Nursing Commons^™

Implementation Of An Online Suicide Prevention Training Program With Undergraduate And Graduate Students At A California State University, Cheryll May P. Villamor

Doctoral Projects

Background: One of the leading causes of death in the college age population is suicide. While colleges provide opportunities in the acquisition of knowledge and skills for future careers; those same opportunities can also bring about challenges that put students at risk for suicide such as: dealing with their mental health issues, finding and maintaining support system, financial costs, and the pressure from ensuring academic success. One of the ways to help student at risk for suicide is by early intervention by connecting them with mental health support system such as crisis counselors. Question, Persuade, and Refer (QPR) is a …

Implementation Of A Peer Support Program To Increase Resilience In Nurse Managers In Acute Care Hospitals: A Pilot Study, Juana Castillo

Doctoral Projects

Background: Nurse managers are at risk for experiencing stress and burnout. The peer support program was implemented to increase resilience among nurse managers.
Methods: A one-group pretest and posttest design was employed to examine the impact of peer support on nurse manager resilience. The nurse managers participated in bi-weekly 30-minute peer sessions over 12 weeks. The Connor-Davidson Resilience Scale was utilized prior to and following the intervention along with demographic and satisfaction surveys.
Results: There were six nurse managers who participated in the peer support program; however, only four completed both the pre- and post-survey. The peer support program intervention …

Evaluation Of A Care Management Program On Family Caregivers Of Persons With Dementia, Victoria L. Jackson

Doctoral Projects

Dementia due to Alzheimer’s and other disease is a growing concern for healthcare providers as the number of individuals in the U.S. population ages. Persons with dementia (PWDs) rely on caregivers, primarily family caregivers (FCGs), for basic and instrumental activities of daily living as the disease progresses. There may be negative outcomes, such as depression, strain, and distress for FCGs of PWDs. Routine assessment and intervention by healthcare providers can address needs of FCGs of PWDs. There are multiple interventions that have demonstrated effectiveness in caring for PWDs and FCGs; one such intervention is care management. The University of California, …

Does The Enhanced Recovery Pathway Decrease Length Of Stay And Readmission Rates In Patients Undergoing Gynecologic Surgery?, Trinh T. Nguyen

Doctoral Projects

The Enhanced Recovery After Surgery (ERAS) pathway promotes an early recovery after surgery using an evidence-based multidisciplinary approach. The ERAS protocol is aimed at standardizing care to improve patient outcomes. There is consistent evidence that ERAS pathways reduce hospital length of stay (LOS) and readmission rates, decrease healthcare costs, and improve patient satisfaction and outcomes. By attenuating the surgical stress response and supporting the return of physiological function, the ERAS pathway achieves its effectiveness. This scholarly project aimed to evaluate how ERAS improves patient outcomes in gynecology patients at a county hospital. A standardized method for improving patient recovery was …

Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus

Doctoral Projects

Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …

Health Promotion Module For Migrant Youth Adults In Obesity Prevention: A Pilot Project, James Chongsu Wong

Doctoral Projects

The obesity epidemic continues to worsen. It is estimated there are over one half billion adults worldwide struggling with obesity. In the United States of America, 42% of the adults and over 15 million children are obese. Obesity leads to a myriad of other chronic diseases such as diabetes mellitus, hypertension, and hyperlipidemia. With an annual spending exceeding 173 billion dollars, obesity not only has a negative impact on quality of life but also a huge economic impact on the health care system.
This quality improvement project utilized 4 educational modules as intervention and measured the mean changes using a …

Is Sepsis Hiding In Plain Sight? Implementation Of An Interprofessional (Ip) Sepsis Simulation To Detect Early Sepsis, Sarah Chang, Amanda Bennett, Anne Dean, Meaghan Anderson, Micheline Chipman

Costas T. Lambrew Research Retreat 2023

Early detection of hospital-acquired sepsis can be challenging. With highly effective IP teams and efficient healthcare systems, sepsis treated quickly can influence morbidity and mortality. This project is aimed at training IP teams in early recognition of sepsis using simulation. Nurses and providers rarely have opportunities to learn together. Simulation followed by an IP debrief is an excellent tool to collaborate for safe patient care.

