Public Health and Community Nursing Commons^™

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Leman E. Bush

Master's Projects and Capstones

Abstract

Problem: Sepsis is a life-threatening infection that needs immediate treatment. The ED uses sepsis bundle protocols to treat sepsis but the compliance rates for the order sets are below the institution’s guidelines.

Context: A Centers for Medicare and Medicaid Services (CMS) instituted a sepsis performance measure bundle in 2015 called (SEP-1) to promote cost-effective, high-quality care for septic patients admitted to the Emergency Department (ED) (Wang et al., 2020). The ED in a chosen San Francisco, CA acute care hospital has been experiencing unsteady sepsis bundle compliance rates. Sepsis is caught by 1.7 million American adults per year …

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration, Purnima Krishna

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure (HF) patients have a high risk of rehospitalization after discharge from acute care. Post-discharge management of HF patients requires coordinating services outside the hospital, such as skilled nursing and home health care to address patients’ complex needs.

Local Problem. High HF readmission rates negatively impact a hospital’s efficiency and pose a risk of financial penalties. In the project setting, the HF patients discharged to skilled nursing facilities and home health agencies had a higher rate of 30-day readmission than patients discharged to home.

Methods: Fourteen post-acute care (PAC) facilities were selected for the interventions. The …

Therapeutic Gardening For Mental Health In Substance Use Recovery, Stephanie E. Schafer

Master's Projects and Capstones

Abstract

As the clinical nurse leader (CNL) in this project, I used the “[CNL]

Essential 1: Background for Practice from Sciences and Humanities” (Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice, 2013) and its competencies to focus on designing nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences and to synthesize evidence for practice to determine appropriate application of interventions across diverse populations. With the help of the CNL competencies and collaboration with the healthcare team, we created and implemented a therapeutic garden for residents in a substance use …

Implementation Of A Decision Aid To Increase The Rate Of Routine Breast Cancer Screening Among Women Between 50 To 74 Years Old At A Federally Qualified Health Center, Dana Mars

Doctor of Nursing Practice Scholarly Projects

Background: Breast cancer is the most prevalent form of cancer in the U.S. Cancer screenings can result in prompt treatments and positive health outcomes. Disparities in screening rates are prevalent among vulnerable populations. At a Federally Qualified Health Center (FQHC), where the project occurred, the rate of breast cancer screening in 2021 (64%) was lower than the target set by the Healthy People 2030 (77%). This quality improvement project aimed to increase the rate of routine breast cancer screening among women aged 50-74 years old in the FQHC.

Methods: Previous studies have reported that decision aids on breast cancer screening …

A Rapid Review Of The Literature: Cardiovascular Disease Preventive Practices And Rural Black Women, Modjadji M. Choshi, Maria Devalpine

Virginia Journal of Public Health

Cardiovascular disease (CVD) is the leading cause of death among Black/African American women. Rural Black women have the highest CVD prevalence and are more likely to have modifiable risk factors such as high blood pressure, diabetes, and obesity than any other race. Accessible evidence-based culture-appropriate self-care programs for risk reduction and CVD prevention can address these disparities. This rapid review aims to provide a comprehensive collection of such programs. Methods. Searches were performed in PubMed, CINAHL, Web of Science, Psychinfo-Embase, and Scopus for studies reporting CVD prevention programs for rural Black women. Three articles met the inclusion criteria, with …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

Exploring The Effects Of Psychosocial Factors And Relationships To Postpartum Depression Symptoms Among Iranian Immigrant Women Living In Canada: A Cross-Sectional Study, Monica Gola

Electronic Theses and Dissertations

Introduction: Immigrant women’s health garners attention as migration creates changes in social networks and parenting needs. The effect of psychosocial factors, such as maternal self-efficacy, measured by ability to manage parenting responsibilities, social support and cultural postpartum practices on postpartum depression symptoms are not well known in Canadian immigrant women. Methodology: A cross-sectional descriptive survey design guided by Bandura’s Reciprocal Determinism was used to explore the relationships between psychosocial factors including: maternal self-efficacy, social support, cultural postpartum practices; and symptoms of postpartum depression (PPD) among recent Iranian immigrant women living in Canada. Results: A total of 114 participants completed the …

The Threat Of Hospital Wastewater: An Evidence-Based Call To Action, Ann P. Nguyen

