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: …

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Wellness In Motion: A Quality Improvement Initiative To Support Resident Mobility And Reduce Falls., San N. Pham

Master's Theses and Capstones

Background: Falls are a significant concern in community living centers for older adult veterans. Promoting physical activity and resident engagement is crucial for reducing fall risk among this population.

Local Problem: A specific microsystem within this setting has a fall rate of 3 falls per month. This discrepancy underscores the need for targeted interventions to effectively address this issue.

Methods: This study measured key metrics related to falls and resident engagement in mobility programs both before and after the implementation of an exercise program within the microsystem.

Intervention: The "GIMME 10" exercise program, grounded in evidence-based practices and emphasizing resident-centric …

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 …

Provider And Staff Education Surrounding Universal Hcv Screening And Linkage To Care In An Ambulatory Care Setting, Lauren Clifford

DNP Projects

Abstract

Background: In the United States, it is estimated that there are more than 2 million cases of Hepatitis C (HCV), with over 66,000 new cases since 2020 However, an estimated 75% of those with HCV go undiagnosed and less than 35% receive treatment within a year of diagnosis. In 2018, UK Healthcare (UKHC) implemented a universal HCV screening method using a Best Practice Advisory (BPA) for anyone 18 and older who presented to the Emergency Department and had labs ordered. Patients who screened positive were then referred to outpatient clinics for HCV treatment. Approximately ten percent of positive patients …

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 …

Age, Body Mass Index, Physical Activity And Quality Of Life In Turkish Pregnant Woman With And Without A Diagnosis Of Gestational Diabetes Mellitus: A Comparative Study, Yaren Nur Tayyar, Hatice Kahyaoglu Sut

Makara Journal of Health Research

Background: This study aimed to examine and compare the age, body mass index (BMI), physical activity (PA), and quality of life (QOL) of third-trimester Turkish pregnant women with and without a diagnosis of gestational diabetes mellitus (GDM).

Methods: A comparative study was conducted in the obstetrics clinic of a university hospital in Turkey, and it included 210 women (GDM women = 105 and non-GDM women = 105). Personal Information Form, International Physical Activity Questionnaire-Short Form (IPAQ), and World Health Organization Quality of Life-Short Form-Turkish (WHOQOL-Bref-TR) were used.

Results: The age and BMI of GDM women were higher …

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 …

Factors Associated With Postacute Covid-19 Syndrome Among Patients In Malaysia, Ahtheemathurra Ballasingam, Farida Islahudin, Siti Azdiah Abdul Aziz, Mohd Makmor-Bakry

Makara Journal of Health Research

Background: Post-acute COVID-19 is known to affect multiple organs. It is essential to determine factors that affect post-acute COVID-19 syndrome and medications needed by patients for optimized care.

Methods: A prospective cohort study was conducted among patients recruited by stratified sampling from two COVID-19 hospitals in Malaysia. Patients were followed up for 6 months using a standard questionnaire to identify demographics, symptoms, medications taken, and factors associated with post-acute COVID-19 syndrome.

Results: A total of 388 were successfully followed up. The most frequently reported symptom was respiratory symptoms (N = 168, 43.30%), of which cough (N = …

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 …

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 …

School Nurses And The Sexual Health And Education Of Public-School Students In Tennessee, Amy Wake

Electronic Theses and Dissertations

Tennesseans have been experiencing increasing rates of sexually transmitted diseases since the year 2000. Those rates are highest among those 15- to 24-year-olds. At the same time, Tennessee policy requires the teaching of abstinence as the primary form of sexual health education and emphasized the use of abstinence-only curriculum. The school nurse represents an available resource in the Tennessee public schools. The purpose of the qualitative study was to explore, describe, and interpret the perceptions and experiences of public-school nurses from rural, suburban, and urban areas of Tennessee related to the sexual health and sexual health education of students. School …

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

Improving Blood Pressure In Adults 65 Years And Older Via Weekly Telehealth Coaching, Janet Bathini

Student Scholarly Projects

Practice Problem: Hypertension is a significant modifiable risk factor for CVD and is on the rise with advancing age. The management at the VA hospital's GEC clinic acknowledged the importance of managing HTN in veterans to lower their CVD risk and were open to implementing EBP to enhance HTN management.