Infertility: An Evaluation Of Treatment Modalities And Ethical Considerations, Elise Ferenczy

Senior Honors Theses

This thesis reviews a variety of options for treatment of infertility, along with ethical considerations for each. The basis for ethical concerns will be primarily a biblical worldview, as the goal is to support Christian couples in decisions regarding infertility treatment. The biblical worldview is outlined to provide readers with an understanding of its core principles, and the Bible is used as the primary source for ethical discussion. The most common etiologies of infertility are outlined, followed by treatment modalities grouped by category. While some modalities present very few ethical concerns, others require careful consideration in many regards. Many of …

Trends In The Incidence Of Head And Neck Cancer: A Nationwide Population-Based Study, Tzong-Hann Yang, Sudha Xirasagar Mbbs., Ph.D., Yen-Fu Cheng, Chin-Shyan Chen, Wei-Pin Chang, Herng-Ching Lin

Publications

OBJECTIVE: This study aimed to demonstrate the temporal trend in incidence of head and neck cancer (HNC) in Taiwan. MATERIALS AND METHODS: Patients with a HNC were retrieved from the Taiwan's Health Insurance Database. We identified 16,894 patients aged ≥20 years who had received a first-time diagnosis of cancer of the oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, sinonasal, salivary gland or thyroid gland between 2010 and 2018. We calculated the annual incidence rate per 100,000 population, overall, and classified by gender and cancer type. We also used the annual percent change (APC) to characterize trends in head and neck cancer …

Enhancing Communication Pathways Between Care Environments To Improve Patient Outcomes, Heather Tucker

Doctor of Nursing Practice Projects

Conducting hand-off communication among healthcare providers can impact patient outcomes. Lack of communication between healthcare entities at the time of care transition can produce patient harm and lead to adverse events such as medication errors, hospital readmission, and unnecessary emergency department visits. The project goal was to evaluate the impact of communication between acute care and primary practice nurses using a standardized, electronic communication tool within the EHR upon patient discharge from a community-hospital based setting. During implementation, forty-two patients were included in the project based on primary practice follow-up location. Of the 42 eligible patients, the acute care nurses …

Recognizing Barriers In The Elderly Population And Increasing Access To Case Management Services, Loveleena Alex

Doctor of Nursing Practice Projects

Abstract

Implementing case management can lead to fewer hospitalizations in the elderly population. Barriers influencing the number of hospitalizations include low socioeconomic status, transportation needs, health literacy, financial strain, multiple comorbidities, underserved populations, medication availability, availability of community resources, and access to primary care. A review of the available literature revealed that by addressing these barriers in a primary care setting and implementing case management, the number of hospitalizations can be decreased and the quality of life in the elderly population can be improved. This quality improvement project implemented a screening and referral process for chronic care management in the …

Emergency Department Nurse Preceptor Development, Allison Helmerichs

Doctor of Nursing Practice Projects

Abstract

The Emergency Department (ED) new graduate nurse (NGN) requires an orientation to prepare them to work with patients with complex medical issues in a challenging, fast-paced environment. Clinically competent and effective preceptors are essential to prepare an NGN to work in an emergency environment while adopting multiple active learning strategies. Preceptor education and training are necessary to improve the confidence and competence of the ED nurse preceptor. Currently, the project site lacked preceptor training specifically for the ED nurse preceptor.

