Public Health and Community Nursing Commons^™

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 …

Effect Of Activity Trackers And Text Messaging On Exercise, Fitness, And Physical Activity Self-Efficacy Of Middle School Students, Alison F. Pittman

Nursing Theses and Dissertations

A decrease in physical activity as children age is a contributing factor to the U.S. obesity epidemic. Middle school children are particularly vulnerable to sedentary activities. Activity trackers show promise as a means to motivate children and adults to increase physical activity (PA). This study examined the effect of a text messaging intervention and use of activity trackers with a companion social website on the body mass index (BMI), body fat percentage, physical fitness, and PA self-efficacy of middle school children. Children aged 11-14 (n=102) were randomly assigned to one of three groups for a 10-week intervention: activity tracker group; …

The Benefits Of Breastfeeding, Annagrace E. Anderson

Senior Honors Theses

Breast milk is the gold standard for infant nutrition. In the past, infant formula was promoted as equal or superior to breast milk. However, research has shown that breastfeeding is the superior form of infant nutrition except in rare circumstances. Breast milk provides for all of a newborn’s caloric needs and has the correct balance of nutrients to promote proper development. In addition, breast milk provides protection against illnesses, supports an infant’s immune system, and promotes life-long health for the newborn. Mothers also experience personal benefits by breastfeeding such as decreased cancer risks, bonding with their babies, and faster postpartum …

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

Social Ecological Factors Associated With Parental Vaccination Decisions And Perceptions Of Barriers To Childhood Immunizations, Catherine A. Ferris

Dissertations

The success of childhood immunizations has led to a decrease in the visibility of the morbidity and mortality of vaccine-preventable diseases. Parents are questioning the validity and safety of vaccines resulting in significantly increasing numbers of underimmunized and unvaccinated children throughout the country. The purpose of this dissertation was to explore the perceptions of barriers to immunizations in parents with children, birth to 12 months of age presenting for a well-child or vaccinations-only visit to one of two pediatric primary care clinics located in San Diego County. The social ecological model was used to guide this dissertation. A cross-sectional, descriptive …

A Systematic Review: The Prenatal And Postnatal Events Associated With Infant Mortality Rate (Imr), Ariel L. Thomas, Sarah A. Awwad, Briana E. Clark

Williams Honors College, Honors Research Projects

Infant mortality rate (IMR) is an indication of overall population health, maternal and child health, accessibility and quality of primary health care, and the availability of community resources. The current IMR in the United States is high despite advances made in the medical field. The purpose of our systematic review is to describe and critically appraise research about prenatal events, postnatal events, and increased infant mortality rate and to give nursing practice recommendations to help decrease the rate. We used CINAHL, Medline and PubMed to find 20 research articles. Overall, the research stated that going to prenatal visits had a …

Effectiveness Of School-Based Interventions Versus Family-Based Interventions In The Prevention And Treatment Of Childhood Obesity, Ashley Capestrain, Emily Montague, Meghan Frantz

Williams Honors College, Honors Research Projects

Childhood obesity affects 155 million children worldwide. As prevalence increases, it is important to identify effective interventions in the treatment and prevention of childhood obesity. Obesity may result in short and long term effects linked to some of the leading causes of morbidity and early mortality. The purpose of this systematic review is to identify, review, and critically appraise evidence from studies examining the effect of family and school based interventions. This review answers the following PICO question: In children, how do family based interventions compare to school based interventions, in the prevention and treatment of obesity? Methods included literature …

Associations Between Pre-Pregnancy Weight Status And/Or Gestational Weight Gain And Obesity In Older Children, Marisa P. Hammond

Honors Undergraduate Theses

Childhood obesity is a global health concern that puts children at risk for developing serious health complications. With increasing rates worldwide, it is important to determine how to decrease its prevalence and promote prevention in future generations. Emerging evidence indicating that pre-pregnancy weight status and/or gestational weight gain (GWG) may be linked with overweight/obesity in children. Much of this body of research focused on weight status of offspring at birth and at preschool age. The purpose of this study is to: (1) analyze the research findings regarding obesity in children 5 to 18 years and their mother’s pre-pregnancy weight status …

Goals Of Exclusive Breastfeeding And The Effectiveness Of Programs And Initiatives In Attaining Them, Natalie Scott

Senior Honors Theses

Over recent years, breastfeeding has gained renewed significance in research and practice. Both in the United States and around the world, especially in poor countries that do not have easy access to quality healthcare, breastfeeding has been shown to dramatically and positively affect the health and lifespan of infants. However, there is still a low prevalence of effective breastfeeding practices universally. Even with the presence of global programs and goals that are geared toward exclusive breastfeeding habits, global rates are lower than what is desired. There are various determinants of breastfeeding that factor into a woman’s decision and practice of …

Lactation Clinic: Improving Patient Lactation Support, Iana Johnson

Master's Projects and Capstones

Despite the numerous health benefits and recommendations that breastfeeding is the optimal method for nourishing infants, many still choose other ways to feed their babies during the first year of life. This project considers the initiation and future implementation of a Lactation Clinic as an additional patient support service provided in the inpatient and outpatient settings. A Failure Modes and Effects Analysis (FMEA) was conducted in an effort to evaluate and eliminate “what could go wrong” before such an establishment becomes operational. The Risk Priority Numbers (RPNs) from the analysis reveal the lack of use (RPN 50) and streamlining (RPN …

Reducing Annual Emergency Department Visits Through Improved Asthma Discharge Teaching, Alvin R. Walters

Master's Projects and Capstones

Asthma is the most common pediatric condition in the United States, and a child's home environment plays an impactful role in the triggering of asthma exacerbations (Harper et al., 2015). Current emergency department (ED) ideology focuses on symptoms management, with little time spent on education, and virtually no attention paid to the home environment. Evidence shows that programs which incorporate home environmental assessments into asthma patient education produce a reduction in annual ED visits, fewer missed school days, decreased use of rescue medications, and improvements in quality of life (Gruber K.J., et al, 2016, Hollenbach J.P. & Cloutier M.M., 2015, …

A Quality Improvement Project On Diagnosis And Management Of Asthma In A Private Pediatric Setting., Sosamma Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Although national guidelines exist for the diagnosis and management of asthma, general practice differs significantly from recommendations. Quality improvement methodology when implemented can narrow quality gaps.

Objective: The objective of the project was to create and implement a plan of action to address identified gaps in key clinical activities of asthma care among pediatric population in a private pediatric setting in Northern California

Methods: The project was centered on the use of Education in Quality Improvement for Pediatric Practice (EQIPP), a program of the American Academy of the Pediatrics. Both the pediatrician and the DNP student took this …

Training Traditional Birth Attendants In Sub-Saharan Africa, Lindsey J. Smith

Senior Honors Theses

Even after many adjustments, recommended practice regarding traditional birth attendants (TBAs) and their contribution to lowering the maternal mortality rate (MMR) continues to be disputed among various stakeholders. Sub-Saharan Africa continues to see high maternal mortality rates, despite various attempts by the World Health Organization (WHO) and others at utilizing the formal health care system (Prata, et al., 2011). Considering all factors and variables behind the reason for this problem in Sub-Saharan African, it is reasonable to conclude that training traditional birth attendants (TBAs) in evidence-based practice, in conjunction with developing longer-term strategies, is an appropriate approach for the short …

The Secret Ingredient For Improving Infant/Child Mental Health: Teaching Parents To Play, Geraldine Healy Marini

Occupational Therapy Doctorate Capstone Projects

Disorders in mental health are the highest of all disorders and results in the most common form of disability. Since 2011, mental health disorders have increased at alarming rates. It is estimated that 9.5 to 14.2% of children between the ages of 0 to 5 years have and emotional or behavioral problem. The mental health of parents or caregivers can affect and impact the development of young children (Nelson & Mann, 2011, Zero to Three, 2004).

