Public Health and Community Nursing Commons^™

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

Association Of Lung Cancer With Pneumonia And Chlamydia Pneumoniae Infection, Johnny Zakhour Md, Daniel Muller, Alex Glynn, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: The degree of association and type of causal versus non-causal relationship between pneumonia and lung cancer (LC) are evolving discussions. We reviewed English publications on the degree of association between pneumonia and subsequent LC.

Methods: We searched the PubMed database using key words for pneumonia, LC, and chlamydia infection. We selected peer-reviewed studies of patients with pneumonia and LC. Case reports and other literature reviews were excluded from this review.

Results: Five studies examined the incidence and/or risk of LC for a total of 415,750 patients, and four studies examined cases with Chlamydia pneumoniae chronic infection at the time …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

Pulmonary Inflammation And Injury Triggered By Spine Surgery In Recovered Covid-19 Patients Demand Consideration, Luciano Rodrigo Lopes, Silvana Kertzer Kasinski

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

By Utilizing Technology Can Nursing Students Gain More Confidence And Decrease Anxiety When Communicating With Chronically Ill Patients About Their Sexual Relationship?, Sheri Rickman Patrick, Alice Butzlaff

Faculty Research, Scholarly, and Creative Activity

Introduction
Effective communication is an essential part of nursing care. Nurses need to effectively communicate with patients, families, providers and staff. The purpose of this study was to show how the use of technology (i.e., video conferencing on an electronic device) could assist nursing students to gain more confidence and reduce anxiety when discussing difficult topics such as sexual intimacy.
Methods
Pre-licensure nursing students were recruited to participate as part of regular class activities. A pre- and post-survey asking about their confidence and anxiety in communicating with patients was completed; then subjects were randomly placed into groups of 4 to …

The Association Of Demographics, Social And Personal/Family Characteristics With Treatment Utilization Among Young Adults With Opioid Use Disorder In The United States, Marva L. Frederick

Dissertations, Theses, and Capstone Projects

Background

Opioid use disorder is a life-threatening medical condition and an ongoing public health problem in the United States. Treatment is necessary to combat opioid use disorder and to minimize the health-associated problems. Opioid use disorder is treatable with life-extending medications. Studies that examined treatment utilization among young adults with opioid use disorder in the United States was scarce. This study investigated the characteristics posited in the Andersen Behavioral Model of health utilization which may be associated with treatment utilization, among young adults with opioid use disorder in the United States. The urgency posed by the continuing opioid crisis in …

Factors Associated With Health-Promoting Behaviors Of Adult Protective Service Workers And Professionals Who Support Vulnerable Adults, Cynthia Sterling-Fox

Dissertations, Theses, and Capstone Projects

Background: Adult protective services encompass social services provided to vulnerable adults: abused, neglected and exploited elderly and adults with significant disabilities in the United States. Adult Protective Services (APS) workers investigate allegations of abuse, neglect, and exploitation of vulnerable adults. APS workers work closely with multidisciplinary teams and professionals in various fields to assist with the investigations. APS workers and other professionals are exposed to individual and work environment stressors that result in a lower professional quality of life. There is evidence, however, that health-promoting behaviors mitigate the negative effects of stressors.

Purpose: Using the Health Promotion Theory by Nola …

Ksu Sna Period Party Project: Advocating For Women’S Health In The Homeless Population Of Kennesaw State University, Alice Barry

Symposium of Student Scholars

In one of the wealthiest countries in the world, women are being deprived of the basic human right of access to proper feminine hygiene products and education. The purpose of this service leadership project was to review current literature to describe menstrual hygiene as a basic human right, to explore the cost/access to feminine hygiene products in multiple studies, to examine political and international initiatives surrounding access to feminine hygiene products, and to synthesize how nursing students can advocate for primary care and health promotion in the community in which they live. The project aimed to address the overwhelming need …

Why Should People Use Face Masks In The Time Of Covid? The Jri Position, Jose Bordon, Alex Glynn, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …

Focused Ethnography: Storytelling For Hispanics With Low Health Literacy And Diabetes, Virginia H. Cadenhead

Nursing Theses and Dissertations

Background: Storytelling is an intervention for health communication that has many forms, addresses varied health issues, and is suitable for low health-literate populations. Storytelling can impact knowledge, behaviors, attitudes, and health outcomes. Population Focus: Fictional storytelling has not been researched as an educational adaption in diabetes self-management for Hispanics with low health literacy. Forty-one percent of Hispanics in the United States have low health literacy, a contributing factor to poor health outcomes in chronic disease management. The Hispanic population has disproportional rates of diabetes complications. Research Question: How can short, fictional, orally presented stories be developed as culturally-adapted educational tools …

Communication Strategies To Promote Infection Control Compliance: My Health Is In Your Hands, Ezra Macabio

Master's Projects and Capstones

Abstract

Problem: The facility has less than 70% adherence to handwashing hygiene every week. Moreover, staff does not comply with the required PPE, affecting their infection-control performance and compliance to circumvent COVID-19. Furthermore, the microsystem lacks information flow and communication systems focusing on hand hygiene, and PPE usage significantly affects the healthcare staff's ability to perform such vital practices.

