Nursing Commons^™

Using Readiness To Change For Dietary Modification In A Rural Primary Care Setting, Rebecca Johnson Beller

Theses & Dissertations

Cardiovascular disease is a prevalent noncommunicable disease. Modifying lifestyle behavior can decrease cardiovascular disease morbidity and mortality outcomes. This dissertation's purpose was to explore behavioral change interventions with dietary strategies to reduce cardiovascular disease rates. The integrative review explored aspects of dietary strategies in the primary care setting. Despite the importance of diverse studies, comparing all the components results in limited generalizability. In the following chapter, a cross-sectional study elicited healthcare professionals’ perceptions of the usefulness of a readiness for lifestyle change tool in clinical practice. Currently, a common, widespread adoption of a readiness for lifestyle change tool is not …

Incorporating A High Fidelity Transgender Simulation Into Undergraduate Nursing Curriculum, Kacee Child, Jenniepearl Spencer

Doctor of Nursing Practice Projects: College of Nursing

Purpose

The purpose of this study was to evaluate the knowledge and attitudes of nursing students participating in a high-fidelity transgender patient simulation. The aims were to increase student knowledge and confidence to improve communication and provide more inclusive and equitable care.

Healthcare providers are not adequately prepared to manage the unique health needs of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Nurses are ideally positioned to address gaps in LGBTQ healthcare by providing culturally competent care. Yet, LGBTQ health education is lacking in most undergraduate nursing school curriculums.

Methods

62 undergraduate nursing students participated in a post-surgical …

Improving Collection Of Second Blood Pressure For Patients In Primary Care Who Present With An Elevated Reading, Jordan Sieh, Elizabeth Sundberg, Tania Arreguin

Doctor of Nursing Practice Projects: College of Nursing

Purpose: Early diagnosis of hypertension is critical to prevent complications such as renal and cardiovascular diseases. Many healthcare facilities do not have a blood pressure training program educating appropriate staff on importance of accurate blood pressure readings and techniques. The purpose of this project is to improve the number of patients with elevated blood pressure reading at the OneWorld Quick Sick Clinic.

Methods: Health aides/Health Assistants/Medical assistants at OneWorld Quick Sick will receive blood pressure training to review proper techniques. During this training they will also be educated on appropriate follow-up blood pressure readings and a new technique to document …

Key Stakeholder Perceptions Of Doula Support For Persons With Perinatal Opioid Use Disorder, Meghan Gannon, Phd, Msph, Dennis Hand, Phd, Vanessa Short, Phd, Taylor Carrubba, Grace Thiele, Samantha Pancoe, Sarah Lawson, Nadia H-Yazdi, Phd, Scott Keith, Phd, Diane Abatemarco, Phd

Health Equity and Quality Improvement (HEQI) Summit

Background

• Maternal child health disparities are prevalent among pregnant and parenting women in treatment for opioid use disorder (OUD).
• Doulas have been utilized as a perinatal support in other vulnerable populations to increase healthcare utilization and improve birth outcomes.
• While research demonstrated that doula services can be feasibly implemented for populations experiencing poverty and trauma, there are limited studies to support that this could be true for patients with OUD as well.

Promoting Physiologic Birth By Improving Access To Doulas, Karen Schwartz

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Birth in the United States (U.S.) leans towards a medicalized approach, overlooking the advantages of physiologic birth. Physiologic birth is a natural approach to childbirth, without medical interventions. Intrapartum nurses play an integral role in caring for women during labor by providing continuous labor support. Competing nursing tasks, exacerbated nursing shortages and increased nurse to patient ratios have made it increasingly challenging for intrapartum (IP) nurses to provide continuous labor support to their patients. The aim of this DNP project is to gain insight into the beliefs of IP nurses regarding childbirth and how these beliefs impact their approach to …

The Impact Of The News2 On Self-Confidence And Anxiety In Nursing Students, Ashley Barnes

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

The purpose of this pre-and post-interventional design study was to determine the impact of the National Early Warning Scale 2 (NEWS2) on self-confidence and anxiety levels of undergraduate Associate of Science in Nursing (ASN) and Bachelor of Science in Nursing (BSN) senior level nursing students during a clinical deterioration simulation. New graduate nurses and experienced nurses report a lack of self-confidence and increased anxiety when caring for a patient experiencing clinical deterioration or decline. Senior level nursing students self-reported their self-confidence and anxiety levels using the Nursing Anxiety & Self-Confidence with Clinical Decision Making (NASC-CDM^Ó ) scale before and …

Dnp Final Report: Double Gloving As Part Of The Surgical Site Infection Prevention Bundle For Colorectal Surgeries, Dave P. Calubaquib

