospitals have employed to bridge this gap. The use of the teleICU has been associated with improved outcomes for patients (Williams et al., 2019), and reduction in failure to rescue (FTR) events. Despite the increasing availability of teleICU programs and the associated potential benefits, there continue to be inconsistencies in terms of usage …

The Effects Of Retrieval Practice On Knowledge Acquisition And Durable Learning In Undergraduate Nursing Students, Jessica Everritt Gay

Dissertations

Recent reports of unpreparedness and failure to rescue incidents among new graduate nurses are concerning for nurse educators and health care. New graduates must retrieve and apply learned knowledge to make sound clinical decisions, emphasizing the need for durable learning and knowledge acquisition. Durable learning, which involves understanding and recalling learned information days, weeks, or months later is crucial for clinical judgment. Nurse educators should facilitate durable learning through effective, evidence-based learning techniques such as retrieval practice (RP), which has shown promise in health professions education but is underutilized in nursing education.

This study explored the impact of RP on …

Is There A Relationship Between Motivation And Nursing Student Engagement? A Quantitative, Cross-Sectional, Correlational Study, Angela Coes

Dissertations

Nursing education is concerned with helping to alleviate the nursing shortage in the United States; this can be done by graduating safe competent novice nurses. Motivation and engagement levels in nursing students have been tied to better academic outcomes including graduation rates, transition to practice, and first time National Council Licensure Examination for Registered Nurses pass rates. There was a gap in prelicensure nursing education research in the United States concerning the relationship among motivation, engagement, and possible influential variables.

The purpose of this study was to investigate the relationship between motivation and academic engagement among prelicensure nursing students in …

The Role Of Self Esteem Upon The Recovery Of Eating Disordered Patients, Samanta Flores Velazquez

Undergraduate Honors Theses

Eating disorders such as anorexia-nervosa, bulimia-nervosa, and binge-eating disorders are detrimental to overall health and well-being. The demands of beauty ideals and attitudes impact young adults negatively as they attempt to meet societal beauty standards. The need for approval, fitting in with the community, and confidence drive the behaviors of people in negative ways. In recent years, the modernization of social media has contributed to dieting cultures, the thin ideal, harmful weight-loss practices, and the cycle to use the body as a means to control or repent. External factors affect the risk of eating disorders which contribute to the challenge …

Interventions Of Eating Habits And Healthy Behaviors, Diego Armando Mazariegos Espinosa

Undergraduate Honors Theses

About thirty to fifty percent of college students report having negative emotions such as anxiety, depression, sadness, anger, hopelessness, shame, fear, and more. And over seventy percent feel exhausted or overwhelmed by schoolwork. According to scholarly research, these emotions pose obstacles during college life impacting the eating habits and healthy behaviors of college students. These habits can have a possibility of bringing lifelong issues in social, educational, and self-esteem aspects. Technology has revolutionized the world in a spectacular way in a short period of time. As students today have access to all sorts of technology like phones and computers, the …

Produce Prescription Policy Project For The Securement Of A Grant To Address Food Insecurity For Low-Income Type Ii Diabetic Patients, Isabel D. Garcia-Gallegos

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This policy-focused Doctor of Nursing Practice (DNP) quality improvement (QI) project aims to secure grant funding through the Gus Schumacher Nutrition Incentive Program (GusNIP) to implement a produce prescription program at a community clinic in Texas. The program targets low-income adults (18-65 years) with type II diabetes who experience food insecurity and are affected by Medicaid non-expansion.

BACKGROUND

Texas’ decision not to expand Medicaid has exacerbated food insecurity among low-income residents, particularly those managing type II diabetes. This decision creates a healthcare policy gap that this project aims to address with a food-as-medicine program.

METHODOLOGY

Using the Plan-Do-Study-Act (PDSA) …

Improving Scheduling Accuracy Through A Standardized Dermatology Consult Order, Deion Whitehead

Doctor of Nursing Practice Final Project Abstract

Improving Scheduling Accuracy through a Standardized Dermatology Consult Order

PURPOSE

This quality improvement (QI) project aimed to improve scheduling accuracy and reduce referral errors in a dermatology department by implementing a standardized consult order form within the electronic health record (EHR).

