Caring In The Margins: A Scholarship Of Accompaniment For Advanced Transcultural Nursing Practice, Ruth C. Enestvedt, Kathleen M. Clark, Kaija Freborg, Joyce P. Miller, Cheryl J. Leuning, Deborah K. Shuhmacher, Kristin M. Mchale, Katherine A. Baumgartner, Susan L. Loushin

Faculty Authored Articles

Nurses must learn essential skills based in transcultural nursing to address issues of equity and social justice. The development of a model for nursing practice for an urban nurse-led drop-in center for individuals experiencing marginalization provides an opportunity for student nurses to learn transcultural nursing skills that shifts care from acknowledging the need of others to accompanying others on their health journey. The practice model provides the opportunity for undergraduate and graduate nursing students at Augsburg University to de-emphasize tasks and build relationships. Students learn to listen to others' stories and acknowledge their struggles in the margins. Four stages of …

Utilizing Home Health Services To Reduce High-Risk Readmissions: A Quality Improvement Project, Courtney Robare

Nursing and Health Professions Faculty Research and Publications

The Centers for Medicare and Medicaid (CMS), the Joint Commission (TJC), Institute for Healthcare Improvement (IHI), and the Agency for Healthcare Research and Quality (AHRQ) have all highlighted readmissions as an issue in healthcare that needs to be addressed. Many of these organizations have piloted programs which aim to decrease readmissions.

The MAP (Medication Focus, Access Assistance, and Provider Collaboration) program seeks to decrease the readmission rate of high-risk patients. Readmissions are costly and often lead to negative patient outcomes. To decrease cost to the hospital and avoid penalties from the Centers for Medicare and Medicaid (CMS), the MAP program …

Pain Management: A Flowsheet For Providers, Lisa Swezey

Doctoral Dissertations and Projects

Many different factors led to the trend of providers prescribing opioids for chronic pain. However, the misuse of and many deaths related to opioid prescriptions have caused the trend to reverse its direction. National organizations call for providers to stay clear of opioid medication and increase the use of nonpharmacological pain management, but also to treat pain adequately. There are still many barriers to decreasing the use of opioids and increasing the use of nonpharmacological methods. This scholarly project hoped to use an educational flowsheet to assist providers in meeting the demands from national organizations to decrease the use of …

Using Theories And Models For Operationalization Of Patient Trust In Doctors In Chronic Disease Response In Low Income Africa: ‘Best Fit Approach’, Kahabi Isangula

School of Nursing & Midwifery, East Africa

Background: Recent evidence suggest that improved patient trust in doctors can facilitate their healthcare seeking, adherence and continuity with care. With the growing burden of chronic disease in low income Africa (LIA) characterized by challenges of poor patient healthcare seeking, non-adherence and poor continuity with care, trust forms an important entry point for addressing these challenges. However, the topic of trust has generally received weaker attention among researchers in LIA contexts. To date, there has been no attempts to generate a clear guide for theory-driven inquiries as a means of operationalization of trust as a public health lens for chronic …

Nutrition Education To Improve Health Outcomes In Community Dwelling Older Adults, Sara Giessinger

Master's Projects and Capstones

Abstract

The proportion of people age 60 and over is growing faster than other age group, and will double by 2050 from approximately 605 million to 2 billion worldwide, in addition to the 80 and over population quadrupling by the same time. Non-communicable diseases such as obesity, cancer, coronary heart and lung disease, diabetes, hypertension, insulin resistance, and hyperlipidemia,represent 63% of deaths annually worldwide. Due to the immense contact nurses have with clients, they play a key role in screening, referrals and education to guide this demographic to improved health outcomes through nutrition and physical activity interventions (Xiaoyue, Parker, Ferguson, …

