Theses and Dissertations, Capstones, and Directed Research
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Electronic theses and dissertations, and graduate and undergraduate Capstones and Directed Research.
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Browsing Theses and Dissertations, Capstones, and Directed Research by Type "Poster"
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Item A Quality Improvement Initiative to Explore Barriers Facing Associate Degreed Nurses Obtaining a Bachelor’s Degree [poster](2021-12) Gersbach, KendalIn 2010, the Institute of Medicine recommended that 80% of nurses in the workforce be BSN-prepared by the year 2020 (IOM, 2010). As shown by multiple surveys, the United States did not meet this recommendation by the year 2020. In 2018, a survey conducted by the U.S. Department of Health and Human Services using The National Center for Health Workforce Analysis team reported that only 63.9% of the RNs surveyed held a BSN degree (U.S. Department of Health and Human Services, 2019). The question remains to what is preventing more ADN-prepared nurses from advancing their degree to BSN and beyond. This project aims to identify barriers ADN nurses perceive when enrolling in or completing a bachelor’s degree.Item A Systematic Review of Common Symptoms Associated with Urinary Tract Infections in the Elderly [poster](2022-12) Woodall, LynnIntroduction: Urinary tract infections (UTIs) are a common infection seen in primary care. There are many key predictive factors including age, gender, comorbidities, and symptom presentation that can be used to quickly identify UTIs for rapid treatment to be implemented. Methods: This systematic review of literature was guided by Dorothea Orem’s Self Care Deficit Theory, and by using databases including CINAHL, PubMed, and Medline to gather and evaluate articles for relevance and guidance. A Rapid Critical Appraisal Tool was used to further screen these articles for relevance and validity through a screening process with inclusion criteria to include or exclude articles for the review. The articles reviewed were used to answer the clinical PICOT question presented and the articles were presented in the form of an evidence synthesis table to give a side-by-side comparison of the research. Results: Six cohort studies were ultimately included and used based on relevance, to show strong evidence that there are many key predictive factors of UTI in the elderly population that a provider can assess for in their practice to identify and quickly treat before complications occur. All six studies were able to support the clinical question presented. Discussion: Based on the studies reviewed, there is evidence that improvements can be made in identification and rapid treatment of UTIs in the elderly with further quality improvement projects, more research into the signs and symptoms noted in a larger population with the key focus on identification prior to having positive confirmation of urinary tract infection.Item Alternative Treatment for ADHD: A Systemic Review of Polyunsaturated Fat Supplementation Interventions in Children [poster](2023-12) Rutherford, MikhailaThe purpose of this project is to compare the current research available regarding the effects of polyunsaturated fatty acids/omega-3 supplementation (PUFAs) on ADHD symptoms in children. The conceptual framework that guided this systematic review was the Neuman’s Systems Model (Petiprin, 2020). Neuman’s System Model is a strong guide to develop nursing knowledge because it encompasses looking at the entire person, in addition to their interactions within their environment and other people. All people are complex individuals and treatment considerations should be made toward their unique multidimensional qualities, including taking into account individual family preferences for treatment.Item Barriers and Outcomes for Low-income Women with Mental Illness During Post-Partum [poster](2023-12) Bibles, Sharmelle R.Introduction: Maternal mortality among low-income mothers in the United States (U.S.) is steadily increasing (Eckert, 2020). The risk for developing mental illness is higher among middle- and low-income households, where 1 in 4 women report depression during pregnancy and 1 in 5 report having postpartum depression (Awini et al., 2023). Several research studies have examined social determinants of health (SDOH) impact on mental healthcare treatment among pregnant and post-partum women. However, gaps in the literature suggest that more research is needed to examine mental health outcomes for mothers and babies with untreated mental illness during the post-partum period. This systematic literature review aims to identify barriers to healthcare, patient outcomes, and helpful interventions for post-partum women with mental illness in low-income communities. Methods: The author extracted data from articles between 2018 and 2023 via CINHAL, Pubmed, and Psychinfo electronic