Family Practice Nursing Commons^™

Animal-Assisted Therapy And Oncology Hospice Patients, Lauren Anderson

Grace Peterson Nursing Research Colloquium

Background: If there are more ways to induce comfort during hospice care, all options should be explored, which is why animal-assisted therapy (AAT) could be a viable, non-pharmacological option for oncology hospice patients.

Objectives: The aim of this research is to show that the use of AAT with oncology patients receiving hospice care will result in enhanced comfort and diminished pain. The purpose of this study is to determine the effects on pain for oncology hospice patients receiving AAT compared to oncology hospice patients who do not receive AAT.

Method: This study is performed as an integrative …

Getting To Zero: Creating An Infrastructure To Support Fall Prevention In A Medical–Surgical Unit, Krys Elgarico

Master's Projects and Capstones

Problem: Hospital falls are a growing national patient safety concern that cause anxiety, pain, distress, serious injuries, and increased health care utilization. Despite the presence of a well-developed falls prevention protocol since 2017. Internal data from an inpatient medical-surgical telemetry (MST) unit indicate the largest number of fall-related events among the hospital’s departments.

Context: Practice improvement project was initiated in a 217-bed community hospital to determine barriers and potential success factors. This MST is a dynamic, 48-bed unit providing care to mainly geriatric patients who require continuous telemetry monitoring and complex medical, trauma, and surgical services. Senior leaders in the …

Helicobacter Pylori Pathophysiology, Alisha Smith

Nursing Student Class Projects (Formerly MSN)

Abstract

This poster provides current research evidence on Helicobacter Pylori pathophysiology, treatment guidelines, and the potential etiology of associated disorders. The purpose is to provide a detailed overview of the functional changes within the intestinal cells caused by the microorganism. Furthermore, explaining of the mechanism and clinical manifestations of symptoms. The research focuses on risk factors, transmission, diagnostic evaluation, and the implications for nursing care. The best-available evidence offers concrete data examining the detrimental effects of the immune and inflammatory response stimulated by H. pylori. A description of the functional structures of H. pylori and its’ ability to survive. …

Hypermobile Ehlers-Danlos Syndrome (Heds), Jocelyn Akers

Nursing Student Class Projects (Formerly MSN)

Ehlers-Danlos Syndrome is a genetic connective tissue disease with varying expressions and phenotypes. Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most prevalent subgroup within this disease category. It is estimated to make up about 80% of the total population of those with EDS (Tinkle et al., 2017). New and updated diagnostic criteria was established in 2017 for hEDS as a way to categorize the syndrome apart from other connective tissue diseases on the hypermobility spectrum of diseases. The disease expressive itself through a complex pathological process and in varying degrees and levels of severity for those who inherit it (Castori et …

Aortic Stenosis Poster, Katonya Lawson

Nursing Student Class Projects (Formerly MSN)

Aortic stenosis is the narrowing of the aortic valve secondary to calcification and fibrosis. It is the most common valve disorder and the second most frequent reason for cardiac surgery. As the elderly population increases, the number of patients presenting with aortic stenosis will increase. RNs and APRNs need to be aware of the pathophysiology and clinical manifestations of aortic stenosis because the disease can progress quickly and be fatal if mismanaged. Patients with aortic stenosis have an increased risk of morbidity and mortality during the peri-operative period during non-cardiac surgery. Therefore, CRNAs must remain vigilant when caring for this …

Ischemic Stroke, Rachele Gualtieri

Nursing Student Class Projects (Formerly MSN)

Stroke is one of the leading causes of death in the United States, and a very large percentage of those who suffer a stroke experience an ischemic stroke. It is detrimental that the healthcare providers caring for these patients are proficient in understanding the pathophysiology and treatment of a stroke to preserve maximal function of the brain and promote a full recovery. It is also crucial that providers are aware of risk factors for stroke, events leading up to an ischemic injury, and the events that follow an ischemic injury. This poster discusses the underlying pathophysiology, signs and symptoms, risk …

