Public Health and Community Nursing Commons^™

Implementation Of A Nurse-Led Transitional Care Model For Older Adults With Copd Admitted To Home Health, Michelle Ryan Hunt

Doctor of Nursing Practice Projects

Problem Description: The importance of management of chronic disease and preventing rehospitalization has been identified at national and local levels. Chronic obstructive pulmonary disease (COPD) is one of the chronic diseases with notable rates of emergency department use and recurrence of hospitalizations.

Rationale: Implementation of transitional care models have been successful for health care organizations in chronic disease management.

Interventions: The health-social partnership transitional care management program (HSTCMP) was used to design a transitional care model process pilot for a home health agency (HHA) within a health system. This process used a multidisciplinary team led by a registered nurse for …

Built Food Environment And Perinatal Depression: An Integrative Literature Review, Rachel N. Mileski

Grace Peterson Nursing Research Colloquium

Background: Built food environment contributes to food access and insecurity, which impactsmaternal health due to increased rates of perinatal depression.

Objectives: The purpose of this integrative literature review will be to (1) identify contributing factors of built food environments in communities that increase the rate of perinatal depression and (2) evaluate the current intervention programs and methods addressing these factors in order to provide recommendations for further research.

Method: An integrative literature review will be used, in accordance with the Ecological Model, to evaluate contributing factors and suggestions.

Results: Findings from this integrative literature review revealed a link that connects …

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.

Kangaroo Mother Care And Traditional Care, Arianna Smola, Kirsten Lawson

Williams Honors College, Honors Research Projects

Prematurity and low birth weight are leading causes of infant death. Throughout recent years care methods for this population have evolved from incubator care to Kangaroo Mother Care (KMC). The purpose of this systematic review was to answer the following PICO question: in the case of preterm and low birth weight (LBW) infants, how does the technique of Kangaroo Mother Care (KMC) compare to traditional incubator use, regarding long and short-term outcomes of preterm and LBW infant recovery. Methods of this study included the selection of twenty peer-reviewed articles that studied the effect of incubators and KMC on premature and …

The Effect Of A School Nurse Intervention Program On Student Absenteeism In Jefferson County Public Schools: A Pilot Study, Eva Stone

DNP Projects

Background: School attendance has a significant impact on student achievement. In early grades, students who miss 10% or more of school are considered chronically absent and at risk to be behind in reading. High school students with similar attendance patterns are less likely to enroll and stay in college after graduation. Evidence shows that the presence of school nurses can result in improved school attendance.
Purpose: The purpose of this pilot project was to implement a targeted school nurse intervention at an elementary, middle and high school in Jefferson County. The intervention included assessment by a registered nurse for children …

Provider Adherence To National Heart, Lung, And Blood Institute’S Guidelines On Screening, Diagnosis, And Treatment Of Hypercholesterolemia In The Pediatric Population Aged 9-11 Years, Alanna Cox

DNP Projects

Purpose: High cholesterol levels have been directly linked to atherosclerosis, which is a leading cause of cardiovascular disease (CVD). Risk factors that accelerate the development of atherosclerosis, such as high cholesterol can begin in childhood. The purpose of this project was to evaluate provider adherence to the National Heart, Lung, and Blood Institute’s (NHLBI) Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, specifically the guidelines on universal lipid screening in children aged 9-11 years. The objectives were: 1) determine the rate of lipid screening in children 9-11 years old; 2) determine the number of children who …

Patient-Centered Medical Homes In Community Oncology Practices: Changes In Spending And Care Quality Associated With The Come Home Experience, Teresa M. Waters, Cameron M. Kaplan, Ilana Graetz, Mary M. Price, Laura A. Stevens, Barbara L. Mcaneny

Health Management and Policy Faculty Publications

PURPOSE:

We examined whether the Community Oncology Medical Home (COME HOME) program, a medical home program implemented in seven community oncology practices, was associated with changes in spending and care quality.