The over arching goal of this research is to explore issues of mental health within parent-child interactions. Coaching parents during the co-occupation of play …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Perinatal Health Education Intervention For Adolescent And Young Adult Pregnant Homeless Women Living In Transitional Housing, And Best Practice Teaching Intervention Program For Staff Responsible For Care Of The Mother-Baby Dyad, Colleen Carrington

Seton Hall University DNP Final Projects

Purpose: A population at great risk is pregnant homeless adolescents and young adult women. Research shows that about 20% of homeless young women become pregnant (Bender, & Thompson, 2007). These pregnant young women are at an increased risk for low birth weight infants and a high infant mortality due to inadequate health care, poor dietary habits, and a knowledge deficit related to maintaining good health during pregnancy and to care of the infant and growing child. A transitional shelter may offer many psychosocial services to assist the women in becoming independent; however, a significant gap exists regarding the medical …

Family And Child Development Education For Harrisonburg Adolescents, Mollie M. Moran, Jennifer E. Corser, Julia M. Glauber

Senior Honors Projects, 2010-2019

The pregnancy rate among 15- to 17-year-old women in Harrisonburg is double Virginia's state rate (Townsend, 2008). While meeting administers and guidance counselors of Harrisonburg High School we learned that Harrisonburg High School views this issue as one that cannot be addressed by teaching abstinence in their public school. They have found that because of cultural beliefs, abstinence is not an effective tool for preventing teenage pregnancy. Instead, HHS teaches their students about safe sexual practices and how to have a healthy pregnancy in the event they were to become pregnant. The high school offers a class called “Child and …

Effects Of Multimodal Fever Education On Parents Of Febrile Children, Teresa S. Parkhouse

Evidence-Based Practice Project Reports

Insufficient knowledge regarding the physiology and appropriate management of fever in children often contributes to an increased parental anxiety, inappropriate antipyretic use, and overutilization of medical resources (Chang, Liu, & Huang, 2013; Crocetti, Moghbeli, & Serwint, 2001; Schmitt, 1980). Parental concerns regarding childhood fever can lead to an overuse of health care resources as febrile illness in children accounts for approximately 20% of emergency department visits, 30% of office visits, and over 50% of after-hour phone calls to private physicians (Zomorrodi & Attia, 2008). Research shows that multidimensional educational interventions are most effective in improving parental management of fever (Young …

Use Of Immunotherapy In The Treatment Of Peanut Allergies In The Pediatric Population, Bethany Rauscher

Senior Honors Theses

Peanut allergies are a serious issue that must be monitored and treated effectively to avoid severe adverse effects and death. In the last decade, their incidence has increased significantly, due to indeterminate factors. Because people typically do not outgrow peanut allergies and the effects of exposure can be life-threatening, it is important that a cure or management method is developed and refined. Recent research regarding treatment for peanut allergies has focused on the use of immunotherapy, a process aimed at desensitizing children's immune systems so that they do not reject foods that contain peanuts. Some studies utilizing immunotherapy have provided …

Pediatric Nurse Practitioner Home Visitation Is Associated With A Decrease In Home Care And Healthcare Utilization Errors In High Risk Infants, Rupalee Patel

Doctoral Projects

The Santa Clara Valley Health and Hospital System’s (SCVHHS) Babies Reaching Improved Development and Growth in their Environment (BRIDGE) program was developed in 2011 to optimize high risk infants' care transition from Neonatal Intensive Care Unit (NICU) to home. In addition to hospital discharge teaching and public health nursing efforts, NICU infants need further in home support given their medical vulnerability after discharge. The objectives of the SCVHHS BRIDGE program are to provide caregiver interventions to minimize home care errors after NICU discharge and to optimize health care access and utilization across the transition of care. SCVHHS NICU infants at …

The Effect Of An Antenatal Breastfeeding Intervention On Breastfeeding Self-Efficacy And Intention Among Inner City Adolescents, Jamie El Harit

