Other Nursing Commons^™

Barriers In Health Care In Hmong Men And Women With Cardiac Diseases, Ying Thao

Doctoral Projects

Lauver’s theory of care seeking behaviors is applied to identify perceived barriers to accessing healthcare in Hmong men and women that may influence care seeking behaviors. The purpose of this study is to identify barriers in accessing health care among Hmong men and women ages 50 to 80 with cardiovascular heart disease (CHD) and risk factors for CHD (e.g., diabetes, hyperlipidemia, and hypertension). A quantitative descriptive analysis was used to look at demographic characteristics while a multiple regression analysis was used to statistically compare correlations between barriers to care, risk factors for CHD, sex, and access to health care. The …

Promoting Self-Efficacy Among Head And Neck Cancer Patients, Lily Lam

Doctoral Projects

Current survivorship visits at the Stanford head and neck oncology program are not standardized to address ongoing post-treatment sequelae. The objectives of this study help to address whether current non-standardized visits actually help to empower patients to self-manage their chronic diagnosis of head and neck cancer by measuring their self-efficacy levels before and after their post-treatment survivorship visit.

Given the convenience sampling method, 17 patients were enrolled in this quasi-experimental pilot study. Demographic information was collected for each patient: gender, ethnicity, smoker status, and age. Head and neck cancer patients would first be surveyed before and after their follow up …

Research, Evidence-Based Practice And Quality Improvement, Tonya Traylor

DNP Final Reports

Background: The United States is in the midst of an opioid epidemic. In 2012 alone there were approximately 259 million prescriptions written by primary care providers for opioids painkillers. The U.S. Center for Disease Control (CDC) now has new guidelines and recommendation due to the opioid analgesic epidemic. Education has been found to raise provider awareness and, subsequently, has decreased opioid use. Provider education helps with reinforcing the short-term use of opioids and adjunctive therapies and helps reinforce the idea of an individualized treatment plan for patients. Purpose: The purpose of this intervention is to increase provider education on opioid …

Sustainability In Quality Improvement And Patient Safety Initiatives, Angelo P. Giardino, Eileen R. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The question often asked of a quality improvement initiative is whether the improvement process has been sustained within the organization. Rarely is the question answered satisfactorily. The sustainability of an improvement process is important as it justifies the investment of human and financial capital. The term 'evaporation of improvements' addresses the dilemma that between 33% to 70% of all innovations are reportedly not sustained (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015) . This evaporation of improvement captures the frustrating inability of many institutions to maintain the achieved improvement after the newness of the initial effort wears off (Buchanan, Fitzgerald, & …

Early Identification Of Frailty Predictors In A Vowed Religious Community Of Catholic Men: A Strategy For Successful Aging In Place, Julia Senn-Reeves

Graduate Theses, Dissertations, and Capstones

Background: The population in the United States is aging and experiencing age- and disease-related changes, leading to increased frailty, as well as increased disability, morbidity, and mortality. Timely recognition of these vulnerabilities, and intervention implementation, are crucial to prevent adverse outcomes and to support successful aging in place. Purpose: The purpose of this project is to develop and implement a multifaceted assessment process to identify early predictors of frailty among members of a vowed religious community of Catholic men to ultimately support successful aging in place. Participants: A single vowed religious community of Catholic men in the United States, living …

Implementation Of A Nurse-Led Transitional Care Model For Older Adults With Copd Admitted To Home Health, Michelle Ryan Hunt

Doctor of Nursing Practice Projects

Problem Description: The importance of management of chronic disease and preventing rehospitalization has been identified at national and local levels. Chronic obstructive pulmonary disease (COPD) is one of the chronic diseases with notable rates of emergency department use and recurrence of hospitalizations.

Rationale: Implementation of transitional care models have been successful for health care organizations in chronic disease management.