BACKGROUND

Inaccurate dermatology referrals led to misdirected consultations, increased reconsultation rates, and treatment delays. A lack of standardization contributed to inefficiencies, impacting patient outcomes and workflow. Implementing a structured referral form aimed to enhance triaging accuracy and improve timely dermatologic care.

METHODOLOGY

A pre- and post-intervention design was used. An eight-week baseline data collection period (n=288) assessed existing referral …

Managing Cardiovascular Health In The Hispanic Community: Implementing The Share Approach At A Primary Care Clinic, Jacqueline Molina

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this project was to determine the effectiveness of the Seek, Help, Assess, Reach, and Evaluate (SHARE) approach in the management of cardiovascular disease (CVD) risk factors in the Hispanic population at a primary care clinic while improving health literacy. The aim was that by February 2025, Hispanic patients at the clinic would achieve a 10% reduction in CVD risk factors.

Background: The project was implemented at a small private primary care clinic in Texas. CVD risk factors prevalent include hypertension, mixed hyperlipidemia, and diabetes mellitus.

Methodology: Before implementation provider and staff were educated on the SHARE …

Participant Personal Characteristics And Adherence To Oral Capsules: A Secondary Analysis Of A Randomized Placebo-Controlled Trial Of Antenatal Probiotics, Lisa Hanson, Kathlyn Albert, Emily Malloy, Maharaj Singh, Mikala Kallay, Ava Brandt, Courtney Morris, Diana Kleber, Marie Forgie

College of Nursing Faculty Research and Publications

Background

Adherence to study interventions is critical to the conduct of randomized controlled trials (RCTs). The relationships between participant characteristics and intervention adherence are understudied in pregnant populations. The purpose of this study was to conduct a secondary analysis of adherence to study capsules in a double-masked, placebo-controlled RCT of a probiotic intervention to reduce antenatal Group B Streptococcus colonization, in relationship to participant characteristics.

Methods

We analyzed the relationship between capsule adherence rates and demographic characteristics among 81 RCT participants. Categorical variables were reported using counts and percentages, and continuous variables were expressed as means along with their standard …

The Impact Of Covid-19 During The First Two Years: Giving Voice To Pediatric Nurses, Karen S. Gralton, Kathryn J. Malin, Eileen Sherburne, Danielle Smith, Stacy Wenner, Julie Averbeck, Amy Newman, Anita Norton, Genesee Hornung, Karen Kavanaugh

College of Nursing Faculty Research and Publications

Purpose

The purpose of this study was to describe the experiences of pediatric nurses providing direct care in a variety of settings during the first two years of the COVID-19 pandemic.

Design and methods

This was a qualitative descriptive study. Donabedian's Quality Framework for the Evaluation of Healthcare was used to guide the design. Purposive sampling was used to recruit 24 direct care nurses from inpatient and outpatient settings within one healthcare system. Semi-structured, audio-recorded interviews were conducted in-person or via a virtual platform from November 2021 through March 2022.

Results

Four major themes were determined across all settings and …

Polypharmacy And Pharmacogenomics In High-Acuity Behavioral Health Care For Autism Spectrum Disorder: A Retrospective Study, Sheldon R. Garrison, Sophie A. Schweinert, Matthew W. Boyer, Maharaj Singh, Sreya Vadapalli, Jeffery M. Engelmann, Rachel A. Schwartz, Madeline M. Hartig

College of Nursing Faculty Research and Publications

Background

This study evaluated pharmacogenomic (PGx) testing in children and adolescents with autism spectrum disorder (ASD). ASD frequently presents with co-occurring depression and anxiety. This complex phenotype often results in psychotropic medication polypharmacy. Incorporating PGx testing into the medical work-up may reduce polypharmacy and improve quality of life with symptom reduction.