Evidence-Based Practice Project Reports

According to Healthy People 2020, infants who are breastfed have improved nutritional, immunological, developmental, and social outcomes (USDHHS, 2014). Despite the benefits of breastfeeding and the focused international efforts to increase levels of breastfeeding, adolescents remain largely unaware and continue to have among the lowest levels of breastfeeding initiation (CDC, 2013; Spear, 2006). The purpose of this EBP project was to reduce the disparities of breastfeeding initiation by increasing breastfeeding self-efficacy and intention in an inner city specialty high school. Synthesis of the evidence demonstrated that needs-based, repeated antenatal education delivered by a lactation expert including breastfeeding peer counselor supports …

Maine's Breastfeeding Gap: How Initiation And Duration Differ By Socioeconomic Status, Zoe Miller

Thinking Matters Symposium Archive

The preventive health benefits of breastfeeding for both mothers and children are widely recognized. Leading health authorities recommend exclusive breastfeeding for the first six months of life.

Though breastfeeding rates in the United States have been increasing for the past decade, significant disparities continue across race and socioeconomic status.

The Benefits Of Breastfeeding, Helen L. Byers

Senior Honors Theses

It is important to educate women of childbearing age, their families, and society of the benefits that breastfeeding has over bottle-feeding and formula-feeding. The benefits of breastfeeding are in three main categories. First, the developmental, physical, emotional, and spiritual benefits of the baby will be discussed. Then the physical, emotional, and spiritual benefits for the mother will be talked about along with possible contraindications or difficulties. Finally, the financial benefits of breastfeeding over feeding an infant from the bottle will be discussed as it relates to the family and government. The goal is to persuade that breastfeeding is a superior …

Induced And Spontaneous Labor Education: Evaluation, Knowledge, And Intent To Discuss Options In Pregnant Women, Kathleen Hartzell, Katherine Bartolotta

Williams Honors College, Honors Research Projects

Labor inductions are increasing worldwide, with rates continuing to rise each year. Currently 30% of labors in the United States result from inductions. The purpose of the study was to examine the effect of an educational intervention about induced and spontaneous labor on knowledge and intent to discuss options with health providers in pregnant women. This study was guided by the health-belief model which explains that people’s beliefs about how a health care decision may affect their lives affect how they make the decisions. This study was conducted using a quantitative and descriptive design with pre and post paper and …

Don’T Diss The Reninjaza: A Case For Integrating Traditional Birthing Attendants Into The Allopathic System To Improve Prenatal Health In Rural Madagascar, Shenna Bannish

Independent Study Project (ISP) Collection

This project seeks to prove the practicality of using Reninjazas (traditional birthing attendants) in rural Madagascar to better prenatal care and diminish the maternal and infant mortality rates in this country. Prenatal care is of vital importance to expecting mothers. Without it, birth defects, complicated labor and delivery, miscommunications concerning fetal development, and even death can occur (Mayo Clinic, 2014). There is no doubt that the lack of adequate prenatal care in Madagascar contributes to its unfortunately high maternal and infant death statistics. While listed as “moderate” in terms of severity, the maternal and infant mortality rates in Madagascar are …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

The Baby Friendly Hospital Initiative, Kathryn E. Brackett

Senior Honors Theses

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a worldwide movement started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that is aimed at providing hospitals with a certification that guarantees the best possible patient-centered care for mothers and infants. It focuses on breastfeeding as optimal infant nutrition, and implements strategies to encourage and support mothers to breastfeed their infants exclusively for six months after birth. The Ten Steps to Successful Breastfeeding are a set of 10 simple, easy to understand guidelines developed by WHO and UNICEF for implementing this initiative in the hospital setting and …

Standardized Care Of The Late Preterm Infant In Upper Midwest Hospitals, Michelle Susanne Foy

All Graduate Theses, Dissertations, and Other Capstone Projects

Standardizing care or critical pathways have delivered evidence-based care in adult medicine and have positive patient outcomes. Some aspects of standardized care have been used in neonatology, but less often in caring for the late preterm infant (gestational week 34-37 weeks). With each level of care nursery, Level-I, level-II or level-III, there can be a wide range of how to care for the late preterm infant. The purpose of this study was to determine if nurseries or various levels of care had established standards of care specific to the late preterm infant and what barriers existed that prohibited standards of …