This project aimed to develop a preceptor workshop to meet the training needs of the ED nurse preceptor. Qualitative …

Just Culture In Undergraduate Nursing Academia, Marcie Leonard

Doctor of Nursing Practice Projects

Understanding the importance of reporting errors, near misses, and good catches by nursing students is not a standard part of the curriculum at the project site. Nursing students lack pre-requisite knowledge of how just culture does not aim to place blame on individuals but focuses on system flaws. Nursing students fear being dismissed from the nursing program if they make and/or report errors. A focus on eliminating the fear of dismissal from a nursing program for error reporting and formally educating how error reporting can help shape practice for many other nursing students and nurses will result in better data …

New Graduate Nurse Professional Development Planning, Cassandra Adkins

Doctor of Nursing Practice Projects

A 150-bed urban hospital in Chicago lacked a formal process to assist new graduate nurses (NGRN) in developing incremental goals as a part of their longitudinal plan during their first year of professional nursing practice. This left NGRNs feeling unsupported in their journey from novice to expert. With many NGRNs choosing to leave the nursing profession within the first year of practice, organizations must invest in programs to support their transition from academia to practice. This project implemented First Year Coaches and regularly scheduled touchpoints with NGRNs to increase intent to stay at the organization, feelings of support, and future …

Postdural Puncture Headaches And The Development Of A Treatment Protocol, Matthew Gill

Doctor of Nursing Practice Projects

Roughly 1% of patients receiving an epidural for analgesia will experience an accidental dural puncture (ADP). Of that 1%, half will go on to develop a postdural puncture headache (PDPH) (Apfel, 2010). PDPH presents 24-48 hours after neuraxial anesthesia as a dull, bilateral, throbbing, postural headache that is often accompanied by nausea (Patel et al., 2020). Although PDPH is a fairly common complication associated with neuraxial anesthesia, many facilities offering obstetric services lack a written protocol addressing ADP and PDPH treatment. The purpose of this project was to design and introduce a PDPH evidence-based treatment protocol for a hospital in …

Enhancement Of A Peer Mentorship Program For Student Registered Nurse Anesthetist, Cassie Starrett, Katrina Harlan

Doctor of Nursing Practice Projects

Nurse anesthesia programs are associated with rigorous didactic work, doctoral projects, long clinical days, and high levels of financial debt (Mesisca & Mainwaring, 2021). Doctoral students experience significantly higher levels of stress than other graduate students, necessitating resources that support emotional wellness (Griffin et al., 2017). A mentorship program for student registered nurse anesthesiologists (SRNA) may help minimize perceived stress and lessen the adverse physical and psychological effects. While mentorships foster both personal and professional success for mentees, mentors also report increased interest in professional development, productivity, and satisfaction (Flexman & Gelb, 2011). This study aimed to evaluate the effectiveness …

Improving Traumatic Brain Injury Outcomes: Early Identification And Management Of Paroxysmal Sympathetic Hyperactivity, Randi Rockwell

Doctor of Nursing Practice Projects

Abstract

Background: Paroxysmal sympathetic hyperactivity (PSH) can occur in patients with acutely acquired brain injury and is associated with mortality, poor clinical outcomes, prolonged hospitalizations, physical disability, and increased healthcare costs. The most common cause of PSH syndrome is traumatic brain injury (TBI). Symptoms consist of hyperthermia, diaphoresis, arterial hypertension, tachycardia, tachypnea, and extremity motor dystonic posturing, often in response to evoked stimuli and occurs in 8% to 33% of TBI patients. Critical care nurses are at the forefront of providing direct patient care to TBI patients and are often the first to identify PSH.

Purpose: The objective of this …

Identification Of Molecular Markers Associated With Copd In Non-Smokers And Smokers: A Bioinformatics Analysis, Agede O. Ayodele, Isa M. Wasagu, Ademola E. Fawibe, Alakija K. Salami

The University of Louisville Journal of Respiratory Infections

Background

Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential.

Methods

Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively.

Results

In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The …

Barriers And Facilitators To Anti-Retroviral Therapy Adherence Among Adolescents Aged 10 To 19 Years Living With Hiv In Sub-Saharan Africa: A Mixed-Methods Systematic Review And Meta-Analysis, Londiwe D. Hlophe, Jacques L. Tamuzi, Constance Shumba, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Background: Human Immunodeficiency Virus (HIV) significantly affects adolescents globally, with the sub-Saharan Africa (SSA) reporting a high burden of the disease. HIV testing, treatment, and retention to care are low among adolescents. We conducted a mixed-method systematic review to assess anti-retroviral therapy (ART) adherence; barriers and facilitators to ART adherence and ART outcomes among adolescents living with HIV and on ART in sub-Saharan Africa.

