Public Health and Community Nursing Commons^™

Assessing The Effectiveness Of A Non-Punitive Fall Prevention Program, Nicki Roderman, Shandlie Wilcox, Cynthia Lang

HCA Healthcare Journal of Medicine

Background

Our single-center, quality improvement project evaluated the impact of a fall reduction plan while using a Just Culture Algorithm that included weekly fall reviews involving front line staff using a non-punitive structure. The project has shown successful results.

Methods

Prior to starting the program, data at this institution indicated falls were higher than the national fall rate of 3-5 per 1000 patient days. To achieve the goal of reducing the fall rate to below 3.1, an interdisciplinary fall committee was formed, consisting of nurses, nursing leaders, patient care technicians, pharmacists, and physical therapists. The committee operated in a non-punitive …

Preparedness For Practice Of Health Professionals In Papua New Guinea: A Cross-Sectional Survey Of Nurses And Community Health Workers., Mary Kililo, Julie Dopsie, Sulpain Passingan, Julie Kep, Nina Joseph, Russel Kitau, Mary Roroi, Chris Rossiter, Jenny Sim, Di Brown, Caroline Havery, Ali Moloney, Michele Rumsey

Pacific Journal of Health

Introduction

Papua New Guinea (PNG) experiences widespread health inequity and shortage of health professionals, exacerbated by poverty, isolation, gender-based violence and limited infrastructure, transport and accessible services. Nurses and community health workers (CHW) represent 72% of health workforce. However, health professional education programs are outdated and not aligned with national health priorities. We aimed to explore the adequacy of current curricula for nurses and CHWs by examining graduate competencies and preparedness for practice.

Methods

Cross-sectional study with four cohorts: 1) 130 new nurse graduates, 2) 75 nurses who supervised them, 3) 105 new CHW graduates and 4) 65 CHW supervisors. …

Factors Influencing Self-Wound Care Adoption In Singaporean Communities: A Cross-Sectional Survey, Ling Jia Goh, Xiaoli Zhu

Journal of Patient-Centered Research and Reviews

Purpose: Managing wounds often requires frequent clinic visits, posing a burden on both patients and the healthcare system. Shared wound care, which encourages patients to manage dressings at home, has emerged as a potential solution. This study investigates factors influencing self-wound care adoption in Singapore.

Methods: A cross-sectional survey involving 328 participants from six primary healthcare centers was conducted. The survey examined demographics, wound characteristics, and perceptions towards shared wound care using a locally validated questionnaire. Parametric tests and logistic regression were used to analyze the data.

Results: Unlike older participants, younger adults valued time saved through self-care and found …

An Epiq Mass Shelter Training For Public Health Nurses In Georgia To Improve Core Competencies In Disaster Preparedness: A Pilot Study, Ashlie L. Pullen, Sonya Shinhoster

Journal of the Georgia Public Health Association

Background: Research shows that nurses are often ill-prepared for disaster response. A survey conducted by the Georgia Department of Public Health Office of Nursing in April of 2021, demonstrated that 45% of the public health nurses surveyed had never deployed to a mass congregate shelter, and 43% reported they had no formal training related to emergency preparedness or mass sheltering. The purpose of this pilot study was to measure public health nurses’ improvement in familiarity with emergency preparedness and disaster response core competencies as defined by the Emergency Preparedness Information Questionnaire (EPIQ) after a focused educational program and tabletop workshop. …

Predicting Access Barriers And Facilitators To Pediatric Specialty Care Among Children With Complex Chronic Conditions, Elisabeth Vestal

MUSC Theses and Dissertations

Children with complex chronic conditions (CCC) face healthcare inequities when accessing pediatric specialty care. Social or economic barriers may exacerbate the challenges faced by families with a child/children with CCC and include increased geographical distance to specialty services, familial poverty, inadequate neighborhood resources, and food insecurity. Understanding how social and economic factors may impact equitable access to care are essential in improving health outcomes for children with CCC. The first manuscript in this compendium is an integrative review focused on the barriers and facilitators of accessing pediatric specialty care for rural dwelling children with CCC. The second manuscript presents a …

Implementation Of Barcode Medication Administration To Reduce Vaccine Errors, Elizabeth R. Schwarz

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: In the project organization, a large ambulatory medical group, there have been high rates of vaccine administration errors, particularly within family practice locations, which have the most variety of vaccines given.

