Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

Youth Sports In A Pandemic Age, Robert Bohnert

Dissertations

Abstract

Problem: Youth sporting events is a public health concern as infected youth with coronavirus disease 2019 may unknowingly spread the virus, as many show little to no symptoms (Zimmerman & Nigel, 2020). This project aimed to identify level of adherence to posted Youth Sports Guidelines, which were designed to mitigate the spread of virus at youth sporting events.

Methods: An observational descriptive design was utilized. Two observers tallied guideline violations by participants and spectators at six high-contact (basketball) and six low-contact (swimming) public high school youth sporting events.

Results: A total of 726 youth sport participants and 139 …

The Associations Of Chronic Stress, Social Support, Health Behaviors And Metabolic Syndrome Among Hispanic Women, Edna Esquer

Dissertations

The Associations of Chronic Stress, Social Support, Health Behaviors and Metabolic Syndrome Among Hispanic Women

Background: Metabolic syndrome (MetS) prevalence is 25% among Mexican American women 30 – 49 years of age, compared to 22% among non-Hispanic Whites in the United States. Little is known about the additional contributions of chronic stress, social support and health behaviors to the development of MetS among this population.

Purpose: Describe the associations between chronic stress, social support, and health behaviors and the presence of MetS in Hispanic women living in an underserved community.

Methods: A retrospective cohort study design. The Adult Treatment Panel …

Food Insecure Copd Patients And Healthcare Utilization: A Retrospective Study, Kristine Mendoza

Dissertations

Abstract

Purposes/Aims: Despite advances in the recognition and treatment of high-cost users of health care, the incidence of healthcare utilization remains high. Rates of hospital admissions and emergency room visits among chronic disease like COPD have become a targeted group for health management. COPD patients have multiple and complex health and social needs, but the impact of their unmet food needs is not well understood and warrants further investigation. The purpose of this study is to explore the relationships between COPD food insecure patients and healthcare utilization in San Diego County.

Background/Rationale: Government programs targeting patients with high healthcare costs …

A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard

Dissertations

There is a need to understand the influences and outcomes related to loneliness in veterans living with complex illness. Patients require self-care to manage complications and exacerbations associated with complex illness. Deficits in self-care result in negative health outcomes and drive resource utilization upward. The identification of potential factors related to self-care is important. Loneliness may be one factor that influences patients’ ability and desire to care for themselves. Descriptive correlational design was used to evaluate loneliness both as a predictor and outcome in veterans admitted to the hospital for three complex respiratory illnesses (heart failure, chronic obstructive pulmonary disease, …

Utilization Of Asthma Guidelines In Primary Care, Kate R. Miller

Dissertations

Background: Chronic lower respiratory disease, including asthma, is the fourth leading cause of death in the U.S. Financially, asthma accounts for approximately 54 billion dollars in healthcare spending annually. The National Heart Lung and Blood Institute [NHLBI] established guidelines to reduce impairment and to reduce future asthma attacks.

Purpose: This Quality Improvement (QI) pilot implemented the Asthma Control Test (ACT) and the Asthma Action Plan (AAP) per NHLBI guidelines. This project aimed to increase provider use of the ACT and AAP to 50% in patients with a diagnosis of asthma over one month.

Methods: A convenience sample of six adult …

Community Health Nurse Educators And Disaster Nursing Education, Jody Spiess

Dissertations

Abstract

The world is struggling with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and the need for disaster nursing education has never been more clear. Recently, the American Nurses Association reported that of the over 32,000 nurses surveyed; only 11% felt well prepared to care for a COVID-19 patient (ANA, 2020). Community health nurse educators are tasked with educating future nurses on disasters, yet, little is known about this population’s perceived competence in disaster preparedness. The purpose of this study is to describe community health nurse educators' perceived competence in disaster preparedness.

The study is a descriptive, correlational …

Comorbidity And Quality Of Life Of Hiv-Positive Adults Living In Supportive Housing, Rose Sharp

Dissertations

Problem: Life expectancy for people living with HIV significantly increased with widespread use of antiretroviral therapy, resulting in population increases in comorbidity prevalence. The increased burden of living with both HIV and comorbidities lowers health-related quality of life (HRQoL).

Methods: Using a descriptive, correlational, cross-sectional design, a convenience sample of HIV-positive adults was selected from seven supportive housing communities. Comorbidities were assessed using a modified Self-Administered Comorbidity Questionnaire, and HRQoL using the Patient-Reported Outcome Measurement Information System Scale v1.2 – Global Health.

Results: A sample of 17 (N = 17) adults reported a mean of 4.2 (SD = …

Diet Behaviors, Physical Activity, And Sociodemographic Factors In A Sample Of Racially Diverse Adults: A Secondary Analysis Of Nhanes (2017-2018) Data, Fatemeh Choupani

Dissertations

Background: The prevalence of obesity is increasing among adults in the United States and is related to a high risk to health. Obesity has been linked to lifestyle behaviors such as diet behaviors and physical activity.