Interventions: The health-social partnership transitional care management program (HSTCMP) was used to design a transitional care model process pilot for a home health agency (HHA) within a health system. This process used a multidisciplinary team led by a registered nurse for …

Increasing Physical Activity In Hispanic Adults To Reduce Complications Of Type 2 Diabetes, Linda C. Valenzuela

Doctor of Nursing Practice Projects

Problem Description: Adults in the United States do not exercise sufficiently to meet the specifications outlined in the 2018 Physical Activity Guidelines (U.S. Department of Health and Human Services, 2018). The Office of Disease Prevention and Health Promotion’s (2018) Healthy People 2020 aims to eliminate health disparities and achieve health equity among all population groups in the United States. However, statistics from the U.S. Office of Minority Health (2014) indicate that Hispanics are twice as likely to be diagnosed with type 2 diabetes as non-Hispanic whites. According to a Centers for Disease Control and Prevention (CDC) report in 2015, …

Diabetes Shared Medical Appointment: An Evidence-Based Innovation Project, Mohamed Bojang

DNP Final Reports

The purpose of the evidence-based practice innovation project (EPIP) is to address uncontrolled diabetes by implementing an evidence-based shared medical appointment (SMA) intervention which based on the body of the evidence will help improve diabetes outcomes. A pilot implementation and retrospective chart review were conducted. Data was collected on outcome indicators such as blood pressure, lipid values, body mass index, A1C, and knowledge. The results of a pilot SMA implementation revealed that patients who participated in the weekly SMA saw an improvement in post-mean values compared to pre-mean values. Mean A1c dropped to 7.0% from 7.11%; systolic blood pressure improved …

An Evidence-Based Project: Implementing A Nursing Handoff Protocol To Improve Patient Outcomes, Marcella Y. Upshaw-Owens

DNP Final Reports

The role of handoff communication is known to impact the patient experience and other patient outcomes. Handoffs are a common practice in healthcare and occur multiple times a day for each patient. Nurses are involved in handoff each shift. Based on clinical inquiry, the following question was postulated: In acute care nurses, how does a standardized handoff communication protocol, compared to no standardized communication protocol, affect outcomes (i.e., patient satisfaction, falls, medication errors, and missed orders) within a 3-month period? After completion of a literature review and critical appraisal, a bedside report protocol was developed and implemented using the Iowa …

Enhancing Retention For Nursing Assistants: Effective Strategies To Reduce Turnover, Tiffany Omann-Bidinger

Nursing Posters

Develop and implement a hospital-wide, evidence-based recruitment and retention program to reduce turnover rates for Nursing Assistants (NAs).

Nursing Students’ Knowledge And Understanding Of Acute Cystitis, Kayla Weber

Undergraduate Honors Theses

Acute cystitis (AC) is characterized by a sudden inflammation of the bladder caused by bacteria. The severity of AC ranges from mild to severe and may be recurrent, especially in at-risk populations. Bacteria in the bladder may travel further into the urinary system, causes urinary tract infections (UTI’s) resulting in urosepsis. Hygienic procedures play a large role in decreasing the bacteria that causes AC, so it is important for nursing students to understand and correctly apply the knowledge learned throughout the curriculum. This study focused on the knowledge and understanding nursing students have about AC. To determine this information, a …

Complete Care Model Impact On Glycemic Control In California State Prisons, Diane M. O’Laughlin

Doctoral Projects

The Complete Care Model (CCM) is a health care delivery model based on the well-studied and internationally validated chronic care theory. Since the integration of the chronic care theory into California Department of Corrections and Rehabilitation (CDCR) patient care in 2008, steady improvement in health care related mortality has been seen, and there have been no unavoidable health care related deaths in CDCR since 2012 (Gransee, 2018). However glycemic control in CDCR diabetic patients has made no statistically significant change since the implementation of the CCM in 2015 when comparing the two years before and the two years after implementation …

Does Preoperative Ostomy Education Decrease Anxiety In The New Ostomy Patient?, Michelle Suzann Harris

Doctoral Projects

Background: There are approximately 100,000 patients with new ileostomies and colostomies created in the United States each year. These patients have specialized needs that include acceptance of altered body image, psychological stress, learning of difficult tasks, and occasionally an ominous diagnosis leading to the need for surgery. In addition to pre-surgical stoma site marking on the abdomen, ostomy nurses have identified early education to be an important factor in long-term success and management of the patient . Early education and stoma site marking may assist with a better-situated stoma leading to fewer complications related to appliance adherence and leakage. …

Is There A Relationship Between Limited English Proficiency (Lep), Medication Adherence Behaviors, And Adverse Asthma Outcomes In Hispanic Adults With Moderate To Severe Persistent Asthma?, Archana Kartik Chandra

Doctoral Projects

The effects of LEP are well documented in the literature. LEP decreases medication adherence, causes ineffective communication between patients and providers, and reduces health outcomes. Asthma is known to be misdiagnosed and under-treated in Hispanic adults. There are discrepancies in the literature about the effects of LEP in Hispanic adults with persistent asthma.