Aim of the Project: This project aimed to improve the safety of vaccine administration by implementing barcode medication administration (BCMA) in two family practice locations.

Review of the Evidence: BCMA is increasingly recommended for outpatient settings by patient safety groups like the Institute for Safe Medication Practices (2022). Studies show BCMA can save time, improve vaccine data capture and can decrease medication errors by up to 74% (Evanson …

Challenges And Barriers Faced By Healthcare Workers In Implementing Strategies To Reduce Teenage Pregnancy In Iligan City, Elise Janella A. Denila, Jydel Anne P. Dalangin, Wynne Nicole P. Englatiera, Dave William E. Almonia, Ian C. Abordo, Donna Belle P. Sumugat Rn, Man, Raymond M. Salvador

Pacific Journal of Health

Aims: To investigate nursing strategies and their perceived barriers in reducing teenage pregnancy among barangays in Iligan City with high incidence of teenage pregnancy.

Study Design: This study uses qualitative, exploratory research design. This design is ideal for delving into complex issues and understanding phenomena in their real-world context.

Place and Duration of the Study: Iligan City Philippines, between September 2023 and May 2024

Methods: This study includes 6 healthcare workers experienced in handling teenage pregnancy and 25 teenagers who have experienced it. Participants were selected using purposive sampling to ensure they had relevant experiences. Data was collected through face-to-face, …

A Cross Cultural Comparison Of Adolescent Sexual Socialization In Family Settings In Four Thai Regions: A Cross Sectional Survey, Ampornpan T้Heeranut, Pongdech Sarakarn, Donlagon Jumparway, Arina Abdulloh, Piches Ruangsuksud, Chaiyun Sakulsriprasert, Bhunyabhadh Chaimay, Linda L. Shield, Alison Hutton, Kesinee Saranrittichai

Journal of Health Research

Background: Sexual socialization is different across cultural contexts due to norms and values including adolescents’ growth & development and characteristics. Patterns of sexual socialization across different cultural contexts and adolescents in Thailand are still unknown. This analytical cross-sectional study aimed to explain and compare 5 patterns of adolescent sexual socialization in Thailand (SSFA): trust, strict, exhaust, review, and general patterns.

Methods: The sample included 1,050 parents living in the same house with their adolescent offspring aged 13-19 years. Stratified cluster randomized sampling was performed to access participants. The instrument used for measuring adolescent sexualization in families with adolescents was …

Reducing The Incidence Of Frequent Hospital Readmissions In Veterans Population, Dasari Reddy

Student Scholarly Projects

Practice Problem: Veterans hospital readmission problems are challenging, specifically in the heart failure department, which severely impacts the patient's health, mortality, family, and quality of life. Frequent readmissions increase the usage cost, hospital budget, and loss of time from providers to other veterans, and failure to meet the key guidelines of the Center for Medicare and Medicaid for improvement.

PICOT: The PICOT question that guided this project was, in veterans with heart failure and one or more frequent hospital readmissions discharged in the last 30 days(P), does the appointment of a dedicated discharge nurse practitioner as a coordinator(I), compared to …

Companion Dogs And Depression, Anxiety, And Posttraumatic Stress Disorder In Adult Icu Survivors: A Scoping Review, Lindsey Nelson, Sue Lasiter, Amanda Emerson

People and Animals: The International Journal of Research and Practice

Intensive care unit (ICU) survivors are at risk for developing persistent psychological sequelae that have been linked to decreased quality of life and increased mortality after hospital discharge. Standardized evidence-based treatments are lacking, mainly focus on physical rather than psychological recovery, and often occur in formal settings. Benefits of human– companion dog relationships have not been explored in the ICU survivor population before. Thus, the purposes of our review were to summarize the literature focused on the influence of companion dogs on depression, anxiety, and posttraumatic stress disorder (PTSD); identify what is known about the potential role companion dogs play …

Improving The Diagnosis And Treatment Of Obstetric Sepsis, Edwije Joseph

Master's Projects and Capstones

Problem: Maternal mortality affects women during four phases of obstetrics, including triage, antepartum, labor & delivery, and postpartum. In the U.S., sepsis is the third leading cause of maternal death. Inconsistent screening practices and delays in recognizing symptoms can occur in any phase. These factors were identified as root causes in a northern California community hospital with 600 monthly deliveries.

