Family Practice Nursing Commons^™

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Improving Effective Care In Obese Patients In A Primary Care Clinic, Amy Miller

Journal of Interprofessional Practice and Collaboration

Background: Obesity is a preventable epidemic and costs the United States $200 billion annually. The leading causes of death are linked to obesity.

Local Problem: In a chart review, 53% of patients at a northeast Louisiana primary care clinic were obese. However, none were offered comprehensive lifestyle intervention. The aim was to increase the percentage of patients with BMI < 30 kg/m2 to 60% over 8 weeks.

Methods: A rapid-cycle quality improvement initiative was implemented using four Plan-Do-Study-Act cycles over 8 weeks. Each cycle produced tests of change related to screening, patient and team engagement, and assessing effective care. Run charts and aggregate tables were used to analyze …

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

The Effects Of Screen Time On Children, Jacqueline Valdepenas

Nursing | Senior Theses

With the development of technology continuing to grow at a fast-paced pace in society, children are now becoming exposed to such technology at a younger age. The introduction of smartphones and tablets, which is defined as screen time in this paper, are being introduced to children as young as 6 months of age. Instead of children playing with toys recommended for their age, they use screen time for their play needs and entertainment. Some parents use screen time as a distraction and/or relief for their own needs when the child is upset or they’re unable to tend to the child. …

Mental Health Benefits Of Physical Activity In Older Adults, Adrian Kurt Zitzmann

Master of Science in Nursing Family Nurse Practitioner

Physical activity is the fountain of youth, strengthening both the physical body as well as the mind, leading to better emotional stability and a general sense of well-being. The population over age 65 is nearing retirement age and are transitioning from a high paced work and family life to a slower and less active “empty nest” lifestyle. Among adults over age 65, will implementing an exercise program for 30 minutes per day increase mental well-being? The benefits of physical activity will be supported by gathering a group of older adults ages 65 and up from a local retirement community to …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

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 …

Global Child And Family-Centered Care Fellowship, Education And Mentorship For Pediatric Healthcare Professionals: A Literature Review, Ashley Zheng, Bobbijo Pansier

Patient Experience Journal

Child- and family-centered care (FCC) is increasingly accepted and implemented to optimize the healthcare experience for patients, their families, and healthcare professionals. Standish Foundation for Children, a 501(c)(3) non-profit, has designed and piloted a fellowship to educate pediatric healthcare professionals in FCC & psychosocial care via an inquiry and mentorship model in Tbilisis, Georgia. This review aimed to evaluate and synthesize existing literature on psychosocial and FCC mentorship for pediatric healthcare professionals in four parts: ongoing need, effects on healthcare professionals, effects on children and their families and/or caregivers, and in cross-country healthcare settings. Reviewers searched open-source databases for articles …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

Early Integration Of Palliative Care With Curative Oncology Treatment For Patients With Advanced Cancer: Implications For Clinical Nursing Practice, Rhea Rughani

Honors Projects

Palliative care, though clinically established to improve health-related quality of life measures for patients with advanced illness, remains underutilized and largely limited to end of life care. This project aims to inform oncology nursing practice through the analysis of literature supporting the early integration of palliative care with standard curative oncology treatment for patients with clinically advanced cancer. Informed by relevant research, clinical practice guidelines, and improved specialty palliative care training, oncology nurses and nurse practitioners are ideally situated to advocate for and initiate early palliative care integration, to holistically improve the standard approach to complex cancer care.

Caregiver Satisfaction Of Telehealth Initiatives For Developmental Surveillance And Evaluation In Pediatric Autism Spectrum Disorder, Aashiyana Patel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

PURPOSE: To examine parental satisfaction of a telehealth program aimed to improve the identification and diagnosis of pediatric ASD in Northwest Arkansas.

DESIGN/METHODS: caregivers referred to the Access for Autism clinic received a satisfaction survey regarding the telehealth practices the clinic employs. This 5-point Likert scale survey was designed to measure six different constructs associated with telehealth satisfaction: assurance, empathy, reliability, responsiveness, usability, and patient satisfaction

CONCLUSIONS: Telehealth is a suitable alternative to attending medical appointments. The key finding indicated that 40% of caregivers believed the level of care received to be equal in telehealth and in-person appointments.

The Nutritional Management And Glycemic Control In Adolescents With Diabetes, Jennifer Durham

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this literature review is to explore the relationship of nutritional management on glycemic control amongst adolescents who have diabetes. The adolescent population has significant negative or positive peer influence on the management of their diabetes (Yang, 2018, p.104). These peer perceptions can include empathy, curiosity, knowledge seeking, enthusiasm, fearfulness, and bullying (Yang, 2018, p.104). These influences directly affect nutritional management, blood glucose levels, and insulin management. When the peer influence is negative the individual is less inclined to acknowledge their medical condition (Yang, 2018, p.105). Other influences on the management of diabetes include technology, physical exercise, and …

The Associations Of Chronic Stress, Social Support, Health Behaviors And Metabolic Syndrome Among Hispanic Women, Edna Esquer

Dissertations

The Associations of Chronic Stress, Social Support, Health Behaviors and Metabolic Syndrome Among Hispanic Women

Background: Metabolic syndrome (MetS) prevalence is 25% among Mexican American women 30 – 49 years of age, compared to 22% among non-Hispanic Whites in the United States. Little is known about the additional contributions of chronic stress, social support and health behaviors to the development of MetS among this population.

