Family Practice Nursing Commons^™

Optimizing Peripheral Neuropathy Management Through Vitamin B12 Screening In Adults With Type Two Diabetes Mellitus Taking Metformin, Jonathan Sidle

Doctor of Nursing Practice

Peripheral neuropathy is a significant co-morbidity for patients with diabetes and as early as 1969, metformin was linked to reductions in vitamin B12, leading to deficiency. Vitamin B12 deficiency causes increased levels of homocysteine and methylmalonyl-CoA which are toxic to the nervous system and therefore can contribute to demyelination. This quality improvement study aimed to optimize the management of peripheral neuropathy symptoms by implementing a process to identify patients with clinical or subclinical vitamin B12 deficiency and initiating replacement therapy. Adult patients presenting for a scheduled office visit with a diagnosis of type two diabetes and are taking metformin or …

Effect Of A Self-Care And Self-Awareness Education Program On Resilience To Burnout And Depression In Clinically Experienced Nursing Students, Andrew Taylor

Undergraduate Honors Theses

The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these …

Utilization Of Asthma Guidelines In Primary Care, Kate R. Miller

Dissertations

Background: Chronic lower respiratory disease, including asthma, is the fourth leading cause of death in the U.S. Financially, asthma accounts for approximately 54 billion dollars in healthcare spending annually. The National Heart Lung and Blood Institute [NHLBI] established guidelines to reduce impairment and to reduce future asthma attacks.

Purpose: This Quality Improvement (QI) pilot implemented the Asthma Control Test (ACT) and the Asthma Action Plan (AAP) per NHLBI guidelines. This project aimed to increase provider use of the ACT and AAP to 50% in patients with a diagnosis of asthma over one month.

Methods: A convenience sample of six adult …

Effect Of An Intervention To Improve Smoking Cessation Treatment In A Federally Qualified Healthcare Clinic, Shirley A. Camp

The Corinthian

Abstract

Significant progress has been made in the reduction of tobacco use in the United States, but the smoking prevalence among the socially and economically disadvantaged populations (i.e. individuals who are homeless, uninsured, LGBT, and living with HIV) is significantly higher than the general population (CDC, 2018b). As a result, these vulnerable populations carry a disproportionate burden of tobacco-related mortality and morbidity (CDC, 2018b). There is a cost-effective and evidence-based treatment for tobacco use dependence (Fiore et al, 2008), but the delivery by primary care providers to this population is inconsistent (Tyman, Bonevski, Paul, & Bryant, 2014). This study focused …

Implementing Trauma-Informed Care Early In The Lives Of Children And Adults, Carley Clymer

Scholars Week

Throughout the health care industry, providers are failing to recognize the implications that adverse childhood experiences (ACEs) have upon adult health. As a result, these patients not only have to endure these traumas, but they’re also faced with crippling health conditions that accompany them including depression, heart disease and obesity. The prevalence of common high-risk behaviors such as smoking, drinking and illicit drug use can also co-exist with adversity, which leads to an exacerbation of already poor health. This presentation aims to relay the significance of adopting a trauma informed care (TIC) approach early in the lives of clients to …

Implementing Mandatory Psychiatric Training For Medical-Surgical Nurses, Hannah Berry

Scholars Week

Hospitals worldwide experience poor outcomes for patients with mental illnesses. Psychiatric patients have a lesser likelihood of surviving a particular illness than does a person with that same illness who does not have a psychiatric comorbidity. This is a bleak reality that nurses have the unique opportunity to influence for the better. Destigmatizing mental illness is perhaps the largest component of stepping toward this goal. Our nurses being more educated on the nature of mental illnesses—their signs, symptoms, and common treatments—will improve care outcomes for patients who suffer from them. Not only should we educate nurses on mental illness for …

Brown Bag Review For Identification Of Discrepancies In Patient Medication Use, Chandra James, Shawna Mason, Shellye Vardaman, Amy Yoder Spurlock