DNP Final Reports

Surgical site infection (SSI) is the costliest healthcare-acquired infection that encompasses around three to ten billion dollars annually. The costs do not include the societal challenges and personal losses that patients endure when they have SSI. The evidence-based project revolves around decreasing SSI among colorectal surgical patients with a PICOT question: In patients having colorectal surgery, how does an educational project regarding double gloving for reducing SSIs, compared to no educational project, improve compliance rates for double gloving? The evidence recommends that double-gloving techniques among surgical members (surgeon, surgical assistant, and scrub techs/nurses) during surgery prevent SSI. The project utilized …

Prevalence And Predictors Of Secondary Traumatic Stress In A National Sample Of Emergency Nurses: A Cross-Sectional Study, Christian Paige Owen

Dissertations and Theses (Open Access)

Background: Emergency nurses experience traumatic situations as part of their professional role, leaving them vulnerable to secondary traumatic stress (STS). The distressing behaviors and symptoms of STS negatively impacts their well-being and ability to provide high quality care. Studies report that emergency nurses experience high levels of STS but less is known about how STS is influenced by their coping strategies and work-related factors. Further evidence is needed to better understand predictors of STS in order to support strategic efforts to improve the well-being and retention of nurses working in trauma-prone environments.

Aims: The specific aims of this study sought …

Improving Nurses’ Communication Skills Using The Situation-Background-Assessment-Recommendation Model, Leslie Gonzalez

Walden Dissertations and Doctoral Studies

Lack of effective communication among health care providers results in negative health outcomes, low patient satisfaction, and compromised patient safety. An educational intervention to improve communication skills was implemented with staff including licensed practical nurses, registered nurses, and nurse practitioners. The project was implemented and evaluated for improved patient outcomes and satisfaction. The framework for the project was the situation-background-assessment-recommendation (SBAR) model. Pre- and postimplementation surveys were used to assess nurses’ knowledge of the effectiveness of SBAR on communication skills and patient satisfaction. Descriptive statistics and inferential analysis, including the Wilcoxon sign test, were employed to analyze pre- and postintervention …

Evaluation And Education Of Enhanced Recovery After Surgery Protocols For Total Knee Arthroplasty, Lauren Hunt, Jessica Prost

Doctor of Nursing Practice Projects

Enhanced recovery after surgery (ERAS) utilizes a multimodal, multidisciplinary perioperative protocol to minimize hospital length of stay, surgical complications, readmissions, and patient hospital costs (Frassanito et al., 2020). The protocols were initially established for abdominal and colorectal surgical patients; however, ERAS protocols are now widely used in other areas, including orthopedic surgery (Kaye et al., 2019). To achieve the maximum benefits, ERAS protocols must contain preoperative, intraoperative, and postoperative components. A rural critical access hospital in Eastern Illinois, Crawford Memorial Hospital, serves numerous patients requiring total knee arthroplasties (TKA). While the providers utilize some aspects of ERAS protocols for these …

A Behavioral Intervention Checklist To Reduce Re-Hospitalizations In Residents With Mental Illness, Jeffery Davis

Doctor of Nursing Practice Projects

Skilled nursing facilities are an essential component of the continuum of care and, with the rapidly aging population, represent an increasing cost to the healthcare system. The policies beginning in the 1960s promoting the deinstitutionalization of mental health institutions have resulted in increasing numbers of individuals with serious mental illnesses now residing in skilled nursing facilities. The complex needs of individuals with mental illness have been associated with an even greater cost of care, deficient quality, and safety concerns. This quality improvement project analyzed the impact of an evidenced-based, structured behavioral intervention checklist on rehospitalization rates in individuals with mental …

Hepatitis C Management For Individuals In Custody, Oluronke D. Akinola

Doctor of Nursing Practice Projects

The hepatitis C virus (HCV) is a pathogen that spreads through blood and causes hepatitis C disease, a liver infection. Early infection symptoms are rare, making it a silent killer. HCV, the chronic liver disease accounts for half of all hepatocellular carcinoma cases and is the leading cause of liver transplantation in the US. This quality improvement project aimed to create an educational toolkit for the Department of Correction staff working with individuals in custody refusing HCV treatment. The education tools comprised an infographic flyer (English and Spanish) to teach individuals in custody about HCV treatment and a PowerPoint presentation …

Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford

Doctor of Nursing Practice Projects

Asthma is the most prevalent disease in childhood and disproportionately affects African American (AA) populations in terms of prevalence and frequency of exacerbations. Air quality and environmental factors are strongly associated with the diagnosis and management of asthma and AA children are more likely to live in areas with poor air quality. An air quality flag program was implemented in a daycare located in a county with a predominantly AA population with a high prevalence of asthma diagnoses. The goal of the intervention was to increase staff awareness of air quality and the impact it can have on asthma diagnosis …

