Public Health and Community Nursing Commons^™

Examining The Effect Of Provider Bias On Pain Management In Black Patients: A Systematic Literature Review, John Massey, Monica Gambilado

Thinking Matters Symposium

Black Americans face unequal treatment for pain management when seeking care. The aim of this systematic literature review is to examine the impact of provider bias on Black patients receiving appropriate pain management interventions in the clinical setting. This review followed the Preferred Reporting Items for Systematic Literature Reviews and Meta-Analysis guidelines. CINAHL and PubMed were searched with the following key search terms: Black/African American, bias, prejudice, discrimination, unconscious bias, pain management, pain reduction, pain control and analgesic. A self-developed Critical Appraisal Tool was used for quality assessment of the studies included in the review. A total of 101 probable …

Impact Of Group Prenatal Care On Health Outcomes For Women Of Color In The United States: A Systematic Literature Review, Morgan Brockington, Emily Bauer, Julie Kameisha

Thinking Matters Symposium

Women of color in the United States experience disproportionately higher rates of adverse pregnancy-related outcomes, both in the prenatal and postpartum period. Group prenatal care (GPC) has been gaining popularity in recent years and has demonstrated improved health outcomes. The aim of this systematic literature review was to examine and summarize the impact of group prenatal care on health outcomes for women of color in the United States. Using a systematic approach and PRISMA guidelines, two electronic databases—CINAHL and PubMed—were used to search the literature. Quantitative research studies that were published in peer-reviewed journals between 2010 and 2020, written in …

Opioid Overdose Prevention And Naloxone Training Among College Students, Mackenzie Thode

DNP Projects

Background: Opioid abuse is a serious national crisis affecting both public health and economic welfare across the United States. In Tennessee, more than 1,800 overdose deaths were reported in 2018, with nearly 20% of those deaths occurring in Davidson County alone. The number of overdose deaths in Nashville has steadily risen amidst the COVID-19 pandemic by approximately 32% since 2019 to a total of 619 fatal overdoses in 2020, making it the city’s deadliest year on record. Review of evidence: Research shows that intranasal (IN) naloxone training is an effective approach to combating the opioid overdose crisis and can be …

Efficacy Of Diabetes Self-Management Education Administered Via Telehealth For Adults With Uncontrolled Diabetes, Tanner Free

Evidence-Based Practice Project Reports

Patient’s with a diagnosis of diabetes require significant lifestyle modification and education. The need for patient education has led to the development of diabetes self-management education (DSME) classes. Unfortunately, utilization of DSME classes is only 5% among Medicare beneficiaries and 6.8% among privately insured patients (Centers for Disease Control [CDC], 2018). The purpose of this evidence-based practice (EBP) project was to implement DSME via telehealth and assist with goal formation to help patients with uncontrolled diabetes achieve glycemic control by increasing access to crucial education. The intervention consisted of bi-weekly calls for a period of 3 months. Participant data were …

The Use Of Automated Text Messaging As An Intervention For Smoking Cessation, Oluwasayo Sinkaiye

Evidence-Based Practice Project Reports

Tobacco smoking is a widespread problem that affects the adult population in the United States (U.S.). In 2018, about 14 of every 100 adults in the USA aged 18 years or older were cigarette smokers (Centers for Disease Control and Prevention [CDC], 2020). Tobacco smoking is associated with chronic disease conditions that have serious health implications including cancer, heart disease, diabetes, and chronic obstructive pulmonary disease (COPD) (CDC, 2020). The purpose of this evidence-based practice project (EBP) was to determine the effectiveness of an automated text messaging application (SmokefreeTXT) for smoking cessation in a primary care setting for adult cigarette …

Dnp Final Report: The Impact Of The Care Coordination Management Tool On Children With Special Health Care Needs, Keisia N. Sobers-Butler, Ms, Bsba, Rn, Cmcn

DNP Final Reports

Children with Special Health Care Needs (CSHCN) population, account for 30% of spending or $233.5 billion of the costs (Bui et al., 2017). Identifying barriers to care in the CSHCN population can be multi-faceted and complex incorporating high utilization of time, and clinical resources. This project aims to evaluate the impact of care coordination, and utilization on the CSHCN population through a Patient-centered Medical Home, use of embedded case management assessing this population through using the evidence-based Care