Purpose: Describe the associations between chronic stress, social support, and health behaviors and the presence of MetS in Hispanic women living in an underserved community.

Methods: A retrospective cohort study design. The Adult Treatment Panel …

Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel

Doctor of Nursing Practice Final Manuscripts

Abstract

Background

Congenital heart disease (CHD) is the most common birth defect and affects almost 1% of all live births. Treatment anxiety is common among children with CHD who undergo multiple procedures early in their lifetime. Dramatically increased life spans for this cardiac population has led to a shift from focusing on survival to their long-term health outcomes.

Methods:

Administration of the Peds QL Cardiac Module 3.0 assesses health related quality of life (HRQOL) during annual visits to a Cardiac Neurodevelopmental (ND) Clinic by evaluating the level of Treatment Anxiety a patient experiences during healthcare appointments. The questionnaire scores are …

Eastern European Orthodox Christian Immigrant Women: A Pilot Study And Needs Assessment, Kimberly A. Babich-Speck

Doctor of Nursing Practice Scholarly Projects

The healthcare perceptions of the Eastern European Orthodox Christian immigrant women (EEOCIW) to the United States (U.S.) are under-represented in the literature. Although they appear similar to Americans, their cultural and religious traditions are outside the mainstream American culture. This pilot study and health needs assessment examines the women’s healthcare perceptions of 14 EEOCIW and identifies similarities and differences with 25 U.S. born Orthodox Christian women (USOCW). Between September and November 2020, interviews were conducted with Orthodox Christian immigrant women from Eastern Europe and Orthodox Christian women born in the U.S. Questions covered the perceptions of women’s healthcare, factors influencing …

Evaluating Va Nurse Acceptance Of Virtual Healthcare Technology During The Coronavirus Outbreak, Francesca Bryan-Couch

Doctor of Nursing Practice Scholarly Projects

At a regional Veterans Administration (VA) hospital, nurses performing case management were unable to perform face-to-face visits with patients due to coronavirus. Care coordination and discharge planning efforts occurred through telephonic case management to preserve personal protective equipment and reduce transmission rates through social distancing. Trust and rapport between patients and nurses were reduced without personal contact. Peplau’s theory of interpersonal relations described six nurse roles and three phases of relationship development required to create therapeutic nurse-patient relationships. Connectedness was a key concept considered to be the path to a successful meaningful therapeutic nurse-patient relationship (Hrabe, 2005).

To evaluate current …

Examining The Effect Of Provider Bias On Pain Management In Black Patients: A Systematic Literature Review, John Massey, Monica Gambilado

Thinking Matters Symposium

Black Americans face unequal treatment for pain management when seeking care. The aim of this systematic literature review is to examine the impact of provider bias on Black patients receiving appropriate pain management interventions in the clinical setting. This review followed the Preferred Reporting Items for Systematic Literature Reviews and Meta-Analysis guidelines. CINAHL and PubMed were searched with the following key search terms: Black/African American, bias, prejudice, discrimination, unconscious bias, pain management, pain reduction, pain control and analgesic. A self-developed Critical Appraisal Tool was used for quality assessment of the studies included in the review. A total of 101 probable …

Impact Of Group Prenatal Care On Health Outcomes For Women Of Color In The United States: A Systematic Literature Review, Morgan Brockington, Emily Bauer, Julie Kameisha

Thinking Matters Symposium

Women of color in the United States experience disproportionately higher rates of adverse pregnancy-related outcomes, both in the prenatal and postpartum period. Group prenatal care (GPC) has been gaining popularity in recent years and has demonstrated improved health outcomes. The aim of this systematic literature review was to examine and summarize the impact of group prenatal care on health outcomes for women of color in the United States. Using a systematic approach and PRISMA guidelines, two electronic databases—CINAHL and PubMed—were used to search the literature. Quantitative research studies that were published in peer-reviewed journals between 2010 and 2020, written in …

Don't Miss These Patients! The Experience Of Working Full Time While Also Being A Caregiver, Debbie Conner, Alyncia Bowen

All Faculty and Staff Scholarship

The project sought to understand the experiences of working professionals who are also the caregiver for others with a health care issue. A caregiver in this research study is an individual who provides personal, financial, social, physical, and or psychological support from individuals other than themselves. It has believed that a significant number of professionals serve as a caregiver for individuals such as, but not limited to, a parent, partner, significant other, spouse or child.

