Other Nursing Commons^™

Pursuing Equity In Diabetes Population, Aisha Rawlinson

Master's Projects and Capstones

Abstract

Background

Poor glycemic control (HbA1c >8) overtime leads to microvascular and macrovascular complications after the first and third years respectively, ultimately resulting in death after five years (Karter, 2016). Current Kaiser Permanente (KP) data stratified by race, ethnicity, age, and gender shows a significant disparity gap between Hispanics/Latino and Caucasian populations. The Pursuing IHI initiative is over a 2-year period completed at a microsystem that is focusing on health equity practices to reduce disparity gaps.

Project aim

KP Riverside, microsystem selected has a large population of Hispanic/Latino KP members, with focus on health equity. The project aim is to …

Cnl As Educator In The Emergency Department: Improving Hand Hygiene Outcomes, Michelle Batz

Master's Projects and Capstones

Prevention of hospital acquired infections (HAI) is a National Patient Safety Goal. Proper and frequent hand hygiene (HH) prevents HAI and various cross-infections in any setting. Audits of visual adherence for HH generates low compliance scores. During a yearlong improvement project, low monthly compliance scores of 52% in the Emergency Department (ED) of a community hospital, were reported by hospital auditors and found to be inaccurate by ED staff due to lack of visibility of HH actions because they occurred behind curtains or closed doors. Low scores and challenges were associated with behavioral change among ED team members, requiring multiple …

Aligning Theory And Evidence-Based Practices To Enhance Human Flourishing In Nurse Executives, Jim D'Alfonso

Doctor of Nursing Practice (DNP) Projects

Today’s nurse executives lead highly complex and bureaucratic organizations undergoing sweeping reform at an unprecedented rate of change. Change and high levels of stress are the norm in health care, and ineffective stress management can hinder organizational performance and adversely impact personal wellbeing. The risks of nurse executive burnout and unprecedented turnover led to the development of a 4-hour program to teach theory-guided and evidence-based stress management techniques. The program was intended to increase awareness, enhance effective stress management skills, and improve the nurse executive’s ability to flourish in high stress environments. A pre-intervention and 6-month post-intervention assessment (n …

Acute Bronchospasm Under General Anesthesia, Cody Rasmussen

Nursing Student Class Projects (Formerly MSN)

An acute bronchospasm during general anesthesia can become a life-threatening intraoperative condition for any patient. Bronchospasm occurs when the bronchial smooth muscle constricts which makes ventilating the patient difficult, and can ultimately lead to hypoventilation, hypoxemia, and metabolic acidosis. It’s imperative for any anesthesia provider to understand what a bronchospasm is, its pathophysiology, differential diagnosis, and algorithm of treatments. This poster presentation provides a summary based discussion of acute bronchospasm under general anesthesia.

Should Nurse Practitioners Be Required To Record Immunizations In Immunization Information Systems?, Donald Gardenier, Lacey Eden, Karlen E. (Beth) Luthy

Faculty Publications

The United States Centers for Disease Control and Prevention (CDC)’s Vaccines for Children (VFC) Program, which provides the majority of childhood immunizations, has been in existence for over 20 years. The CDC also created the Immunization Information Systems (IIS) program in which states were allocated funding to create statewide immunization databases. The goal was to maintain a reliable immunization tracking system to keep children on schedule and avoid unnecessary immunizations. In most states, however, only health care providers who are enrolled in the VFC Program are required to enter data into the IIS. Should all providers be required to enter …

Critical Care Nurses’ Suggestions To Improve End-Of-Life Care Obstacles: Minimal Change Over 17 Years, Renea L. Beckstrand, Kacie Hart Hadley, Karlen E. Luthy, Janelle L. B. Macintosh

Faculty Publications

Background: Critical-care nurses (CCNs) provide end-of-life (EOL) care on a daily basis as 1 in 5 patients dies while in intensive care units. Critical-care nurses overcome many obstacles to perform quality EOL care for dying patients.

Objectives: The purposes of this study were to collect CCNs’ current suggestions for improving EOL care and determine if EOL care obstacles have changed by comparing results to data gathered in 1998.

Methods: A 72-item questionnaire regarding EOL care perceptions was mailed to a national, geographically dispersed, random sample of 2000 members of the American Association of Critical-Care Nurses. One of 3 qualitative questions …

A Functional Algorithm For Weight Loss And Obesity Practice: Guide For Clinical Decision-Making For Treating Women, Jennifer A. Tice Williams

Dissertations

ABSTRACT

Background

Overweight and obesity have significant impact and consequences on women leading to reduced quality of life, comorbid conditions and premature mortality. Many healthcare providers lack adequate training and the time to properly treat overweight and obesity. Algorithms have been shown to improve clinical knowledge and save time.

Objectives

To develop an algorithm for weight loss assessment and treatment to aid in the clinical decision-making process while improving the quality of care for overweight and obese clients in an efficient manner that can be replicated.

Methods

After an extensive literature review to identify best-practice guidelines for weight loss a …

Best Practice For Prevention Of Vaccination Common Problems With Antipyretic/Analgesic Medications, Lacey M. Eden, Meridith G. Lind, Karlen E. Luthy, Janelle L. B. Macintosh

Faculty Publications

Nurse practitioners are on the front lines providing parental education regarding vaccines. Some reasons for vaccine hesitancy include the potential common mild problems of vaccine administration, such as pain and/or elevated temperature. According to research, prophylactic administration of an antipyretic/analgesic medication, such as acetaminophen, reduces common mild problems related to vaccines when administered before or at the time of vaccination. Additionally, the evidence that prophylactic administration of antipyretic/analgesic medication decreases antibody response to vaccinations is insufficient at this time. However, this research has led to some confusion on best practice guidelines. This review of the literature resulted in recommendations that …

Identifying United States And Territory Education Requirements For Childhood Vaccination Exemptions, Lacey M. Eden, Emily G. Dunn, Karlen E. Luthy, Katelyn Wells, Janelle L. B. Macintosh, Renea Beckstrand

Faculty Publications

Background: : Children are required by law to receive vaccinations to enter school. States and territories offer exemptions for parents who refuse to vaccinate their children. Types of exemptions vary by state or territory, as does the exemption filing process. The purpose of this research was to identify the various education-related processes implemented by states and territories which allow parents to exempt children from vaccinations.

Methods: A questionnaire was distributed to immunization program managers in the 50 United States, District of Columbia, the United States Indian Health Service, and eight United States territories. Managers reported vaccination requirements for their jurisdiction …

Role Of The Endocannabinoid System And Medical Cannabis, Sabrina Jarvis, Sean Rassmussen, Blaine A. Winters

Faculty Publications

Our bodies produce complex substrates called endocannabinoids, which attach to the endocannabinoid system (ECS) receptors and impact many physiologic processes. Current research on the ECS and cannabis-based medications is accelerating in the presence of continued conflict between federal and state laws. In this article we present a summary of the latest information on the ECS, its receptors, and current research on the cannabis-based medicines and their potential to treat various disease pathologies and medical conditions. Our study includes the latest information on the continued legal ramifications nurse practitioners face in treating patients with these medications.

The Peanut Allergic Patient: Diagnosis, Treatment, And Prevention, Daniel W. Hill, Jane H. Lassetter, Craig Nuttall

Faculty Publications

The prevalence of peanut allergies (PAs) continues to rise through recent decades, despite the best attempts to reverse that trend. PAs are unpredictable and can be life-threatening. Therefore, it is imperative that nurse practitioners (NPs) are fully aware of the most recent guidelines and evidence regarding diagnosis, treatment, and prevention of PAs. This article presents information on the current research in the diagnosis and treatment of PAs as well as the latest guidelines established to prevent PA development. NPs should understand this information, allowing them to provide the best care possible for their patients.