Purpose: This study aimed to determine if an association exits between foods prepared outside of the home, walking or biking, vigorous/moderate recreational activities, sociodemographic factors and the outcomes, body mass index, percentage of body fat, and waist circumference.

Method: A secondary analysis was conducted using data from 3942 adults from the U.S. aged 20 years, as recorded in the National Health …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Utilizing Wellness Champions As A Faith-Based Initiative For Mental Health Promotion, Tracy M. Webster Cooley

Dissertations

Abstract

Purpose: This program evaluation project evaluated the effectiveness of mental health training and support provided to wellness champions affiliated with a behavioral health organization. This project sought to gain a better understanding of how clergy and laypersons acting as wellness champions in predominately African-American faith-based organizations perceive they create an atmosphere to decrease stigma and increase mental health promotion and wellness when receiving education and training on mental health.

Methods: A descriptive project using a program evaluation design to evaluate the effectiveness of the training of 122 wellness champions from faith-based organizations received from a behavioral health organization …

Pain And Spiritual Distress At End Of Life, Kathryn Lee Robinson

Dissertations

Purpose: The purpose of this study is to examine the relationship between unmanaged pain and spiritual distress in adults newly admitted to hospice.

Background/Rationale: Current evidence supports the presence of a positive relationship between increased physical pain and spiritual distress for those with advanced cancer and/or receiving palliative care services. Nonetheless, spiritual distress remains a relatively understudied area; anecdotally, assessment and management of physical symptoms often take precedence over interventions for spiritual distress in patients at end of life (EOL) on hospice. Research is needed to examine the relationships between physical pain, spiritual distress, and other relevant variables specific to …

Health Care Access And Utilization By U.S. Farmworkers, Genesis Bojorquez

Dissertations

Background: Agriculture industry has the highest fatality rate among all United States industries. Farmworkers experience high rates of occupational injury, illness, and mortality, yet have limited access to health care. Implementation of the Patient Protection and Affordable Care Act (ACA) of 2010 increased health care accessibility and broadened farmworker eligibility for health insurance, yet no study has measured the impact of the ACA upon U.S. farmworkers.

Purpose: The purpose of this research was to examine health care access and health care services utilization among U.S. farmworkers following the implementation of the ACA in 2010.

Specific Aims:

1. Apply the …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Management And Support Of Uninsured Patients With Diabetes Type Ii Within A Nurse Managed Clinic, Emma Spencer

Dissertations

The purpose of the project was to improve the quality of care for the uninsured, Type II Diabetics residing in a Midwestern urban underserved community. Community Health in Partnership Services (CHIPS) was a nurse-managed clinic, located in that area, that sought to lessen the burden of being uninsured. An annual fee of $35.00 allowed an uninsured community member access to a variety of different health care providers including specialists. In order to utilize this health care team efficiently, it was necessary to implement nurse-led care coordination for patients diagnosed with Type II Diabetes. This quality improvement project followed the Plan …

A Vaccine Administration Training Program To Increase Adolescent Vaccination Rates, Claire Jensen

Dissertations

Abstract

Immunizations have been proven to control life-threatening diseases. Often Registered Nurses (RNs) administer vaccines but are unsure how to discuss vaccines with vaccine hesitant patients. Missouri’s adolescent vaccination rates are below its neighboring states. This initiative’s purpose was to increase adolescent vaccine administrations at a Missouri County Health Department (MCHD).

This quality improvement initiative had an observational, cross-sectional, descriptive design. RNs employed at three MCHD clinics attended an adolescent vaccine administration training program (VAT) and completed pre-/post-tests regarding the Advisory Council on Immunization Practices recommendations. Medical record reviews from March 1-April 30, 2018 and March 1-April 30, 2019 compared …

A Rural Telehealth Objective Structured Clinical Examination, Devon Schlottach

Dissertations

Problem Rural healthcare consumers experience increased health disparities, especially when accessing health care. The use of telehealth to improve access has become an essential competency for nurse practitioner (NP) students. This study evaluated NP students’ confidence and competence of rural social determinants of health (rSDOH) before and after a telehealth simulation.

Methods A descriptive, cohort design was used to review NP students’ pre- and post-surveys, written case studies, and a video-recorded telehealth OSCE for a patient living in a rural area.

Results Student self-rated knowledge of rural health care did not improve despite didactic learning and simulation (z = …

Primary Care Delays In Underserved Areas: A Strategic Plan To Improve Access To Care, Debra Connell-Dent

Dissertations

Hypertension (HTN) and Diabetes Mellitus Type 2 (DM2) are two chronic conditions contributing to morbidity and mortality. 23.1 million people have DM2 and 7.2 million people have it an are undiagnosed in the U.S. During 2015-2016, the prevalence of HTN was 29.0% and increases with age (CDC, 2018). This purpose of this article was to discuss the benefits of developing a Transition Clinic (TC) in a highly traveled metro transit area and the development of a strategic plan on implementing this project, as well as the barriers that may be encountered when implementing such a clinic similar to this. A …

Depression In Hiv-Positive Individuals Living In A Residential Housing Community, Danielle Njeri

Dissertations

Problem: Depression is the most prevalent psychiatric disorder among individuals living with HIV. Depression rates are three times greater than those found in the general population . Undiagnosed and untreated depression can have a negative effect on the management of HIV infection, resulting in increased mortality and a poorer quality of life. The purpose of this quality improvement initiative was to assess the incidence of depression in HIV-positive individuals living in a residential community.

