Public Health and Community Nursing Commons^™

An Exploration Of Social Capital Among Nurses In The Ambulatory Setting, Anna Lutz, Tamara Mckinnon

Doctoral Projects

Bullying and lateral violence are a sadly, common phenomena among nurses. While this issue has been examined within the inpatient, acute setting, it has not been widely researched in the ambulatory setting. This concept is usually looked at from a negative standpoint, looking at the levels of lateral violence. The purpose of this research study was done to explore the levels of social capital, also known as positive peer support, among nurses in the ambulatory setting. The participants of the study were 39 registered nurses from a public health department and an embedded care management department. The tool used was …

The Effectiveness Of California Assembly Bill 2109: Personal Belief Exemptions For Kindergarten Immunizations, Lilli Shizuka Goishi-Bessey

Doctoral Projects

The numbers of vaccine preventable diseases (VPDs) in the United States has declined with the development, administration, and effectiveness of vaccines during the 1970s and 1980s. As the eminent threat of VPDs to the public began to wane, parents started questioning the safety and necessity of vaccines. When parents were given the option of selecting personal belief exemption (PBE) waivers for state mandated immunizations for their incoming kindergarten children, an increase in PBEs and the number of VPD outbreaks began to occur. To counter the growing trend of PBEs, and to prevent outbreaks of VPDs in school settings and communities, …

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 …

Using Technology To Improve Diabetes Self-Management Within A Federally Qualified Community Health Center, Lisa Diane Morgan

Doctoral Projects

The Patient Centered Medical Home (PCMH) concept places the patient and family at the center of healthcare. The patient becomes actively involved in their own care. One aspect of PCMH is managing care and increasing chronic disease self-management. Diabetes, a chronic disease, is a leading diagnosis among the patients served by the federally qualified community health center (FQCHC). The prevalence of diabetes in Mississippi in 2012 was 12.3%. The purpose of this DNP Capstone project was to implement a pilot study to increase diabetes self-management knowledge. The program utilized the current technology of text messaging to send biweekly supportive and …

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

Doctoral Projects

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

Evidence-Based Strategies To Minimize Risk For Opioid Pain Medication Misuse Among Patients With Chronic Pain In A Primary Care Setting, Carolyn Diane Coleman

Doctoral Projects

Background: Prescription opioid pain medication misuse has become a nationwide epidemic. Many states have implemented prescription drug monitoring programs (PDMP) to assist in combating the problem of prescription opioid pain medication misuse. Evidence-based clinical practice guidelines as well as the PMDP should be utilized by healthcare providers to guide treatment of chronic pain with opioid pain medications. Purpose: The purpose of this doctoral capstone project was to determine if providers are accessing the Prescription Drug Monitoring Program (PDMP) and utilizing evidence-based guidelines to minimize opioid pain medications misuse among patients with chronic pain in a primary care setting. …

Attention Deficit Hyperactivity Disorder And Mindfulness Practice In Children And Adolescents: A Comprehensive Review Of Evidence-Based Research, Donna Nikander

Doctoral Projects

Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental illness in the United States among male and female children and adolescents between the ages of 3 and 17. The emerging fields of neurobiology and neuroimaging have proposed a relationship between mindfulness meditation therapies—initially referred to as mindfulness-based stress reduction (MBSR) and now simply known as mindfulness—and improvements in attention and self-regulation, two major problem areas for ADHD sufferers. Furthermore, recent studies suggest that mindfulness therapies may be effective in reducing symptoms of ADHD in children and adolescents. The purpose of this paper is to review, analyze and synthesize the …

Sexually Transmitted Disease Education And Effects On Condom Use In College Students, Patricia Alvarez

Doctoral Projects

In the United States, nearly 50% of the sexually transmitted diseases (STDs) reported each year occur in adolescents and young adults ages 15-24. An IRB approved, exploratory mix method research study was conducted in a California Community College to investigate participants' opinions on STD education tools, effectiveness, and to rank preferred instructional methods used in 51h-12'h grades. One hundred and thirteen students participated and reported use of variety of educational tools with the lecture technique selected by almost 80% surveyed. Demonstration of condom application had highest percent ranked as number one for the preferred educational tool; yet had the least …

Increasing Hpv Vaccination Rates Using Social Marketing Strategies, Sharon Wilson Catledge

Doctoral Projects

The human papillomavirus (HPV) is the most common sexually-transmitted infection (STI). Approximately 20 million Americans between the ages of 15 and 49 years currently have HPV with > 6.2 million new HPV infections estimated to occur each year. Yet, HPV vaccination rates remain relatively low. More than 40 strains of HPV are transmitted through genital contact during vaginal, anal, or oral sex and can infect males and females. In addition to causing genital warts, HPV is associated with cervical, vulvar, vaginal, anus, penile, and oropharyngeal cancers. In women, the most prominent type of cancer is cervical with > 12,000 diagnoses each year …

Evaluating The Perceptions Of Quality Of Life In Informal Caregivers Caring For Hospice Patients, Rashandra Fisher Laws

Doctoral Projects

Maintaining or improving quality of life for informal caregivers is important as they endure the burden of providing care to terminally ill loved ones on a daily basis. Caregivers are at a greater risk for depression, deteriorating physical health, financial difficulties, and premature death than demographically similar non-caregivers (Demiris et al., 2010). The goal of this capstone project was to determine the effectiveness of the creativity, optimism, planning, and expert information (COPE) intervention, which address specific needs of the family and caregiver.