Coordination Management Tool (CCMT). CSHCN (N=117) and families were assessed using the CCMT at every interaction from September 1, 2020 – November …

Eating For Health, Tanya Reese

Theses and Graduate Projects

As anxiety and depression have increased exponentially, researchers have discovered a link between nutrition and incidences of anxiety and depression. The communication between the gut and the brain is imperative for mental health. The inflammatory process that is initiated in the intestinal tract can change the chemistry of the brain resulting in anxiety and depression. Newman’s Theory, Health as Expanding Consciousness, helps people to identify patterns in their food choices and change those patterns to choose healthier foods. This scholarly project was implemented to teach youth and adults living in a rural community about the link between food and anxiety …

From Bunks And Bars To Sidewalks And Skies: Support For Reentry From Incarceration, Ashley Ann Steen

Theses and Graduate Projects

Currently, there are over 2.3 million inmates in the prison system throughout the United States (Bureau of Justice Statistics, 2018). Over 10,000 ex-prisoners are released from America's state and federal prisons every week and studies show that approximately two-thirds will likely be rearrested within three years of release (Bureau of Justice Statistics, 2018). This scholarly project will explore the literature on why inmates face such a high rate of recidivism. It will further explore the current programming that is provided to inmates prior to release back to the community and offer a questionnaire to utilize in all reentry programs to …

Social Empowerment Of Children With Attention Deficit Hyperactivity Disorder, Shawna Hanson

Theses and Graduate Projects

Attention deficit hyperactivity disorder is the most common childhood neurodevelopmental disorder, marked by symptoms of inattention, impulsivity, and hyperactivity. These symptoms contribute to difficulties with psychosocial functioning, often leading to feelings of inferiority. Several studies identify that those with attention deficit hyperactivity disorder have lower self-perceptions with risks for comorbidities and poor quality of life. However, few studies have attempted to provide interventions to increase the self-perceptions of children with attention deficit hyperactivity disorder. Most interventions for those with attention deficit hyperactivity disorder focus on giving medications and implementing behavioral modification techniques to externally control behaviors. However, this scholarly project …

Nurse Practitioners And Community Health Workers Improve Community Health, Emmalee F. Voskuil

Theses and Graduate Projects

Addressing health disparities in primary care is essential for the advanced practice nurse practitioner(NP). Recent research demonstrates that the United States spends more money on health care than any other country of equal income but has worse outcomes, including lower life expectancy, higher infant mortality rates, and more stratified health inequities (Papanicolas, Woskie, & Jha, 2018). The NP has many opportunities to improve healthcare by partnering with diverse voices that seek to change the healthcare system. To better address health disparities among marginalized people in Minnesota, this scholarly project will determine best practices for the development and incorporation of community …

Latina Adolescent Dating Violence Public Narrative, Megan Staffen

Theses and Graduate Projects

A scholarly project has been conducted to assess use of public narrative between health care providers (HCPs) and Latina adolescents to reduce dating violence (DV) health consequences. Latina adolescents require an innovative, transcultural approach for dating violence care to reduce barriers to care. Healthcare providers must structure dating violence care to Latina adolescents due to different dating violence patterns and health consequences compared to other ethnicities and generations. There is minimal evidence- based research on the use of public narrative and its effects of use in the healthcare setting. The application of public narrative and the citizen professional will be …

Treatment Of Acute Bronchitis In Active Duty Military Members Benchmark Project, Nicole Williams

MSN Capstone Projects

Antibiotic resistant infections are a growing problem in the United States and the world. The main cause of this is antibiotic prescriptions, which can not only cause antibiotic resistance but adverse events. Decreasing the amount of antibiotics prescribed for inappropriate conditions can help to decrease the rates of antibiotic resistant infections and the problems these infections can cause. One illness that is treated frequently with antibiotics, against recommendations, is acute bronchitis. Acute bronchitis is a self-limiting viral infection, characterized by cough. By decreasing the number of providers who are prescribing antibiotics for acute bronchitis, the clinic can help to prevent …