Effect Of An Intervention To Improve Smoking Cessation Treatment In A Federally Qualified Healthcare Clinic, Shirley A. Camp

The Corinthian

Abstract

Significant progress has been made in the reduction of tobacco use in the United States, but the smoking prevalence among the socially and economically disadvantaged populations (i.e. individuals who are homeless, uninsured, LGBT, and living with HIV) is significantly higher than the general population (CDC, 2018b). As a result, these vulnerable populations carry a disproportionate burden of tobacco-related mortality and morbidity (CDC, 2018b). There is a cost-effective and evidence-based treatment for tobacco use dependence (Fiore et al, 2008), but the delivery by primary care providers to this population is inconsistent (Tyman, Bonevski, Paul, & Bryant, 2014). This study focused …

Brown Bag Review For Identification Of Discrepancies In Patient Medication Use, Chandra James, Shawna Mason, Shellye Vardaman, Amy Yoder Spurlock

Journal of Interprofessional Practice and Collaboration

Patients suffer unintentional harm from their medications. Many organizations have proposed that healthcare providers implement strategies to decrease medication related harm for patients. This study implemented a brown bag review along with medication safety education within a clinic that caters to the poor and uninsured. It was notable that the majority of the participants educational levels were equivalent to a high school graduate or beyond. In the pre-intervention survey, they expressed that they were knowledgeable about the purpose of their medicines, they knew the correct way to use their medications, and they were aware of potential side effects. During their …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Medical Noncompliance In A Pediatric Patient Living In A Single-Parent Household, Lucy Obianuju Norrell

Electronic Theses and Dissertations

Abstract Noncompliance is a patient’s inability to comply with the recommended treatment for their complete recovery from an ailment, while compliance is the extent to which a patient adheres to the provider’s directive, such as medication and orders given. The purpose of this study was to determine if motivational interviewing when applied to noncompliant pediatric patients from single-parent households, would improve global medical compliance in this population as compared to the standard of care at the end of three months. Thirty-two participants were recruited using the homogeneous purposeful sampling. The project employed a mixed-method approach. Fred Kleinsinger’s noncompliant behavior tool …

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …

What's All The Buzzy About? Using Cryotherapy And Vibration For Pain During Vaccinations In Children, Marta L. Byma

Evidence-Based Practice Project Reports

Vaccinations are the most common painful needle procedure, with an estimated 12 billion injections given per year (CDC, 2019). The usual method for administration of vaccinations is through needle puncture, which is often painful. Children often report receiving a shot as one of the most feared and painful experiences (McMurtry et al., 2015). The purpose of this evidence-based practice (EBP) project was to improve patient experiences by decreasing the pain that is associated with vaccinations through the use of a nonpharmacological method for comfort via the Buzzy® device. After thorough analysis and synthesis of the literature, the Buzzy® device that …

Supporting Positive Lifestyle Changes Among Patients With Diabetes Mellitus Type 2, Alison Tynan

Nursing | Senior Theses

The following thesis is a compilation of literature reviewed to formulate background research for a pilot study. The literature reviewed pertains to the potential benefit of added case management for patients with diabetes mellitus type 2. A proposed pilot study, based off of this research, aims to identify topics, tools, facts, and changes that can be made to case management to improve not just the biological aspects, like HbA1c levels, but the mental and emotional as well to allow for whole person care.

The primary question being asked is “what types of support do people with diabetes mellitus type 2 …

Adolescent Mental Health Training For Middle School Educators, Sarah Minton

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Adolescent mental health disorders are an increasing concern in the United States. School systems, specifically educators, are in the unique role to aid in early identification of mental health disorders, as well to intervene in mental health distress. However, mental health training for educators is lacking, leaving educators unprepared to manage mental health concerns within their classroom.

Purpose: The purpose was to utilize an evidence-based training, the “Teacher Knowledge Update Guide” from TeenMentalHealth.org to train middle school educators on the signs and symptoms of mental health conditions in the adolescent population with the intent to increase awareness, knowledge, …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

A Multi-Component Education, Skill, And Resource Evidence-Based Practice Intervention For The Alzheimer’S Caregiver, Cheryl Garmon

DNP Final Reports

Abstract

Dementia caregiving is expensive, stressful, and consumes all facets of the caregiver’s (CGs) life. The purpose of this project is to introduce the evidence-based practice (EBP) interventions most helpful in decreasing stress and burden in those who are in-home caregivers for Alzheimer’s disease and related dementias (ADRD) individuals.

The three primary intervention domains of the EBP studies that results in a positive impact are; providing education about the terminal course of the disease, introducing communication and caregiving skills, and furnishing resource and social network information.

The methodology included a convenient and voluntary population of CGs who sought service at …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …