Multi-Method Approach To Examining Psychosocial Responses And Reactions To Covid-19 In The Us And China, Fan Li

Dissertations

Objective

The purpose is to examine health care providers’ psychosocial responses to COVID-19 in China and the US via exploring relationships among psychological responses and describing experiences of working at the epicenter during the pandemic.

Methods

In manuscript one, a cross-sectional study was conducted in nurse and physician volunteers who provided direct care to COVID-19 patients in Wuhan (volunteers) and those with no COVID-19 contact outside of Wuhan (non-volunteers). A path analysis theoretical model was developed to illustrate the relationships among psychosocial variables and was separately applied to volunteer and non-volunteer groups.

In manuscript two, a cross-sectional study was conducted …

Evaluation Of An Education Program Implementation For Adults With Stage 4 And 5 Chronic Kidney Disease, Dana Marie Carter

Dissertations

Abstract

Problem: Patients with long-term medical conditions represent a significant public health issue. Therefore, patients diagnosed with a chronic illness must have a high level of health literacy (HL) to manage their condition effectively. This Quality Improvement (QI) project evaluated the impact of an existing education-based program for stage 4 and 5 chronic kidney disease (CKD) patients and its effect on laboratory values compared before and after an NP-led education program that included vascular access, and modality choices.

Methods: A retrospective chart review was completed on 20 patients with an inclusive diagnosis of CKD stage 4 or 5 from …

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …

Effect Of A Turn Clock On Hospital-Acquired Pressure Injury Incidence, Sydney Warren

Dissertations

Problem: Hospital-Acquired Pressure Injuries (HAPIs) are the only quality metric increasing in incidence and are preventable. HAPIs are wounds to bony prominences during a hospitalization and can increase hospital costs, morbidity, and mortality. HAPIs could be prevented through interventions, including repositioning patients every 2 hours and using a turn clock method. The aim of this quality improvement (QI) pilot project was to decrease HAPI incidence.

Methods: A turn clock method was implemented on a general medicine floor at a mid-sized, suburban medical center utilizing a descriptive retrospective observational design. Data was collected for the pre-intervention timeframe from June through August …

Implementing Patient Acuity Scale On A Medical-Surgical Unit, Coreen Ladd

Dissertations

Problem: Nurses commonly report dissatisfaction with their workload levels due to inequity of shift assignments. Imbalanced workload distribution has been shown to lead to missing or delayed care. Increased nursing workload has been linked to increased fall rates, healthcare associated infections, and avoidable deaths. Research has shown that patient classification is more accurate when an instrument is used. The purpose of this quality improvement project was to implement a patient acuity tool to aid nurse-patient shift assignments on a medical-surgical unit. The project aimed to provide a standardized and objective method of measuring patient acuity.

Methods: The project took place …

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

The Effectiveness Of Continuous Video Monitoring In Reducing Inpatient Fall Rates, Yunhee Cruse

Dissertations

Abstract

Problem: Falls are one of the most frequently occurring safety events in hospitalized patients, resulting injuries that can be devastating and burdensome. Patients in neuro-telemetry unit are at greater risks for falls due to their conditions. The continuous video monitoring (CVM) program was implemented to reduce fall rates in the neuro-telemetry unit. This project was to examine the effectiveness of CVM program in reducing fall rates.

Method: A pre- and post-implementation observational evaluation was conducted. By reviewing retrospective data from January 1, 2020 to January 31, 2021 for pre-implementation period and from March 1, 2021 to October 31, …

Nursing Anxiety Self-Evaluation And Resiliency Methods, Dianne Deck

Dissertations

Abstract

Introduction: Nurses are stressed due to the demands of their job. This study aims to determine whether MICU nurses at a large Midwestern hospital would have reduced stress and anxiety after a 30-day meditation and exercise intervention.

Design and Methods: A quasi-experimental pre-post pilot study design was adopted. The convenience sample consisted of eight Medicine Intensive Care Unit (MICU) nurses in a large Midwestern urban tertiary medical center. Data collected included demographics, pre- post-Beck Anxiety Inventory Scale (BAIS), pre- and post-Single Item Stress Scale (SISS), and weekly diaries on exercise and meditation.