Journal of Interprofessional Practice and Collaboration

Patients suffer unintentional harm from their medications. Many organizations have proposed that healthcare providers implement strategies to decrease medication related harm for patients. This study implemented a brown bag review along with medication safety education within a clinic that caters to the poor and uninsured. It was notable that the majority of the participants educational levels were equivalent to a high school graduate or beyond. In the pre-intervention survey, they expressed that they were knowledgeable about the purpose of their medicines, they knew the correct way to use their medications, and they were aware of potential side effects. During their …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Contraceptive Methods In The United States: The Question Of Abortive Mechanisms, Tara Ferenczy

Senior Honors Theses

This thesis reviews the many methods of contraception available in the United States. Although society’s understanding of women’s health has become a major topic, there is still a significant deficit of information regarding how the accessible methods affect women’s bodies, specifically reproductive tissue. The thesis analyzes numerous contraceptive options focusing specifically on the mechanisms of action to determine whether options have abortifacient properties so that readers may develop educated opinions regarding medical and ethical uses. Information involving strengths and limitations of each technique and the effects on both the female body and the reproductive material assist in understanding the process …

Promoting Recognition And Rescue: Human Trafficking Screening, Erin E. Pittman

MSN Capstone Projects

The exploitation of human beings is a serious public health concern (Centers for Disease Control [CDC] 2018). The United States Department of Justice (2018) defines human trafficking as an act of coercing a person’s labor services or commercial sex acts. Family Nurse Practitioners play a significant role in the identification of victims, especially those practicing in emergency departments. A majority of healthcare providers have yet to establish a standardized screening tool and there is little evidence regarding the impact these screening tools have in recognizing victims of human trafficking (Emergency Nurses Association, 2018). This alarming information brings about the clinical …

Decreasing Bias And Improving Education On Non-Invasive Colorectal Screening Methods, Sara H. Hughes

MSN Capstone Projects

It is estimated that in 2020, nearly 148,000 Americans will be diagnosed with colorectal cancer and 53,200 Americans will die from colorectal cancer (Siegel et al., 2020). One- half of all cases and deaths are due to modifiable risk factors such as diet and smoking and it has been shown that early screening and detection can greatly decrease the morbidity and mortality of colorectal cancer yet colorectal cancer related deaths still ranks among the leading causes of cancer-related deaths in the United States and the world. Early detection of colorectal cancer is crucial to reducing mortality and although this is …

Patient Controlled Fluid Restriction Monitoring, Christina Tindel

MSN Capstone Projects

Patients are often placed under non-pharmacologic orders such as fluid restrictions during their hospital stay. The following article will discuss a plan to implement a change to have patients take a more active role in their plan of care by being the main ones to monitor their fluid intake.

Pcos Lifestyle Management Change Project, Elizabeth King

MSN Capstone Projects

This paper proposes the Lifestyle Modification Change Project to help fulfill this lack of education and emphasis on lifestyle modifications that occurs with patients diagnosed with PCOS. This change project would include a 16-week lifestyle modification program that would evaluate pre- and post- participation data including: BMI, weight, inches, testosterone levels, menstrual cycle regularity numbers, and quality of life questionnaire.

Aging: The Impact Of Diet And Inflammation, Morgan Wiland-Gress

Nursing Student Class Projects (Formerly MSN)

The immune system is a complex cohesive network. It requires every cell to work efficiently at maintaining homeostasis. It also prevents and repairs damage from internal and external pathogens. Recent research has focused on the concept of inflammaging, which is defined as age-related changes that occur in the immune system leading to dysfunction. The current understanding is that inflammaging contributes to the development of chronic diseases including; Type II Diabetes, Cardiovascular disease, Cancer, autoimmune disorders, neurological disorders, Alzheimer and Parkinson’s disease. The underlying pathophysiology of inflammaging is chronic inflammation and the imbalance of pro-inflammatory and anti-inflammatory mediators. This imbalance leads …

