Occupational and Environmental Health Nursing Commons^™

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 …

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 …

Patient Perception Of Fall Risk And High Fall Risk Screening Scores, Nicole D. Pena

Dissertations

Purpose: The purpose of the study was to describe the relationship between patient

perception of fall risk and high fall risk screening scores.

Background: Despite mandated government regulations and multiple hospital

interventions, falls are the most prevalent adverse event among hospitalized patients and

are the leading driver of health care costs, amounting to over $30 billion each year with

projections to double by 2030. Recently, perception was identified as a major component

in preventing falls. A dearth of research examines the relationship between a patient’s

perceived risk for falls and standardized fall screening scores.

Methods: A descriptive correlational design with …

Comparison Of A Numeric And A Descriptive Pain Scale In The Occupational Medicine Setting, George Francis Mcmahon Iii

Doctoral Projects

Pain is a universal phenomenon. The assessment of a patient’s pain is difficult to objectively obtain because the perception of the pain by the patient is influenced by many subjective perception variables. These variables can inflate or deflate the patient’s self-reported pain level which can adversely affect the medical provider’s ability to accurately create a treatment plan for the patient. This study compared the patient’s response to a self-rating of their pain on a numeric pain scale with the response given by the patient on the Mankoski pain scale. Comparison of the numeric pain scale to the Mankoski pain scale …

Reducing Re-Hospitalizations Of Patients With Heart Failure At A Skilled Nursing Facility, Louis D'Onofrio Jr.

The Eleanor Mann School of Nursing DNP Capstone Projects

The purpose of this project was to introduce the quality improvement (QI) process to reduce re-hospitalization rates in a skilled nursing facility (SNF) in Stratford, Connecticut for patients having a diagnosis of heart failure (HF). After reviewing the data from the nursing facility for re-hospitalization rates over a three-month period, it was discovered that 22% of patients at the SNF were re-hospitalized within 30 days. Of this population of patients, 22.9% had a diagnosis or complication of HF, which is associated with the highest re-hospitalization rates. This QI project focused on HF education customized towards nursing and nursing assistant staff …

A Framework For Learning During An Honors Internship: Embold Health Inc., Haley Haldeman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Embold Health Inc. is a health care analytics start-up company that identifies top performing providers using large data sets and clinically nuanced measurement. A comprehensive assessment of quality, appropriateness, and cost is what Embold Health delivers. Embold allows payers more control in choosing providers within their region. Being able to identify top provider behaviors through rigorous data driven measurement is significant both clinically and commercially; it provides the opportunity to increase value of care, decrease waste, and drive down cost.

Over the past year as an intern, I’ve had a first-hand look into the complexity that surrounds data driven health …

Organizational Wellness Programs As Internal Social Marketing: A Literature Review Of Feasible Approaches, Faith Bontrager Rn, Bsn, Kimball P. Marshall Ph.D.

Atlantic Marketing Association Proceedings

No abstract provided.

Exploring Medical-Surgical Nurse Turnover And Stratagies, Amber D. Weaver

Nursing Theses and Capstone Projects

This study explored the issue of medical-surgical unit nurse turnover and strategies to create nurse retention. The goal of this study was to provide nursing administrators with data that shows the cause of nurse turnover in this nursing specialty. The hypothesis was that there will be findings to indicate that medical-surgical nurses are at increased risk for employment turnover due to increased patient load and patient turnover. To study this concept, the Revised Casey-Fink Nurse Retention Survey was utilized. The results of the survey were revealed, and recommendations were made that may lead to nurse retention on the medical-surgical unit.

Active Shooter Awareness Education And Training Using Best Practices For Nurses In Acute Care Facilities, Amanda Carol Dean

Nursing Theses and Capstone Projects

The thought of having an active shooter at your place of work is unimaginable. The thought of having an active shooter at a place of healing is terrifying and distressing for patients, families, and nursing staff. An active shooter event, as defined by Hauk (2018), is when at least one person is actively killing or trying to kill people in a confined populated space. If an active shooter event were to take place in an acute care facility, nurses must be educated on best practices of responding to an active shooter, including identifying the situation, notifying the appropriate personnel of …

Race-Based Discrimination, Occupational Stress, And Depression In Black Registered Nurses, Arica A. Brandford

Theses and Dissertations--Nursing

The purpose of this dissertation was to examine depression, experiences of work-related racism, and occupational stress among black nurses. Nursing is a highly stressful and demanding profession that can negatively affect health. Underscoring this is the high rate of depression experienced by nurses. In fact, nurses experience depression at a rate twice that of individuals in other occupations. Examining depression in nurses can provide insights that can inform measures addressing the psychological health of this group. This may be particularly important in black nurses who, in addition to the already high occupational stress associated with nursing, may experience additional stress …

An Educational Intervention For Skin Cancer Prevention With Hospital Staff: A Pilot Project For System Change, Amy Fran Bruce

Graduate Theses, Dissertations, and Problem Reports (ETD)

PURPOSE: The purpose of this project was to design, implement, and evaluate an educational intervention provided to health care professionals using the Sun Smart U Curriculum created by the Skin Cancer Foundation (2017).