Twenty informal caregivers completed the Quality of Life (QoL) Index tool, which measured their perceptions of five different …

Re-Engineered Discharge Planning In A Rural Mississippi Hospital To Reduce 30 Day Readmission Rates Among Heart Failure Patients, Roxie Mae Hogan

Doctoral Projects

The hospital discharge is a complex process that involves interdisciplinary efforts to avoid readmissions and decrease health care costs. The purpose of this capstone project was to take a leadership role in translating evidence into practice by successfully preparing NWMRMC discharge planning stakeholders to adapt Project RED for use with HF patients admitted to NWMRMC.

A comprehensive systematic improvement plan, Project RED is designed to improve the work flow process through the use of timelines and strategies. Project RED supports discharge planning, helps to prevent readmission, and facilitates knowledge transfer that promotes sustainable changes. Re-Engineered Discharge Planning (RED), 6 step …

Transitioning Traditional Acute-Episodic Primary Care Visits To Group Visits: An Evidence-Based Approach To Diabetes Care, Bridget Michelle Smith

Doctoral Projects

Diabetes is a national problem that has extended epidemic magnitudes. Its management difficulty impends to overwhelm acute-episodic healthcare systems and challenges the resources of current and future individual primary care providers. According to the Centers for Disease Control and Prevention (CDC) (2012), there are 25.8 million people in the United States or 8.3% of the population who have diabetes. Mississippi ranks second in the nation in the prevalence of diabetes and has the highest percentage of overweight and obese adults in the nation (CDC, 2012). In an effort to bridge the gap with delivery of quality care to patients with …

Promoting Behavior Changes In Patients With Type 2 Diabetes Through Shared Medical Appointments, Shonda Lanette Williams

Doctoral Projects

Diabetes Mellitus (DM) is a chronic disease that affects many individuals in the United States. It was reported that a total of $245 billion is spent annually on both direct and indirect health care costs associated with the treatment of diabetes and diabetic related complications. Diabetes related complications can be prevented or delayed if proper education is done and individuals are willing to practice positive behavior changes and self-manage their disease. The purpose of this doctoral capstone project was to promote behavior changes in patients with diabetes through diabetes self-management education (DSME) in shared medical appointments (SMAs).

This project was …

An Evaluation Of The Effectiveness Of Providing Foot Care Education In A Rural Clinic Setting, Gloria Green-Morris

Doctoral Projects

Diabetes is one of the most frequently diagnosed metabolic disorders and is currently at pandemic magnitude. Approximately 1.4 million adults are diagnosed with diabetes each year. According to the American Diabetes Association (2011), the numbers of diagnoses will more than double by 2030. Because of the high prevalence of diabetes, the perceptions of risk factors and healthy behaviors are important. A good understanding of written and verbal healthcare instructions, healthcare accessibility, and socio-economic status have a direct effect on patient health outcomes and the overall health of the population (Jovic-Vranes, Bjegovic-Marinkovic & Marinkovic, 2009).

Diabetic foot complications are common concerns …

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

Doctoral Projects

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

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

Perceptions Of A Dedicated Education Unit In The Mississippi Delta, Jacquelyn Felecia Brownlow

Doctoral Projects

The highest health care disparities in the country plague the Mississippi Delta. A weakened economy, minimal access to healthcare and an outdated traditional clinical learning environment place enormous strains on nursing education in this area to provide more nurses. The office of Nursing Workforce reported a 14% to 16% nursing turnover in the Delta compared to the national average of 13.5%. As a result, the health care organization has encountered high nurse turnover, increased staffing shortages, and a decrease in nursing quality indicators. As an effort to improve clinical education and bridge gaps between education and practice, several schools in …

Exploration Of Self-Care Following Distribution Of Acute Management Tool For Elder Heart Failure Patients In Clinic Setting, Sharon Elaine Vincent

Doctoral Projects

The aim of this study was to develop a broad understanding of heart failure patients’ perceptions about their lived experiences. An acute symptom management tool, Red Flags I Need to Know: Heart Failure Action Plan (Health Net Federal Services, 2011), was distributed to the patients prior to initiation of the project.

The problem of heart failure rehospitalization is significant. Cost of treatment for heart disease in the United States exceeds all other conditions. The national excessive 30-day readmission rate in elders post-discharge is 24.8%. Pay-for-performance initiatives will reduce reimbursement for excessive readmissions beginning FY 2013.

The project was a mixed …

Impact Of Social Marketing On Nurse Practitioners' Acceptance Of Clinical Video Telehealth For Elderly Patients In Rural Mississippi, Teresa Lynn Langley

Doctoral Projects

Elderly patients 65 years and older who have chronic illness and disabilities living in rural Mississippi have increased difficulty in obtaining timely cost-effective healthcare services from nurse practitioners. The purpose of the capstone project was to utilize social marketing strategies for promoting nurse practitioners’ acceptance of clinical video telehealth (CVT) in improving healthcare access for rural elderly patients in Mississippi. Clinical video telehealth is an innovative way to provide healthcare services to populations in need by reducing barriers to healthcare, such as distances, time, and transportation, and financial resources. However, providing healthcare through the use of technology has not always …