Public Health and Community Nursing Commons^™

Getting To Zero: Creating An Infrastructure To Support Fall Prevention In A Medical–Surgical Unit, Krys Elgarico

Master's Projects and Capstones

Problem: Hospital falls are a growing national patient safety concern that cause anxiety, pain, distress, serious injuries, and increased health care utilization. Despite the presence of a well-developed falls prevention protocol since 2017. Internal data from an inpatient medical-surgical telemetry (MST) unit indicate the largest number of fall-related events among the hospital’s departments.

Context: Practice improvement project was initiated in a 217-bed community hospital to determine barriers and potential success factors. This MST is a dynamic, 48-bed unit providing care to mainly geriatric patients who require continuous telemetry monitoring and complex medical, trauma, and surgical services. Senior leaders in the …

Tuberculosis, Jessica Puri

Nursing Student Class Projects (Formerly MSN)

Tuberculosis (TB) is a curable disease that claims the lives of millions each year. TB is an airborne disease spread by inhaling droplets of the tubercle bacillus. There are two different types of TB related conditions; latent TB infection and active TB disease. During latent TB, an individual inhales droplets of tubercle bacillus but the immune system can fight off this infection. However, once droplets of tubercle bacillus penetrate the alveoli, and colonization of droplets multiply, latent TB transitions into active TB disease (Katanekwa & Dahlback, 2016, p. 9). TB is typically found in the lungs but can also develop …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Reducing Re-Hospitalizations Of Patients With Heart Failure At A Skilled Nursing Facility, Louis D'Onofrio Jr.

The Eleanor Mann School of Nursing DNP Capstone Projects

The purpose of this project was to introduce the quality improvement (QI) process to reduce re-hospitalization rates in a skilled nursing facility (SNF) in Stratford, Connecticut for patients having a diagnosis of heart failure (HF). After reviewing the data from the nursing facility for re-hospitalization rates over a three-month period, it was discovered that 22% of patients at the SNF were re-hospitalized within 30 days. Of this population of patients, 22.9% had a diagnosis or complication of HF, which is associated with the highest re-hospitalization rates. This QI project focused on HF education customized towards nursing and nursing assistant staff …

Organizational Wellness Programs As Internal Social Marketing: A Literature Review Of Feasible Approaches, Faith Bontrager Rn, Bsn, Kimball P. Marshall Ph.D.

Atlantic Marketing Association Proceedings

No abstract provided.

An Educational Intervention For Skin Cancer Prevention With Hospital Staff: A Pilot Project For System Change, Amy Fran Bruce

Graduate Theses, Dissertations, and Problem Reports (ETD)

PURPOSE: The purpose of this project was to design, implement, and evaluate an educational intervention provided to health care professionals using the Sun Smart U Curriculum created by the Skin Cancer Foundation (2017).

METHODS: Using a pretest-posttest design with a convenience sample (N=40), this intervention targeted the health professionals and staff from a residential/acute care facility caring for pre-adolescent, adolescent, and adult populations. Aims of this project included: (1) the staff’s baseline level of knowledge regarding sun protective behaviors using the Sun Smart U Curriculum, (2) the staff’s level of knowledge regarding sun protective behaviors post educational intervention …

Building Shared Values In The Community: Culture Of Health, Donnelle D. Storrs

Doctor of Nursing Practice

The zip codes where patients live are stronger determinants of health outcomes than the frequency of visits with a primary care provider. Providers have a unique opportunity to extend health care beyond the clinic walls and engage in efforts to improve the communities where their patients grow, live, work, and age. In order to impact the health of patients, a culture of health needs to be developed. The Robert Wood Johnson Foundation culture of health action framework directed the build of a foundation of health as a shared value in a neighborhood with high morbidity and mortality rates in southwest …

Blood Pressure And Job Domains Among Hotel Housekeepers, Marie-Anne Sanon Rosemberg Phd, Mn, Rn, Bidisha Ghosh Ms., John Shaver Bsn, Maria Militzer Ma, Julia Seng Phd, Cnm, Faan, Marjorie C. Mccullagh Phd, Rn, Aphn-Bc, Cohn-S, Faaohn, Faan

Journal of Health Disparities Research and Practice

Hotel housekeepers have challenging working conditions, putting them at risk for poor health such as hypertension. Despite their risks, few studies have measured their blood pressure (BP). The purpose of this study was to explore hotel housekeepers’ blood pressure and the associations between work and BP. Methods: A community engagement approach was used to recruit study participants. Data sources included questionnaires, and BP measurement. Results: Over 25% of the 39 hotel housekeepers reported hypertension diagnosis and/or antihypertensive medication used. Across the job domains, job satisfaction was correlated with diastolic BP, and workload was correlated with systolic BP. There were difference …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Decreasing Environmental Health Risks In The Philippines: Implementation Of A Culturally Appropriate Screening Tool, Alyssa Samson

Doctor of Nursing Practice (DNP) Projects

Objectives: The purpose of this DNP project was to increase the knowledge of environmental health risk factors in the Philippines among nurses and doctors located within that healthcare system. The overall goal was to educate providers on local environmental health risks, provide training for the use of a screening tool (Tagalog Environmental Health and Safety Assessment Tool [TEHSAT]), and provide resources aimed at increasing screening of at risk populations and provide opportunities for education and health promotion.