Results: The pre- post-SISS showed statistical significance …

Improving Recognition And Treatment Of Depression Among Women Using Phq-9 During Office Visits, Victoria Nwokocha, Heather Owens, Chris Webb

Graduate Theses, Dissertations, and Capstones

Depression can affect productivity and earnings among women, slow down the pace of active participation in social and family life, and increase health costs as well as distract attention from optimal health targets. Depression is the highest source of disability in NYC, with billions of dollars annually in related productivity losses. Although healthcare spending on depression affected patients is largely on hospital admissions, an estimated 40% of affected persons in New York do not get the adequate attention and care needed, with women most often affected by depression. This is an indication that the bedrock of preventive medicine for mental …

Predictors Of Engagement In Nursing Professional Practice: Transforming Organizational Culture In The Post-Covid Healthcare Environment, Jennifer Garnand

Dissertations

Cultivating the shared belief that individuals matter within an organization enhances the empowerment of staff and supports enthusiastic engagement in organizational efforts aimed toward a common mission, vision, and goals (McShane & Von Glinow, 2019). The nursing profession has been plagued by an unprecedented decrease in engagement and diminished job satisfaction, particularly following the prolonged tenure of the COVID-19 pandemic, leading to subsequent attrition amidst a staffing crisis. This quantitative predictive correlational study seeks to determine whether proactive and persevering characteristics, professional identity, and passion of nurses are predictors of engagement in a post-COVID healthcare environment. The research was based …

Culturally Tailored Diabetes Self-Management Educational (Dsme) Program And Its Impact On Motivation And Self-Efficacy Among Hispanic Adults With T2dm: A Pilot Study, Andrellie P. Van Wageningen

Doctoral Projects

Type 2 diabetes mellitus in the United States is an epidemic that disproportionately affects Hispanics in the state of California. Many factors have been attributed to this phenomenon because of their unique characteristics. As recent studies have pointed out, their social determinants of health, cultural influences, and genetic predisposition often lead to poor health outcomes and impaired quality of life. A targeted approach is critical in promoting increased diabetes knowledge, enabling skills to master self-care activities, and positive self-care behaviors to avert poor outcomes. The purpose of this doctoral project is to examine whether culturally tailored DSME influences an individual’s …

Providing Education To Staff Members On Implementing Follow-Up Education At Discharge To Patients With Low Heart Scores, Daniel Burton

Doctor of Nursing Practice Projects

Background: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) provides accreditation to hospitals, including “heart certification.” The facility was successful at meeting the four measures previously assigned to them. As a result, they were given four new measures. One of these standards is providing discharge education based on “heart scores.”. Only 35% of patients are receiving discharge/follow-up education at discharge from the emergency department (ED).

Purpose: The purpose of this study is to increase the number of patients receiving chest pain education and follow-up instructions in the ED as evidenced by the improvement in documentation of the interventions.

Methods: …

Covid's Impact On Nurses & Their Labor Market, Joshua Stanfill

University Honors Theses

The Covid pandemic has swept across the globe impacting many different kinds of people in many different ways. Businesses and workers experienced changes in how their respective labor markets operated with new incentives. One group of laborers that experienced quite a significant impact are nurses working through the Covid pandemic. The pandemic created new incentives for nurses that heavily impacted their labor market. Through a literature review of scientific studies examining the impacts of working through a pandemic on nurses, I discovered that this was causing psychological and emotional damage to nurses. Covid spurred on an already occurring nursing shortage …

Commencement Program 2022, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2022 Events of Commencement

5 | The Academic Procession

6 | Institutional Administration

7 | Board of Trustees

8 | Significance of Academic Regalia

9 | University History Highlights

11 | Criteria for Institutional Awards

13 | Loma Linda University Health and Loma Linda University Honorees

27 | The Programs, The School Honorees, and The Speakers

• School of Medicine, 28
• School of Pharmacy, 52
• School of Dentistry, 67
• School of Public Health, 92
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication Sciences and Disorders, …

Effect Of The Virtual Simulation Paired Prebriefing-Debriefing Strategy On Nursing Students’ Self-Efficacy Perceptions And Virtual Simulation Performance In The Care Of Patients Experiencing A Myocardial Infarction, Laura M. Penalo

Dissertations, Theses, and Capstone Projects

Through the use of virtual simulations (VS) in nursing education, nursing students are exposed to a variety of clinical scenarios that may potentially improve their learning of competencies, increase their self-efficacy, and enhance their future clinical performance. Despite limited quantitative research incorporating evidence-based strategies such as prebriefing and debriefing as part of the VS experience, this educational technology continues to gain popularity. In 2020, the use of VS in the nursing curriculum exponentially increased when the global COVID-19 pandemic impacted traditional in-person clinicals, laboratory, and human patient simulation (HPS) experiences. Associate Degree Nursing (ADN) programs have benefited from the use …

A Nurse Is To A Patient What A Mother Is To A Child, Farhan S. Imran

Advances in Clinical Medical Research and Healthcare Delivery

A physician's tribute the profession of nursing.