Context: Herman Health Care Center provides multiple services to its residents depending on medical needs after patient hospitalizations, such as short-term rehabilitation and long-term skilled nursing services. The COVID-19 pandemic had a remarkably negative impact on the skilled nursing facility. The …

The Impact Of Nurse-Led Initiative Interventions On Cauti, Dalveer Kaur

Master's Projects and Capstones

Problem: National Healthcare Safety Network (NHSN) has reported U.S. hospitals having 0.2 to 4.8 per 1000 catheter-days for adult inpatient units. The insertion of a catheter and delay in removal have a significant impact on morbidity, mortality, length of stay, and reimbursement.

Context: Post-Acute Care Unit (PACU) is a microsystem that provides rehabilitation services for a patient with various post-surgical procedures. The staff of this unit was well aware of policies of catheterizations that led to prolonged use of urinary catheters and an increased rate of CAUTIs in the last quarter of this year. This project aims to increase staff …

Evaluating Self-Management Of Adults With Multiple Chronic Conditions Residing In Rural Communities: A Descriptive Cross-Sectional Study, Jessica J. Miller

Theses & Dissertations

Background

Chronic diseases are the leading cause of death and disability in the United States and are on the rise. Multiple chronic conditions are increasing in frequency with 1 in 4 adults affected. Behaviors of adults from rural communities are at an increased risk of developing MCC because of limited access to health care resources and behaviors. Supporting the development of self-management skills can help adults be more active in their own health and promote healthy lifestyle behaviors. The Individual and Family Self-management was the guiding framework for this cross-sectional study.

Purpose

The purpose of this study was to determine …

Social Determinants Of Health Assessment For Skilled Nursing Patients, Heather Welch

Master's Projects and Capstones

Section I: Abstract

Problem: Skilled nursing facility (SNF) patients are vulnerable, aging, and have complex medical histories. Readmissions from an SNF impact healthcare costs and hospital resources and indicate poorly coordinated transitions home. Patients discharging from SNFs are at risk for higher social determinants of health (SDOH) disparities, such as limited caregiver support, transportation, housing insecurity, and food access. These SDOH risks can significantly increase an SNF patient's risk for hospital readmissions. Assessing and addressing SNF patients' social needs to reduce 30-day post-SNF readmissions can improve health outcomes and positively impact healthcare costs and a patient's financial liabilities.

Context: Frailty, …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao

Master's Projects and Capstones

Abstract

There are multiple layers of oversight across the healthcare delivery system. Measuring acute hospital readmissions has been identified as an important outcome measure of quality care. Our patients are one of the major stakeholders in the healthcare system. One role of a clinical nurse leader is to integrate evidence-based leadership practices that identify and assess outcomes, mitigate risk, enhance health promotion, deliver highly effective patient care, and ensure transparent relationships with stakeholders. Rationales for examining and re-designing the readmission analysis workflow based on the customer’s experience are discussed in this paper. The global aim of the project is to …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

Improving Mammography Rates Among The Hispanic Population: An Evidence-Based Project Utilizing A Promotora Intervention, Dawn Mirowski

Student Scholarly Projects

Practice Problem: Breast cancer is the leading cause of death in Hispanic women in the U.S., with mammography being the most effective means of reducing breast cancer mortality. Promotoras have been shown to improve health promotion, including mammography, among the Hispanic population.

PICOT: The PICOT question that guided this project was: In Hispanic women 40 years or older (P), how does the use of a promotora intervention (I), compared to no promotora intervention (C), affect mammography rates (O) within an 8-week period (T)?

Evidence: Twenty-one studies that met the inclusion criteria supported the use of promotoras to improve mammography …

Use Of A Remote Patient Home Telemonitoring System (Engage Practice Solutions) In A Rural Health System To Decrease Rural Patients’ Utilization Of Acute Healthcare Services: A Quality Improvement Project, Christopher Baker

Doctor of Nursing Practice (DNP) Manuscripts

Individuals in rural areas of the U.S. have less healthcare access in large part due to access barriers, and include travel and wait time, distance to a provider, cost, transportation, and social and cultural components. Rural individuals have been found to be in poorer health and have higher rates of being uninsured and having chronic disease. These disparities lead to rural individuals requiring more expensive acute care once they are at the point of receiving care. A significant burden is placed on the individual and health system. The rates of emergency department (ED) use in rural areas increased 70% from …

"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa Sanchez-Navarro

Doctor of Nursing Practice (DNP) Manuscripts

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early screening intervention tool for individuals with non-dependent substance use, which is employed to identify and provide care before a patient needs extensive specialized treatment. SBIRT can be used in primary care settings, to methodically screen individuals who might not seek help for a substance use issue (Centers for Medicare & Medicaid Services, [CMS], 2020). Gaps in using the SBIRT screening process were identified within the insurance organization’s PCP practices, therefore, a program evaluation was completed to: (a) determine whether Primary Care Physicians (PCPs) were using the SBIRT process, (b) …

Chronic Obstructive Pulmonary Disease, Aaron Mcneilan

Nursing Student Class Projects (Formerly MSN)

The following poster presentation provides a brief overview of the disease process of Chronic Obstructive Pulmonary Disease (COPD). COPD is one of the leading causes of disability and death worldwide, and its incidence does not appear to be declining. The most common factor causing COPD is cigarette smoking, which is modifiable. Other contributors are environmental air pollutants which some people may encounter depending on where they live or their occupation. This presentation is a culmination of information from different scholarly sources which discuss the symptoms, pathophysiology, causes, management, and prevention of COPD.