Methods: We conducted searches in four scientific databases for studies conducted between 2010 and March 2022 to identify relevant primary studies. Studies were screened against inclusion criteria and assessed for quality, and data was …

Facilitating Learner Engagement And Success Through Collaborative Study Guides In Online Nursing Graduate Courses, Yolany Lizzeth Lagos Ortiz

Graduate Theses and Dissertations (2019 - present)

This mixed methods study sought to explore how graduate nursing students engaged with a study guide intervention to determine the relationship between the intervention and students' performance in the end-of-course assessment and their perceptions of cognitive presence and social presence in a fully online graduate evidence-based methods nursing course. This study used a quantitative-driven mixed-methods concurrent research design. The 371 students enrolled in the 28 course sections were invited to participate. 325 students were engaging with the study guide, and 192 responded to the questionnaire. In quantitative analysis, the independent variables in this study were students' responses and views to …

An Examination Of The Impact Of Covid-19 On The Job Satisfaction And Emotional Well-Being Of Icu Nurses, Laura Ruth Daffron

Undergraduate Honors Theses

Healthcare systems have been demonstrably altered because of the COVID-19 pandemic. Resources were stretched and patient conditions deteriorated on a scale previously unseen, leaving nurses at the forefront to face the adversities brought about by the pandemic. In this study, a questionnaire was utilized to better understand how COVID-19 has impacted the stress level, resilience/well-being, moral distress, job satisfaction/enjoyment, practice environment, and intent to remain in the nursing profession of nursing alums from East Tennessee State University. This study focused on a subset of nurses working in critical care, to consider the impact that the pandemic had on ICU nurses’ …

Lesbian, Gay, Bisexual, Transgender, Queer (Lgbtqia+) Health Disparities In Sexual Health And Sexual Education, Cole T. Mcbride

Curriculum and Instruction Undergraduate Honors Theses

Background: Comprehensive sex education instills knowledge and promotes the health of all youth, however, most sex education remains heteronormative. School-based programs in the United States (US) emphasize monogamous, heterosexual relationships. In 2021, only 7.4% of students received sex education that included positive representations of both LGB and transgender people and nonbinary topics, while 72% of programs across the US omit LGBTQ+ topics. Most new HIV diagnoses occur in gay and bisexual men aged 13-34, but the sex education environment for this group is increasingly hostile as more states prohibit addressing these topics in public schools.

Purpose: The purpose …

Utilization Review And Utilization Of Evidence-Based Guidelines, Rosetta E. Hairston

Doctoral Projects

The quality improvement project focused on determining why utilization review nurses submitted epidural steroid injection treatment requests within evidence-based guidelines to peer review. The study reviewed six months of data from June 2022 through December 2022 to develop a pre-training baseline for the number of epidural steroid injection treatment requests approved by the nurse and approved by peer review. Deming's method for quality improvement was identified as the framework for implementing changes. The UR nurses were provided four weeks of refresher training on applying evidence-based guidelines to epidural steroid injection treatment requests. Post-group training sessions reflected a 91% increase in …

Implementation Of Web-Based Patient Education In Newly Transplanted Kidney Recipients, Tabo Mwikisa-Kelly

Doctoral Projects

Kidney transplantation is the preferred treatment for patients suffering from kidney failure. It is a complex process that is intended to improve one’s quality of life by adhering to a lifelong treatment plan of immunosuppressant therapy. Therefore, it is essential for patients or their caregivers to have adequate knowledge to care for themselves following post-transplant, which can contribute to better patient outcomes. In a metropolitan Bay area hospital in Northern California, the current state of practice involves educating newly transplanted kidney recipients through face-to-face interactions with the patient and handing out a transplant booklet during their initial transplant hospital stay. …