Context: Two maternal sepsis cases cost $90,000 annually. A standardized pathway was initiated nationally in October 2023 through the California Maternal Quality Care Collaborative (CMQCC). One regional hospital system initiated a quality improvement project over 5 months within a community …

Environmental Factors (Rurality, Distribution Of Prescribers, And Altitude) Of People Who Died By Suicide In Montana, 2013- 2022, Anne N. Brown

Electronic Theses and Dissertations

Introduction: Suicide is increasingly prevalent in rural areas across the United States, especially in the western Rocky Mountain states. The connection between suicide and rural residency is not well understood, nor is the relationship between the distribution of prescribers, altitude, and suicide. Purpose: This retrospective quantitative study aimed to describe the characteristics of individuals who died by suicide in Montana and investigate the associations among rurality, distribution of prescribers, altitude, and suicide rate. Methods: Montana suicide mortality data for 2013-22 was used to describe individual characteristics. A second dataset was created for each Zip Code Tabulation Area (ZCTA) level in …

A Descriptive Study: Aging In Place In The Rural Southeastern United States, Dama G. Cooley

Electronic Theses and Dissertations

Older Americans will soon outnumber children and younger adults. In 2022, there were 58 million older adults. By 2050, older adult numbers will grow to 82 million, and by 2060, 100 million. The National Institute on Aging calls for ongoing research on the impact that a historically large aging population will have on health, well-being, and quality of life. A key concern is how to meet needs while decreasing costs associated with institutional long-term care.

Most of these elders reside in the community and wish to live in their homes throughout their lives, but they will experience an increased need …

Examining The Relationship Between Shift Work And Diabetes Mellitus Among Nurses: An Evidence-Based Case Report, Angga Arifianto, Indah Suci Widyahening, Levina Chandra Khoe, M. Ikhsan Mokoagow

Occupational and Environmental Medicine Journal of Indonesia

Background : Work shifts could cause numerous health problems, such as sleep disorders, weight gain disorders, and unhealthy food intake consumption, leading to obesity and changes in blood glucose levels, that eventually lead to diabetes mellitus. This evidence-based case report aims to provide an evidence of association between shift work and the risk of diabetes mellitus among nurses.

Methods : We performed a literature searching from Pubmed, Embase, Cochrane, Scopus, and Google Scholar in September 2023 using keywords ‘shift work’ AND ‘diabetes’ AND ‘nurse’. We included studies that assessed the association between shift work and diabetes among nurses using observational …

Integration Of Depression And Anxiety Screening Among Uninsured And Underinsured Patients In A Mobile Nurse-Led Clinic, Samantha Hamm

DNP Projects

This quality improvement project sought to increase screening rates and referrals for pregnant and postpartum depression/ anxiety using the Edinburgh Postnatal Depression Scale (EPDS) and increase the rate of mental health referrals as a result of that screening in an underserved population /community health mobile clinic. Maternal mental health is a key public health concern. In the most recent community health needs assessment (2022-2025) in one Midwestern rural community, priority needs were identified with the top priority of building families with access to culturally competent healthcare, including access to mental health services (Central MN Alliance, 2022). Under-reporting anxiety and depression …

Improving Patient Awareness And Compliance With Telephone Follow-Up Calls Post Visit, Ajibola Kutti

Student Scholarly Projects

Practice Problem: In a high-volume clinic without current follow up practices post visit, a telephone follow-up (TFU) intervention was implemented within three days of patient outpatient appointments.

PICOT: The PICOT question that guided this project was: In adult patients in a high-volume clinic (P), does the implementation of telephone follow-up calls by nurses (I) compared to current practices (C) improve patient compliance and post-office follow-up visits (O) over 10-weeks (T)?

Evidence: The literature provided recommendations and evidence that supported the effectiveness of following up with patients within three days of leaving the healthcare clinic. TFU’s are a cost-effective intervention that …

Transformative Learning: Changing Nurses’ Perceptions About People In Poverty, Jacqueline Debrew

Journal of Social, Behavioral, and Health Sciences

Background: Meaningful learning experiences with clients in poverty may help nursing students change their perceptions towards those experiencing poverty and, thus, provide unbiased, nonjudgmental care when they become nurses.

Purpose: The purpose of this research was to understand what learning activities and experiences nursing students found meaningful and led to a change in prior perceptions of people in poverty.