DNP Qualifying Manuscripts

Introduction: Hospital wastewater carries a unique composition of pollutants, a burden that includes high chemical and biological residuals. These pollutants are discharged into sewage treatment plants and natural environments where they contaminate human water sources and larger ecosystems. Water treatment plants are not designed to treat the high loads of biomedical waste and persistent organic compounds found in hospital wastewater and therefore pollutants survive in conventionally treated water. Evidence of contaminated soil, municipal wastewater, surface water, ground water, and even drinking water have been demonstrated in studies conducted around the world highlighting the ubiquity of the problem. Hospital effluent as …

The Effect Of Implementing Behavioral Counseling For Elevated Ldl Levels, Blake L. Hansen

Evidence-Based Practice Project Reports

Hyperlipidemia is a key risk factor in cardiovascular mortality, and is prevalent in approximately 38% of American adults (CDC, 2022b). Cholesterol levels are intensified by unhealthy lifestyle choices, which means a change in lifestyle behaviors could prevent cardiovascular related deaths (WHO, 2022). The PICOT question for this project was: In adults aged 20 years or older in the primary care setting who have elevated low-density lipoprotein (LDL) levels (P), does the implementation of behavioral counseling on lifestyle modifications (I) compared to current practice (C) decrease LDL levels (O) over a 10- to 12- week period (T)? Fourteen participants from a …

Introduction Of Hiv Point-Of-Care Testing In Adolescent Primary Care: A Quality Improvement Project, Jennifer Quinn Belfry

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: HIV, first identified in 1981, remains a persistent public health problem affecting 1.1 million Americans today. Detection is a critical first step to ending the HIV epidemic and the CDC recommends universal HIV screening for all patients 13-64 years of age regardless of risk factors. HIV screening rates are suboptimal especially in adolescent and young adult populations who face unique barriers to screening. The aim of this project was to improve HIV screening rates in adolescent and young adult patients at a large, urban FQHC.

LOCAL PROBLEM: In the state of Rhode Island, 1 in 10 persons living with …

Barriers And Facilitators Of Dairy Consumption Among Individuals With Metabolic Syndrome., Kofi Amoh-Mensah

Electronic Theses and Dissertations

About 35% of the United States adult population meets the criteria for metabolic syndrome, representing about 85 million individuals. Consuming dairy products protects against the development of the metabolic syndrome and protects against the development of complications associated with it. However, approximately 10% of the U.S. population meets the daily recommendation for dairy products. Information about the use of dairy products among people living with metabolic syndrome is relatively unknown, even though it will benefit them the most. About 49% of respondents met the guidance of three servings per day, and the most common facilitator was access to dairy products.

Barriers And Facilitators To Anti-Retroviral Therapy Adherence Among Adolescents Aged 10 To 19 Years Living With Hiv In Sub-Saharan Africa: A Mixed-Methods Systematic Review And Meta-Analysis, Londiwe D. Hlophe, Jacques L. Tamuzi, Constance Shumba, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Background: Human Immunodeficiency Virus (HIV) significantly affects adolescents globally, with the sub-Saharan Africa (SSA) reporting a high burden of the disease. HIV testing, treatment, and retention to care are low among adolescents. We conducted a mixed-method systematic review to assess anti-retroviral therapy (ART) adherence; barriers and facilitators to ART adherence and ART outcomes among adolescents living with HIV and on ART in sub-Saharan Africa.

Methods: We conducted searches in four scientific databases for studies conducted between 2010 and March 2022 to identify relevant primary studies. Studies were screened against inclusion criteria and assessed for quality, and data was …

Pilot Study: The Effect Of Individual Versus Group Animal-Assisted Therapy On Undergraduate Student Anxiety, Jessica Hanson, Hannah Tucker

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Purpose: The purpose of this study was to evaluate the relationship of Animal-Assisted Therapy (AAT) on undergraduate student test anxiety; comparing an individual AAT session to a group AAT session. AAT may be a solution for decreasing anxiety for undergraduate students. The study adds empirical knowledge to the field of AAT and student anxiety coping methods. The study question was: What is the effect of one-on-one and group Animal-Assisted Therapy sessions on undergraduate student anxiety?

