Public Health and Community 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. …

Assessing Lung Cancer Screening Protocols And Outcomes: A Comparative Analysis Between Indonesia And The United States, Priscilla Sitorus

Nursing | Senior Theses

Background/Significance: Social inequity is a large problem within the healthcare system, especially in third-world countries, like Indonesia. Poor access to healthcare and screening protocols can contribute to delayed diagnoses, poorer outcomes, and increasing mortality rates. Purpose: This study aims to assess the effectiveness of lung cancer screening protocols in Indonesia compared to California and help identify potential barriers and factors in lung cancer screening in both regions. This will later help reform policy interventions and decisions to improve community access. Methods: The study will be divided into two portions using a mixed method approach. The qualitative component will include lung …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Garden-Based Nutrition Education May Lead To Increased Dietary Knowledge In Low Income Hispanic School Children, Larry Bui

Nursing | Senior Theses

Background: Childhood obesity is a pressing public health concern in the United States, with rates continuing to increase in recent years. This problem disproportionately affects Latino children as well as those from low socioeconomic status. It is well established that nutrition knowledge deficiencies and resulting poor dietary habits are some of the most common contributing factors to childhood obesity. Garden-based nutrition education programs have been introduced to remedy this knowledge deficit; however, a gap remains regarding whether this model can be viable for low-income, culturally diverse populations.
Aim: This literature review investigates the importance of diet in reducing childhood obesity …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Student Research Posters

California schools currently only screen for vision and hearing, leaving many other health concerns unaddressed. Among these, gastrointestinal (GI) health is particularly significant, as digestive disorders can lead to severe consequences, like malnutrition and stunted growth. By incorporating routine GI screenings, school nurses can promote the early detection of disease, allowing for timely intervention and improved health outcomes in children.

Based on existing literature, we have developed a novel pediatric GI screening tool for school nurses to use in routine screenings, presented below.

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Factors Associated With Covid-19 Vaccine Hesitancy In South Central Appalachia, Florence M. Weierbach, Rebecca Adkins Fletcher, Ingrid E. Luffman, Cynthia Meyer, Janet M. Keener, Manik Ahuja, Hadii M. Mamudu

Journal of Appalachian Health

Introduction: The newly emergent COVID-19 virus reached pandemic levels in March 2020. By the middle of August 2020, there were over 1 million deaths attributed to COVID-19 in the U.S., with those in rural areas outpacing urban counterparts. Prior to emergency approval of the Pfizer, Moderna and Johnson & Johnson vaccine formulations, mitigation efforts addressing individual behavior were challenging. However, even with the entrance of these three new vaccines, herd immunity was not achieved in rural areas, as vaccine uptake remained low there. Although there has since been an abundance of COVID-19-related research addressing health literacy, vaccine hesitancy and overall …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Attitudes Toward Caring For Older Adults Among Undergraduate Nursing Students At A Public University In Kuala Lumpur, Malaysia, Azera Hasra Ismail, Siti Zuhaida Hussein, Aslina Mohamed Yasi, Nurul Izzati Ishak, Nurul Nazira Mohd Yazar, Nur Syafiqah Sabri

Makara Journal of Health Research

Background: The growing number of elderly members of the population is expected to increase the demand for more dedicated nursing students committed to providing excellent care. This study aims to determine prevailing attitudes toward the care of older adults among undergraduate nursing students at a public university in Kuala Lumpur, Malaysia.

Methods: This is a quantitative cross-sectional survey of 107 undergraduate nursing students enrolled at a public university in Kuala Lumpur, Malaysia. The students were recruited using stratified random sampling. The respondents’ attitudes toward caring for older adults were measured using 14 items from the Geriatrics Attitudes Scale …

Feasibility Of Using Podcasts For Knowledge Dissemination To Reduce Health Disparities For Women Targeting Preventative Initiatives And Lifestyle Medicine Interventions, Kristin Stovern

Doctor of Nursing Practice Scholarly Project

The purpose of this feasibility project was to look at podcasts to shed light on the issues that affect the well-being of women with gender-based disparities in healthcare. Women face persistent obstacles when it comes to the quality of healthcare they receive. One of the barriers that has been ever-present is with failure of the medical system to rigorously study the effects of diseases and drugs on women or to fund studies on women’s health conditions. Implicit biases and lack of access to care inhibit the quality of healthcare. Collectively, these issues result in unnecessary sickness, disability, and decreased quality …

Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

Point Of Care Testing: Best Practice Toolkit For Improving Access To Point Of Care Testing In Mobile Medicine, Michaela Gist

Student Scholarly Projects

Practice Problem: Healthcare for persons experiencing homelessness (PEH) is a complex issue. Chronic and communicable diseases are disproportionately represented within this population. Healthcare spending is 2.5 times more costly in comparison to those who have not experienced homelessness. Although mobile health clinics aim to reduce the concerns with access to care, they do not eliminate barriers if the appropriate tests are not immediately available.

PICO: In the homeless population treated in mobile medicine (P), what is the effect of point of care testing (I) on turnaround time (O) compared with outside laboratory testing (C)?

Evidence: Critical analysis of the literature …

Garden-Based Nutrition Education For Low Income Hispanic School Children, Larry Bui

Nursing | Student Research Posters

Background: Childhood obesity is a pressing public health concern in the United States, with rates continuing to increase in recent years. This problem disproportionately affects Latino children as well as those from low socioeconomic status. It's well established that nutrition knowledge deficiencies and resulting poor dietary habits are some of the most common contributing factors to childhood obesity. Garden-based nutrition education programs have been introduced as a way to remedy this knowledge deficit, however a gap remains as to whether or not this model can be viable for low-income, culturally diverse populations. Aim: The purpose of this literature review is …

Patient Navigational Tool Increase Resource Use In A Latino Population, Kimberly Burrus

Student Scholarly Projects

Practice Problem: The practice problem is a patient navigation tool in a mobile health clinic for the Latino population to help improve utilization of resources within Daviess County, Indiana, and improve overall health literacy and health of those populations?

PICOT: The PICOT question that guided this project was: In a mobile health clinic serving Latino populations (P), does a navigation tool (I) compared to current practices (C) improve utilization of services (O) within a 12-week timeframe (T)?

Evidence: The evidence that guided this project showed patients with limited English proficiency, immigrant families have a disparity of health literacy, and an …

Community Health Worker Program: Chronic Non-Communicable Diseases In Children, Julia L. Newell

DNP Qualifying Manuscripts

Abstract

Background: Childhood obesity, asthma, and untreated mental health conditions, are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Community health workers (CHWs) are in a unique position to address these negative health externalities by leveraging linguistic, cultural, and socioemotional connectedness within their communities.

Local Problem: Minority children in the Central Valley of California, face additional risk factors for the development of CNDs. CHWs working in this area require enhanced training on CNDs to improve their practice.

Methods: In partnership with Save the Children (STC), the University of San Francisco (USF) …

Hypertension: Care Management Program And Medication Adherence, Courtney Montgomery

Student Scholarly Projects

Practice Problem: Medication adherence is a major concern in healthcare as it is a contributing factor to uncontrolled hypertension and resistant hypertension. Uncontrolled hypertension can lead to strokes, heart attacks, kidney failure, and even death.

PICOT: The PICOT question that guided this project was in Medicare Advantage members with hypertension located in Kansas, who were admitted to the hospital or emergency room identified by stratification (P), does care management utilization using hypertension clinical guidelines (I), compared to the stand-alone hypertension clinical practice guideline (C), improve medication adherence (O) over 10 weeks (T)?

Evidence: Hypertension is one of the leading preventable …

Hypertension Education To Enhance Health Literacy, Kylee Westrip

Student Scholarly Projects

Practice Problem: The health of patients suffers greatly when their health literacy is not addressed through evidence-based education material.

PICOT: The PICOT question that guided this project was, in adult patients with hypertension (P), how does evidence-based education material (I) compared to the current state of verbal instructions provided (C) affect health literacy rates based on the high blood pressure health literacy scale (O) within 12-weeks (T)?

Evidence: The literature evidence revealed three strong themes, which included information on who is most at risk for low health literacy levels, education delivery methods, and specific education to be used.