databases. An ancestry search strategy was also used for data collection. Articles selected for this study meet inclusion criteria: (1) primary research articles, (2) published in English, (3) published in a peer-reviewed journal, (4) published within the last five years, and (5) addressed or related to barriers and outcomes for low-income, post-partum women with mental illness. The Rapid Quality Critical Appraisal Tool, adapted by Melnyk and Fineout-Overholt (2019), was used to appraise and evaluate quality of the literature. Results: 1,512 articles were identified, and seven studies met inclusion criteria. Five common themes were identified across studies as barriers for low-income post-partum women in need of mental healthcare: (1) lack of social and community support, (2) lack of transportation and community resources, (3) lack of financial assistance and income, (4) lack of provide education (understanding) and advocacy (5) lack of mental health education. Discussion: Results suggest a critical need for multiple stakeholders to address the complex barriers and social determinants of health that result in poor outcomes for low-income postpartum women with mental illness.Item Barriers in Seeking Treatment for Perinatal Depression in Low-Income African Americans: A Systematic Review [poster](2022-12) Basa, Jessica; Garcia, TheresaIntroduction: Perinatal depression is a mood disorder that can occur during pregnancy and within four weeks of childbirth. Individuals at the greatest risk for perinatal depression include low-income African American and Hispanic women. African American women are least likely to seek psychiatric treatments for perinatal depression. Current literature presents conflicting findings as to the existence of racial and ethnic differences in screening and treatment for perinatal depression. This systematic review aimed to summarize and categorize the barriers faced by low-income, pregnant Black/African American women that discourages treatment engagement for depression. Methods: The author abstracted evidence from articles published between 2008 and 2021 from CINAHL, PubMed, and ScienceDirect electronic databases and ancestry search strategy. Papers eligible for inclusion included: full-text, peer-reviewed studies, and a focus on the barriers for low-income, pregnant African Americans in seeking treatment for depression. Quality assessment was conducted, using Melnyk and Fineout-Overholt’s Rapid Critical Appraisal Checklists. Results: Of 8,715 papers identified, 7 studies met the inclusion criteria. Common themes were 1) avoidance of psychiatric medications with greater preference for faith-based interventions and 2) time constraints and costs as significant barriers to treatment for perinatal depression in this population. Discussion: The results suggest the need to include faith-based approaches to appeal more to African American women, ask more culturally sensitive questions, integrate mental health services in obstetric clinics, and offer virtual appointments and/or options for mothers to bring their children for easier convenience.Item Bedside Educational Tool: Improving Patient Education and Nursing Documentation [poster](2019-12) David, Katie; Dolan, Diana; Willson, PamelaBackground: The aim of the Bedside Education Tool (BET) project was to increase patient discharge knowledge by expanding Krames© Patient Education (Krames) selections recorded in the Electronic Health Record (EHR). Methods: A descriptive pre- post-comparison evidence-based improvement project was undertaken to determine if cueing with a collaborative patient point-of-care educational tool facilitated nurse-patient education and discharge documentation. Three instruments were used: 1) BET Sheet, 2) Nurse Usability and Usefulness Survey, and 3) the patients EHR Discharge Record education section. Nursing staff were educated regarding documentation of Krames selections in the EHR. EHR record audits (N=230) were reviewed; 101 pre-implementation records and 129 post-implementation records. Results: Nurses on the selected medical-surgical unit, (N=37, 90.24%) participated in the BET project after education. BET project HealthStream education was completed. EHR Krames documentation increased 153% and the number of Krames items selected per patient increased 229% after the BET implementation. Conclusion: In hospitalized patients, the introduction of a patient-nurse bedside education collaborative tool (BET) increased collaborative patient-centered education and Krames education selections recorded in the EHR discharge plan.Item Behavioral Cuing: Improving Hospital Visitor Hand Hygiene Behaviors [poster](2019-05) Sumner, LaurenBackground: Visitors hand hygiene (VHH) prior to entering intensive care (ICU), telemetry, and intermediate care units is crucial in preventing spread of infections. During the influenza 2018-2019 outbreak, 50% of units' population tested positive for the influenza viruses; adding to the