PATIENTS AND METHODS:

We compared outcomes from elderly fee-for-service Medicare beneficiaries diagnosed between 2011 and 2015 with breast, lung, colorectal, thyroid, or pancreatic cancer, lymphoma, or melanoma and served by COME HOME practices before and after program implementation versus similar beneficiaries served by other geographically proximate oncologists. Difference-in-differences analysis compared changes in outcomes for COME HOME patients versus concurrent controls. Propensity score matching and regression methods were adjusted for …

Advanced Practice Nursing In Nigerian Healthcare: Prospects And Challenges, Raymond O. Chimezie, Sally N. Ibe

Journal of Sustainable Social Impact

This study explored the prospects and challenges of introducing advanced practice nursing (APN) in the Nigerian health system. It sought to address the following: career pathways for registered nurses and midwives, advanced duties performed by them and the circumstances, their views and willingness for autonomous practice, and doctors’ degree of acceptance. Research population composed of registered nurses, midwives and medical doctors in primary healthcare. The conceptual framework for this study was based on the scope of practice, standards and competencies of the APN established by the International Council of Nurses (2008). A 12-item checklist of typical duties of APN from …

Peer Support For Addiction In The Inpatient Setting, Rebecca Sweeney

DNP Scholarly Projects

Background: In 2006 the Institute of Medicine reported that combined mental illness and substance use disorder was the second leading cause of disability and death in women and the highest cause in men. More recent data obtained from the 2016 National Survey on Drug Use and Health (Ahrnsbratz et al 2016) indicates in 2016 only one in ten of the people who need treatment, receive it. At Cambridge Health Alliance’s Everett Hospital, the site of this pilot project, opioid overdose and acute alcohol intoxication comprise one in every ten visits in the Emergency Department. In January of 2018, CHA partnered …

The Impact On Cost, Quality, And Patient Satisfaction When Delivering Care To Acutely Ill Adults In An At-Home Care Model Versus An Inpatient Hospital Setting., Franchesca M. Adams

Honors Theses and Capstones

The impact on cost, quality, and patient satisfaction when delivering care to acutely ill adults in an at-home care model versus an inpatient hospital setting. Hospital level care for certain acute conditions can be safely delivered in the patient’s home while lowering the cost per episode of care, maintaining or improving patient experience, and improving safety and patient/care giver education as well as care coordination, at the Critical Access Hospital (CAH) level.

Video-Based Diabetes Education For A Culturally Diverse Population, Heather Harris

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Immigrants and refugees represent an underserved population in need of quality, accessible, and culturally appropriate healthcare and education. Diabetes is a chronic condition frequently seen in this population. The author utilized the Wagner Chronic Care Model (CCM) as a theoretical framework for planning diabetes education delivery in this diverse population. Studies report significant health disparities in diabetes care and subsequent poor diabetes quality indicators in refugees and immigrants. Research has found that culturally sensitive diabetes education can improve diabetes outcomes in ethnically diverse populations. The author implemented a translational project to develop and evaluate a video-based diabetes health education intervention …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Correctional Nurse Competency And Quality Care Outcomes, Deborah Shelton, Bill Barta, Louise A. Reagan

Journal for Evidence-based Practice in Correctional Health

Purpose: In this paper, we report on the clinical care outcomes resulting from implementing a nurse competency education intervention to a nursing staff in a statewide correctional system. Background: State correctional healthcare systems face ongoing and serious challenges attracting and retaining an adequate number of qualified health professionals owing to the perceived undesirability of working in correctional facilities; high occupational stressors; and the effects of high turnover on the workloads of remaining nursing staff.

Methods: Nursing outcomes were evaluated on four most frequently used nursing protocols. The education intervention consisted of self-directed computer-based modules, hands-on clinical review of skills, and …

Changing Health Care Policy By Utilizing Kingdon's Policy Stream Theory, Brittney Welch

Graduate Theses, Dissertations, and Capstones

The purpose of this paper is to describe the policy process of changing current regulations regarding rural health clinics (RHCs). Using Kingdon’s Policy Stream Theory for guidance, the change project was designed to amend current regulations regarding the directorship of the RHCs, consequently allowing Nurse Practitioners (NP) to act as medical directors for rural health clinics (RHCs). This change fulfills the Institute of Medicine’s charge to have nurses work to the highest level of their education, as well as a defined need to fill a gap in the health care system by decreasing rural health disparities. The Rural Health Care …