Intervention: …

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Building Up Cal Poly Global Brigades Student Group: Reflections On Designing And Implementing One Undergraduate-Led Community Info Session, Caroline Nicole Smith, Jafra D. Thomas

Kinesiology and Public Health

Intro: Global Brigades, an international non-profit organization, trains college students and other pre-professionals in community-based health promotion by mobilizing community service trips around the world, which are taught and led by local community groups. Cal Poly’s Global Brigades student group was founded in 2018, and thus far, they have carried out three annual, medically-focused brigades to Honduras (two in-person, one virtual).

Purpose: The aim of this report is to present the findings of one experiential senior project to promote Cal Poly’s Global Brigades student group^[1] (conducted January to March 2023).

Methods: The student designed material for …

Social Identities And Campus Belonging As Predictors Of Flourishing Among College Students, Christine Gilchrist

Dissertations, Theses, and Capstone Projects

Annual data since 2012 shows college students’ flourishing (a measure of psychological well-being) in continuous decline, with 2022 showing the largest decrease. Since the knowledge base of the predictors of flourishing is limited, how college executives can best address this issue is unclear. Variations in flourishing have been observed in studies that examined the relationship between food insecurity (DeBate et al., 2021), race/ethnicity (Lipson et al., 2018, 2022; Nyunt et al., 2022; Parr, 2022), immigration status (Cadenas & Nienhusser, 2021), as well as gender identity and sexual orientation (Parr, 2022). The intersectional impact of demographic and social identities has not …

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration, Purnima Krishna

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure (HF) patients have a high risk of rehospitalization after discharge from acute care. Post-discharge management of HF patients requires coordinating services outside the hospital, such as skilled nursing and home health care to address patients’ complex needs.

Local Problem. High HF readmission rates negatively impact a hospital’s efficiency and pose a risk of financial penalties. In the project setting, the HF patients discharged to skilled nursing facilities and home health agencies had a higher rate of 30-day readmission than patients discharged to home.

Methods: Fourteen post-acute care (PAC) facilities were selected for the interventions. The …

Implementation Of A Decision Aid To Increase The Rate Of Routine Breast Cancer Screening Among Women Between 50 To 74 Years Old At A Federally Qualified Health Center, Dana Mars

Doctor of Nursing Practice Scholarly Projects

Background: Breast cancer is the most prevalent form of cancer in the U.S. Cancer screenings can result in prompt treatments and positive health outcomes. Disparities in screening rates are prevalent among vulnerable populations. At a Federally Qualified Health Center (FQHC), where the project occurred, the rate of breast cancer screening in 2021 (64%) was lower than the target set by the Healthy People 2030 (77%). This quality improvement project aimed to increase the rate of routine breast cancer screening among women aged 50-74 years old in the FQHC.

Methods: Previous studies have reported that decision aids on breast cancer screening …

The Threat Of Hospital Wastewater: An Evidence-Based Call To Action, Ann P. Nguyen

DNP Qualifying Manuscripts

Introduction: Hospital wastewater carries a unique composition of pollutants, a burden that includes high chemical and biological residuals. These pollutants are discharged into sewage treatment plants and natural environments where they contaminate human water sources and larger ecosystems. Water treatment plants are not designed to treat the high loads of biomedical waste and persistent organic compounds found in hospital wastewater and therefore pollutants survive in conventionally treated water. Evidence of contaminated soil, municipal wastewater, surface water, ground water, and even drinking water have been demonstrated in studies conducted around the world highlighting the ubiquity of the problem. Hospital effluent as …

Introduction Of Hiv Point-Of-Care Testing In Adolescent Primary Care: A Quality Improvement Project, Jennifer Quinn Belfry

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: HIV, first identified in 1981, remains a persistent public health problem affecting 1.1 million Americans today. Detection is a critical first step to ending the HIV epidemic and the CDC recommends universal HIV screening for all patients 13-64 years of age regardless of risk factors. HIV screening rates are suboptimal especially in adolescent and young adult populations who face unique barriers to screening. The aim of this project was to improve HIV screening rates in adolescent and young adult patients at a large, urban FQHC.

LOCAL PROBLEM: In the state of Rhode Island, 1 in 10 persons living with …

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 …

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 …