Family Practice Nursing Commons^™

Creation Of Care Coordination Team, Linda Peterson

Theses and Graduate Projects

Healthcare in the United States is fragmented and costly. Care coordination positively impacts healthcare cost and quality in healthcare systems. Case managers, social workers, and community health workers create health care teams in a health care home model. A team approach, formed by relationships built from collaboration, communication, and application of Complexity Theory, produces these outcomes. Relational coordination based on shared goals, shared knowledge, and mutual respect creates the framework from which to establish a team. Watson's Caring Science theory provides the conceptual framework to support the connectedness that occurs within a team approach. Creating a collaborative team of case …

Diabetic Assessment In A Wound Care Clinic, Laura Dooley

Theses and Graduate Projects

The number of people with diabetes in the United States is continuing to grow at an alarming rate. Over 23 million people in the United States are affected with the disease and it is estimated that the number of people diagnosed with diabetes in the United States is increasing by 1 million people annually. It is essential that nurses working in all capacities help with the prevention and management of this disease. lssues surrounding adequate patient self-management of the disease are identified as smoking, glycemic control, diabetes education, footcare, and financial concerns. An algorithm for diabetes assessment was developed to …

Pediatric Obesity: Taking Advantage Of Well-Child Visits For Early Identification, James E. Gelement

DNP Projects

Background: Pediatric obesity has reached epidemic levels in the United States and the burden of early identification and prevention lies with Primary Care Providers. With this burden comes the responsibility of increased documentation in order for patients to obtain the appropriate counseling, treatment, and referrals.

Objective: The objective of this study is to identify missed opportunities to identify pediatric patients that meet the criteria for overweight or obesity during well-child visits within a primary care practice.

Method: A retrospective chart review of 100 randomly selected patients born between 9/1/2001 and 9/1/2010 that have received a well-child visit between 1/1/2010 and …

Assessing Provider Adherence To An Emergency Contraception Guideline In Reproductive Age Women, Amber E. Davis

DNP Projects

Purpose: To determine current provider adherence to the 2010 ACOG Emergency Contraception (EC) guidelines, specifically by assessing provider EC counseling with patients at well-woman annual exam visits or during contraceptive counseling visits. A second aim of this study is to identify provider facilitators and barriers of EC discussion with patients.

Methods: Using a retrospective design, 90 medical records of patients presenting to a university clinic within the previous year were reviewed for the discussion of EC during annual exams or contraceptive counseling. Forty-five medical records were reviewed prior to implementation of the Ambulatory Electronic Health Record (AEHR) and forty-five medical …

Evaluating The Effects Of An Educational Lifestyle Modification Intervention On Blood Pressure In Adults With Prehypertension, Andrea M. Patterson

UNF Graduate Theses and Dissertations

The purpose of this project was to evaluate the effectiveness of an educational lifestyle modification (LM) intervention on blood pressure (BP) among adults with prehypertension. Prehypertension is a precursor to hypertension (HTN) and is a public epidemic in the United States. Approximately 68 million (31%) U.S. adult’s aged ≥18 years have hypertension. Hypertension can cause significant target organ damage, lead to coronary heart disease, heart failure, stroke, and kidney failure. Early identification and the primary treatment of persons with prehypertension with LM have the potential to minimize the progression and delay the onset of comorbidities associated with hypertension. This quality …

Primary Stroke Prevention: 3-Hydroxy-3-Methyl-Glutaryl-Coenzyme A (Hmg-Coa) Reductase Inhibitor (Statin) Use In The Diabetic Patient, Amy L. Hatcher

DNP Projects

Purpose: The primary objective for this retrospective chart review was to evaluate provider adherence to the 2011 AHA/ASA Primary Stroke Prevention guideline of prescribing a statin to all diabetic patients for primary prevention of stroke, regardless of dyslipidemia. A second aim of this study is to identify provider facilitators and barriers to prescribing a statin therapy for primary prevention.

Methods: Using a retrospective study design, a random sample of 100 medical records of diabetic patients presenting to a university women’s health clinic within the previous year were reviewed for statin use and rationale.

