Public Health and Community Nursing Commons^™

Lesbian, Gay, Bisexual, And Transgender (Lgbt) Healthcare In Rural Settings: An Integrative Review Of The Literature, Caitlin Cox

Honors Undergraduate Theses

The lesbian, gay, bisexual, and transgender (LGBT) community is a unique population that has specific health issues and health care needs associated with lifestyle behaviors that increase risk for certain diseases. Health concerns include mental and behavioral health, issues associated with gender identity and relationships (i.e. intimate partner violence), sexually transmitted infections, and chronic illnesses. The research suggests poorer health outcomes for the LGBT population compared to heterosexual and/or cisgender counterparts. Most research conducted with LGBT populations occurred in more populated urban settings with very few studies focusing on this population in the rural context. Consequently, there is a paucity …

Understanding The Healthcare Experiences Of Deferred Action For Childhood Arrivals (Daca) Recipients, Jacob A. Kluesener

Honors Undergraduate Theses

Background: There is limited research on the healthcare experience of Deferred Action for Childhood Arrivals (DACA) recipients both before and after enrollment in the program. DACA is a program designed to defer deportation to children and young adults in the United States for up to 2 years. The goal of this qualitative study is to explore the lived experiences of DACA students with regards to access to healthcare and perceptions of treatment. Method: This study is qualitative and uses a phenomenological approach. DACA Recipients (N = 5) were recruited from the UCF student population and 1:1 interviews were conducted. Interviews …

Giving To The Giver: A Research Proposal On Implementing Donor Nutrition Education To Promote Healthier Options In The Food Bank, Antionette Rivera, David Pantagan, Tavia Hunt, Mia Mitnaul, Chelsa Johnson, Joana San Luis, Kirstine Huey

OUR Journal: ODU Undergraduate Research Journal

Objective: To increase the nutritional value of donations given by donor organizations to the Food Bank based on a Red-Yellow-Green (RYG) scale. Background: Food banks have been planted across the Southeastern Virginia region to help with the prevalent issue of food insecurity. The food bank receives various food donations. The goal, however, is to implement education to the donor organizations to improve the nutritional value of the donations based on the Red-Yellow-Green scale. Participants and Methods: A Quasi-Experimental Before-and-After design across multiple groups will be used. Consistent donor groups will be selected for the intervention and baseline …

Evaluation Of Emergency Department Use By Adult Patients With Established Primary Care Provider, Sherry Tolentino

DNP Projects

BACKGROUND: Overutilization of the Emergency Department (ED) contributes to the unnecessary use of healthcare resources. One common cause is related to barriers to Primary Care access. Patients use the ED for conditions that can be managed in primary care due to the perception of urgency and convenience.

PURPOSE: The purpose of this project was to evaluate factors contributing to the use of the ED for adult patients with primary care providers (PCP). METHODS: A retrospective chart review was completed on 280 randomly selected patients over the age of 18 who presented to the ED between January and June 2018. Only …

Depressive Symptoms Among Farm Women Aged 50 And Older, Cheryl Dean Witt

Theses and Dissertations--Nursing

Alarming rates of suicide among production farmers have prompted researchers to investigate factors associated with depressive symptoms among this population. Aspects of farm life and farming can contribute to higher levels of depressive symptoms. Higher levels of depression can also increase an individual’s risk of injury and development of chronic disease, impacting overall quality of life. Despite the approximate 3.5 million farm women in the U.S., current research has focused on the male farmer.

Men and women have different responses to stressors, and women in general have a higher prevalence of depressive symptoms. Farm women can be further subjected to …

Promoting Heart Healthy Behavior In Adolescents At The Boys And Girls Club, Morgan Tomasiewicz

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

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 Association Of Attitude, Perceived Behavioral Control, And Intention With Fruit And Vegetable Intake Among Rural West Virginian Residents With Pre-Diabetes In Mineral And Hampshire Counties, Diana Leigh Niland

Graduate Theses, Dissertations, and Problem Reports (ETD)

The Association of Attitude, Perceived Behavioral Control, and Intention with Fruit and Vegetable Intake among Rural West Virginian Residents in Mineral and Hampshire Counties with Pre-diabetes

Introduction: Pre-diabetes affects approximately 84.1 million adults in the United States. Pre-diabetes is one of the leading predictors of type 2 diabetes. West Virginia ranks number one in the prevalence of diabetes. Fruit and vegetable intake may assist in reducing risk for pre-diabetes. However, most adults do not consume the recommended daily amount. There are no studies investigating the fruit and vegetable intake (FVI) of rural West Virginian residents with pre-diabetes.