Speak Up For Hand Hygiene And Decrease Healthcare Associated Infections, Bernadette Priya Pandya-Orozco

Doctoral Projects

Background: Hand hygiene (HH) is one of the most cost-effective and simplest ways to reduce healthcare associated infections (HAIs). Incorporating Speak Up for hand hygiene enables healthcare workers (HCW) to communicate without fear when they observe noncompliance with HH requirements.
Objective: To increase HH compliance by utilizing Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS education to encourage Speak Up for HH and lead to reduction in HAIs.
Methods: The researcher provided educational training on “Speak Up for Hand Hygiene” and performed regular audits to examine its effects on one hospital unit in a California Bay Area healthcare system. A …

Experiences Of Transitioning Medics And Hospital Corpsman, David Renfro

Doctoral Projects

Approximately 2,000 medics transition from military service to civilian jobs annually, and the civilian workforce currently does not have a mechanism to utilize the skills of these transitioning veterans. Medics and Hospital Corpsmen are not licensed or certified, making transferring into employment in the community difficult. The Veterans Affairs (VA) has an intermediate care technician (ICT) program that provides employment for previous active-duty medics and hospital corpsmen. Understanding the transition of medics and hospital corpsmen better positions the Department of Defense and the VA leadership to support the transitioning veteran.
This DNP project used a quality improvement framework, and a …

Nursing Professional Development Practitioner’S Experience Of Use Of Instructional Design Industry Standards, Denise Renfro

Doctoral Projects

Instructional design (ID) is a critical skill for nursing professional development practitioners (NPDs). Instructional design seeks to solve gaps in knowledge or skill by identifying both the educational issue and the outcomes by designing how to achieve the outcomes. There are complex and advanced instructional design needs for problem solving that requires an educational foundation in instructional design and experience. The purpose of the quality-improvement project was to assess the changes in NPD practitioners’/nurse educators’ adaptation to industry standards for ID pre- and post-implementation of a standardized instructional design model. The Nurse Educator Self-Assessment in Measuring Learning survey was developed …

Examining The Effectiveness Of Physical Activity Patient Education In Improving Hba1c, Nadieh Samiaei

Doctoral Projects

Regular physical activity plays an important role in maintaining good health and managing and reducing HbA1c among type 2 diabetes patients. The goal of this study is to examine the effectiveness of physical activity in reducing the HbA1c among the type 2 diabetes patients of a local community health center in San Leandro, California. A quasi-experimental, pretest-posttest single site design project was conducted among a sample of 24 patients who had type 2 diabetes. The participants were selected to attend regular patient education classes promoting physical activity, diet, and lifestyle change as a measure of controlling diabetes. A paired sample …

An Evaluation Of A Structural Competency Training For School Nurses, Rachel J. Torres

Doctoral Projects

The aim of this quality improvement project was to use structural competency as a tool to highlight the broad social, political, and economic structures that influence health and subsequent inequities and disparities. A one group, pre-and post-design quality improvement project was used to determine whether the Structural Competency Working Group curriculum influenced school nurses’ thought processes regarding the factors that influence health outcomes. The curriculum was adapted to a 1.5-hour training and delivered to a group of school nurses from a highly populated and socially, economically, and culturally diverse urban county in northern California. The results showed that after the …

Expanding Labor Support Education To Nurses Caring For Women In Labor, Ana L. Viera-Martinez

Doctoral Projects

The ability to provide emotional and physical support to a patient during one of the most significant moments of her life is a privilege afforded to intrapartum nurses who attend to laboring and delivering mothers. Labor support improves birth outcomes, reduces cesarean birth rates, and decreases anesthesia use. More labor support education needs to be made available to intrapartum nurses. Within the hospital context, this quality improvement (QI) project investigated the effects of educating intrapartum nurses about labor support and providing them with hands-on training. Surveys, including the Self-Efficacy Labor Support Scale, were as given pre- and post-education to evaluate …