hospital acquired infection rates of the three units. An Agent-Based Model of infection spread approach was used with the goal of preventing infection transmission by hospital visitors in three high risk care units. Specifically, a visitor low dose educational intervention consisting of visual static and verbal cuing was undertaken to improve VHH behavior. Method: A four-week, pre-post-observational design (N=635) was completed by trained observers during day and nigh shifts for a large tertiary hospital to determine VHH rates. Strategies of visual static cuing included educational posters and patient door signage and verbal cuing to wash and/or sanitize hands by health care workers. Results: VHH adherence for the ICU was very low at baseline; out of 228 consecutive observations 20% (n=46) adherence was found. After behavioral cuing intervention, 407 observations resulted in 42% adherence to hand washing behaviors. Conclusion: Low does educational cuing strategies increased VHH behaviors. However, additional public education is needed to decrease infection spread from community sources.Item Early Steps, Lasting Impact: Enhancing Autism Screening Guidelines for Early Interventions [poster](2023-12) Torres, AmberThe purpose of this project is to encourage providers to conduct advanced screening for children who are at high risk or who they suspect may have ASD but don’t meet the full criteria for diagnosis to facilitate the earliest interventions.Item Education of Hypertensive Young Adults to Improve Health Habits [poster](2023-12) Martin, BreenaThe purpose of this systematic review is to determine if providing e-health education to young adults will promote lifelong health habit changes that reduce high-risk disease complications associated with hypertension.Item Effectiveness of Prolonged Exposure Therapy vs. Cognitive Processing Therapy in Veterans with Post-Traumatic Stress Disorder [poster](2023-12) Crook, RavenThis systematic review investigates the comparative effectiveness of two evidence-based trauma-focused psychotherapies: Prolonged Exposure Therapy (PE) and Cognitive Processing Therapy (CPT). Specifically tailored for veterans battling PTSD, these therapies aim to address the deep and lasting consequences of trauma, with the overarching goal of improving patient outcomes.Item Effects of Delayed Antibiotic Prescribing vs. Immediate or No Antibiotic for URI's in Primary Care: A Systematic Review [poster](2022-12) Duong, Lanh T.; Garcia, TheresaIntroduction: Delayed antibiotic prescription (DAP) is an evidence-based intervention to fight the global issue of antibiotic resistance. Evidence of its benefits for treating respiratory tract infections (RTIs) have long existed in literature but never fully accepted. This paper’s purpose is to evaluate new evidence and the overall effects of DAP on patients with upper respiratory infections in the primary care practice. Methods: This systematic review of the literature was guided by the PARIHS model to investigate patient outcomes and satisfaction rates with delayed antibiotic prescription compared to immediate and no prescription when treating RTI symptoms. JSTOR Journals, Health Source, OVID, CINAHL, Cochrane, PubMed, and MEDLINE were databases used in gathering the literature. Articles were screened with an inclusion criterion. A Rapid Critical Appraisal Tool was used to score articles on its relevance and validity to answer the PICOT question. Articles’ quality appraisal score of less than four were excluded from this review. Scores are illustrated in the Evidence Synthesis Table. Results: Five randomized controlled trials and three cohort studies were analyzed. Study findings overall revealed that DAP reduces antibiotic use, and no significant difference was seen in symptom severity through all prescribing approaches. Interestingly, only two of the three studies found that DAP is related to higher patient satisfaction. Discussion: DAP can be used safely in most patients with acute RTIs. However, more research is needed in the United States to give a better generalizability to the population.Item Effects of Gender-Affirming Care on Depression and Suicidality in Transgender and Gender Non-Conforming Youth: A Systematic Review [poster](2022-12) Medic, Lejla; Garcia, TheresaDue to the increased burden of depression and suicidality carried by the transgender and gender non-conforming youth population, legislative patterns limiting gender-affirming care, and recent increase in primary research on gender-affirming care in youth, a systematic review was conducted to address these trends. This review, guided by the Perceived Chronic Social Adversity Theory, began by searching databases PubMed, CINAHL, and Ovid Medline for full text, peer reviewed articles on the topic published between 2017 and 2022. Utilizing the Newcastle-Ottawa Scale, only studies with a score of 7 and above, indicating high quality, were included. An evidence synthesis table was