Methods: Guided by Mezirow’s Theory of Transformative Learning, accelerated BSN students enrolled in a mental health nursing course (n = 14) were assigned reflective journals throughout the semester on their assigned clinical experiences, which were analyzed for emergent themes.

Results: …

Interdisciplinary Medication Reconciliation Approach For Arabic-Speaking Patients, Rebecca Rodman

Dissertations

Abstract

Problem: Limited English Proficiency (LEP), which includes Arabic speakers, presents challenges in healthcare and can impact medication reconciliation and adherence. Interdisciplinary collaboration involving patients and interpreters is crucial for improving medication reconciliation and adherence. This project aimed to examine the impact of an interdisciplinary medication reconciliation approach on medication adherence with Arabic-speaking patients ages 18-99 over three months.

Methods: This quality improvement (QI) pilot project utilized a descriptive cohort design. A translated validated Morisky, Green, and Levine (MGL) adherence survey consisting of four questions was administered pre- and post-implementation to a convenience sample of Arabic-speaking patients 18 years …

Evaluation Of A Smoking Cessation Program In Primary Care, Yolanda Duncan-Watt

Dissertations

Abstract

Problem: The adult tobacco smoking rate exceeds 12.5%. The problem is the insufficient attention given to smoking cessation education in low socioeconomic status(SES) communities. There is a lack of access to and awareness of smoking cessation programs for low-income populations.

Methods: This quality improvement (QI) study will use a descriptive, observational approach. A retrospective medical record review will be conducted to determine the rate of individuals who got the smoking cessation intervention and the rate of those who successfully quit one month after the intervention. Data was collected throughout the spring of 2024, during primary care visits and phone …

Increasing Stroke Symptom Awareness In The Hispanic Community, Karina Barabash

DNP Projects

Ethnic and racial minorities are at higher risk for many health conditions including coronary artery disease and stroke (Mital et al., 2021). The Hispanic population specifically faces more risk factors, less knowledge of stroke symptoms, and higher probability of death and disability post stroke (Eisenstein et al., 2018). Unless this gap is addressed, ethnic and racial minority patients will continue to experience higher rates of death and disability from stroke, compared to non-Hispanic White patients. Therefore, the purpose of this project was to provide clinic-based stroke education in Spanish to Hispanic community members. The goal was to increase awareness of …

Role Of Hospital Leadership In Pandemic Preparedness: Experience At A Tertiary Hospital In Kenya During The Covid-19 Pandemic, Lucy Wangari, William Macharia, Benjamin Wachira, Jemimah Kimeu, Boniface Mativa, Lukoye Atwoli

Emergency Medicine, East Africa

Introduction Pandemic preparedness refers to being ready for, responding to and recovering from public health crises, and is integral for health security. Hospital leadership is a critical building block of an effective healthcare system, providing policy, accountability and stewardship in a health crisis.

Objectives and methods We aimed to describe the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi, a private not-for-profit tertiary healthcare facility, following the COVID-19 pandemic. We reviewed over 200 hospital documents archived in the COVID-19 repository including those received from the Kenya Ministry of Health, emails, memos, bulletins, meeting minutes, …

A School-Based Asthma Initiative To Improve Student Self-Management Behaviors, Jenni R. Newland

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: In a Midwest public school system, students received robust academic education. Health education programs, specifically asthma management, were not offered. Over 400 elementary students with asthma lacked the knowledge and skills to effectively recognize and manage their asthma symptoms resulting in increased school clinic visits and absences, highlighting the urgent need for targeted intervention.

Aim of the Project: The aim of this project was to improve students’ asthma self-management skills by providing education based on the Open Airways for Schools (OAS) curriculum. Improving asthma self-management skills reduces student absences and time away from the classroom.

Review of Evidence: A …

A Quality Improvement Project To Reduce Facility-Acquired Pressure Injuries, Carolina Rosario

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: Facility-acquired pressure injuries (FAPIs) pose significant risks to patient outcomes and healthcare costs ($500 to $70,000 per PI) in subacute rehabilitation (SAR) facilities. An assessment in a SAR identified a concerning pressure injury (PI) rate of 15.3%, exceeding the national benchmark of 10% for such facilities. This prompted an evidence-based quality improvement (QI) initiative.