Methods: This project included a two-part educational training session. The first part included a preliminary presentation on environmental health and the use of …

The Clinical Nurse Leader As Outcomes Manager: Optimizing Screening Mammography In An Outpatient Breast Center, Yao Luo

Master's Projects and Capstones

The Clinical Nurse Leader as Outcomes Manager: Optimizing Screening Mammography in an Outpatient Breast Center

Abstract

This clinical nurse leader (CNL) practice improvement project was conducted in an outpatient breast center that is part of a community safety-net hospital. The patient population consists of a large proportion of disadvantaged, low income, low English literacy, and high-risk women over 445 years of age. Recent observations and baseline data from the breast center and the mobile mammography van indicated that five to eight radiologic views were taken during a routine mammogram in a subset of screening patients which exceeds the standard set …

Rates Of Autoimmune Disease Increasing In Women, Rosa De La Cotera

Grace Peterson Nursing Research Colloquium

Abstract

Autoimmune disorders (AD) are a group of highly disabling pathological conditions that are growing at an alarming rate affecting approximately 8% of the population. These disorders occur more frequently in women, as 78% of those diagnosed are women. Little conclusive research has been conducted as to determine why there is a tremendous sex disparity when looking at the rates. Due to the overall poor health that results from these disorders, there is an increase in the societal burden in terms of health care costs, loss of work productivity and reduced quality of life. The aim of this integrative literature …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

Evaluating An Employee Health Tobacco Cessation Program For Enhanced Success, Leah Griffiths, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Tobacco smoking is the number one cause of preventable death in the US. It increases risk for cardiovascular and respiratory disease, diabetes, and many types of cancer. When contrasted with nonsmoking employees, smokers have a greater amount of lost productivity, as well as cost of health and life insurance claims due to illness. The purpose of this evidence-based project was to identify current smokers and monitor the consistency of their progression through the 5 A’s framework within an employee health clinic. Data was collected over two years and 600 charts were reviewed. After the data was analyzed, it was estimated …

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 …

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 …

A Snapshot Of Physical Activity Programs Targeting Aboriginal And Torres Strait Islander People In Australia, Rona Macniven, Michelle Elwell, Kathy Ride, Adrian Bauman, Justin W. Richards

Research outputs 2014 to 2021

Issue addressed Participation in physical activity programs can be an effective strategy to reduce chronic disease risk factors and improve broader social outcomes. Health and social outcomes are worse among Aboriginal and Torres Strait Islanders than non-Indigenous Australians, who represent an important group for culturally specific programs. The extent of current practice in physical activity programs is largely unknown. This study identifies such programs targeting this population group and describes their characteristics. Methods Bibliographic and Internet searches and snowball sampling identified eligible programs operating between 2012 and 2015 in Australia (phase 1). Program coordinators were contacted to verify sourced information …

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, …

Stress Management In A Corporate Setting, Erinn Gelakoska, Susan Instone

Doctor of Nursing Practice Final Manuscripts

Abstract

The purpose of this evidence-based project was to implement a sustainable stress management program in a corporate setting, utilizing company stress management resources. A three-step program was initiated to include a 30-minute stress education session, followed by a 30-minute one-on-one session with a nurse practitioner student utilizing aspects of motivational interviewing to develop a goal oriented stress management plan. An individual one-month follow up was also performed. Of the 30 employees who attended the educational session, 15 signed up for a one-on-one session. Eight out of the 15 employees completed the one-month follow up. Employees completed a pre and …

Ua61/1 Nursing Spirit, Volume 1, Neal Chambler, Dean, Mary Bennett, Director, Susan Megahee, Editor, Creative, Wku School Of Nursing

School of Nursing Publications

No abstract provided.

A Phenomenological Assessment Of Factors That Affect Medication Adherence Among Hypertensive Nigerian Immigrants, Beulah Iroegbu

Doctoral Projects

This qualitative study explored the perceptions that affect medication adherence among hypertensive Nigerian immigrants in Sacramento, California. The research questions focused on factors that influenced the adherence to hypertension medication; specifically, how the sample population explained the cause of hypertension and whether culture and religion impacted the cause and management of hypertension. A phenomenological approach was used to understand perceptions about medication adherence. A predefined group of 9 acted as a purposive sample and was given semi-structured individual interviews. Qualitative data analysis of the interviews was performed using Colaizzi's 7-step method. Results from the study found the cause of hypertension …

Stress Of Conscience: Concept Clarification, Muder Alkrisat, Manal Alatrash

Journal of Health Ethics

Workers in healthcare systems are predisposed to work-related stress based on moral factors. Stress results when nurses are exposed to ambiguous moral situations, or when they are prevented by hospitals or their employees from doing what they ought to do. Such experiences have been described as stress of conscience because they give rise to a troubled conscience. Empirical studies indicate that health care employees, including nurses, sometimes refer to stress of conscience when faced with ethically difficult situations related to patient care.