METHODS: Using a pretest-posttest design with a convenience sample (N=40), this intervention targeted the health professionals and staff from a residential/acute care facility caring for pre-adolescent, adolescent, and adult populations. Aims of this project included: (1) the staff’s baseline level of knowledge regarding sun protective behaviors using the Sun Smart U Curriculum, (2) the staff’s level of knowledge regarding sun protective behaviors post educational intervention …

Building Shared Values In The Community: Culture Of Health, Donnelle D. Storrs

Doctor of Nursing Practice

The zip codes where patients live are stronger determinants of health outcomes than the frequency of visits with a primary care provider. Providers have a unique opportunity to extend health care beyond the clinic walls and engage in efforts to improve the communities where their patients grow, live, work, and age. In order to impact the health of patients, a culture of health needs to be developed. The Robert Wood Johnson Foundation culture of health action framework directed the build of a foundation of health as a shared value in a neighborhood with high morbidity and mortality rates in southwest …

Improving Communication To Reduce Patient Falls In A 48-Bed Medical-Surgical Unit, Christian Gella

Nursing and Health Professions Faculty Research and Publications

Abstract

Problem: Patient falls has been associated with increased morbidity, mortality and decreased quality of life. The increase in total patient falls for 2018 relative to 2017, and a spike of 10 patient falls for the month of June 2018 from a baseline of 5.3 falls per month has gained greater attention to reduce patient harm from falls while hospitalized. Prevention of falls minimizes patient exposure to the possibility of being injured. Despite efforts to curtail patient falls, improvement in communication is essential to address the safety issues surrounding improving quality of care practices, and consequentially reduce un-reimbursable hospital costs …

Blood Pressure And Job Domains Among Hotel Housekeepers, Marie-Anne Sanon Rosemberg Phd, Mn, Rn, Bidisha Ghosh Ms., John Shaver Bsn, Maria Militzer Ma, Julia Seng Phd, Cnm, Faan, Marjorie C. Mccullagh Phd, Rn, Aphn-Bc, Cohn-S, Faaohn, Faan

Journal of Health Disparities Research and Practice

Hotel housekeepers have challenging working conditions, putting them at risk for poor health such as hypertension. Despite their risks, few studies have measured their blood pressure (BP). The purpose of this study was to explore hotel housekeepers’ blood pressure and the associations between work and BP. Methods: A community engagement approach was used to recruit study participants. Data sources included questionnaires, and BP measurement. Results: Over 25% of the 39 hotel housekeepers reported hypertension diagnosis and/or antihypertensive medication used. Across the job domains, job satisfaction was correlated with diastolic BP, and workload was correlated with systolic BP. There were difference …

Antibiotic Stewardship Among Primary Care Providers In Mississippi, Foley D. Graham, Hayden S. Kilgore, Kali D. Rogers, Sierra G. Cain, Brittany D. Dickerson, Kayla L. Warner

MSN Research Projects

The World Health Organization states antimicrobial resistance is the ability of a microorganism to stop an antimicrobial from working which results in ineffective treatment and persistent infections. The Center for Disease Control and Prevention (CDC, 2017) reported that in the year 2015, 269.4 million antibiotic prescriptions were written in the outpatient setting, and approximately 30% of antibiotics written are unwarranted. Of those cases, most patients receive an antibiotic related to acute uncomplicated bronchitis, pharyngitis, or rhinosinusitis. The CDC reported that Americans spend nearly $11 billion yearly on antibiotics alone. However, up to 50% of all antibiotics prescribed are not indicated …

Employee Influenza Immunization: Education And A Directive To Increase Immunization Rates, Ashley Roman

Doctor of Nursing Practice

Purpose: The aim of this quality improvement project was to improve the influenza vaccination rate of health care workers at an ambulatory care center to meet the national benchmark of 90%.

Background: Influenza is a communicable disease that affects over 130,000 people causing 7,000 deaths (CDC, 2017b). Over the last 3 years the influenza immunization rates at the facility of interest have been on a downward trend despite multiple interventions, resulting in 43% last season. A directive was published at the beginning of the 2017-2018 influenza season mandating each employee to either get a vaccine or decline in writing. This …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Musculoskeletal Disorders In Healthcare Workers, Josephine Lauer

Master's Projects and Capstones

Musculoskeletal Disorders (MSD) are one of the leading causes of disability in hospital nurses and nursing aids and is a high cost problem in the healthcare industry. Working in a complex environment of an acute medical floor where repetitive nature of patient handling, can lead to musculoskeletal injuries for healthcare workers. This is evidenced by work-related injuries in hospitals nearly doubling compared to private industry and hospitals are one of the most hazardous work environments in the country. Musculoskeletal injuries of healthcare workers are an ongoing problem which requires investigation due to high risk of reoccurrence. This is especially true …

The Clinical Nurse Leader As Outcomes Manager: Optimizing Screening Mammography In An Outpatient Breast Center, Yao Luo

Master's Projects and Capstones

The Clinical Nurse Leader as Outcomes Manager: Optimizing Screening Mammography in an Outpatient Breast Center

Abstract

This clinical nurse leader (CNL) practice improvement project was conducted in an outpatient breast center that is part of a community safety-net hospital. The patient population consists of a large proportion of disadvantaged, low income, low English literacy, and high-risk women over 445 years of age. Recent observations and baseline data from the breast center and the mobile mammography van indicated that five to eight radiologic views were taken during a routine mammogram in a subset of screening patients which exceeds the standard set …

Hazardous Drug Administration In The Home Setting: Reducing Exposure Risks, Cynthia D. Huff Msn, Rn, Ocn, Crni, Cnl

Master's Projects and Capstones

Hazardous drug (HD) administration used to be contained in controlled-healthcare settings, however, the introduction of HDs for home administration has become a growing area of concern for home health agencies. The objectives of the Clinical Nurse Leader (CNL) project aims to improve homecare nurses' knowledge of HDs and improve competency with personal protective equipment (PPE). The microsystem provides short-term homecare services for acute and chronically-ill patients. One team leader, two home infusion coordinators, and twelve registered infusion nurses participated in learning about exposure risks and PPE use with HD administration. Kotter's 8-step change theory was used to develop behavior change …