Correlates Of Health Literacy And Perceptions Of Burden Among Caregivers Of Persons Diagnosed With Chronic Illnesses, Mubarak Aldawsare

Dissertations

Background/Rationale: Greater attention is needed on factors effectively supporting caregivers because poor well-being of caregivers can hamper overall patient outcomes. Lack of awareness of caregiver burden has implications for healthcare systems globally. Caregivers may encounter various levels of burden as a result of providing long-term care to individuals diagnosed with one or more chronic illnesses. Caregivers with inadequate health literacy are more likely to experience feelings of uncertainty, and as a result, caregiver burden. Little is known about the impact of the health literacy of caregivers on the level of burden when providing care to individuals with complex care …

Phenomenological Study Of The Lived Experience Of New Graduate Nurses Caring For Hospitalized Patients Living With Dementia, Geline Buenconsejo

Dissertations

Title. Phenomenological Study of the Lived Experience of New Graduate Nurses Caring for Hospitalized Patients Living with Dementia.

Purpose. This study explored new graduate nurses’ lived experiences in caring for hospitalized patients living with dementia.

Background. The first twelve months of transitioning from student to professional nurse in acute care settings are the most stressful, emotionally challenging, and mentally exhausting for new nurses striving to apply newly acquired skills into practice. Some of the most challenging patients for nurses to care for are hospitalized patients living with dementia (PtLWD). With the projected increase in the number of patients with dementia …

A Description Of Impostor Phenomenon In Certified Registered Nurse Anesthesiologists, Jeffrey R. Darna

Dissertations

Background: Imposter Phenomenon (IP) is an evolving, multidimensional construct defined as self-perceived intellectual phoniness and professional ineptitude frequently experienced by individuals working in high performance or competitive environments. IP consequences include psychological distress, role under-optimization, and professional paralysis. Certified Registered Nurse Anesthesiologists (CRNAs) are at risk for impostorism; however, IP presence, intensity, and career effects are unknown.

Purpose: The study measured IP in CRNAs and determined the relationship between IP and select sociodemographic and practice variables.

Methods:

Design: A descriptive, cross-sectional correlation design measured IP using an Internet-based survey from a random sample of 170 members of the American …

Econsent Forms On Ancillary Applications With Electronic Medical Record Integration – Reducing Consent Error, Lilian Chan

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The purpose of this project is to utilize electronic consents (eConsents) with ancillary applications as an evidence-based intervention to reduce consent errors.

Background: Studies show that paper-based handwritten forms have an error rate of up to 50%. Consent errors, especially in the preparation of surgery, are not merely documentation errors but patient safety pitfalls that allow for incorrect surgeries or financial loss due to aborted or delayed interventional cases. Internal organizational evidence indicates the implementation of an evidence-based opportunity as there was no use of electronic tools for consents utilized in the inpatient setting.

Methods: Inpatient departments …

A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford

Mindfulness Studies Theses

The Center for Mind-Body Medicine (CMBM), founded by Dr. James Gordon, provides communities with evidence-based Mind-Body Skills Groups (MBSGs) that foster self-care, self-awareness, and self-expression. MBSGs range from 8 to 12-week series on various mind-body practices wherein group members meet, practice, and reflect on the impact of mind-body skills in their lives. Research has demonstrated that participants in MBSGs have positive outcomes. Healthcare professionals (HCPs), especially nurses, gain resiliency from MBSGs. As facilitators of MBSGs, nurses develop essential skills transferable to clinical and educational settings. MBSGs are therapeutic for adult participants with chronic stress. Prior to this thesis, only one …

Supporting The Nursing Workforce And Addressing The Phenomena Of Nursing Burnout With Evidence-Based Mental Health Interventions, Kelly Leung

Master's Projects and Capstones

Problem: Burnout within healthcare has been an existing phenomenon, contributing to increased hospital staff turnover rates and the nationwide nursing shortage. The COVID-19 pandemic has exacerbated this issue leading to a decrease in the quality of patient care, nurse satisfaction, and organizational financial security.

Context: At a South Bay Area public healthcare system, staff were displaced throughout the community to support the overflow of COVID-19 patients at ambulatory clinics. Due to the nature of COVID-19, this healthcare system has experienced barriers in maintaining available staff for the demand of work. Studies indicate that signs of increased stress and burnout observed …

Mentorship In Retail Health - A Quality Improvement Project Initiative, Judith Thigpen

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Nurse practitioners (NPs) practicing in retail health face issues that complicate provision of care including isolation, lack of support staff, and non-clinical administrative and business duties. To address this, a national retail health company implemented a mentorship program for newly graduated, newly hired NPs. This quality improvement project will facilitate the implementation and evaluation of this mentorship program in one of the company’s regions in Georgia.

AVAILABLE KNOWLEDGE: Literature suggests that NPs believe that a mentor can help contribute to professional development, counter stress and anxiety, provide support, increase job satisfaction, and guide in critical decision making.