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 …

Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph

Doctor of Nursing Practice Final Manuscripts

Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. …

An Assessment Of Maternal Mortality In Papua New Guinea: An Explanatory Sequential Mixed Methods Approach, Jennifer Litau

Adventist Human-Subject Researchers Association

Research into the serious manifestation of maternal mortality in Papua New Guinea is essential for formative knowledge and intervention. Explanatory sequential mixed methods approach employed first involved SPSS analyses of Gulf Provincial Hospital’s obstetric data revealing high rates of home deliveries by mothers. Interviews in high incidence communities provided explanations and mortality experiences.

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …

Pornography As A Public Health Issue: Promoting Violence And Exploitation Of Children, Youth, And Adults, Elisabeth Taylor

Dignity: A Journal of Analysis of Exploitation and Violence

The pornography industry is expanding exponentially as a result of ongoing technological advances. The ability to stream videos over the internet and the ubiquity of the smart phone have meant that pornography producers are able to use algorithms to target potential consumers, to cultivate new sexual tastes and to deliver content to a more diverse audience over mobile devices. The advent of virtual reality pornography with interactive sex toys and sex robots imbued with artificial intelligence promises to unleash a further step-change in the extent to which pornography influences ‘real-world’ sexual culture. The critical analysis of pornography undertaken over decades …

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …

Factors Associated With Household Contacts' Tuberculosis Testing And Evaluation, Elvy G. Barroso

Dissertations, Theses, and Capstone Projects

Contact investigation (CI) is one of the core elements of tuberculosis (TB) control. It is intended to achieve early identification of contacts who may have been exposed to a patient with infectious active TB and contacts who may benefit from treatment for latent tuberculosis infection (LTBI). LTBI is an infection in which the Mycobacterium tuberculosis organisms cause no signs and symptoms but the infection can be reactivated and develop into full-blown active TB disease. Failure to be identified as a contact is the primary reason for disease development in more than half of TB patients, thus a complete and timely …

Culture Care Needs Of Puerto Rican Women Receiving Hiv Care From Nurse Practitioners In New York City, Michele Crespo-Fierro

Dissertations, Theses, and Capstone Projects

The purpose of this mini-ethnonursing research study was to discover, describe, and interpret culture care values, beliefs, expressions, practices and needs of Puerto Rican women receiving HIV care from nurse practitioners (NPs) and other providers in New York City. The emic, or insider, perspective of Puerto Rican women living with HIV was the focus of this study and Leininger’s Culture Care Theory (CCT) provided the theoretical framework. Various enablers of the CCT, including Leininger’s Sunrise Enabler to Discover Culture Care, guided the design andimplementation of the study. Six key and twelve general informantswere interviewed and data from the interviews were …

Associations Between Nurse Experience, Clinical Specialty Setting, And Level Of Nursing Education With Adherence To Clinical Practice Guidelines For Inpatient Influenza And Pneumococcal Vaccination Administration, Amy C. Alsante, Dnp, Ms, Rn, Ne-Bc, Chep

Doctor of Nursing Practice Projects

Background: This research project examines associations between years of nursing practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration. Previous research demonstrates novice nurses are at higher risk for errors of omission and face challenges with critical thinking.

Objectives: 1) Identify associations between years of practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration and 2) to identify associations among independent variables including levels of education, and specialty setting.

