Public Health and Community Nursing Commons^™

The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson

Evidence-Based Practice Project Reports

Anxiety disorders are very prevalent in the United States. The most common type, Generalized Anxiety Disorder (GAD), affects 6.8 million adults every year. GAD can cause significant deficits in a person’s ability to function, decrease their quality of life and increases a person’s risk of attempting suicide. The purpose of this evidence-based practice (EBP) project was to improve the outcomes of adults diagnosed with GAD in an internal medicine setting by implementing a protocol composed of a combination of interventions. A thorough literature search was conducted to find the best available evidence to support the project. A total of 11 …

The School Nurse's Experience Of Secondary Exposure To Trauma, Catherine A. Grano

Seton Hall University Dissertations and Theses (ETDs)

The school nurse (SN) is often the sole health care expert in the school setting, providing for the physical and socio-emotional needs of others. SN may be exposed to reports of trauma, a widespread and costly public health issue. This study sought to explore the experience of the SN when exposed to reports of trauma from those in their care. Seven N.J. certified school nurses participated in two online interviews via Microsoft Teams, spaced one to two weeks apart between June 2021 and September 2021. Interviews were recorded & transcribed verbatim and thematic analysis applied. This study found that SN …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

Using The Whole School, Whole Child, Whole Community Approach To Improve An Urban Early Learning Center Students’ Social, Emotional, And Physical Health And Wellness, Joelle Chateauneuf

Doctor of Nursing Practice Scholarly Projects

Background: Integrating school-based health education and models of healthy lifestyles in early childhood provides a foundation for lifelong health learning. Many chronic may be prevented or mitigated through early childhood health education. Early learning centers (ELCs) may be a perfect setting to enable young children to achieve their full potential.

Problem: In Boston, Massachusetts, there are differences in health experience across population groups. Children of color and lower socioeconomic challenges experience higher rates of chronic conditions.

Available Knowledge: Search of literature showed that school-based healthy lifestyle interventions improve healthy behaviors and can be taught to children as young as preschool. …

Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez

Doctor of Nursing Practice Scholarly Projects

Description of the problem: Obesity is a growing healthcare problem worldwide with extraordinary costs to the individual's health and the healthcare system. Individuals most affected by obesity include socioeconomically disadvantaged individuals, often with limited resources to seek specialized care.

Available knowledge: Various weight-loss interventions exist but access and success rates vary. Weight loss is often modest and additional factors such as social determinants of health, health literacy, and patient motivation are all factors important to the success of an intervention.

Specific Aims: The purpose of this quality improvement project was to improve self-regulatory weight loss behaviors and increase weight loss …

A Multimodal Approach To Decreasing Hesitancy And Increasing Uptake Of The Covid-19 Vaccine In The Family Care Setting, Meghan Zwierzynski

Evidence-Based Practice Project Reports

Since December 2019, the coronavirus disease 2019 (COVID-19) has swept across the world, infecting and killing millions of people, making it one of the worst pandemics in history (WHO, 2021). However, the rates of confirmed cases and deaths have slowed since the discovery of the COVID-19 vaccine. The purpose of this evidence-based practice (EBP) project was to decrease vaccine hesitancy and increase uptake of the COVID-19 vaccine in the family care setting. The Iowa Model-Revised (Iowa Model Collaborative, 2017) is a practical, effective multi-step change process that acted as a guide for the EBP project. A review of literature showed …

Implementing High-Intensity Trauma-Informed Sexual Behavior Risk Reduction In Justice-Involved Women, Lakisha M. Holton

Doctoral Projects

Sexually transmitted infections continue to be a source of significant morbidity in people with a history of incarceration, particularly women. Justice-involved women are at exceptionally high risk of long-lasting and severe health consequences of contracting an STI. This evidence-based practice implementation project used a repeated measures design to compare sexually transmitted infection knowledge acquisition and condom use self-efficacy in a group of incarcerated women before, immediately after, and three weeks following participation in the Safer Sex Self-Efficacy Workshop. Of the participants (N= 21), 100% demonstrated a significant increase in sexually transmitted infection knowledge and condom use self-efficacy between pre- and …

Evaluation Of Awareness, Knowledge, And Preventive Intervention Of Nonalcoholic Fatty Liver Disease Among Chinese Young Adults, Yi Du

Theses & Dissertations

The prevalence of nonalcoholic fatty liver disease (NAFLD) among Chinese young adults (CYA) aged 18-25 years ranges from 4.7% to 15.1% and has kept increasing in recent years. Previous studies reported limited awareness and knowledge of NALFD among middle-aged and older Chinese populations, however, they have not investigated awareness in CYA, for which there is no well-validated questionnaire. There is currently no efficacious educational intervention on NAFLD for CYA.