Pediatric Primary Care Concussion Evaluation And Management, Kaitlyn Layman

Doctoral Dissertations and Scholarly Projects

Concussions are an important and timely subject, especially within the pediatric population, as they are the most involved in extracurricular contact sports and are susceptible to concussions and their sequelae. The researcher performed a quasi-experimental pilot study in a pediatric primary care office where the researcher educated 15 providers on the HEADS UP concussion screening tool and management approach. The researcher gave providers pre- and post-intervention surveys to determine if providers’ comfort and knowledge regarding assessing and managing concussions within the pediatric primary care setting changed. Four providers participated in the study. The researcher conducted a chart review two months …

Common Components Of Fetal Alcohol Spectrum Disorder Prevention Intervention Programs: A Review Of Literature, Ross Siemering

Grace Peterson Nursing Research Colloquium

Abstract

Background: Fetal alcohol spectrum disorders (FASD) are the most common yet completely preventable cause of mental disability in the western world.

Objective: The purpose of this integrative literature review is to examine and identify the common elements among varying interventions for FASD prevention that have demonstrated effectiveness for reducing the risk of FASD to better understand what defining features may contribute to the efficacy of the interventions.

Methods: An integrative literature review was conducted. The databases searched included: CINAHL, PubMed, Cochrane Library, and Science Direct. Articles were then reviewed to determine if they were appropriate for inclusion based upon …

Barriers To Providing Psychiatric Care Within Cook County Public Health System: An Integrative Literature Review, Elizabeth Ann Reuter

Grace Peterson Nursing Research Colloquium

Abstract

Background: Cook County Public Health Systems located in Cook County, Illinois, are responsible for providing free and low cost psychiatric care to thousands of residents despite continuing state and federal budget cuts and inadequate Medicaid reimbursements. This not only financially strains county taxpayers, but it also limits treatment options, negatively impacts patients, and places an extreme burden on the public service workforce.

Objectives: The purpose of this integrative literature review was to identify the major barriers of providing psychiatric care within Cook County Public Health Systems.

Method: An integrative literature review was conductedusing the databases of Academic Search …

Maternal Mortality In Non-Hispanic Black Women, Amelia Major

Grace Peterson Nursing Research Colloquium

Background: The United States has the highest maternal mortality among all developed countries, among these mothers, non-Hispanic black women are three times more likely than women of any other racial group to die from pregnancy-related causes.

Purpose: To investigate racial disparities among pregnant women who die from pregnancy related causes (maternal mortality) and determine possible interventions to improve outcomes.

Methods: An integrative literature review was conducted to analyze peer-reviewed articles published from 2007 to 2018; a computerized search of literature was performed using Cumulative Index to Nursing and Health Literature (CINAHL), Proquest Nursing and Allied Health Sources, …

Public Perceptions Of Sugar Sweetened Beverage Taxes: An Integrative Literature Review, Stacy Gates

Grace Peterson Nursing Research Colloquium

Background: Carbonated soft drinks are one of the largest sources of calories in the American diet, providing over 5% of caloric intake, and no significant nutritional value. Governments across the globe have begun to implement sugar sweetened beverage taxes in an attempt to stem the proliferation of these health issues, but such policies remain unpopular and implementation difficult.

Objectives: The purpose of this integrative literature review was to examine the public perception of sugar sweetened beverage taxes and to determine what strategies are needed to successfully implement similar policies in the future.

Method: An integrative literature review …

Nurses Role In Health Home Mixed Methods Study, Jacqueline S. Prokop

Nursing Theses and Dissertations

Managing individuals with chronic health conditions in the primary care setting continues to be a significant challenge in the U.S. health care system. This issue is further compounded for low-income individuals with both mental health and physical health chronic conditions. With the enactment of the Affordable Care Act (ACA), new chronic disease health home opportunities have emerged to address the existing structural and process gaps found in primary healthcare. The nurse’s role is integral to health homes as they empower nurses to play a greater role in improving patient experiences, population health, and lowering healthcare costs. Three research manuscripts presented …

Standardizing The Palliative Care Referral Process, Ronaviv M. Garcia

Master's Projects and Capstones

Standardizing the Palliative Care Referral Process

Problem: Heart failure (HF) is one of the most common causes of hospital admissions and emergency department visits in the United States. HF patients are at high risk for hospital readmission: 25% of HF patients discharged from the hospital are readmitted within 30 days of discharge, and 50% are readmitted within 6 months (Vedel & Khanossov, 2015).