A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard

Dissertations

There is a need to understand the influences and outcomes related to loneliness in veterans living with complex illness. Patients require self-care to manage complications and exacerbations associated with complex illness. Deficits in self-care result in negative health outcomes and drive resource utilization upward. The identification of potential factors related to self-care is important. Loneliness may be one factor that influences patients’ ability and desire to care for themselves. Descriptive correlational design was used to evaluate loneliness both as a predictor and outcome in veterans admitted to the hospital for three complex respiratory illnesses (heart failure, chronic obstructive pulmonary disease, …

Going Out Or Staying In: How The Covid-19 Pandemic Has Influenced College Students’ Drinking And Socializing, Megan Huey, Amy Yuhas, Mai-Ly N. Steers, Chelsie M. Young

Undergraduate Research and Scholarship Symposium

People’s daily social activities have been altered during the pandemic since they carry risk for contracting COVID-19. Prior to the pandemic, drinking socially has been the highlight of many college students’ lives. This study explores how COVID-19 has impacted college students’ drinking and social activities. We examined samples from a large, southern, public university both prior (N=65, Mean age=22.15, SD=2.03, 78.87% female) and during COVID-19 (N=47, Mean age=22.42, SD=1.64, 75.47% female). Students filled out an alcohol-related Timeline Followback measure (TLFB), in which they recalled their drinking over the past 30 days using anchor events inputted into a calendar. The events …

Hypertension Management: Improving Medication Adherence Through The Use Of Daily Text Messages, Gaelle Bulabula

Evidence-Based Practice Project Reports

Hypertension (HTN) is the leading cause of hospitalization and is responsible for approximately 50% of cardiovascular and cerebrovascular events (Al-Noumani, et al., 2018). Uncontrolled HTN can lead to comorbidities including ischemic heart disease, renal disease, or life-threatening arrythmias (World Health Organization [WHO], 2019). The leading cause of HTN is medication non-compliance (Varleta, et al., 2017). The purpose of this evidence-based practice project was to determine the effectiveness of daily text messages on antihypertensive medication adherence. A comprehensive review of literature generated ten high-level evidence studies demonstrating that daily text messages near each medication dosing time is best practice for improving …

Collaborating To Offer Hpv Vaccinations In Jails: Results From A Pre-Implementation Study In Four States, Amanda Emerson, Molly Allison, Lisa Saldana, Patricia Kelly, Megha Ramaswamy

Department of Nursing Papers

BACKGROUND: Correctional facilities are an underutilized venue for reaching young adults who have not vaccinated for human papillomavirus (HPV). The objective of this study was to identify factors that are associated with jail and local health department (LHD) interest in partnering to offer HPV vaccinations to young adults in jail.

METHODS: Consolidated framework for implementation research (CFIR)-guided surveys were conducted with jail administrators in Iowa, Kansas, Missouri, and Nebraska, September 2017-October 2018. Jail survey data were analyzed using chi square distribution and relative risk regression. Using data from sister surveys conducted with LHD administrators in the same counties (results previously …

The Efficacy Of A Communication Guide On Stress Experienced By Family Members Of Patients Admitted In The Intensive Care Unit With Covid-19, Kandace Williams

The Eleanor Mann School of Nursing DNP Capstone Projects

Coronavirus disease (COVID-19), first introduced in the United States on January 20, 2020, has created worldwide panic due insufficient research and understanding of the nature of this new disease. Patients suffering from COVID-19 often require intensive care unit (ICU) admissions, resulting in stress and confusion amongst patients and their families. The high transmissibility of the disease has caused hospitals to adopt firm visitor restrictions to protect the public from exposure and spread. Families experience increased anxiety and stress due to ineffective communication with staff and restricted access to their hospitalized loved ones. A needs assessment revealed a gap in care …

The Effects Of A Survivorship Care Plan On Hospital Readmission Rates In Allogenic Stem Cell Transplant Patients, Chantaney Williams

The Eleanor Mann School of Nursing DNP Capstone Projects

Stem cell transplants (SCTs) are complicated treatments utilized to treat hematologic malignancies and other disorders, such as multiple myeloma, non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, acute myeloid leukemia, neuroblastomas, germ cell tumors, amyloidosis, and autoimmune disorders such as systemic lupus erythematosus and systemic sclerosis. The complex care of patients undergoing SCTs place them at high risk for adverse outcomes, including infection, cytomegalovirus, graft vs host disease, secondary new cancers, infertility, and sexual dysfunction (American Cancer Society, 2020). Survivorship care plans (SCPs) are a vital part of the discharge process to educate allogenic SCT patients about post-transplantation care. SCPs are implemented to reduce …