Commencement Program 2017, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2017 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | The University Honorees

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

• School of Medicine, 27
• School of Pharmacy, 52
• School of Dentistry, 64
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication Sciences and Disorders, Health Informatics and Information Management, Nutrition and Dietetics, Physician Assistant Sciences, Radiation …

Pilot Test Of Communication With A ‘Rapid Fire’ Technique, Desiree A. Díaz, Candace Pettigrew, Christine Dileone, Meredith Dodge, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

Abstract

An innovative communication training technique, ‘Rapid Fire’, was created to enhance communication and was incorporated into the debrief component of a simulation designed for correctional nurses to promote learning and engagement. The term ‘Rapid Fire’ was used to expose the critical time element that appears in the first five minutes of many crisis situations, where a quick relay of information and problem solving is essential; such as in a cardiac arrest or other rapidly deteriorating patient situations. This technique consists of a five-minute session prior to the structured debrief. During the ‘Rapid Fire’ portion of the debrief, all learners …

Implementing An Emr Change For The Diabetic Foot Assessment, Nicole O'Neil, Karen Sue Hoyt

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to implement the American Diabetes Association (ADA) foot assessment guidelines utilizing an electronic medical record (EMR) template. Aims of this evidence based practice (EBP) project were to improve documentation of the comprehensive diabetic foot exam, increase identification of loss of protective sensation (LOPS), and increase podiatry and vascular surgery referrals. Diabetes Mellitus (DM) causes many health complications. The lifetime risk of foot ulceration in diabetic patients is 25%. The goal of Healthy People 2020 is to increase this number by 10% to a total of 21,617,200 individuals. The ADA recommends annual comprehensive foot exam …

Opportunistic Diagnosis Of Stis In High-Risk Populations, Kathleen W. Fitzgerald

Doctor of Nursing Practice Final Manuscripts

Introduction

Chlamydia and gonorrhea continue to be a detriment to public health, particularly those under the age of 25. These sexually transmitted infections can cause long-term health problems and should not be viewed lightly. Specifically, untreated or recurrent Chlamydia is the number one cause of ectopic pregnancy, tubal infertility, and pelvic inflammatory disease. Urinary tract complaints are a prime opportunity for concurrent testing since many patients with dysuria may actually have a sexually transmitted infection causing urethritis. Traditional testing can be difficult and invasive because it requires either a pelvic exam or a repeat dirty urine sample spaced at least …

Copd Management And Role Of The Nurse Coach: Increasing Referrals And Participation In Pulmonary Rehabilitation, Carol Upcraft, C. Hoover, Joy Plamann, Jessica Oman

Articles

Chronic obstructive pulmonary disease (COPD) remains a significant cause for hospitalization and with complex management issues upon discharge a significant portion are being re-admitted within 30-days of first hospitalization. The beneficial effects of pulmonary rehabilitation (PR) in the management of COPD is well documented but continues to be underutilized as an important management strategy to reduce hospital readmissions. Transitional care programs which include nurse coaches, have immerged to empower patients to manage their disease and facilitate transitions through multiple care environments. Little is known about the efficacy of such programs on referral and participation in PR and subsequent reductions in …

The Lived Experience Of Chemo Brain In Early Stage Breast Cancer In Women 50 And Under, Patricia A. Gibbons

Seton Hall University Dissertations and Theses (ETDs)

Cognitive deficits have been shown to affect those who have undergone treatment with chemotherapy. This is often referred to as chemo-brain. The purpose of this descriptive phenomenological study was to explore the lived experience of the chemo brain after undergoing chemotherapy for breast cancer. The study sample consisted of six women between the ages of 29 and 50 with early stage breast cancer. van Manen’s (1997) descriptive phenomenological method guided data analysis. The recurrent themes identified in this study were (1) Struggles with day to day life (2) Emotions related to diagnosis and treatment, (3) Fatigue (4) Coping and support, …

Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano

Doctor of Nursing Practice (DNP) Projects

Background: Healthcare workers are 4 times more likely to be exposed to workplace violence than workers employed in private industry, with assault rates as high as 7.8 per 10,000 workers. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults, and or threats of assault, directed toward persons at work or on duty” (OSHA, 2015, p. 2). Verbal de-escalation techniques that assist with care of the agitated patient are not routinely taught to Family Nurse Practitioners (FNPs) throughout their years of advanced coursework, yet it is something they are likely to encounter …

Improving Communication And Satisfaction Through Hourly Rounds, Karen E. Sondeno

Master's Projects and Capstones

The focus of this CNL project is quality improvement using high quality hourly rounds to achieve improved patient satisfaction and communication with nurses. It was determined by reviewing survey results that patient satisfaction and nurse communication is below National levels. Data shows that rounds are not being done well on a medical unit before the improvement project. It is proven that patients receive and perceive higher quality care and communication with increased nurse presence at the bedside. The population of the medical unit has high numbers of confused/dementia, and dual-diagnosis patients. It was determined that the unit would benefit from …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

Hospital Acquired Clostridium Difficile Infection Prevention, Sandy Maalouf

Master's Projects and Capstones

Abstract

The aim of my CNL Internship Project is to decrease the incidence of healthcare acquired C diff infections at the acute care unit 1800 to zero for the next quarter. This will be accomplished by developing an action plan to address the issue by collecting data from audits and developing evidence based practice interventions. The process begins with patient’s admission to the medical surgical unit and ends with patient’s discharge from the medical surgical unit.

By working on the process, the Hospital Acquired Infection (HAI) team expects to improve infection control among all units, increase patient safety, reduce unnecessary …

Perception And Behavior For Underreporting Workplace Violence, Marissa L. Payne

Master's Projects and Capstones

The project is focused in a medical centers’ emergency department that serves a diverse population, varying in age, health, socio-economic status, and mentation; and at a given 24-hour period, the department will care for about 150 to 200 patients. The focus is on the Clinical Nurse Leader (CNL) essential to advocate a change in the culture of acceptance of workplace violence and the perception of the value of reporting violent behavior. To identify the factors that hindered reporting of workplace violence, a root and cause analysis was performed. The analysis revealed that the most common reason behind underreporting is the …

Implementation Of Patient Mobility Assessment Tool: A Clinical Nurse Leader Initiative Towards Improved Patient And Nurse Health Outcomes, Janet Lopez

Master's Projects and Capstones

Abstract

Early ambulation during hospitalization has been recognized as a fundamental and logical intervention to reduce patients functional decline and muscle weakness. Recently, our healthcare system is encouraging nurses to become more actively involved in assessing patient’s mobility status and managing their mobilization. However, since the high nursing workload affects the time that a nurse can assign per task, more often than not they have little time to accurately assess patient’s mobility status; Presenting a safety concern for nurses and patients. In an effort to ease this challenge, the Patient Mobility Assessment Tool (PMAT) is introduced as an efficient nurse-driven …

Implementation Of Sbar Reporting In The Ed, William Russel Carpenter

Master's Projects and Capstones

Implementation of SBAR reporting in the ED

Abstract

In our emergency department, reports given to the accepting floor nurse, transfer of care between emergency department nurses and nurses reporting to physicians are given in many different formats with no continuity. It has been reported that 1,744 deaths and $1.7 billion in hospital costs related to miscommunications (CRICO Strategies, 2015). With the implementation of the SBAR reporting tool, we can begin to see a decrease in miscommunications, and improve patient and staff satisfaction. The SBAR framework not only enhances the clarity and efficiency of communication between team members but also assures …

The Application Of Grounded Theory: An Example From Nursing Workforce Research, Latoya J. Lewis-Pierre 4572586, Joann Kovacich, Linda Amankwaa