The objectives were 1) to develop and validate a questionnaire which can be used to assess the awareness and knowledge of NAFLD among CYA; 2) to assess the awareness and knowledge …

Implementation Of Community Health Workers To Improve Birth Outcomes, Emiko Maruri, Trinette Radasa, Jo Loomis

DNP Qualifying Manuscripts

Those who have ever been affected by an adverse childhood experience (ACE) have a greater likelihood of having poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss. Black and Latina women have been identified by the Center’s for Disease Control (CDC) as those most affected by ACEs. The direct relationship is that Black and Latinas therefore have poor birth outcomes. With the implementation of nurse trained Community Health Workers (CHWs), the impacts within the community includes decreasing health care costs, adopting healthier choices for mother and child, and providing support and …

Behavioral Intervention To Increase Condom Use Among Men Who Take Pre-Exposure Prophylaxis And Have Sex With Men, Marek J. Piszczatowski

Evidence-Based Practice Project Reports

In the absence of an effective vaccine, the introduction of pre-exposure prophylaxis (PrEP) in 2012 offered a promising new approach to human immunodeficiency virus (HIV) prevention. However, the introduction of a single-pill regimen which helps to prevent HIV transmission created, in men who have sex with men (MSM) population, a phenomenon referred to as risk compensation resulting in PrEP replacing consistent condom use as a preventive measure (Freeborn & Portillo, 2018; Kumar et al., 2020; Montaño et al., 2018; Ramchandani & Golden, 2019; Traeger et al., 2018). The purpose of the evidence-based practice project was to implement a single, one-on-one …

Improving Depression Surveillance At The We Care Clinic, Kaitlin Springer, Emma Hanney

Doctor of Nursing Practice Projects

Depression is one of the most underdiagnosed and untreated disorders affecting more than 16 million people in the United States each year (Henry et al., 2020). Unmanaged depression can lead to emotional suffering, decreased productivity, reduced income, impaired relationships, and an increased risk for comorbidities (Sinisalchi et al., 2020). It can affect anyone, however, individuals who are non-white, female, undereducated, disabled, pregnant or postpartum, have low socioeconomic status, or lack social support are at an increased risk (United States Preventative Services Task Force, 2019). The Southern Illinois University Edwardsville We Care Clinic provides primary care to minority patient populations who …

Creating A Guideline For Sti Testing In The Pediatric Population, Alexandria Molaro, Alexandra Evans, Alex Niebrugge

Doctor of Nursing Practice Projects

Sexually transmitted infection (STI) prevention, education, screening, and management in pediatric primary care settings are of importance due to the increasing number of cases yearly. Almost half of the 26 million new STIs that occurred in 2018 were among young people 15-24. An opportunity existed in a rural pediatric primary clinic, for improved adherence to Centers for Disease Control and Prevention (CDC) or American Academy of Pediatrics (AAP) recommendations to screen/test patients. An evidence-based project (EBP) was developed to address this concern. Project objectives included: developing STI screening guidelines for pre-teen to young adults, developing a screening algorithm, providing alternative …

Improving Osteoporosis Screening Rates Of Women In A Primary Care Setting, Kristine E. Davis

Evidence-Based Practice Project Reports

Osteoporosis is caused by caused by low bone mass, microarchitecture disruption and increase in skeletal fragility (Rosen & Drezner, 2021). This disease presents as a silent disease without any clinical manifestations and increases risk for bone fracture. The purpose of this Evidence-Based Practice (EBP) project was to increase screening rates for osteoporosis in the female population by mailing a patient reminder letter to the home of qualifying patients in the primary care setting and to determine if mailing a patient reminder letter would increase screening rates. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare professionals (JHEBP) model was used …