Methods

A retrospective electronic health record (EHR) review between January 2017 and May 2023. Individuals either received PGx testing or treatment as usual (TAU). The co-primary outcomes were instance of polypharmacy and the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Secondary outcomes included length of stay, average …

Building Health Policy Advocacy Expertise In Pediatric Nurse Practitioners Through Civic-Based Experiential Learning, Christine A. Schindler, Jill C. Kuester, Jennifer K. Pfister, Katie L. Mcdermott

College of Nursing Faculty Research and Publications

Background:

Many nurses work largely as policy implementers rather than policy developers. The literature posits several multifaceted reasons for this lack of policy acumen including interprofessional power dynamics, marginalization of nurses in policy making, and lack of formal training in public policy advocacy.

Purpose:

To evaluate the impact of a targeted teaching strategy on increasing political astuteness, perceived skill, and comfort in health policy advocacy among a cohort of acute care pediatric nurse practitioner students.

Methods:

Curriculum assessment data were collected using the Political Astuteness Inventory, pre- and postclass discussions, and written reflections.Results: This curriculum evaluation suggests that specific policy …

Predicting Perinatal Mood Disorders, Honey Newton

Doctor of Nursing Practice

Perinatal Mood Disorders (PMD) constitute a significant public health concern, impacting the perinatal patient and the family.

Purpose

This project describes the relationship between Adverse Childhood Experiences and Perinatal Mood Disorders including depression and anxiety.

Goals

The goals of this study were to define the perinatal population in a rural Montana clinic and describe the relationship between ACEs and PMDs to identify early intervention opportunities.

Methods

A ten-year retrospective IRB approved study described the relationship between ACE, PHQ9 and OASIS scores to determine the prevalence of PMD and connection to ACE’s in perinatal patients in rural northwest Montana. Calculations were …

Prediabetes In Rural Primary Care: Screening, Diagnosis And Treatment, Rebecca M. Bodle-Shingu

Doctor of Nursing Practice

Background

Prediabetes affects one in three US adults. Over 80% of individuals with prediabetes are unaware of having the condition. Evidence-based clinical practice guidelines (CPG) recommend screening adults 35 to 70 years old with a BMI of 25 or higher. Prediabetes treatment consists of lifestyle modification, referrals to nutrition counseling, and metformin for individuals who cannot make lifestyle changes. Diagnosis and treatment of prediabetes reduces the risks or delays the progression to type 2 diabetes.

Purpose

The purpose of this DNP quality improvement project was to impact primary care providers beliefs, knowledge, and practices in identifying, diagnosing, and treating …

Relationship Between Mental Health Education And Nurse Preparedness, Deborah C. O'Dell

Doctoral Dissertations and Projects

This quantitative study was to see if there was a relationship between the type of Mental Health education undergraduate nurses received or the number of Mental Health clinical days they experienced and how prepared they were to care for Mental Health Consumers (MHCs) when they first were employed. This information had never before been studied, so had the potential to change nursing curriculum and provide better care for MHCs. An anonymous survey using the Behavioral Health Care Competency’s questions was used and an invitation to participate was placed on various nursing discussion forums and social media sites. Participants (n = …

Nursing Faculty Experiences Of Teaching Dementia Care: A Transcendental Phenomenological Study, Jeannie Simpson

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the experiences of nursing faculty teaching dementia care to nursing students in Texas. The theory guiding this study was Kolb’s experiential learning theory as it offers a structured framework for examining how experiences lead to learning. This theory also introduced the concept of the Experiential Educator profile, specifically delineating the role of educators in facilitating knowledge acquisition (Kolb, 2014). This study bridged the gap in existing literature regarding the experiences of nursing faculty in teaching dementia care to nursing students and provided a comprehensive look at dementia education in nursing schools. …

A Quantitative Study Teaching De-Escalation With Virtual Reality Simulation To Associate Nursing Students Measuring Effectiveness, Learning, And Confidence, Michele Rene Marbet