AIMS: 1. …

Revision And Deployment Of An Oral Anticancer Medication Adherence Toolkit, Kristine Lefebvre

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Oral anticancer medications offer state-of-the-art cancer treatment with the convenience and autonomy of self-care in the home. Professional organizations often provide expert guidance and resources to support the provision of high quality, safe, evidence-based care. LOCAL PROBLEM: Many institutions lack a formal oral anticancer medication program, including a process to assess and monitor adherence. Nurses and their colleagues look to the literature, training, collaboration with colleagues, and through practice tools and programs available through their specialty associations for support in their adherence work. The Oral Adherence Toolkit released in 2016 needed updating to reflect current best practices. METHODS: The …

Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland

Doctor of Nursing Practice (DNP) Projects

BACKGROUND: Millions of nurse practitioners (NP), physician assistants (PA), and registered nurses (RN) are optimistic that their current employers will help them reach their full potential. One area that can add value to the hospital and empower employees to work to the full scope of their practice, and utilize the skillsets like that of an NP, is to train these providers to support medical device equipment in the operating room instead of relying on medical device representatives (MDRs) of medical device companies.

METHODS: Training NPs, PAs, or RNs how to support neurological medical device equipment will better utilize the skillset …

Does Nurses Confidence Improve After Attending A Training For Teaching Home Infusion Patients?, Carol Menorah Young Dnp

Doctor of Nursing Practice Scholarly Projects

Discharge can be a difficult step for patients and their families and a challenging task for nurses. Poor instructions have a negative impact on the patient population. In addition, improper and incomplete discharge information negatively affects the posthospital recovery period and may cause the patient to return to the hospital for the same episode of care. Returning to the hospital emergency room or readmission for the same episode of care will increase the dangers to the patient’s health and recovery plan and increase the cost of individual healthcare. The patient population ranks the quality of discharge information via their responses …

Improving Readiness For Nursing Practice Via Simulation In Workplace Violence Mitigation, Paul J. Weingartner

Doctoral Projects

Workplace Violence (WPV), a significant problem in health care in the United States and worldwide, causes emotional and physical harm to nurses, negatively affects quality care delivery, and contributes to burn out, job dissatisfaction, and attrition. Clinical simulation was used to educate registered nursing students about WPV and train them in mitigation techniques in an effort to improve their awareness and readiness for professional nursing practice. Data from 37 students in their final semester of nursing school were collected anonymously prior to and after reviewing online materials about WPV and attending a 3-hour simulation experience in which two scenarios were …

Nurses In New Mexico: Their Awareness Of Safe Harbor As Reflected In A Survey During A Time Of Covid-19, Ashley R. Gonzales

Doctor of Nursing Practice Scholarly Projects

The healthcare industry is highly regulated to ensure patients receive safe, high-quality, patient-centered care. Even with these regulations, patient outcomes remain poor, given the high expenditure and percentage of the gross domestic product that healthcare comprises in the United States. Nurses make up the largest proportion of the healthcare field and are often overlooked when it comes to policies to ensure their practice remains safe and licenses protected. Nurses are the eyes and ears of their board-certified providers and detect subtle changes in a patient’s condition. However, such attention to detail can be executed only when the nurses can care …

How Implementing A Digital Competency Management System Reduced Nurse Training Cost And Improved Npd Practitioner Satisfaction In A Pediatric Hospital, Dionne Margallo

Doctoral Projects

Healthcare organizations must have high-quality nursing staff to deliver optimal patient care. Educators and managers evaluate nurses by their performance through nursing competencies, or “knowledge, skills, [and] abilities” (KSA) (American Nurses Association, 2015, p. 86). Traditional competency evaluations and manual tracking posed a problem within one pediatric hospital. Leaders did not have a transparent way to see the knowledge and skills of their nursing staff. This resulted in increased organizational costs due to retraining and increased workload and job dissatisfaction among educators. The purpose of this quality improvement (QI) project was to evaluate how implementing a digital competency management system …

Evaluating The Impact Of An Evidence Based Practice Education Program In A Nurse Residency Program On Evidence Based Practice Beliefs, Implementation And Competency, Amy Hu

Doctoral Projects

For organizations to ensure that they are providing safe and quality patient care, they must promote a culture of care based on Evidence Based Practice (EBP). To improve healthcare quality nurses must make care decisions based on the most current scientific evidence. In fact the Institute of Medicine set a goal that 90% of clinical decisions be evidence based by 2020 (Institute of Medicine, 2008). Unfortunately it can take up to 15-20 years for newly discovered treatments to be implemented into patient care (Institute of Medicine, 2001). Healthcare providers continue to base healthcare decisions on outdated practices derived from tradition …