The Qualitative Report

The application of grounded theory was the conduit to theory development in this study. The intent was to explore nurse manager, educator, preceptor, and new graduates’ perceptions of workplace readiness for new graduates entering an Intensive Care Unit. Research participants were drawn from five different ICUs: Medical, Coronary Care, Surgical, Neuroscience, and Trauma. One-on-one interviews were conducted to collect participants’ perspectives on readiness to practice in the ICU. Using grounded theory, four themes emerged giving rise to the novice nurse embracing the ICU theory (NNEIT). Reflections on the type of grounded theory used, reasons for the selection, challenges faced in …

Peer Intervention To Increase Physical Activity Among Working Women, Sheri A. Rowland

Theses & Dissertations

Most Americans do not engage in enough healthy physical activity (PA), with working women particularly at-risk for inactivity. Workplace PA interventions have been effective, however studies using peers as the central theoretical strategy, have not been found. Social cognitive theory and social comparison theory were used to develop a peer-modeling workplace PA intervention. The aims of this experimental, two-group, preliminary study were: 1) assess intervention feasibility, 2) determine the intervention effect on cardiorespiratory fitness (primary outcome), and PA behavior, cardiovascular risk, self-efficacy, motivation, and social comparison, and 3) describe participant perceptions of the intervention using qualitative focus-group data. Female employees …

Rural Emergency Nurses’ Suggestions For Improving End-Of-Life Care, Renea L. Beckstrand, Kelly E. Smith, Karlen E. (Bethy) Luthy, Janelle L. B. Macintosh

Faculty Publications

Introduction: Many patient visits to emergency departments result in the patient dying or being pronounced dead on arrival. The numbers of deaths in emergency departments are likely to increase as a significant portion of the U.S. population ages. Consequently, emergency nurses face many obstacles to providing quality end-of-life (EOL) care when death occurs. The purpose of this study was to identify suggestions that emergency nurses have to improve EOL care, specifically in rural emergency departments.

Methods: A 57-item questionnaire was sent to 53 rural hospitals in 4 states in the Intermountain West, plus Alaska. One item asked nurses to identify …

A Clinical Practice Change Initiative To Incorporate Animal Assisted Therapy In Advanced Practice Registered Nurses' Clinical Practice For Children And Adolescents, Donna Rae Cowell

Doctoral Projects

Background: Children and adolescents mental healthcare needs is vital for the future of our nation’s welfare (American Psychology Association, 2014). Research has indicated AAT may be a considerable choice to help with pediatrics mental healthcare and may be utilized as an adjunct to enhance the care within the psychiatric healthcare field (Chandler, 2012). AAT has become popular within the healthcare realm (Friesen, 2009; Uyemura, 2016) and is a unique method for providing “patients” health care, which may improve patient outcomes (Chandler, 2012; Cowell, 2013; McCullough, 2016; McQuarrie & Urichuk, 2008). Research supports that “providers” in the health care field may …

Importance Of And Satisfaction With Characteristics Of Mentoring Among Nursing Faculty, Jacklyn Gentry

Graduate Theses and Dissertations

The nursing faculty shortage and its contributing factors have been well documented in the literature. Contributory factors include lack of graduate prepared faculty, difficulty recruiting and retaining faculty, and a decrease in job satisfaction within the faculty role. The use of mentoring programs has the potential to impact the nursing faculty shortage by increasing job satisfaction while providing novice faculty with additional support during the transition from clinical nurse to nursing faculty.

The purpose of the study was to examine the relationship between the importance of and satisfaction with characteristics of mentoring in full time nursing faculty teaching in baccalaureate …

Nurses’ Perspectives On Hope In Outpatient Oncology Patients: A Concept Analysis, Natalie-Jo Sidman

Senior Honors Projects

In contemporary times, everyone you meet has either been directly or indirectly affected by cancer. Cancer often creates a whirlwind of emotions as the individual wonders how and why this has happened to them. In health care, oncology is a field that is in constant evolution with the development of new chemotherapeutic agents and clinical trials that bring a sense of hope to oncology patients. Outpatient infusion nurses quickly become a part of a person’s life when they begin their chemotherapy. These nurses are with patients through every scan, procedure, and eight-hour infusion day. Nursing is essential in fostering hope …