Improving Sepsis Bundle Compliance In The Emergency Department, Meredith Burkhart

The Eleanor Mann School of Nursing DNP Capstone Projects

Sepsis is one of the leading causes of death in hospitals across the nation. It is also the costliest condition a patient can be admitted to the hospital for. This proposal discussed the significance of sepsis in the local, national, and international level. It also covered the SEP-1 guidelines given by the Centers for Medicare and Medicaid. Prior to project implementation, the clinical site had at least one sepsis bundle fall out every month, meaning that a portion of the SEP-1 guideline was not met. This project introduced an alert system for the emergency department to respond to patients with …

Adolescent E-Cigarette Use, Carley Lueken

The Eleanor Mann School of Nursing DNP Capstone Projects

Adolescent e-cigarette use in the United States (U.S.) is trending upward at a concerning rate. Many of the short-term and long-term effects of e-cigarette use are unknown. However, scientists do know that e-cigarettes can have harmful effects on the respiratory system playing a role in E-cigarette or Vaping Use-Associated Lung Injury (EVALI) and Coronavirus Disease 2019 (COVID-19). Additionally, some e-cigarettes contain nicotine, which is widely known to have negative effects on the developing adolescent brain. Previously, there is only one e-cigarette prevention program that has been developed, implemented, and evaluated in the U.S. Thus, showing the need for further research …

Depression Symptoms And Covid-19, Kaylee Armendariz

The Eleanor Mann School of Nursing DNP Capstone Projects

The COVID-19 pandemic presents new challenges in behavioral healthcare. Americans may face anxiety surrounding the virus, economic strain, isolation, and grief, putting them at increased risk for depression symptoms. This Doctor of Nursing Practice (DNP) quality improvement project aimed to increase depression screening rates and utilized data from a Federally Qualified Health Center (FQHC) to identify population groups at higher risk for depression symptoms during the COVID-19 pandemic. Using the Patient Health Questionnaire (PHQ) depression screening tool, a statistical analysis determined if being tested for COVID-19 or testing positive for COVID-19 had an impact on depression symptoms. Additionally, this project …

A Community-Based Pilot Prevention Program To Prevent Electronic Cigarette Use Among Teens, Rosanna Moreno

Doctor of Nursing Practice Projects

With over 3.6 million teens using tobacco, we have lost the opportunity to create the first tobacco-free generation. This pilot project presented the CATCH My Breath (CMB) E-Cigarette and JUUL prevention program to local teens experiencing a global pandemic. The program was condensed from a 4-week multi-session offering into a one-day seminar with an intense focus on student safety and engagement. While contextual factors significantly impacted the project implementation, the content remained largely the same. This accounted for the achievement of many of the project’s desired outcomes. Participants increased their baseline knowledge of the effects and dangers of e-cigarette use …

A Faith-Based Approach To Promote African American Healthy Heart Behaviors, Gwendolyn Gaston

Electronic Theses and Dissertations

More than 100 million American people have some form of cardiovascular disease. African American life expectancy is 3.4 years shorter than that of Caucasians, with an estimated 32% difference in cardiovascular disease mortality between Caucasian and African American men and a 43% difference between Caucasian and African American women. The purpose of this project was to utilize a faith-based approach in developing a heart-healthy program for addressing health disparities in an African American Baptist Church. The program focused on improving cardiovascular health literacy and addressing modifiable risk factors. The results of this project revealed that African Americans need interventions to …

The Effect Of Breastfeeding Education In African American Women On Initiation And Duration Of Breastfeeding, Shalawn F. Harris

Electronic Theses and Dissertations

Abstract

This Doctor of Nursing Practice scholarly project aimed to evaluate the effectiveness of breastfeeding education in African American women on the initiation and duration of breastfeeding. Studies demonstrated that breastfeeding education by providers and a breastfeeding support network positively influenced breastfeeding initiation and continuation in African American women. Breastfeeding education containing information on the decreased risk of breast cancer in African American women may be an even greater motivator for breastfeeding. Participants for this project were African American women, ages 18–50, in their last trimester of pregnancy. The project was approved to be implemented at an urban clinic in …