Doctoral Dissertations and Projects

Workplace violence against nurses is a critical global public health issue, as one in four nurses reportedly experience physical assault by patients. This quantitative quasi-experimental, pretest-posttest study aimed to assess the effectiveness of virtual reality simulation as a teaching strategy for de-escalation education in associate nursing students’ (N = 29) perception in learning and confidence. The study utilized the Simulation Effectiveness Tool-Modified (SET-M) instrument to measure outcomes guided by Kolb's experiential learning theory and the NLN Jeffries simulation theory. The learning variable demonstrated significant improvement as confirmed by paired t-test analysis (p < .01). For the effectiveness and confidence variables, which violated assumptions of normality, a comprehensive statistical approach was implemented. Analysis included parametric testing via paired t-tests, supplemented by nonparametric methods (Wilcoxon Signed-ranks test and Sign test) to ensure statistical rigor. The cumulative results across all three statistical tests consistently demonstrated significant improvements (p < .001). Effect size calculations revealed medium to large significance for all variables measured by Cohen’s d. The conclusive findings of this research included a rejection of all three null hypotheses, which suggests that virtual reality simulation is an effective teaching strategy for developing de-escalation skills, enhancing both learning and confidence among associate nursing students. Future studies are needed to further validate and expand upon the findings of the current research, potentially leading to more widespread adoption of virtual reality simulation in nursing education for teaching de-escalation.

Impact Of Education For Bedside Nurses In A Community Hospital To Increase Intent Or Utilization Of A Career Ladder Advancement Tool, Carrie E. White

Doctoral Dissertations and Projects

This scholarly project is centered on lack of engagement in a new career ladder program. This project includes the creation of career ladder education with an intent to help with understanding, support, and engagement of the nursing caregivers. Education was created to propel the work of the career ladder within a small rural hospital. The program is 12 weeks long and covers eligibility criteria, activity details, technology education, and one-on-one support for understanding of the career ladder program. The hopes for the educational program were to increase nursing satisfaction, with the intent to stay with the organization, and foster participation …

Improving Glycemic Management Of The Inpatient Adult With Diabetes Mellitus Through The Development Of A Bedside Decision Support Tool For The Medical-Surgical Floor Nurse, Robin Deville Guidry

Doctor of Nursing Practice Final Project Abstract

Background: Uncontrolled blood sugar can lead to adverse events in the adult perioperative inpatient population. Hyperglycemia can lead to diabetic ketoacidosis (DKA), infection, delayed wound healing, increased hospital lengths of stay (LOS), and even mortality. Uncontrolled hypoglycemia can result in confusion, seizures, and even coma.

Purpose: This single-PDSA-cycle quality improvement project aimed to prevent and/or minimize the duration of uncontrolled blood sugar in the peri-operative adult inpatient. The primary objective was to reduce the incidence of hyperglycemia defined as >180 mg/dL by at least 10% from baseline with a goal rate of less than 25%, while also reducing the incidence …

Improving Nurse Confidence Around Communication With Physician Partners Through The Caritas Processes, Deborah M. Yracheta

Doctoral Projects

Nurses are the eyes and ears at the bedside during a patient’s hospital stay. They are responsible for communicating significant changes in a patient’s health status, mainly to their physician partners. Unfortunately, good communication between nurses and doctors is a shortcoming of the nursing profession. Seven thousand reviewed malpractice lawsuits were directly related to poor provider communication, resulting in $1.7 billion in malpractice cases and 2,000 preventable deaths. These communication errors also lead to prolonged hospital delays in care, underscoring the need for improved communication. These poor outcomes compromise patients’ lives, safety, and well-being and decrease patient satisfaction scores, ultimately …

Sexual And/Or Gender Minority (Sgm) Stigma Within Nursing Schools: The Relationship Between Stigmatic School Attributes, Minority Stressors, And Sgm Nursing Student Mental Health, Michelle Gee