Method: After IRB …

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 …

Perceived Stress, Salivary Cortisol, And Depression In Adults Diagnosed With Postconcussion Syndrome; A Pilot Study, Christine Fish-Huson

Theses and Dissertations

Traumatic Brain Injury (TBI) affects approximately 1.7 million persons in the United States annually, 75% are categorized as mild (mTBI). Most persons who experience mTBI will recover, however an estimated 10% will develop Postconcussion Syndrome (PCS). Evidence supports a relationship between perceived stress, salivary cortisol, and depressive symptoms in persons after TBI; however, there are no known studies exploring these relationships in the PCS patient population. A sample of 17 men and women diagnosed with PCS were recruited from Southwest and Central Virginia. Data collection included the Rivermead Postconcussion Questionnaire, Perceived Stress Scale-10, Center for Epidemiological Studies-Depression Scale and the …

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 …

An Educational Intervention For Skin Cancer Prevention With Hospital Staff: A Pilot Project For System Change, Amy Fran Bruce

Graduate Theses, Dissertations, and Problem Reports (ETD)

PURPOSE: The purpose of this project was to design, implement, and evaluate an educational intervention provided to health care professionals using the Sun Smart U Curriculum created by the Skin Cancer Foundation (2017).

METHODS: Using a pretest-posttest design with a convenience sample (N=40), this intervention targeted the health professionals and staff from a residential/acute care facility caring for pre-adolescent, adolescent, and adult populations. Aims of this project included: (1) the staff’s baseline level of knowledge regarding sun protective behaviors using the Sun Smart U Curriculum, (2) the staff’s level of knowledge regarding sun protective behaviors post educational intervention …

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.

Improving Breastfeeding In Rural Tanzania Using Bardach’S Policy Analysis Methodology, Katherine Skiff

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Appropriate breastfeeding has the potential to have the broadest impact on childhood survival in children under five years (U5Y) compared to all other preventive interventions. The World Health Organization (WHO) and United Nations International Children’s Emergency Fund (UNICEF) recommend that all facilities providing maternal services and newborn care have a written policy addressing breastfeeding that is routinely disseminated to staff. Shirati hospital, in rural Tanzania, does not have a breastfeeding policy. Bardach’s 8-Fold Pathway for policy analysis methodology (adapted by Collins for health policy) was used to evaluate three promising breastfeeding policies to improve compliance with this recommendation. They include …

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 …

Transitions Of Care: Implementing Early Follow-Up Appointment To Help Decrease Readmission Rate, Lualhati Espina Dursun

Master's Projects and Capstones

Abstract

Problem – The rate of readmission in the country is at a severe level. According to CMS, in 2017 the average national readmission rate was 18.4%(CMS, 2018). Hospitals are penalized for unnecessary readmissions (HRRP, 2018). In addition to the financial burden of readmissions, quality of life is decreased with readmission.

Context – Early or timely outpatient follow-up after hospitalization has been projected as a means of decreasing readmission rates.

Interventions – Integrating follow-up appointment to the current care transition - HUB process as a means in reducing readmission rates.

Measures & Results – Identified high-risk patients that need timely …

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 …

Staff Retention Through Standardized Training Materials In Adult Primary Care Clinic, David Smith

Master's Projects and Capstones

As non-profits, community health clinics face a unique set of challenges. Primary amongst these is a shortage of financial resources. Staff turnover, including Registered Nurses (RNs) and Medical Assistants (MAs), can result in avoidable increased wage costs related to training of newly-hired RNs/MAs (clinical staff). Retention of experienced RNs/MAs can be directly correlated with job satisfaction, the obverse of which is job frustration. The intent of this RN/MA training and orientation project is to ameliorate frustration related to a lack of informational resources and clear competency expectations. Upon completion and implementation, project efficacy will be assessed via four longitudinal measures: …

Strong Recommendation Towards Hpv Vaccination, Danielle Bogue

Doctor of Nursing Practice Projects

Risk of future HPV related cancers remains high in individuals unvaccinated against HPV, leading to too many people dying from this preventable cancer. However, primary care providers’ strong recommendation to vaccinate and family education about HPV and vaccine efficacy have a positive impact on a family’s decision to vaccinate. The setting for this project was a Midwest suburban family healthcare practice. This process was implemented by providing the guardian with a handout, a short video on HPV, a question and answer period with the provider, and ended with the provider giving a strong recommendation towards HPV vaccination. Of the 35 …

Suicide In High School Students And The Effectiveness Of State Suicide Prevention Plans, Patricia G. Wilson