used to extract pertinent information from the included articles. Data analysis was conducted to find overarching themes between the intervention, gender-affirming care, and the measured outcomes, depression and suicidality, in transgender and gender non-conforming youth. Two themes were synthesized from the evidence: gender-affirming care is associated with decreased depressive symptoms/suicidality and support of gender identity is associated with less psychological distress. Based on these findings, healthcare providers should educate legislators as well as the community of this evidence, oppose bills that limit healthcare access, oppose bills that increase social adversity among this population, and support the use of the evidence-based guidelines already published by numerous professional medical organizations.Item Effects of Pharmacist Intervention on Medication Adherence [poster](2023-12) Fulk, MelanieMedication adherence is a complex healthcare issues with many variables. The purpose of this systematic review is to determine if involvement of pharmacists in medication adherence interventions will improve adherence and patient outcomes. The conceptual framework used to help guide this project is Albert Bandura’s self-efficacy theory. Self-efficacy is a person’s belief in their own ability to achieve a goal or task. This theory was used because self-efficacy is important to goal setting and motivation. Motivation and goal setting are important parts of changing behavior and those who are nonadherent with their medications would benefit from behavior changes to improve their adherence to medications and improving their health.Item Emergency Department Triage Protocols: Improving Length of Stay for the Low Acuity Patient(2023-05) Daemen, CynthiaEmergency Department (ED) overcrowding has been linked to a 45% increase in mortality, a 75% increase in poor quality of patient care, and 100% of patients reporting their condition was much worse (Badr et al., 2022). The purpose of this quality improvement project was to identify a way to improve (ED) length of stay (LOS) for low acuity patients. The triage area was identified as an area that could be changed and is the initial location for patients seeking care in the ED. A patient’s LOS can be affected by several factors such as, number of patients in the department, ED admission holds, and staffing census. The purpose of this quality improvement project was to decrease LOS for Emergency Severity Index (ESI) level IV & V patients in this Level II 48 bed trauma facility by implementing an educational initiative for ED nurses to increase the use of existing triage protocols.Item Evaluating the Effectiveness of the Personal Diabetes Questionnaire in the Primary Care Setting [poster](2019-05) Wisco, Carolyn; Urbanosky, Staci; Fisher, RogerType 2 diabetes mellitus (T2DM) is a chronic illness managed daily by patients themselves. Poorly controlled diabetes is associated with micro- and macrovascular complications leading to increased morbidity. The Personal Diabetes Questionnaire (PDQ) is a reliable and valid tool that has not been tested in primary care and provides a comprehensive evaluation of knowledge, perceived barriers, and motivational aspects in T2DM self-management. The study aims were to evaluate T2DM self-management of patients in primary care as measured by the PDQ and explore the relationships between perceived barriers and readiness to change and patient self-reported glycated hemoglobin values (HbA1c). A cross-sectional, pilot study was conducted in a convenience sample from south central Texas, N=11. The PDQ assesses four behavioral domains by 13 subscales: blood glucose control, diet, medications, and physical activity. The SPSS software was used for statistical analysis and correlation coefficient techniques were applied to determine significant associations between study variables. Overall, subscales demonstrated good internal consistency (Cronbach’s α=0.56-0.82). No statistically significant correlations existed between HbA1c and participant perceived barriers or readiness to change. Participants were reportedly preparing or actively trying to lose weight and perceived few barriers to completing self-care activities. While participants reported well managed diabetes, their self-management was suboptimal regarding diet behaviors, glucose monitoring, and physical activity. Participants reported optimal diabetes medication adherence. The PDQ remains a valuable tool that can be used by primary care providers to facilitate optimal, patient-centered self-management evaluation and education and minimize diabetes complications.Item Hourly Rounding Protocol Quality Improvement Initiative to Decrease Call Light Usage and Increase HCAHPS in an LTACH Facility [poster](2023-05) Schultz, DanielleThe purpose of this quality improvement project was to describe an acute care facility’s change in process implementing an hourly rounding initiative to