Self-Management And Quality Of Life In Young Adults After Healthcare Transition, Jennifer Herbert

Grace Peterson Nursing Research Colloquium

The transition from pediatric to adult healthcare has become healthcare concern of increasing importance as more adolescents with chronic conditions survive to adulthood requiring continuing care. In order to understand the current status of healthcare transition (HCT), we identified the HCT services received by young adults, their existing healthcare self-management skills and how skills correlated with their quality of life. A correlational and retrospective cross-sectional online survey of English-speaking young adults in the United States ages 18-26 with at least one pediatrically diagnosed chronic condition was conducted August-October 2019. Participants completed a healthcare transition feedback survey, the TRANSITION-Q self-management skills …

Improving Care For Homeless Young Adults: A Shelter Client And Health Service Provider Perspective, Kenya Kawanee Hemingway

Grace Peterson Nursing Research Colloquium

The purpose of this study was to determine if the healthcare needs of homeless young adults from the client, shelter staff, and shelter healthcare provider’s perspectives. Data was collected via focus group with homeless unaccompanied young adults (n=4), and an online survey with shelter staff and healthcare staff (n=8) of The Night Ministry (TNM) and Ignite Promise. The focus group was recorded, transcribed, and coded for themes. Inductive analysis revealed themes focused on improving the quality of services provided. Based on the findings, recommendations include assessing the needs of homeless unaccompanied young adults from their perspective utilizing larger sample sizes, …

Trust In Primary Care Providers: Perspectives From Deaf People., Greir Ander Huck Flynn

Electronic Theses and Dissertations

Trust is an integral part of the patient-provider relationship, responsible for influencing several key aspects of healthcare behaviors and patient perceptions of health outcomes. Though the topic has previously been discussed by scholars, little evidence exists to support the application of our understanding of trust in culturally Deaf populations. As such, this dissertation seeks to lay the necessary groundwork for further investigations on the topic by first understanding the nature of trust in patient-provider relationships from the perspectives of culturally Deaf people. The dissertation is comprised of five chapters. The first chapter provides an introduction to salient terms and concepts …

Solutions To Address Frequent Hospital Attendance, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

In this editorial, practical solutions and considerations in helping the most complex and at-risk patients in our health systems are discussed. These patients, sometimes referred to as health care “super-utilizers” in the literature, tend to be frequently seen and cared for in costly hospital and emergency department settings. Innovative care models that aim to bridge system gaps, achieve better health outcomes, and improve the well-being of both patients and providers are needed and should continue to be explored.

Bridging The Gap In Primary Care Of Inflammatory Bowel Disease (Ibd) Patients, Deanna Dial

Dissertations

Abstract

Problem. Patients in rural or medically underserved areas (MUAs) with inflammatory bowel disease (IBD) have limited access to primary care preventative services, making them even less likely to obtain preventative care, placing them at even greater risk for adverse health outcomes.

Methods. A two-phase retrospective chart review utilizing a convenience sample of patients diagnosed with IBD from a privately-owned gastroenterology office to evaluate the effectiveness of increasing preventative screenings for IBD patients. The first review included 53 patients seen from January to April 2019. A preventative screening

evaluation tool (PSET) was developed based on literature recommendations, including the American …

The Effects Of High Dose Intravenous Vitamin C In Cancer Patients, Bankole Aluko

Dissertations

Problem: Currently used standard treatments (Chemotherapy, radiation) in cancer patients are generally accompanied with side effects, which may include pain, nausea, vomiting, fatigue, and chemotherapy-induced peripheral neuropathy (CIPN) during and after completion of treatments. High dose IV C may improve the anti-cancer action of chemotherapeutic agents by reducing side effects of fatigue, pain, nausea and vomiting and boosting immune cell functioning, and inhibiting angiogenesis (Mikirova, Casciari, & Hunninghake, 2019).The purpose of this quality improvement project was to explore whether high dose intravenous vitamin C (IV C) prevented major side effects that frequently occur with standard treatments in cancer patients and …