Nursing Theses and Dissertations

With suicide rates rising across all demographics and regions in the U.S., suicide prevention is one of the most challenging public health issues in recent history. Because of its prevalence, the number of federal agencies and national organizations involved with suicide prevention activities is at an all-time high (Office of the Surgeon General & National Action Alliance for Suicide Prevention, 2012). Instituted in 2001, the National Strategy for Suicide Prevention (NSSP) was revised in 2012 and serves as a guide for states in the fight against suicide through its strategies, goals, and objectives (Office of the Surgeon General & National …

Building Shared Values In The Community: Culture Of Health, Donnelle D. Storrs

Doctor of Nursing Practice

The zip codes where patients live are stronger determinants of health outcomes than the frequency of visits with a primary care provider. Providers have a unique opportunity to extend health care beyond the clinic walls and engage in efforts to improve the communities where their patients grow, live, work, and age. In order to impact the health of patients, a culture of health needs to be developed. The Robert Wood Johnson Foundation culture of health action framework directed the build of a foundation of health as a shared value in a neighborhood with high morbidity and mortality rates in southwest …

Quality Improvement On Depression Protocols In The Military Training Environment, Priscilla R. Colunga

Doctor of Nursing Practice

Background: Active Duty military members are highly susceptible to depression and suicide due to separation from family during training and deployments, exposure to traumatic experiences in combat, and loss of friends during combat.

Purpose and Objectives: Depression and suicide remain a high priority among military personnel. This process improvement project aimed to improve the rate of depression screening and improve the assessment, treatment, and management of soldiers with depression in a primary care setting to prevent disease progression while waiting to be seen by a behavior health specialist.

Interventions: During the 6-week time frame, all active duty military and reservists …

Assessing The Effectiveness Of A Quality Improvement Intervention To Decrease Missed Opportunities For Human Papillomavirus Vaccination At A Nurse Managed Health Center, Maria Medina-Calvo

Doctor of Nursing Practice

Purpose: To decrease the number of missed opportunities for human papillomavirus vaccine eligible patients seeking healthcare in a Nurse Managed Health Center. Background & Significance: Human papillomavirus genital infection has inflicted nearly 79 million Americans. Annually, about 14 million newly infected individuals are identified, with noted predominance in teens and young adults, and of this number approximately 19,200 females and 11,600 males receive a cancer diagnosis as a result of the human papillomavirus infection. The incidence of infections can be reduced with a human papillomavirus vaccine, but only about 63% of females and even fewer males initiate the human papillomavirus …

Implementation Of The Human Papillomavirus Vaccine Among Health Professions Students, Emeka C. Nnabuife

Doctor of Nursing Practice

The human papillomavirus (HPV) is the most widespread sexually transmitted infection in America. College-aged students are a high-risk group for HPV transmission, but their HPV vaccination rates are low. The purpose of this evidence-based project was to implement an HPV vaccination program at a health science center university student health clinic to increase vaccination rates to meet the guidelines of the American College Health Association (ACHA) and the Centers for Disease Control and Prevention (CDC). The objectives of this project were as follows: 1) to educate providers and staff on the importance of the HPV vaccine; 2) to increase HPV …

Improving Adolescent Risk Behavior Screening: Implementation Of The I-Cloud Rapid Assessment Adolescent Preventive Screening (Raaps) Tool, Donna L. Rinker

Doctoral Projects

Adolescents are engaging in risky behaviors earlier contributing to 75% of adolescent morbidity and mortality with unintentional injuries listed as the most common cause of death among this population in the United States. It is reported that engaging in more than one risk behavior will lead to other risk behaviors resulting in the rise of indirect and direct costs in society today. The scholarly project was conducted in response to a midwestern Michigan primary care clinic need to improve the early identification and documentation of adolescent risk behaviors with evidence-based technology screening. The purpose of this quality improvement project was …

Effects Of An Educational Intervention On Exclusive Breastfeeding Rates In Marshallese Mothers Residing In The U.S., Connor K. Otto

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: The largest population of Marshallese immigrants in the Contiguous U.S. resides in Northwest Arkansas. Despite adequate access to healthcare, the Marshallese face many health disparities, perhaps partly due to the language barrier they face in healthcare settings and education. Regarding breastfeeding rates, women in the Marshall Islands have a significantly higher rate of exclusive breastfeeding than in Marshallese women residing in the U.S. who face cultural barriers. Breastfeeding is positively correlated to many benefits for infants and is recommended exclusively for at least 6 months by pediatric policy organizations.

Objective: The purpose of this research is to examine breastfeeding …

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 …