Doctor of Nursing Practice

Title: Does the Use of Technology Assist Parents to Increase the Sun Protective Behaviors for their Children?
Description: This analytic observational study was undertaken to determine if the use of technology, specifically a SPOT UV indicator™ would have any effect or assist parents of children aged 5-7 years old to increase the sun protective behaviors for their children, including sunscreen application, seeking shade, sun avoidance, and wearing skin covering clothing. Recruitment of adults was made by public announcement through local online news resources, email notification of students at regional universities and staff at two local hospitals and the partnership with one Northwest Pennsylvania School District who agreed to publicize the voluntary opportunity for participation through their district resources. After obtaining informed consent from the adult, each adult completed a baseline sun habit survey and received a diary to document the sun protective behaviors of their child aged 5-7 over a four-day period. All adult participants received structured sun protective education defining sun protective behaviors and risks of skin cancer via a voice over power point presentation. Participants were divided into three groups based on the day they agreed to participate in the study. Group One received the sun habit survey, a sun exposure diary and sun protective education after the diary was complete and submitted. Group Two received the sun habit survey, a sun exposure diary and sun protective education at the time of enrollment. Group Three received the sun habit survey, a sun exposure diary, sun protective education at the time of enrollment and a packet of SPOT UV indicator™ to be worn by the child participant each day during the study with instructions on how to use. Data was obtained from the sun habit survey and diary entries. Inclusion criteria involved one parent with a child aged 5-7 years old, resident of North Western Pennsylvania, willingness to provide a minimum SPF 30 sunscreen for self-use in the study and a commitment to keep a 4-day, daily entry self-reported diary of behaviors. Exclusion criteria included parent or family member being treated for skin cancer, non-English speaking, plans to be away from home during study timeframe and allergy to sunscreen.
subject: sun protective behavior
technology
spot UV indicator

Title: Does viewing an educational documentary about HPV disease and vaccination on a college campus in rural Northwest PA: improve the knowledge level of HPV disease and vaccine among attendees of the program?
Description: Human Papillomavirus (HPV) is the most common sexually transmitted infection causing cervical, oropharyngeal cancers and genital warts. In the United States (U.S.), it is estimated that one in four individuals are infected, with an additional 14 million new cases of HPV infections occurring annually. HPV contributes to 17,600 cancers in women and 9,300 cancers in men annually. HPV vaccine is the most effective way to protect against HPV related cancers. However, there is a lag in HPV vaccination due to barriers such as: health care providers hesitancy to promote the HPV vaccine, low baseline knowledge of HPV and HPV vaccine, safety concerns, cost and system barriers. Studies show that there is low overall knowledge of baseline HPV and HPV vaccine among college students. The purpose of this study is to determine if an educational video intervention increases baseline knowledge of HPV and HPV vaccine in the attendees on a college campus in Northwestern Pennsylvania. To test this, a study design consisting of an educational session that utilizes an HPV educational video, followed by a brief question and answer session was developed. A questionnaire is implemented pre- and post-intervention to analyze HPV knowledge in participants. There were 22 participants who completed the study. Comparison analysis between the pre- and post-knowledge assessments show statistically significant improvement of results after viewing the educational documentary on HPV. The likelihood of getting a perfect score on the assessment increased by 13.7%, equating to a 70 percent reduction of incorrect answers from viewing the educational video. Does viewing an educational documentary about HPV disease and vaccination on a college campus in rural Northwest PA improve the knowledge level of HPV disease and vaccine among attendees of the program?
subject: HPV disease
HPV vaccine
HPV knowledge
educational videos
documentaries

Title: Eating Disorder Screening via Electronic Medical Record
Description: This study examined whether use of an electronic medical record (EMR) to prompt screening of eating disorder risk among a college female population improved identification of risk for the disease. Data were obtained via a convenience sample of patients accessing a university health service gynecology clinic. The SCOFF tool is a well-validated 5-item questionnaire with sensitivity of up to 87.5% and specificity of 95% for bulimia nervosa and anorexia nervosa. Clinicians were prompted by EMR to administer the tool to all gynecology patients seeking care not related to eating disorder symptoms. A comparison of positive identification of eating disorder risk from the previous year, during the same time frame when EMR prompt was not embedded, was conducted via an EMR data search. Results show a relationship between eating disorder risk identification and EMR prompt (p = .0047). The study concludes that ease of use of the SCOFF tool combined with the EMR prompt improves screening for eating disorders in the college health setting.
subject: college students
screening
college health
primary care
eating disorders

Title: The effect of an escape room teaching intervention for new clinical nurses learning about CLABSI, CAUTHI, HAPI: and falls in an acute care facility,
subject: Nursing
Health education (Higher)
Escape room games