increase patient satisfaction and potentially increase patient safety.Item Implementation of a Quality Incident Review Team: Effects on Reporting and Resolution [poster](2019-12) Burgoon, CourtneyBackground: Incident reporting systems (IRS) are used for gathering data to improve knowledge and decrease errors in the hospital. There is an established need for reporting, with available research focused on patient safety culture, barriers to reporting. Process improvement methods to increase incident reporting, and follow-up for of incidents is lacking in literature. Method: In April, an Interdisciplinary Quality Incident Review Team (QIRT) was implemented. The QIRT, involved education of staff and managers, incident assignment, and follow-up for resolution. Three measurement times were (1) Baseline (pre-implementation –January through March 2019), (2) 3-month post-implementation data (April through June 2019), and (3) 6-months post-implementation. Results: Implementation of the QIRT and associated interventions resulted in an increase in overall reporting of patient safety incidents. During the implementation measurement period, there was a 29% increase over the pre-implementation period, and a 37% increase during the post-implementation period. Nursing incidents had the largest decrease in resolution days to an average of 11 in the post-implementation period. Conclusions: Implementation of the QIRT, increased incident reporting in all areas. Nursing incidents showed the only significant decrease in resolution time. Limitations included involvement of leadership in morning huddles, and knowledge of new leaders in use of the IRS, may have impacted the ability for some managers to complete their incidents.Item Implementing a Specialty Nurse Residency Program to Improve Perianesthesia Nurse Confidence and Reduce Errors [poster](2021-12) Eich, Rhiannon; Garcia, TheresaMedical errors are the third most common cause of death in the United States (Markary & Daniel, 2016) and cost society approximately $20 billion a year (Rodziewicz et al., 2021). The purpose of this quality improvement (QI) project was to increase new perianesthesia nurse residents’ confidence levels in preparing patients for surgery and to decrease surgical delays related to perioperative nursing care, in an acute care hospital in Austin, Texas, through a perianesthesia-specific nurse residency program.Item Implementing a Standardized Education Protocol to Improve the Blood Culture Collection Process in a Rural Hospital Setting [poster](2023-12) Heredia, Edward R.The primary purpose of this quality improvement project was to correct the knowledge deficit and improve compliance regarding the identified inconsistencies in the current improper blood culture collection process by implementing a standardized education protocol to improve the blood culture collection process at Crane Memorial Hospital. The quality improvement project consisted of two aims: 1. To evaluate and correct the existing knowledge deficit related to the improper blood culture collection process. 2. To study the effectiveness of an evidence-based standardized education protocol to improve the blood culture collection process.Item Improving Newborn Car Seat Safety Before Hospital Discharge [poster](2019-05) Mowry, ShelbyBackground: A significant cause of infant and childhood injuries and mortality is motor vehicle accidents. Assessment and remediation studies have determined there are many common errors parents make regarding positioning of a newborn in a car safety seat (CSS). A multi-phased project was undertaken to determined CSS misuse rates at baseline and after implementing newborn CSS positioning educational strategies among parent/newborn dyads at a large urban 60-bed postpartum unit. Method: A 12 registered nurse trained quality improvement team using a 7-point checklist, based on positioning recommendations from the American Academy of Pediatrics, conducted dyad assessments at baseline and phase I (N=192). In phase I, a step-by-step CSS positioning educational pamphlet was added to mothers’ discharge teaching. In phase II, a CSS positioning YouTube demonstration video was designed, developed and evaluated by registered nurses working in the field of maternal-child health. Phase II data collection metrics included website viewing and educational tool evaluation of the CSS parental video in continuation of the Plan-Do-Study-Act process. Results: At baseline CSS 7-point criteria was met by few (n=20; 20.8%) dyads with most dyads (n=76) demonstrating one or more positioning errors. Shoulder-strap misalignment was the highest criteria missed. After education, CSS criteria was met by 67 (69.8%) dyads. For phase II, all of the nurse evaluators considered both tools useful and would welcome both types of CSS education on the unit. Conclusion: CSS positioning education at the point of care supports parent safety behaviors.
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