Aim of the Project: This project aimed to reduce FAPI rates by 30% or greater among patients 65 and older using a PI prevention bundle called SSKINS (Skin, Surface, Keep moving, Incontinence/moisture, Nutrition/hydration, Self-management).

Review of the Evidence: A comprehensive literature review indicated that PIs …

Implementing A Comprehensive Tobacco-Cessation Program For Patients With Tobacco Use Disorder, Jalen Eaton

Doctor of Nursing Practice Projects

Background: Individuals who use tobacco are at an increased risk for the development of heart disease, congestive heart failure, and chronic obstructive pulmonary disease. Tobacco use is one of the most preventable causes of death in the world.

Purpose: The focus of the quality improvement project was to improve access to tobacco cessation resources in patients with tobacco use disorder at a primary care clinic.

Methods: Weekly stakeholder meetings were held to ensure the validity of the project. The plan, do, study, act (PDSA) model of continuous quality improvement guided the project. A comprehensive tobacco-cessation program including informational materials and …

Parental View On Hpv Vaccination, Rebecca Elaine Rhodes

Electronic Theses and Dissertations

The human papillomavirus (HPV) is a sexually transmitted infection widely seen in the United States. Millions of Americans are affected by it each year, especially those in their late teens and early 20s. Although most infections will resolve on their own, 1 in 10 will lead to health problems such as cancer. The HPV vaccine can prevent over 90% of associated precancers and cancers. However, uptake of the HPV vaccine and its completion among adolescents are significantly lower than other recommended adolescent immunizations, falling short of the Healthy People 2030 goal of 80% coverage. Understanding parental attitudes, beliefs, and perceptions …

The Role Of Procedural Justice In Alleviating The Stress Of Role Conflict An Applied Study On The Members Of The Nursing Staff At Tripoli Medical Hospital In Libya, Almokhtar Almajdoubi

Al Jinan الجنان

This study aims to study the fairness of the procedures and the stress of the role of the nursing staff in Tripoli Medical Hospital in Libya, and determine the relative importance of the fairness of the procedures and their relevance to the pressures of the role struggle. In the Tripoli Medical Hospital. The researcher concluded that there is no significant effect between the fairness of the procedures and the role conflict. The results also showed significant differences between the perceptions of the nursing staff for the justice of procedures due to the following demographic variables (gender, age, Level of education, …

عدوى المستشفيات, Afaf Taha

Al Jinan الجنان

Despite the progress in the medical fields and technologies used, and the use of a number of antibiotics to eliminate microorganisms that attack the human body, bacterial infections still a major cause of patient deaths. The irony is that hospitals patients turn to for hospitalization are the source of infection caused by microorganisms resistant to a number of antibiotics. The researcher discusses this problem and tells us that the hospital is an ideal place for transmitting pathogens because patients with similar diseases placed in closed groups and are in contact with health workers so that both become a hotbed for …

Lived Experiences, Perceptions, And Caregiving Trajectories Of Family Caregivers Of Youth With Substance Use Disorders (Suds) In Zambia, Ireen Manase Kabembo

Lingnan Theses (MPhil & PhD)

There is unequivocal evidence that family caregivers contribute to healthcare systems worldwide by providing care for persons with chronic illnesses in the home setting. his study explores the lived experiences, perceptions, and caregiving trajectories of 30 family caregivers of youth aged 16-24 diagnosed with Substance Use Disorders (SUDs) in Zambia. Data was collected through in-depth semi-structured interviews, a caregiving timeline, and participant observation and analysed using interpretative phenomenological analysis. Guided by the integrated theoretical framework of positioning theory and the theory of caregiving dynamics, this study offers a new lens for understanding caregiver’s experiences regarding caregiver identity, self-perceptions, interpersonal relationships, …

The Cost Of Long-Term Care In The Mountain West, 2023, Madison Dwyer, Freddy Nie, Annie Vong, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines data on the cost of long-term care for the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah from the Genworth “Cost of Care Survey.” Data on long-term care includes home health care, adult day health care facilities, licensed assisted living facilities, and certified and licensed nursing homes.

Advanced Practice Nursing Initiatives In Africa, Moving Towards The Nurse Practitioner Role: Experiences From The Field, Deborah C. Gray, Melanie Rogers, Minna K. Miller

Ellmer School of Nursing Faculty Publications

AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa.

BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue.

SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects.

DISCUSSION: Four African countries have …