Implementation Of A Postdischarge Virtual Visit And Nurse Follow-Up Protocol To Decrease 30-Day Readmission Rates For Patients With Pulmonary Arterial Hypertension, Kimberly Thompson

The Eleanor Mann School of Nursing DNP Capstone Projects

Pulmonary arterial hypertension (PAH) is a rare, chronic disease with no cure. Patients with this disease have high mortality and morbidity, experience frequent hospitalizations, readmissions, and psychosocial burdens, and require a high degree of self-care management skills (Doyle-Cox et al., 2016; Lattimer et al., 2016; McDevitt & Walter, 2019). More than half of PAH patients are hospitalized within the first year following diagnosis, and about 20% are readmitted to the hospital within thirty days of discharge (Bhattacharya et al., 2019: Tonelli, 2020). These patients also have a high symptom burden, and these symptoms significantly affect their physical and mental quality …

Implementation Of Same Day Discharge Following Elective Percutaneous Coronary Intervention, Kaitlyn Miller Jeffcoat

The Eleanor Mann School of Nursing DNP Capstone Projects

High rates of Cardiovascular disease (CVD) and ischemic heart disease (IHD) have led to ever-increasing numbers of percutaneous coronary interventions (PCI) performed. The prevalence of IHD and subsequent PCI has been found to limit bed availability and access to cardiovascular care. Historically, the standard of care following elective PCI has included overnight observation (OO) though clinical advances to PCI procedures have made it possible for same day discharge (SDD) following elective PCI. There are many benefits of SDD following elective PCI that include increased access to cardiovascular care, hospital cost savings, and patient satisfaction without compromising patient safety. The DNP …

Streamlining The Specialty Weight Management Clinic Referral Process, Callie Ann Talley

The Eleanor Mann School of Nursing DNP Capstone Projects

Obesity affects a vast amount of the population within the state of Arkansas and has a high prevalence across the US. Weight management is notoriously difficult in the primary care setting. Currently the referral process to a specialty weight management clinic in Northeast Arkansas is incredibly lengthy and inefficient, often leading to missed or inappropriate referrals. As a result of a needs assessment within the health system, this DNP Quality Improvement Project focused on improving the referral process to a specialty weight management clinic. The aim was to create a more efficient referral process to benefit both the clinic, the …

The Lost “Doe”: A Quality Improvement Project For Unidentified Patients, Brendi Gale

The Eleanor Mann School of Nursing DNP Capstone Projects

A Mass Casualty Incident (MCI) describes any natural or manmade disaster that stresses a community beyond their normal resources (CMS, 2019). Across the globe, populations have grappled with an increased frequency of natural disasters and a surge of critically ill secondary to pandemic SARs-CoV-2 (Cavallo, Donoho, & Forman, 2020; Smith, 2020; US Global Change Research Program, 2018). In addition, the incidence and severity of mass shootings has risen in the United States with a reported 277 active shooter events between the years of 2000-2018 (Federal Bureau of Investigation, 2018; Smith et al., 2019). An Emergency Department (ED) in Northwest Arkansas …

Laboratory Techniques In Public Health: Bi-520 Introduction To Public Health Lab Manual, Anuradha Srivastava

Open Educational Resources

This laboratory manual for a foundations course Public Health is unique in the sense that very rarely, a foundations course in the field has a lab component offered with the lecture. This lab manual provides basic laboratory exercises that could be useful to introduce undergraduate students to the basics of public health laboratory practices.

Implementation Of An Evidence-Based Practice Discharge Medication Protocol For Heart Failure Patients To Reduce 30-Day Readmissions, Dawn Onstott

Student Scholarly Projects

Practice Problem: An estimated 6.5 million American adults ≥20 years of age have heart failure (HF) and worldwide 1 to 2% of the total healthcare budget is spent on HF. To improve outcomes and streamline the treatment of HF patients, The American Heart Association (AHA) joined with the American College of Cardiology (ACC) and created the Get With The Guidelines Program (GWTG).

PICOT: The PICOT question that guided this project was in adult HF patients admitted to the cardiovascular unit under the care of the hospitalist service, does implementing an evidence-based practice (EBP) discharge medication protocol for physician use …