Covid-19, Vaccination, And Heart Transplantation, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Asthma Care By Unlicensed Personnel In The Elementary School Setting: A Training Program, Teresa Eligio

Doctoral Projects

This Quality Improvement project (QI) aims to improve the competence and confidence of unlicensed school health staff in identifying asthma symptoms, reading an asthma action plan, asthma care, emergency response, medication delivery tools, and trigger reduction in the school setting. The QI project transpired in an Elementary School District in Los Angeles County, CA. The Project Manager, an asthma instructor trained by the American Lung Association, provided evidence-based Asthma-Basics training for health clerks (HCs), substitute health clerks (SHCs), licensed vocational nurse health clerks (LVN HCs), school office coordinators (SOCs), school office attendance clerks (SOAs), and substitute school office staff (SDO). …

Back To The Basics With Smart Goals: A Multimodal Intervention For Adults Who Have Type 2 Diabetes, Alyssa L. Snyder

Evidence-Based Practice Project Reports

Diabetes, the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2020a) and the ninth leading cause of death worldwide (World Health Organization [WHO], 2020), has increased by 70% over the last two decades (WHO, 2020). Type 2 diabetes (T2D), the most prevalent type accounting for 90% to 95% of diagnosed cases (CDC, 2020a), affects individuals of all ages and often results in major health problems including stroke, heart attack, and kidney disease. The purpose of this patient-centered, evidence-based practice (EBP) project was to evaluate the effectiveness of a multimodal intervention on hemoglobin …

Improving Patient Discharge In The Ambulatory Surgical Setting Utilizing A Preoperative Educational Video, Leeann Kluth

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Use of ambulatory surgery centers providing outpatient surgical procedures has grown due to medical advances, short stays that reduce costs, and convenience for the patient. However, due to the reduced time between diagnosis and surgery, there is a decreased amount of time available for education and discharge teaching. Historically, discharge education is provided after surgery in written form while the effects of anesthesia and pain medication impair a patient’s ability to retain information. This leads to increased reports of uncontrolled pain, poor comprehension, and higher rates of adverse events due to poor comprehension of discharge orders.

Methods: The development …

Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar

Nursing | Senior Theses

Background

Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.

Objective

To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …

The Effectiveness Of A Webinar To Improve Icu Nurses’ Competency In Palliative Care, Justine Kirschner

The Eleanor Mann School of Nursing DNP Capstone Projects

Patients with serious illness lack access to quality patient-centered care despite the growth in palliative care awareness and services. Palliative care is an interdisciplinary care system intended to optimize the quality of life of patients with serious, life-limiting illness and their families. Patients admitted to the intensive care unit (ICU) are facing critical illnesses and can benefit from palliative care integration into their care. This DNP quality improvement (QI) project, grounded in Benner’s Novice to Expert nursing theory, aimed to increase ICU nurse competency in palliative care from novice to competent through a continuing education webinar. The study analyzed nurses’ …

Nurse Practitioner-Led Heart Failure Education Program, Ruairi Fox

The Eleanor Mann School of Nursing DNP Capstone Projects

Heart failure is a chronic, progressive disease that has a global burden on the healthcare system and on patient’s lives. HF patients who experience a hospital admission are at a greater risk of being readmitted to the hospital within 30 days, impacting healthcare spending costs and patient quality of life. Self-care activities by patients, such as monitoring weight and making lifestyle changes, are the hallmark of outpatient care, and is shown throughout the literature to reduce readmissions and impact patient quality of life. Unfortunately, many patients are either unaware of proper self-care management techniques or find them hard to follow. …

A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis

Undergraduate Honors Theses

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …

Reducing Medication Non-Adherence With Improved Health Literacy Interventions: An Evidence-Based Practice Quality Improvement Project, Unity Wiles

DNP Projects

Introduction

Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate healthcare decisions and follow instructions for treatment. Patients with low health literacy have been predicted to have poor health outcomes. The inclusion of the single-item literacy tool into the admission process of this project involved the patient-centered-care characteristics of improved patient experience, lower health cost, improved clinical experience, and better outcomes.