Methods: A retrospective chart review was conducted to identify associations between years of practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration. …

Evaluation Of The Carestarttm Glucose-6-Phosphate Dehydrogenase (G6pd) Rapid Diagnostic Test At Community And Health Center Level, Cambodia, Bertha Nyagaya-Wojnarski, Dnp, Fnp-Bc, Mph

Doctor of Nursing Practice Projects

Background: Primaquine (PQ) is the only FDA-approved drug for radical cure of Plasmodium vivax (P.v) malaria, but treatment can result in life-threatening hemolysis if given to a glucose-6- phosphate dehydrogenase deficient (G6PDd) patient. Therefore, the G6PD status of the patient with P.v must be known prior to prescribing PQ. However, patient G6PD status in rural malaria endemic settings is generally unknown, illuminating the need for reliable point of care G6PD diagnostic tests as a prerequisite to safely administer PQ. To increase community PQ access in Cambodia, performance of CareStartTM G6PD rapid diagnostic tests (RDTs) needs to be evaluated in healthcare …

Exploring Significant Impacts Of Global Health On Nursing Education And Resource-Poor Communities: An Integrative Literature Review, Kimberly Elkayam, Elizabeth Del Cimmuto

Grace Peterson Nursing Research Colloquium

Exploring Significant Impact of Global Health Experienced by Nursing Educators: An Integrative Literature Review

Elizabeth Del Cimmuto & Kimberly Elkayam

Faculty Sponsor: Young-Me Lee, PhD, RN

Background: Nursing education in the United States is largely focused on health promotion at the local and community level. Modern advances in communication technology have facilitated a movement in nursing to gradually adopt a global health perspective in both practice and education.

Objective: to explore what research has been done regarding how nurse educators are impacted by adopting global health perspectives in nursing education and to suggest one potential way to add to this …

Exploring The Need Of Hpv Education Programs In Korean American Communities, Emilia Mondragón, Young-Me Lee

Grace Peterson Nursing Research Colloquium

Aim: 1) To identify cultural influences and other barriers affecting HPV vaccination decisions, 2) To identify educational methods that can deliver HPV related information to Korean American (KA) parents effectively

Background: Given significant concerns about HPV infection, lower immunization rates, and higher cervical cancer risks facing Korean Americans, it is imperative to better understand the barriers to vaccination. Currently, there is no HPV-focused education program that considers the linguistic and cultural barriers of the KA community. Additionally, there is a lack of effective educational content and methods available to reach KA parents.

Methods: An exploratory, qualitative design was conducted. Content …

Diabetes Disparities In African Americans: A Cry For Help To Primary Care Providers, Pandora Goode

Journal of Health Disparities Research and Practice

Diabetes is a national public health problem. Low socioeconomic status influence access to quality care for African Americans with Diabetes who must rely on government assisted insurance or are uninsured. Inadequate access and poor quality care for African Americans contributes to increased morbidity and negative health outcomes. This manuscript will examine the existence of diabetes disparities in African Americans pertaining to the role of low socioeconomic status, access, and poor quality care, and suggest some practical strategies for reducing diabetes disparities in this population.

Exploring The Influence Of The Peer Educator Role On Physical Activity, Exercise Patterns, Physical Fitness, Daily Functioning, And Health Harming Habits In People Living With Hiv, Stephanie Jen, Jacob Wait, Amanda Pedrazoli, Kenneisha Edmonds

Undergraduate Research Symposium

With the progression of standardized HIV treatment and antiretroviral drugs, the outcomes for people living with HIV (PLHIV) have improved from a death sentence to a manageable chronic disease. Although PLHIV are living longer than before, they experience multi-morbidities more frequently and earlier than persons without HIV. These morbidities, such as type-2 diabetes, cardiovascular diseases, and obesity, are associated with sedentary lifestyles. It is well-established in the research of the general population that regular physical activity is a health promotion behavior that can prevent and/or mitigate the onset and severity of chronic diseases. Also recent meta-analyses have linked exercise to …

An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Online Support Group For Chinese Women With Ovarian Or Cervical Cancer, Yuan Xing

Honors Undergraduate Theses

Women with gynecological (GYN) cancer experience a wide spectrum of physical, emotional and social effects after diagnosis and treatment of their cancer. The insufficient availability of local support groups, limited transportation for the rural Chinese population and a shortage of oncologists make it difficult to have face-to-face support groups for Chinese GYN cancer patients. However, the wide access of Internet has provided an opportunity for people to have online support groups. The purpose of this study was to observe and describe the types of support given to and by Chinese GYN cancer survivors in a QQ chat group. This was …