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: …

Relationship Among Motivation, Emotion Regulation, And Psychological Well-Being Of Sophomore And Senior Level Nursing Students, Aryene Delgado, Douglas Garner, Nicole Langhals

Williams Honors College, Honors Research Projects

Nursing education and professional work involve stressful circumstances that may lead to attrition, which can further contribute to the projected nursing shortage. This study examines the relationships between motivation, emotional regulation, psychological well-being and academic performance in baccalaureate sophomore and senior level nursing students at a Midwest urban university in the United States. The non-experimental, correlational study is guided by Deci and Ryan’s self-determination theory and uses an online survey data collection and convenience sampling. Measures include: motivation, emotional regulation, psychological well-being (burnout; inauthenticity), and academic performance (GPA), and will be measured using Deci and Ryan’s scale, the Emotion Regulation …

Evaluation Of Serum Vitamin D Levels In Older Adults Who Fall And Sustain A Fracture: A Retrospective Chart Review, Suzanne L. Pilon

DNP Projects

Purpose: This practice inquiry project was designed to (i) evaluate serum vitamin D levels in individuals aged 65 years and older who had fallen and sustained a fracture and (ii) identify if the serum vitamin D levels were within therapeutic range.

Background: Older adults are at increased risk of falling and sustaining a fracture as a result of falls. Vitamin D has been shown to be effective in fall prevention yet vitamin D is deficient in the older population worldwide. Evaluating current serum vitamin D levels in older adults who fall and sustain a fracture may provide additional insight in …

Connecting Gender, Race, Class, And Immigration Status To Disease Management, Marie-Anne S. Rosemberg Phd, Mn, Rn, Jenny Hsin-Chun Tsai Phd, Arnp, Pmhcns-Bc

Journal of Health Disparities Research and Practice

Objective: Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual’s life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management.

Methods: This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited (N = 31) and …

The Effect Of Community Education On Osteoporosis Knowledge, Avis O. Morrow

Nursing Theses and Capstone Projects

Osteoporosis is a metabolic disorder characterized by the loss of bone mass, increased bone fragility, and the increased risk of fractures. Bone loss is accelerated when the diet is deficient in vitamin D and calcium. The National Osteoporosis Foundation estimates that 57 million Americans are at risk for this disorder. The risk depends on the amount of bone mass achieved between ages 25-35 and how much bone loss occurs after that age. Bone loss increases after menopause. Lifestyle modifications needed include knowledge of vitamin D, calcium, and exercise recommendations.

Perceived Patient Satisfaction With Hospital Services And Interventions, Marietta Abernathy

Nursing Theses and Capstone Projects

The patient and family voice should be heard in the healthcare setting. Gaining knowledge and insight from a parent of a pediatric patient will allow hospital staff and administrators to see the hospital experience from the vantage point of a patient and family member (Uhl, Fisher, Docherty, & Brandon, 2013). It is important to continually review feedback and suggestions from families of pediatric patients to improve the care of future patients. Ultimately, this will improve patient satisfaction scores, but most importantly, it will improve the experience of pediatric patients (Creating patient and family advisory councils, 2010). The investigator interviewed ten …

Utilizing Motivational Interviewing To Promote Condom Use Self-Efficacy, Ann Maria Bell

Nursing Theses and Capstone Projects

Condom use is one of the most important preventive mechanisms available to combat sexually transmitted diseases and unintended pregnancies, yet over 70% of adolescents and young adults lack education on the proper use of condoms. Lack of education and confidence in using condoms contributes to a decrease in condom usage, resulting in increased rates of sexually transmitted diseases and unintended pregnancies. The purpose of Project Motivate was to determine if motivational interviewing significantly improves self-efficacy related to condom use among patients presenting for screening of sexually transmitted diseases. The project sought to determine if motivational interviewing is an effective intervention …

Mine Workers, Heat Related Illnesses, And The Role Of The Occupational Health Nurse, Kim Bourne

Nursing Faculty Publications

Across the United States, workers in m any occupations face weather and related extreme conditions on a daily basis. Hot weather and manual labor increase a person’s core body temperature. This heat gain comes from a combination of environmental and self-generated (or internal) heat. Environmental heat is both weather related and man-made, and internal heat is produced from metabolic processes (Xiang, Bi, Pisaniello, & Hansen, 2014). But, it’s just not the heat that causes problems; it’s the humidity, too. E ach year thousands of workers suffer heat related illnesses as a result of becoming overheated. Between June, 2013 and July, …