Results: Of the 100 diabetic patients sampled, …

Efficacy Of Bydureon In Adults With Type 2 Diabetes, Katie L. Fetter

UNF Graduate Theses and Dissertations

Type 2 diabetes is still rapidly on the rise today, affecting 10.5% of individuals in the United States between the ages 45 to 64 and 18.4% of those between the ages of 65 to 74. In the past two decades, type 2 diabetes has doubled in all age groups. Many adults with type 2 diabetes experience difficulty managing their blood sugars, which can result in a range of further complications. One of the newest treatment options on the market today is a glucagon-like peptide-1 (GLP-1) receptor agonist, Bydureon. Similar to Byetta, Bydureon has a main ingredient of exenatide. It offers …

Quality Improvement Measures For Cervical Screening Guidelines In A Clinic For Uninsured Adults, Julie Ann Baker-Townsend

UNF Graduate Theses and Dissertations

Cervical cancer, a completely curable disease with early detection and management, is an international concern. Early identification allows for treatment of the disease, which prevents or slows progression, ultimately reducing morbidity and mortality. Due to the regressive nature of most cervical lesions, the duration between cervical cytology has been lengthened to prevent over diagnosis and treatment. This was reflected in the 2012 United States Preventative Services Task Force (USPSTF) clinical practice guideline for cervical cancer screening.

The purpose of this project was to determine the effectiveness of a quality improvement initiative to increase adherence to the 2012 USPSTF guideline at …

Novel Oral Anticoagulants: Bedrest And Bleeding In Patients Undergoing Atrial Fibrillation Catheter Ablation, Lynn Mcwhirter

UNF Graduate Theses and Dissertations

Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and …

Sleep Disturbance And Outcomes In Patients With Heart Failure And Their Family Caregivers, Sami Al-Rawashdeh

Theses and Dissertations--Nursing

Sleep disturbance is common in patients with heart failure (HF) and the family caregivers. Sleep disturbance is known as a predictor of poor quality of life (QoL) in individual level. The manner in which patients’ and caregivers’ sleep disturbances influence each other’s QoL has not been determined. The purpose of this dissertation was to investigate the associations of sleep disturbance and outcomes in patients with HF and their primary family caregivers. The specific aims were to: 1) examine whether sleep disturbance of patients and their family caregivers predict their own and their partners’ QoL; 2) examine the mediator effects of …

The Benefits Of Breastfeeding, Avery Kordus

Senior Honors Theses

Breastfeeding research is plentiful, and the majority of the literature shows that breast milk is the superior form of infant nutrition except in the rare circumstances of infant metabolic disorders, maternal drug use, or positive HIV status. In comparison to formula, breast milk provides improved cognition, development, behavior, bonding, nutrition, digestion, immunity, and long-term health with fewer diseases and conditions in infants. Mothers are benefited by breastfeeding through bonding, faster weight loss, and reduction in certain cancers and conditions. Breast milk contains the proper amount of carbohydrates, fats, proteins, vitamins, and minerals, and is also specialized for each infant and …

Predicting Post-Deployment Family Adaptation In U.S. Navy Families, Micah A. Scott, Esther H. Condon, Arlene J. Montgomery, Spencer R. Baker

Ellmer School of Nursing Faculty Publications

Background: Although military families worldwide face changes that include adapting to peace and wartime deployments, few studies have explored how military families adapt to the post-deployment return of a service member.

Objectives: To identify variables that predicted post-deployment adaptation of U.S. Navy families.

Methods: A mixed method study guided by the Roy Adaptation Model included a convenience sample of 142 spouses of service members recently returned from deployment. The degree to which length of deployment, prior deployments, and years married, number of children, participation in religious and family support groups, communication, race, and interdependence predicted post-deployment family adaptation was tested. …

Final Dnp Capstone Report: Improving Adolescent Hpv Vaccination Rates, Jessica L. Murray

DNP Projects

Background: Human papillomavirus (HPV) vaccines have been shown to be effective against HPV types that are linked to cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers. Despite Advisory Committee on Immunization Practices (ACIP) recommendations that all 11-12 year old males and females in the U.S. should be vaccinated with the three-dose HPV vaccine series, vaccination rates remain low. In 2012, only 34.9% of adolescent females and 6.8% of adolescent males completed the series. Efforts to increase vaccination rates are needed, and healthcare providers have been shown to be an important part of the solution.