Context: Palliative Care (PC) has been shown to be an effective way of managing distressing HF symptoms and thus of reducing hospital readmissions, yet patients are infrequently referred to PC services during their transition from hospital to …

Implementing A Telephone Triage System, Joanyett Mays-Scott

Master's Projects and Capstones

Implementing a Telephone Triage System

Abstract

Introducing a telephone triage system requires conscientious regard to the organizational configuration and culture, staff abilities and experience, observed need and expected outcomes, staffing issues, and the physical location in which the system will be introduced (Murdoch et al., 2015). For this microsystem A SWOT analysis and microsystem assessment were performed. This community health center’s goal was to have standardized, evidence-based triage protocols followed by the nursing staff and the contracted nursing staff. The workflow was introduced in a series of lunch and learns provided by clinical nurse managers. Once workflows were established a …

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 …

Changing Health Care Policy By Utilizing Kingdon's Policy Stream Theory, Brittney Welch

Graduate Theses, Dissertations, and Capstones

The purpose of this paper is to describe the policy process of changing current regulations regarding rural health clinics (RHCs). Using Kingdon’s Policy Stream Theory for guidance, the change project was designed to amend current regulations regarding the directorship of the RHCs, consequently allowing Nurse Practitioners (NP) to act as medical directors for rural health clinics (RHCs). This change fulfills the Institute of Medicine’s charge to have nurses work to the highest level of their education, as well as a defined need to fill a gap in the health care system by decreasing rural health disparities. The Rural Health Care …

Analyzing The Medical Definition Of Death In Criminal Homicide Prosecution, Mariah Wood

Nursing ETDs

I investigated the use of the medical definition of human death in the criminal justice system and the impact of this definition on the prosecution of criminal homicide. The units of design for this research were two violent crimes cases investigated by the Homicide Unit of the Albuquerque Police Department. Data was collected from officer interviews, case files, Office of the Medical Investigator reports, media and social media.

I identified the themes of pursuit of justice, frustration, and family from the collected data. Key findings include that the medical definition of human death causes confusion and delay in the criminal …

Traumatic Brain Injuries: A Telehealth Alternative For Veterans, Jessica Dickman

Dissertations

Problem: Traumatic Brain Injuries (TBI) are known as the signature wound of veterans serving in Operation Enduring Freedom (OEF) and the Operation Iraqi Freedom (OIF). After the initial TBI diagnosis, outpatient TBI follow-up rates are reported to be approximately 9% less in the Veteran Healthcare Administration (VA) system when compared to the private sector. The purpose of this quality initiative was to decrease the rate of missed appointments among OEF/OIF veterans using a telehealth alternative.

Methods: The Plan-Do-Study-Act (PDSA) method was used to implement a consistent process for the telehealth visit option. A retrospective medical record review over the same …

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 …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Nurse-Led Triage Clinic In An Hiv Supportive Housing Apartment Community, Sally Breen

Dissertations

Problem: HIV-positive persons living in supportive housing who were otherwise homeless are reported to have better health outcomes than those who remain homeless. This was a quality improvement project to obtain baseline information regarding the implementation of onsite nursing services for individuals and their families residing in an HIV-positive supportive housing apartment community in an urban Midwestern city. Methods: A nurse triage clinic was implemented in partnership with the Doorways organization. Two registered nurses staffed the clinic two days per week. Data was collected on demographics and clinic utilization over a nine-week period. Results: Of the apartment residents, N=95, the …