The purpose of this study was to determine if the presence of LEP is associated with medication adherence behaviors and adverse asthma outcomes in Hispanic adults with moderate to severe persistent asthma. Hispanic adults with LEP were assessed for asthma outcomes and medication adherence behaviors.

The results …

Advance Directives: Assessing Effectiveness At A Health System, Rose Allen, Tanya Cohn, Christine Edozie, Susan Howard, Patricia Mccrink

All Publications

No abstract provided.

Outcomes Of Communication, Workflow Efficiency, & Patient Care Quality Resulting From A Hands-Free, Wireless Communication Device, Hyacinth Flores Carreon

Doctoral Projects

Purpose: Failures in communication have long been identified as one of the root causes of preventable medical errors. The purpose of this quality improvement project was to assess staff perceptions on the outcomes of communication, workflow efficiency, and patient care quality after the implementation of a hands-free, wireless communication device in a federal acute care setting.

Methodology: Replicating the quantitative component of a 2012 study by De Grood et al., a 10-item survey using a 5-point Likert scale was administered within a 4-week period to healthcare team members from two inpatient units composed of monitor technicians, nurses, nursing assistants, and …

Human Trafficking Identification Among Nurse Practitioner Students During Objective Structured Clinical Examinations, Zoe Onyun

Dissertations

Problem: Human trafficking (HT) is a significant worldwide and domestic issue affecting all ages, races, and genders resulting in over 40 million victims globally. Nurse practitioners (NP) often unknowingly come into contact with victims of HT, however, few NP’s have had formal education on the topic and may fail to recognize signs and risk factors. The purpose of this study was to initiate HT training for NP students.

Methods: A quality improvement (QI) initiative for a university college of nursing (CON) utilizing a prospective, observational, descriptive, cohort design. A plan-do-study-act (PDSA) methodology was implemented. A written case study given …

Educating Patients About Opioid Disposal: A Key Role For Perianesthesia Nurses, Katreena C. Merrill, Valynn Christina Haslam, Karlen E. (Beth) Luthy, Craig Nuttall

Faculty Publications

Purpose: To examine opioid prescription practices, patient use of opioids after laparoscopic cholecystectomy, and patient knowledge about disposal of unused medication.

Design: Mixed methods design with a chart review and structured phone interview.

Methods: Thirty-four patients were interviewed by phone and asked how many opioids were prescribed, how many excess pills they had 6 to 10 days postoperatively, and if they knew how to dispose of them.

Findings: Average number of excess pills ranged from 0 to 42 (mean = 14; SD = 11.7). Nearly half of patients (47%) perceived the prescribed quantity as “too many.” Seventy-one percent of patients …

Optimization Of Clinical Decision Support Tools For The Care Of Older Adults With Diabetes Mellitus Type Ii, Dorothy Alford

Research Horizons Day Posters

No abstract provided.

Exercises For Older Adults With Knee And Hip Pain, Neil E. Peterson, Kay D. Osterloh, M. Nichole Graff

Faculty Publications

Half of all older adults report knee and/or hip pain. Obesity and sedentary lifestyle contribute to the incidence and prevalence of painful knee and hip conditions. Weight loss should be a priority in overweight or obese patients. Improving joint function over time requires a balance of rest and usage. Practitioners should assess joint disorders and recommend exercises for reducing knee and hip pain with patients when appropriate. Instruction should include a combination of 1) stretching and flexibility, 2) strength training, and 3) endurance conditioning exercises. Even small improvements in exercise can make meaningful improvements in pain, movement, endurance, and quality …