Implementing Pain Management Policies And Procedures At A Rural Pain Clinic, Jamie Swearingen

Doctor of Nursing Practice Projects

The United States is facing an uprising in opioid use disorder and a rise in overdoses due to the disorder. Due to the high addiction potential of opioids and the potential for overdose, providers must be cautious and conservative in their opioid prescribing practices. In 2022, the Centers for Disease Control (CDC) updated the Clinical Practice Guidelines for Prescribing Opioids for Pain to help in prevention of developing opioid use disorder and unintentional overdoses. The lack of an opioid use disorder risk screening tool, random urine drug screens, and clear pain management contracts were identified as issues at one rural …

Increasing Oral Health In A Midwest Elementary School: Quality Improvement Project, Dee Young

Doctor of Nursing Practice Projects

Marginalized communities experience barriers to accessing oral healthcare in the United States (US). Due to this, many children are left to use the emergency department (ED) for dental care. The purpose of this Doctor of Nursing Practice (DNP) project was to improve oral health services access in children at one suburban Midwest elementary school. The objectives of this project were: a) to improve the efficiency of students registering in Fall 2023 to access available oral health exam services, b) to increase the number of students who receive an oral health exam compared to the number in the previous school year. …

Nurse Anesthesiology Education For Regulators, Jonathan Alvarado, Kevin Stein

Doctor of Nursing Practice Projects

Governmental and regulatory entities like the state board of nursing have an active role in regulating all nursing fields, including anesthesiology. The lack of a required nurse anesthesiology representative on the board presents a potential knowledge gap related to anesthesiology practice. Board members and staff must make decisions related to nurse anesthesiology that may cause anxiety due to its complexity. The lack of education in this area allows one to make wrong decisions or spend extended time looking for the correct information.   The main objective of this project was to provide an educational module on nurse anesthesiology practice to the …

The Experience Of Remediation For At-Risk, Pre-Licensure Baccalaureate Student Nurses, Nicole Jager

Walden Dissertations and Doctoral Studies

At-risk students face academic challenges that can affect nursing program progression. Remediation strategies can increase student success. The research problem addressed through this study is a lack of information surrounding the students' remediation experience in an at-risk, pre-licensure baccalaureate student nurse population. Individualizing remediation to the student population can increase success; however, the student perspective is needed to correctly identify and tailor the remediation activities to fit the students’ needs. The purpose of this descriptive qualitative study was to explore the experience of remediation among at-risk, pre-licensure baccalaureate student nurses. Mezirow's transformative learning theory grounded this study. The research design …

The Association Of Discrimination And Coping Style On Cardiovascular Health Among South Asian Individuals In The Masala Study, Raji Pillai

Dissertations and Theses (Open Access)

Objectives: South Asian individuals (SAs) are found to have a heightened state of inflammation contributing to increased cardiovascular disease (CVD). Additionally, social determinants like discrimination are also associated with risks for CVD in SAs. This study examined the associations between discrimination and inflammation and whether an association between discrimination and self-rated health (SRH) is moderated by coping styles among SAs living in the United States to inform effective coping strategies against discrimination.

Design: This secondary data analysis used data from 1164 SAs (mean age = 57 years, SD 9.4, 48% women) enrolled in the Mediators of Atherosclerosis in South Asians …

Implementation Of A Validated Suicide Screening Tool In A University Student Health Center, Tessa Welniak, Bailey Coslor, Cathrin Carithers

Doctor of Nursing Practice Projects: College of Nursing

Purpose. Suicide is the second leading cause of death among adults in the United States and Nebraska. Death by suicide impacts millions of adults every year in the United States but warning signs are often missed during visits with primary care providers. The University of Nebraska at Kearney (UNK) Student Health Center (SHC), like many other primary care clinics, did not routinely screen patients for suicide risk. According to the Joint Commission, all patients over 12 years of age should be screened for suicide using a validated screening tool if the visit is for any behavioral health concern. The project’s …

Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to expand the areas of focus within a maternal wellness program at a Black community center and to evaluate the satisfaction levels of the doulas who utilized the material during postpartum home visits. The toolkit covers a range of postpartum topics in the areas of nutrition, exercise, sexual health, mindfulness, and social support as well as a postpartum mental health screening tool.

Design: This quality improvement project included three distinct phases: The pre-implementation phase, the implementation phase, and the post-implementation phase.

Setting: The project location was a Black community center in Lincoln, Nebraska. …