Methods: This study used a convenience sample randomly assigned to either a group of 3 to 5 students (n=9) or an individual AAT session (n=10) …

Tiny Tusk Internship: Barriers To Effective Breastfeeding Within Low Socioeconomic Populations, Catherine Johnson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusk Breastfeeding and Infant Support is a program created to facilitate safe and quiet places for mothers to breastfeed at various events at the University of Arkansas. It serves as a platform to spread important and essential information about breastfeeding to mothers and reach various women all from different backgrounds and populations. The purpose of this review of literature is to identify barriers that women within low socioeconomic populations face that influence their decision to breastfeed. These barriers included lack of social support from family, friends, and healthcare providers; latch difficulty; and concerns of milk supply. Altogether, low-income women …

Implementation Of A Peer Support Program To Increase Resilience In Nurse Managers In Acute Care Hospitals: A Pilot Study, Juana Castillo

Doctoral Projects

Background: Nurse managers are at risk for experiencing stress and burnout. The peer support program was implemented to increase resilience among nurse managers.
Methods: A one-group pretest and posttest design was employed to examine the impact of peer support on nurse manager resilience. The nurse managers participated in bi-weekly 30-minute peer sessions over 12 weeks. The Connor-Davidson Resilience Scale was utilized prior to and following the intervention along with demographic and satisfaction surveys.
Results: There were six nurse managers who participated in the peer support program; however, only four completed both the pre- and post-survey. The peer support program intervention …

Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus

Doctoral Projects

Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …

Health Promotion Module For Migrant Youth Adults In Obesity Prevention: A Pilot Project, James Chongsu Wong

Doctoral Projects

The obesity epidemic continues to worsen. It is estimated there are over one half billion adults worldwide struggling with obesity. In the United States of America, 42% of the adults and over 15 million children are obese. Obesity leads to a myriad of other chronic diseases such as diabetes mellitus, hypertension, and hyperlipidemia. With an annual spending exceeding 173 billion dollars, obesity not only has a negative impact on quality of life but also a huge economic impact on the health care system.
This quality improvement project utilized 4 educational modules as intervention and measured the mean changes using a …

Identification Of Molecular Markers Associated With Copd In Non-Smokers And Smokers: A Bioinformatics Analysis, Agede O. Ayodele, Isa M. Wasagu, Ademola E. Fawibe, Alakija K. Salami

The University of Louisville Journal of Respiratory Infections

Background

Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential.

Methods

Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively.

Results

In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The …

Lesbian, Gay, Bisexual, Transgender, Queer (Lgbtqia+) Health Disparities In Sexual Health And Sexual Education, Cole T. Mcbride

Curriculum and Instruction Undergraduate Honors Theses

Background: Comprehensive sex education instills knowledge and promotes the health of all youth, however, most sex education remains heteronormative. School-based programs in the United States (US) emphasize monogamous, heterosexual relationships. In 2021, only 7.4% of students received sex education that included positive representations of both LGB and transgender people and nonbinary topics, while 72% of programs across the US omit LGBTQ+ topics. Most new HIV diagnoses occur in gay and bisexual men aged 13-34, but the sex education environment for this group is increasingly hostile as more states prohibit addressing these topics in public schools.

Purpose: The purpose …

Ohio Forensic Nurse Examiners: Readiness To Care For Victims Of Sexual Assault With Disability, Deanna Nicole Smith

Doctor of Nursing Practice Scholarly Projects

Forensic nurse examiners (FNEs) care for crime victims in acute care settings. These nurses are specifically trained in trauma-informed care and evidence collection in cases of sexual assault, domestic violence, abuse, and human trafficking (RAINN, 2022). The scholarly project focuses on the care of victims of sexual assault living with disability, as this population is three times more likely to be victimized than any other population (NSVRC, 2022). The project literature review reveals a lack of data on preparation standards for FNEs on caring for victims with disability and providing accommodations during forensic examination. Currently, it is unknown if FNEs …

Social Media Addiction Among Nursing Students And Its Related Factors, Akgün Yeşiltepe, Bedriye Cansu Demirkiran, Sevgi Demir Çam

Makara Journal of Health Research

Background: Social media use has become an indispensable part of our lives as a result of technology advancement and is quite high among students.

Methods: This study employed a cross-sectional design. Participants were 289 students from the Faculty of Health Sciences at Artvin Coruh University, Turkey. The Social Media Addiction Scale (SMAS) was used to obtain data. T-test, one-way ANOVA, Pearson’s correlation, and Bonferroni analysis were used to analyze the data.