Melanoma, Dianna Lauer

Nursing Student Class Projects (Formerly MSN)

There are many types of skin cancer prevalent in the world today. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma (Watson et al, 2015). In the words of Hawryluk & Tsao (2014), “Melanoma is an aggressive malignancy borne of melanocytes, the pigment-generating cells of the skin”. Melanoma is known to cause the most deaths of the three main skin cancers and has many risk factors. The personal risk factors include, “family history, multiple moles, fair skin, blue eyes, red hair, and freckles” (Watson et al, p.e92, 2015). There are risk factors …

Tuberculosis, Jessica Puri

Nursing Student Class Projects (Formerly MSN)

Tuberculosis (TB) is a curable disease that claims the lives of millions each year. TB is an airborne disease spread by inhaling droplets of the tubercle bacillus. There are two different types of TB related conditions; latent TB infection and active TB disease. During latent TB, an individual inhales droplets of tubercle bacillus but the immune system can fight off this infection. However, once droplets of tubercle bacillus penetrate the alveoli, and colonization of droplets multiply, latent TB transitions into active TB disease (Katanekwa & Dahlback, 2016, p. 9). TB is typically found in the lungs but can also develop …

Implementation Of An Evidence-Based, Electronic Clinical Algorithm To Improve Screening, Evaluation, And Referral Of College Students For Depressive Symptoms And An Evaluation Of Differences Based On Sexual Orientation And Gender Identity Data, Chris Webb

Graduate Theses, Dissertations, and Capstones

The purpose of this project was to improve the screening, evaluation, and referral of college students (LGBTQ+/Heterosexual) for depressive symptoms through the implementation of an evidence-based, electronic clinical algorithm. There is evidence in the literature indicating that there are increased mental health disparities among college students and the LGBTQ+ population. The prevalence of depressive symptoms among university students is higher than the general population, requiring university student health centers to implement enhanced screenings for depressive symptoms and identification of depression predictors. Prior to implementation of this project, a student health clinic in the Southeastern part of the United States used …

House Calls Are Reaching The Tipping Point — Now We Need The Workforce, Thomas Cornwell

Journal of Patient-Centered Research and Reviews

Home-based primary care (HBPC) improves the lives of high-cost, frail, homebound patients and their caregivers while reducing costs by keeping patients at home and reducing the use of hospitals and nursing homes. Several forces are behind the resurgence of HBPC, including the rapidly aging population, advancements in portable medical technology, evidence showing the value of HBPC, and improved payments for HBPC. There are 2 million to 4 million patients who could benefit from HBPC, but only 12% are receiving it. The number of these patients is expected to double over the next two decades. This requires a larger and better …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Human Papillomavirus (Hpv) And Cervical Cancer, Stephanie Gregorc

Nursing Student Class Projects (Formerly MSN)

Human papillomavirus (HPV) is one of the most common sexually transmitted diseases with more than 100 types. The American Cancer Society (2019) reports, “Most men and women who have ever had sexual contact will get HPV at some time in their lives.” Certain strands are more detrimental than others, however it is important to understand how it spreads and ways to minimize its occurrence. Preventative actions are available to women, such as pap smear screenings, which can allow for early identification and treatment of abnormalities. As an advanced practicing nurse, it is essential to provide education to women surrounding HPV, …

Male Breast Cancer, Angie Blose

Nursing Student Class Projects (Formerly MSN)

Male breast cancer (MBC) is a disease that claims the lives of many unsuspecting men. MBC affects less than 1% of men only one out of a thousand will be diagnosed with the disease. According to the American Cancer Society (2019) this year, 2,670 men will be diagnosed with breast cancer (MBC) and at least 500 of them will loose their lives to this disease. Most breast cancers in males are diagnosed as ductal carcinomas (Chalasani, 2019). This poster provides insight about risk factors, diagnosis, testing, staging, and signs and symptoms of this disease.