Purpose: This investigation was conducted to …

Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani

DNP Projects

Purpose: To evaluate provider adherence to JNC 7 by assessing documentation of blood pressure control and interventions in the absence of control in order to assist providers in reaching Healthy People 2020 goal of blood pressure control.

Methods: A retrospective chart review was conducted for patients with essential hypertension. Data collected included blood pressure, use of a home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three visits. A provider survey regarding provider barriers to blood pressure control was also completed.

Results: All surveyed providers were aware and …

Delivery Of Evidence-Based Tobacco Use Interventions In Primary Care, Amber Silberman

DNP Projects

This capstone report presents three manuscripts which focus on tobacco use interventions in the primary care setting. The first manuscript presents a critical analysis of the Public Health Service guideline on Treating Tobacco Use and Dependence. The second manuscript presents a literature review pertaining to interventions that increase primary care provider compliance with guideline recommendations. The literature obtained from these first two manuscripts led to a descriptive study, which examined the documentation and implementation of specific guideline recommendations in a primary care clinic. The third and final manuscript details this study, and presents some practical implications for improving documentation …

The Development Of A Comprehensive Adhd Program For Elementary School Educators, Angie Lee Echoles

Doctoral Projects

On average, teachers will teach at least one student with Attention Deficit Hyperactivity Disorder (ADHD) in any given school year without receiving any instructions at all on ADHD. ADHD affects 3% to 7% of school-age students and one in every twenty children (Centers for Disease Control and Prevention (CDC), 2010). It is classified as one of the most common mental health disorders affecting school-age students. The American Psychiatric Association (APA, 2013) defines ADHD as a hereditary, non-curable, common childhood disorder. A triad of symptoms is associated with this disorder: inattention, hyperactivity, and impulsivity, which all have a major impact on …

Perceptions Of A Dedicated Education Unit In The Mississippi Delta, Jacquelyn Felecia Brownlow

Doctoral Projects

The highest health care disparities in the country plague the Mississippi Delta. A weakened economy, minimal access to healthcare and an outdated traditional clinical learning environment place enormous strains on nursing education in this area to provide more nurses. The office of Nursing Workforce reported a 14% to 16% nursing turnover in the Delta compared to the national average of 13.5%. As a result, the health care organization has encountered high nurse turnover, increased staffing shortages, and a decrease in nursing quality indicators. As an effort to improve clinical education and bridge gaps between education and practice, several schools in …

Op-Ed: After Hospital Care, The Test Begins. Even For A Healthcare Professional, A Patient's Care Following Discharge Can Be Overwhelming., Beth Ann Swan

College of Nursing Faculty Papers & Presentations

In 2011, my husband, Eric, a trial attorney, was felled by a brain stem stroke just before he was to board a flight at O'Hare in Chicago. He was just 53 years old with no prior health conditions or problems. From the outset, we knew his recovery and rehabilitation would be long and difficult. We didn't know that his transition to post-hospital medical care would be just as challenging.

I'm the dean and a professor at the Jefferson School of Nursing at Thomas Jefferson University in Philadelphia, and I'm a registered nurse. I thought my training and access to resources …

The Lived Experience Of Families With A Mentally Ill Family Member, Moses Wankiiri, Karen B. Drake, Kimberley R. Meyer

School of Nursing & Midwifery, East Africa

The study of the lived experience of families with a mentally ill family member involved seven family members who had come to visit their mentally ill relatives in the mental Hospital. The major objective was to explore the lived experience of families with a persistent1 mentally ill family member. The study adopted a qualitative descriptive-phenomenological design, participants were purposively sampled and data was collected using a tape recorder. Colaizzi’s phenomenological approach for data management was then employed. The study revealed that family members held misconceptions about mental illness
and described care as a contractual obligation. They lived in misery as …

Cinemeducation: Teaching Family Assessment Skills Using Full-Length Movies, Astrid H. Wilson, Barbara J. Blake, Gloria A. Taylor, Glenda Hannings

Faculty Articles

A thorough family assessment provides a foundation for the nursing process when working with families. Therefore, nurses, along with other health care providers must develop expertise in conducting family assessments to provide the best possible care within the community. This article describes an innovative educational strategy using movies to teach family assessment skills and puts forth recommendations for future research to provide evidence to support this teaching modality.