Results: The participants’ mean SMAS score was 81.03 ± 34.79, which was moderate. A weak and positive correlation was found between social media addiction and daily …

How Covid-19 Has Affected The Hand Hygiene Habits Of Healthcare Majors And Non-Healthcare Majors, Anna Kate Mcdaniel

Merge

The research hypothesis states there is a statistically significant difference in how Covid-19 affected the hand hygiene habits of healthcare majors and non-healthcare majors. The research study utilized survey which students completed at the cafeteria of a small liberal arts college in the southeastern United States. The population assessed were students who entered the cafeteria while the survey was being administered and agreed to complete the survey. The results of the survey determined there is no statistically significant difference in how Covid-19 affected the hand hygiene habits of healthcare majors and non-healthcare majors. An important implication for the healthcare majors …

Do-Not-Hospitalize Orders In Assisted Living Facilities: Perspectives From Direct Care Workers, Alanna Kates Dancis Dr.

Doctor of Nursing Practice Scholarly Projects

Context: Do-not-hospitalize (DNH) orders in assisted living facilities (ALFs) are often misunderstood, ignored, or countermanded by direct care workers (DCWs), potentially leading to residents being sent to the hospital against their wishes.

Objectives: The primary purpose of this study was to gather sufficient qualitative data to create an intervention that would help prevent DCWs from sending residents with DNH orders to the hospital against their wishes. To accomplish this goal, the study centered on three research objectives: 1) to understand more fully how DCWs interpret DNH orders; 2) to determine if carrying out DNH orders causes moral distress for DCWs; …

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Prevention And Education In Medication Assisted Treatment Facilities, Lindsey Mccartt

Epsilon Sigma at-Large Research Conference

Introduction and Background: Between 1999 and 2014 the number of patients in the labor and delivery that were on medication for opioid use disorder (MOUD) quadrupled. The rate of unintended pregnancies in pregnant patients of mOUD is at a tremendous high due to inconsistencies in the use of reliable contraception in this population.

Purpose Statement: To reduce the number of unintended pregnancies and infants born with neonatal abstinence syndrome there is a need for prevention and required education for men and women in medication-assisted facilities.

Literature Review: Twenty research studies were reviewed and evaluated. These articles were …

The Motherhood Crusade: Rural Low-Income Mothers, Support, And Empowerment, Christina Castellano

Dissertations

Previous research has shown that postpartum women with untreated mental health conditions are more likely to fail to manage their own health, have inadequate nutrition, abuse substances, experience abuse, be less responsive to their baby’s needs, have fewer positive interactions with their baby, experience difficulties breastfeeding, and question their abilities as a mother. Rural culture plays a complex role in the transition to motherhood, influencing whether mothers seek out and use resources. While more is known about location and access issues, less is known about how rural culture and, more specifically, how empowerment and social support impact postpartum experience. The …

Education In The Emergency Department For Cardiac Conditions, Shelby Thomason

Nursing | Student Research Posters

In the United States 610,000 people die every year from coronary artery disease which equates to 1 in 4 deaths. Inequity in access to healthcare is a persistent issue that impact patient outcomes. Tracking adherence and patient outcomes can be challenging, especially for patients who may not have access to necessary resources or support. Nurses are often overworked and have limited time to provide in-depth education. Patients and their families often struggle to afford caregivers or other resources that can help manage these chronic cardiac conditions.

Addiction Behind The American Dream: A Case For Harm Reduction Among Upper And Middle Class, Sean Marc Sanga

Nursing | Student Research Posters

The purpose of this study is to help bring awareness to the significant lack of information revolving around the idea of harm reduction interventions. This study will mainly focus on the upper and middle class, therefore, the end goal is to gain insight on what exactly deters or dissuades this specific population from gaining care. In addition, I hope it will provide some solutions to the growing drug problem among Middle America.

Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia

Evidence-Based Practice Project Reports

Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …

Teach-Back Education In Heart Failure Patients Benchmark Study, Bethany N. Johnson

MSN Capstone Projects

Heart failure exasperation is one of the most common causes of hospital readmission in the United States (Breathett et al., 2018). It is estimated that greater than half of all heart failure patients will be readmitted to the hospital within six months of discharge (Caluya, 2021). Additionally, one in four individuals with heart failure are readmitted within thirty days of discharge (Rahmani et al., 2020). This data shows a large area of improvement for hospitals in order to improve patient outcomes. Due to the lack of standardized discharge teaching, heart failure patients are often admitted to the hospital for the …