Polycystic Ovarian Syndrome, Erin Branfield

Nursing Student Class Projects (Formerly MSN)

Abstract

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in females of reproductive age, affecting up to twenty percent of females (McEwen & Hartmann, 2018). Though the pathophysiology of PCOS is not fully understood, several factors such as insulin resistance and increased testosterone levels are prevalent and play a major role in PCOS. PCOS is a complex disease and encompasses many different metabolic, endocrine and reproductive conditions. Common signs and symptoms of PCOS include but are not limited to menstrual cycle disturbances, acne, alopecia and fertility problems (Balen, 2017).

Keywords: PCOS, Polycystic ovarian syndrome, insulin resistance

Nephrolithiasis, Erin Layton

Nursing Student Class Projects (Formerly MSN)

Nephrolithiasis, also known as kidney stones and calculi, pose a significant health and financial burden in the United States and worldwide. With the increasing incidence and prevalence of pediatric and adult nephrolithiasis, health care costs and morbidity are expected to rise (Batavia & Tasian, 2016). Once thought to be an isolated condition, nephrolithiasis is now considered to be a systemic disease and a marker for other systemic diseases like cardiovascular disease and hypertension. Furthermore, there is a correlation between nephrolithiasis and obesity, fractures, and chronic kidney disease (Ziemba & Matlaga, 2017). In the case of obstruction of an infected kidney, …

Multiple Sclerosis Pathophysiology, Carolyn Ricketts

Nursing Student Class Projects (Formerly MSN)

Abstract

Multiple Sclerosis (MS) is a chronic autoimmune disease characterized by inflammation in the central nervous system and demyelination of the white matter in the brain and spinal cord, leading to lesions and axonal damage, possibly followed by relapse. It is a progressively debilitating disease with a variety of symptoms that mimic other diseases, such as blurred vision, nerve pain, fatigue, weakness, paresthesia, and unsteady gait. It occurs more frequently further from the equator. The pathophysiology of MS is unknown. Several new research theories are emerging which include innate and adaptive immunity playing a role (TH1 and TH17 specifically), infection …

A Rural Telehealth Objective Structured Clinical Examination, Devon Schlottach

Dissertations

Problem Rural healthcare consumers experience increased health disparities, especially when accessing health care. The use of telehealth to improve access has become an essential competency for nurse practitioner (NP) students. This study evaluated NP students’ confidence and competence of rural social determinants of health (rSDOH) before and after a telehealth simulation.

Methods A descriptive, cohort design was used to review NP students’ pre- and post-surveys, written case studies, and a video-recorded telehealth OSCE for a patient living in a rural area.

Results Student self-rated knowledge of rural health care did not improve despite didactic learning and simulation (z = …

Depression In Hiv-Positive Individuals Living In A Residential Housing Community, Danielle Njeri

Dissertations

Problem: Depression is the most prevalent psychiatric disorder among individuals living with HIV. Depression rates are three times greater than those found in the general population . Undiagnosed and untreated depression can have a negative effect on the management of HIV infection, resulting in increased mortality and a poorer quality of life. The purpose of this quality improvement initiative was to assess the incidence of depression in HIV-positive individuals living in a residential community.

Methods: A prospective, descriptive, cohort design. Convenience sample of HIV-positive adult residents living in an HIV residential community. The nine-question patient health questionnaire (PHQ-9) …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Kori Fitzgerald Bsn, Rn, Phn, Fnp/Dnp Student

Doctor of Nursing Practice Final Manuscripts

Title: Utilization of Telehealth for Palliative Care Follow-up Visits

Background: A vital part of cancer management is the implementation and integration of palliative care, to prevent and relieve suffering and to improve quality of life for patients with serious chronic illness. However, access to palliative care services continues to be inadequate. There is a nationwide shortage of skilled palliative providers and the supply is insufficient to meet the growing demand.

Purpose of Project: Implementing telehealth visits with palliative care patients with advanced cancer at the UCSD Moores Cancer Center has the potential to maintain patient satisfaction with …