Methods: A prospective, descriptive, cohort design. Convenience sample of HIV-positive adult residents living in an HIV residential community. The nine-question patient health questionnaire (PHQ-9) …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

The Lived Experience Of Discharged And Readmitted African Americans With Chronic Obstructive Pulmonary Disease To A Safety-Net Hospital, Kiiyonna Jones

Dissertations

Background:Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disease that negatively affects the quality of life of those affected and has been a major contributor to the continuous rise in healthcare cost in the Unites States (Guarascio, Ray, Finch, & Self, 2013; National Heart Lung and Blood Institute, 2009; Shavelle, Paculdo, Kush, Mannino, & Straus, 2009; Scott, Smith, Sullivan, & Mahajan, 2001). In 2014, Centers for Medicare & Medicaid Services (CMS) identified COPD as an applicable condition to the Hospital Readmissions Reduction Program, which penalizes healthcare organizations having readmissions higher than the national average. COPD is the second …

Mississippi Registered Nurse Perceptions When Communicating With Limited-English-Speaking And Non-English-Speaking Patients, Mary Pipper Widdig

Dissertations

Communication serves as the foundation for safe and effective healthcare practice. Effective nurse-patient communication is the cornerstone of the nurse-patient relationship and is vital for the delivery of safe and effective healthcare. Research has shown patients who are communication impaired are at a greater risk of medical error and poorer health outcomes. A review of the literature revealed various nurse perceptions of barriers when providing care for limited-English-speaking patients and non-English-speaking patients. LEP and NEP patients also identified similar perceived barriers when receiving care. Both nurses and patients revealed a distrust for interpreters and interpreter services. The literature review revealed …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods

Dissertations

Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

The Lived Experiences Of Parenting Children With Food Allergies: A Phenomenological Study, Anne Zavell

Dissertations

This phenomenological study focuses on five mothers' experiences of the phenomenon of living with a diagnosed food allergy in the family. Attention is given to the contexts or situations that have typically influenced or affected their experiences, including the impact of the diagnoses, travel and restaurants, friendships, sibling relationships, and anxiety. There is a major emphasis on these mothers' experiences advocating for the needs of their children in schools, including their strategies, concerns, and frustrations. Policies related to food allergies are reviewed from the contemporary and historical perspectives, with recommendations for policy change. The lived experiences of food allergy mothers …

The Lived Experience Of Spiritual Well-Being Amongst Informal Caregivers Of Persons With Dementia On Palliative Care Living At Home, Michael Baumgardner

Dissertations

Title. The Lived Experience of Spiritual Well-Being Amongst Informal Caregivers of Persons with Dementia on Palliative Care Living at Home.

Purpose.This study explored the lived experience of spiritual well-being amongst informal caregivers of a person with dementia who were living at home and enrolled in palliative care.

Background. Patients with dementia comprise the third leading diagnosis in palliative care patients and many receive informal care from family members. Palliative care improves quality of life in patients and their informal caregivers. However, little is known about spiritual well-being in the setting of caregiving of persons with dementia on palliative care. …

Traumatic Brain Injuries: A Telehealth Alternative For Veterans, Jessica Dickman

Dissertations

Problem: Traumatic Brain Injuries (TBI) are known as the signature wound of veterans serving in Operation Enduring Freedom (OEF) and the Operation Iraqi Freedom (OIF). After the initial TBI diagnosis, outpatient TBI follow-up rates are reported to be approximately 9% less in the Veteran Healthcare Administration (VA) system when compared to the private sector. The purpose of this quality initiative was to decrease the rate of missed appointments among OEF/OIF veterans using a telehealth alternative.

Methods: The Plan-Do-Study-Act (PDSA) method was used to implement a consistent process for the telehealth visit option. A retrospective medical record review over the same …

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 …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Nurse-Led Triage Clinic In An Hiv Supportive Housing Apartment Community, Sally Breen

Dissertations

Problem: HIV-positive persons living in supportive housing who were otherwise homeless are reported to have better health outcomes than those who remain homeless. This was a quality improvement project to obtain baseline information regarding the implementation of onsite nursing services for individuals and their families residing in an HIV-positive supportive housing apartment community in an urban Midwestern city. Methods: A nurse triage clinic was implemented in partnership with the Doorways organization. Two registered nurses staffed the clinic two days per week. Data was collected on demographics and clinic utilization over a nine-week period. Results: Of the apartment residents, N=95, the …