Dissertations

Nursing education is heteronormative and cis-normative, which has been correlated to stigma and ignorance exhibited by nurses towards sexual and/or gender minorities (SGM). Minority Stress Theory (MST) states that circumstances in the environment that promote stigma related to minority identities lead to unique minority stressors, such as discrimination. These minority stressors subsequently affect mental health. While it is known that SGM patients experience mental health issues that relate to stigma and discrimination in healthcare settings, nothing is known about SGM nursing students dealing with stigma and discrimination within nursing education. The aim of this descriptive correlational study was to inform …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

The Lived Experience Of New Graduate Nurses Implementing Evidence-Based Practice In A Clinical Setting, Kimberly A. Mcfarland

Electronic Theses and Dissertations

The purpose of this qualitative interpretive phenomenological analysis study was to explore the perceptions and lived experiences of new graduate nurses (NGNs) as they implemented evidence-based practice (EBP) in clinical settings. This study addressed the problem that NGNs often lack the skills and confidence to effectively apply EBP, despite its critical role in improving patient outcomes. The research aimed to provide insight into the challenges, support systems, and strategies that influence EBP integration during the transition from student to practicing nurse. The study utilized the interpretive phenomenological analysis methodology to analyze data collected through semistructured interviews conducted via the Teams …

Implementation Of Houdini Guidelines Nurse-Driven Protocol To Lower Catheter-Associated Urinary Tract Infections And Foley Utilization Days, Tammie N. Collins

Electronic Theses and Dissertations

Catheter-associated urinary tract infections are a common issue in healthcare settings. These issues contribute to hospital-acquired infections and can lead to complications and increased healthcare costs. The quality project evaluated the impact of the HOUDINI guidelines nursedriven protocol to reduce infection rates and Foley utilization days. A structured guideline for Foley catheter safe removal was implemented using a quantitative method. Catheter-associated urinary tract infection rates and Foley utilization days pre- and postintervention were tracked. Data were collected using the electronic health records, infection control data sheets, and the HOUDINI checklists. A baseline assessment of catheter-associated urinary tract infections rates was …

Transformative Learning In Homebirth Settings: A Reflexive Thematic Analysis Of Midwifery Students' Experiences, Kate Buchanan, Sara Morris, Sara Bayes, Clare Davison

Research outputs 2022 to 2026

Background: The homebirth setting provides opportunities for midwifery students to witness autonomous midwifery practice, but these experiences are limited. Factors that limit practicum placement in the home birth setting are either logistical, with less than one percent of women having a homebirth in Australia or related to university governance, whereby approval is not granted for midwifery students attending homebirth. Objectives: To explore midwifery students' experiences in the homebirth setting and to determine how this has influenced understandings of the role and scope of practice the midwife. Methods: Qualitative methods were chosen to inform this study. Setting: A University that offers …

Indirect Evidence Of Sex-Selective Abortion Practices To The Imbalanced Sex Ratio At Birth In Australian Migrant Populations, Amanuel Tesfay Gebremedhin, Gizachew A. Tessema, Ravisha Srinivasjois, Judith A. Daire, Kevin A. Chai, Bereket Duko, Kalayu Brhane Mruts, Gavin Pereira

Research outputs 2022 to 2026

A skewed sex ratio at birth (SRB), commonly observed in countries with high son preference can be attributed to prenatal sex-selective abortion. However, the possibility of sex selection among migrants in high-income countries has received little attention. Our study aims to identify the indirect evidence of sex-selective abortion practices to the SRB imbalance in a large Australian cohort. Our study aims to identify the indirect evidence of sex-selective abortion practices to the SRB imbalance in a large Australian cohort. In this population-based study, perinatal data were obtained from all registered births in Western Australia (WA) and New South Wales (NSW) …

Twenty-One Year Trends In Pressure Injury In A Western Australian Hospital, Linda L. Coventry, Istvan Kabdebo, Nicole Walsh, Joelle Winderbaum, Mark Jenkins, Prachi Kaistha, Diane E. Twigg, Shirley Jansen, Dimitri Beeckman

Research outputs 2022 to 2026

No abstract provided.