Purpose

The National Action Plan to improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked multi-sector effort to improve health literacy. Low …

A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah

Capstone Experience: Master of Public Health

This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …

The Relationship Between Perceived Support And Post Traumatic Growth Among Nurses During The Covid-19 Pandemic, Anna Nieman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Nurses continue to experience significant challenges related to the COVID-19 pandemic, putting them at risk of occupational stress, burnout, and turnover. The post-traumatic growth model focuses on growth and knowledge that comes from experiences of stress and trauma.

Aim: Identify post-traumatic growth (PTG) in a population of nurses affected by the COVID 19 pandemic.

Method: PTG was measured by the Post-Traumatic Growth Inventory, a 21-item questionnaire with five factors: relating to others, new possibilities, appreciation of life, personal strength, and spiritual change. Participants (n=22) responded on a 6-point Likert scale, 0 for no change and 5 for great degree …

To Flash Or Not To Flash, Christy Overly

The Eleanor Mann School of Nursing DNP Capstone Projects

In 2015, healthcare-associated infection (HAI) prevalence survey found that there were an estimated 110,800 surgical site infections (SSIs) associated with inpatient surgeries in 2015. Consequently, instruments and implants sterilized by immediate use steam sterilization (IUSS) have been found to increase the patient’s risk for an SSIs. Due to these risks, the Joint Commission (TJC) determined that organizations should implement evidenced-based protocols to reduce IUSS use. A needs assessment revealed a gap in care in that the increasing SSI rates appeared to be correlated with the misuse of IUSS at the physician owned surgical hospital in Tulsa, Oklahoma. This Doctor of …

Food Insecurity And Charitable Food Services: What Do College Students Think About Such Public Health Interventions?, Kaitlyn Driscoll

Senior Honors Projects

Hunger and food insecurity exist across millions of households in the United States. In 2020, an estimated 1 in 8 Americans were food insecure. The U.S. Department of Agriculture defines food insecurity as a lack of consistent access to enough food required for an individual to maintain an active, healthy life. Food insecurity is associated with an increased prevalence of chronic health conditions and directly affects a student’s ability to learn. Approximately 30% of college students obtaining an education in the United States are currently food insecure. Universities across the country are addressing student hunger via the establishment of on-campus …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Safety For Community Health Nurses In Rural And Remote Communities: A Literature Review And Research, Kathlyne Pham

Nursing | Senior Theses

Many safety measures devised and implemented are focused on urban hospital settings, which differs from rural and remote settings. Community health nurses are expected to travel and visit their clients’ homes alone, which leaves the nurses vulnerable to their environment. This brings up the question: Does the safety of community health nurses in rural and remote areas have an impact on the care provided in the communities that they serve? After reviewing the six primary literature, three common themes were revealed: lack of boundaries in their personal and professional lives, safety concerns (i.e. isolated geographical locations, workplace violence), and increased …

Exploring The Efficacy Of Herbal & Medicinal Plants Native To China And Thailand As A Complementary & Alternative Treatment In Mitigating Mild-To-Moderate Covid-19 Symptoms, Jiramanee Apiwansri

Nursing | Senior Theses

Background

In December 2019, the World Health Organization (WHO) was informed of an outbreak of an unknown cause of pneumonia-like symptoms in residents concentrated in Wuhan, China; this marked the start of China’s epidemic, which transformed into a pandemic affecting all continents of the world. The cause of the pneumonia-like symptoms was found to be due to the growth and development of the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which spreads through an infected person’s respiratory droplets through activities such as talking, coughing, and sneezing. With COVID-19 vaccine manufacturers available worldwide, even the economically and technologically forward countries …

First Generation Filipino Children And The Risk Of Childhood Obesity: Influence Of Screen Time, Krystal Joy Joy Ragasa

Nursing | Senior Theses

Background: Obesity is an epidemic in the United States and among all Asian subgroups, Filipinos are particularly at a much higher risk. Obesity raises the risk of acquiring other health complications, especially for those who develop obesity at a younger age. Research has shown that children who engage in higher levels of screen time are more likely to become obese, resulting in screen time restrictions and recommendations. Additionally, rates of obesity are higher in immigrants. There is a gap in the explanation of screen time’s effect on childhood obesity for first generation Filipino children.

Aim: The purpose of the proposed …