Polycystic Ovarian Syndrome: Pathophysiology And Chronic Health Implications, Makilah Witt

Nursing Student Class Projects (Formerly MSN)

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. If untreated, women suffer a myriad of secondary sequala and chronic diseases. The prevalence of PCOS is rising and greatly impacts patients' physical, mental, and emotional health, diminishes community health, and increases healthcare costs. However, many providers fail to properly diagnose patients, understand how this disease impacts women, or provide appropriate interventions to prevent chronic health problems. This paper outlines the pathophysiology of PCOS, identifies signs and symptoms, and provides recommendations for treatment and holistic patient care for the role of the Advance Practice Nurse.

Indian Healthcare System: Reflections Of Swedish Nursing Students, Elisabeth Mangrio

Manipal Journal of Nursing and Health Sciences

Internationalization within nursing programs is essential to provide nurses with cultural competence and for nursing students to gain an international perspective. It has also been shown to be effective to gain a cultural understanding. This paper aims to illuminate and explain the experiences that Swedish nursing students had while they engaged in clinical training during an exchange program in India and to provide a comparison between the health service in both countries. Nursing students from Sweden did a four-week clinical placement within the primary healthcare in India in 2020. During the clinical placement, which consisted of a variety of healthcare …

Impact Of Simple Breastfeeding Initiatives Led By Nurses In A Primary Care Setting, Jessica Semin, Carolyn Hanus, Megan Scott, Amy Ford, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Background: Breastfeeding is recognized by health experts as the preferred infant feeding method. Health professionals, especially nurses, play a vital role in influencing mothers’ infant feeding decisions. This quality improvement project designed, implemented, and evaluated by nurses explores how the implementation of three simple initiatives impacted healthcare staff’s attitudes, beliefs, and perceptions related to breastfeeding.

Materials and Methods: The project was led by three Doctor of Nursing Practice (DNP) students with guidance from their DNP prepared advisor. It took place in a primary care setting at a federally qualified health center. Prior to and after implementation, staff were …

Developing Outpatient, Clinic-Based Education For Patients With Diabetes And Prediabetes, Ruth Ann Slayton

Electronic Theses and Dissertations

Abstract Education and support provided to the newly diagnosed prediabetic or Type 2 Diabetic are inadequate in the outpatient arena. In rural areas, instruction for diabetes is minimal to nonexistent, and patients are paying for this with their health and lives many times. The financial burden of diabetes in the United States is astronomical. The loss of life and life quality is significantly high as well. A systems-based approach to education in the rural health clinic would be of great benefit and has proven to be enough to reverse or avoid the progression of the disease. A clinic or field-based …

Bringing Hospital And Community Together: Interventions To Bridge The Transitional Care Gap, Jeremy Yates

Dissertations

Abstract

Problem

As healthcare spending continues to increase and overall quality lags in comparison to other developed countries, hospital readmission has been targeted to increase quality while decreasing cost. Components of the Affordable Care Act (ACA) have placed an emphasis on preventative and transitional care which has created programs aimed at reducing readmission, including the Community Health Access Programs (CHAP). One program in St. Louis, Missouri consisted of advanced practice paramedics and an occupational therapy assistant that performed discharge follow-up through in-home, in-office, and telephone visits. An in-depth program evaluation can create a foundation to build other programs in communities …

Improving Outcomes For Sexual Assault Patients In Alignment With Hiv Npep Clinical Guidelines, Maria Dahlke, Rachel Kanz

Nursing DNP Projects

Purpose and Rationale

The purpose of this project is to improve the follow-up care given to adult patients, 18 years and older, who require human immunodeficiency virus (HIV) non-occupational post-exposure prophylaxis (nPEP) treatment after a sexual assault. The goal is to determine if organizational alignment with HIV nPEP clinical guidelines through staff education improves medication adherence for adult sexual assault patients. Currently, sexual assault survivors have the lowest medication adherence rate to HIV nPEP among those at risk for HIV.

Synthesis of Evidence

The evidence supports the standardization of care for sexual assault patients' individual needs. Educating health care professionals …

Factors Influencing Rural Women’S Physical Activity Behaviors: A Social Ecological Perspective, Karen Lynn Webb

Nursing ETDs

ABSTRACT

Chronic disease and poor mental health are disproportionally impacting adults living in rural America. Regular physical activity has been shown to promote overall well-being and prevent many chronic diseases. Yet, research shows that many rural adults do not engage in enough physical activity to meet the recommended levels put forth by the federal government. The purpose of this descriptive qualitative study was to explore and describe the experiences of physical activity as perceived by rural women in their own words. Data were collected through semi-structured individual interviews of 20 women aged 25 to 34 living in McDowell County, West …