PICOT: The PICOT question that guided this project was: In the primary care setting, in older adults > 65 years with BP > 140/90 (P), does weekly telehealth coaching (I) compared to no telehealth coaching (C), decrease their BP (O) over a 6-week period (T)?

Evidence: The evidence that guided this project …

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 …

An Educational Program To Improve African American Women’S Knowledge And Self Efficiency In Seeking Treatment For Endometrial Cancer, Lauren Elise Rosenthall

Electronic Theses and Dissertations

In the United States, there is a significant difference in the survival rate for endometrial cancer for African American women when compared to women of other ethnic groups, specifically White women. There is supporting evidence that supports that morbidity and mortality rates for endometrial cancer increase if diagnosed in later stages. There are many contributing factors to a patient receiving an early diagnosis of a disease. One of the key determinants to early diagnosis of endometrial cancer is understanding risk factors, and what symptoms require further evaluation. An educational program was developed to identify knowledge deficits in the African American …

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) …

Results Of Nursing Training Reforms: Estimating The Scope Of Nursing Practice, Marat Serikbayev, Saltanat Mamyrbekova, Ainur B. Kumar, Lyazzat Kosherbayeva, Akmaral Abikulova, Laura Seiduanova, Elmira Serikbayeva

Journal of Health Research

Background: With the adoption of the Astana Declaration on primary health care, modern approaches are being introduced in the Republic of Kazakhstan. The created national foundations of the nursing management system in Kazakhstan are a visible manifestation of a new organizational culture. In connection with the large-scale reform of nursing and the creation of a new position of nurses that meets modern social challenges and international requirements, the role of nurses in healthcare has increased significantly. In this study, we measured the actual scope of nursing practice among nurses in the medical organizations in the Republic of Kazakhstan.

Methods: …

Association Between Chronic Disease And Substance Use Among Older Adults In Tennessee, Manik Ahuja, Jessica Stamey, Johanna Cimilluca, Kawther Al Skir, Mary K. Herndon, Kathleen Baggett, Thiveya Sathiyasaleen, Praveen Fernandopulle

ETSU Faculty Works

Background:

Design and methods:

Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo

Master's Projects and Capstones

Problem: Transition patients at the end-of-life are those patients who are not mentally ready or physically eligible for hospice thus not enrolled in a Palliative or Hospice Program. Only one-third of the Transition patient census had completed and filed advance care plans. Healthcare providers are obligated to perform life-saving measures unless documented otherwise. A lack of advance care planning can create complicated scenarios and cause discordant care incidents.

Context: End-of-life care is a delicate subject to navigate conversations with patients. With holistic care being a large component of hospice and palliative care, it is important to have updated and accurate …

Understanding Healthcare Worker Experiences And Personal Protective Equipment (Ppe)-Related Skin Reactions/Injuries During The Covid-19 Pandemic: A Mixed Methods Approach, Susan Solmos

Theses & Dissertations

Personal protective equipment (PPE)-related facial skin reactions/injuries occurred in 75.13% of healthcare workers during the COVID-19 pandemic. Critical appraisal of cross-sectional studies identified methodological gaps as the majority of survey questions were not content-validated and those that were lacked descriptions of methods and psychometrics for the survey questions/tool. The aims of this dissertation study were to describe the nature, severity, and distribution of selfie captured PPE-related facial injuries using a validated tool (quantitative) and describe the contextual factors associated with PPE-related facial injuries and what factors influence nurses and Health Care Workers (HCWs) to share their experiences (qualitative). The setting …

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: …

Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project, Lauren E. Woll

Dissertations

Abstract

Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased …

Establishing A Routine Process Of Medication Reconciliation In A Rural Primary Care Clinic To Address Unnecessary Polypharmacy In Patients 65 And Older, Jessica Kirkwood-Harp

Doctor of Nursing Practice Projects

Background: Medication safety by reducing the proportion of older adults who use inappropriate medications is a Healthy People 2030 goal (Office of Disease Prevention and Health Promotion, n.d.(a)). The research for this proposal supported an established medication reconciliation (MR) to reduce errors and adverse drug events (ADEs). Consistent MR is essential for patient safety and positive patient outcomes in rural outpatient primary care clinics, as these patients possess multiple comorbidities.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project (QIP) established a routine MR process within a rural primary care clinic with reduced unnecessary polypharmacy and decreased risk of …