Title: The Effect of An Escape Room Teaching Intervention For New Clinical Nurses Learning About CLABSI, CAUTHI, HAPI, and Falls in an Acute Care Facility
Description: Hospital acquired conditions such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infection (CAUTI), hospital acquired pressure injury (HAPI), and falls can be very costly to the hospital and detrimental to the patient. Collectively, these avoidable conditions have been shown to impact the facilities that fail to prevent them and the patients that experience them. This research focused on the questions: Does adding an escape room simulation that covers the four quality initiative measures: CLABSI, CAUTI, HAPI, and falls, affect knowledge on prevention measures for new graduate nurses, and, what is the perception of new graduate nurses toward the escape room educational intervention? An escape room was created and participants completed a pretest, post-test and post activity survey. The study, showed that the nurses’ knowledge did improve by completing the escape room activity and the participants would like to see more educational opportunities presented in this format. Further research could include reviewing a short power point that reviews the hospitals preventative measures they have in place to reduce CAUTI, CLABSI, HAPI and falls before completing the escape room activity with staff and taking the time to review the activities with the participants that they weren’t able to complete in the allotted time., Copyrights are retained by Tamila Salisbury.
subject: Nursing
Escape room games
Health education (Higher)

Title: The Effect of Participation in a Dementia Simulation on Participant Empathy
Description: The purpose of this study was to establish if participants in the Dementia Live® simulation would experience changes in empathy. It is estimated that 5.7 million Americans have Alzheimer's disease, which is the most common form of dementia (Alzheimer's Association facts and figures, 2018). The majority of individuals diagnosed with Alzheimer's disease are over the age of 65 and the incidence increases moderately with age (Alzheimer's Association, n.d.). It is estimated that 50% of people over the age of 85 have some form of dementia (Touhy and Jett, 2016). It is also estimated that 50% of people living in assisted living or long term care facilities have some form of dementia. Research indicates that many dementia care workers lack the skills necessary to respond to dementia related behaviors due to a lack of dementia specific training (Gaugler, Hobday, Robbins, and Barclay 2016). Empathy is often thought of as an essential component of a nurse’s character and is relevant to the delivery of nursing care (Digby, 2016). It is important for the staff to understand what life is like for the person living with dementia. By developing a better understanding of what it is like to live with dementia, the staff can make changes to the care they provide and develop a better understanding of the thoughts and emotions a person living with dementia experiences. It is essential that healthcare professionals understand the uniqueness of dementia as a disease, and how to provide care to persons living with the disease. Enhancing empathy can help the staff understand the fact that the psychological care provided is just as important as the physical care (Pulsford, Duxbuy, and Carter, 2016). Higher levels of empathy have also been found to decrease staff burnout and can improve the staff patient relationship (Wagaman, Geiger,Shockley, and Segal, 2015). The Jefferson Scale of Empathy HP version was administered prior to completion of the simulation. Participants then took part in the simulated experience and complete the Jefferson Scale of Empathy HP immediately after completing the simulation. Pretest and posttest scores were evaluated.
subject: empathy
simulations
Alzheimer's Disease
dementia

Title: The Effect of Participation in a Dementia Simulation on Participants Empathy
Description: Daniel Eaton presents key findings for the dissertation titled, "The Effect of Participation in a Dementia Simulation on Participants Empathy."
subject: dementia
Alzheimer's disease
simulations
empathy

Title: The effect of peer support on treatment engagement in clients with opioid use disorder
Description: Opioid misuse has been a growing concern that has escalated to a public health emergency. Despite substance use programs that offer assistance in the treatment of opioid use disorder (OUD), keeping the client engaged in recovery treatment can be very challenging. Relapse prevention is a priority concern due to the higher risk of overdose following a period of sobriety. The use of Certified Peer Specialists to facilitate client engagement in treatment programs has proven to be beneficial and their role in helping individuals remain in recovery treatment is explored using the theoretical framework of Modeling and Role-modeling. The purpose of this research is to establish whether a peer support program provided by an outpatient facility was effective in achieving client engagement in recovery treatment. Data collected by the facility on client treatment encounters spanning six months was analyzed. Data sets related to individuals enrolled in a certified recovery services (CRS) program versus individuals engaged in treatment as usual were compared. Statistical analysis using the t test revealed greater engagement in recovery services among those enrolled in the CRS program. The findings support the benefit of a peer recovery service program as an option to encourage treatment engagement in clients with OUD. This research will be of value in the design and development of future program policy and treatment guidelines., Copyrights are retained by Michelle Zuccarini.
subject: Nursing
Drug addiction
Treatment
Opioid abuse
Behavior, Addictive
Substance-related Disorders

Title: Evaluating an Educational Intervention's Effectiveness in Reducing Stigma and Negative Attitudes of Registered Nurses Toward Persons with Alcohol Use Disorder.
Description: Alcohol Use Disorder (AUD) is a chronic medical condition characterized by an impaired ability to control or stop the use of alcohol, despite the adverse social, occupational, and health consequences (APA, 2013; Witkiewicz, Litten & Leggio, 2019). The purpose of this study was to identify the presence of stigma and perceived negative attitudes of nurses working with patients diagnosed with AUD in all areas of practice, with the aim of decreasing stigma and enhancing positive attitudes in nurses caring for patients with AUD through an educational intervention. The literature is well established that nurses feel unprepared educationally to care for patients with AUD, and also hold negative attitudes and perceptions of working with patients with AUD (Haskins, et. al, 2014). This research will conduct a pre-and post-survey of registered nurses’ attitudes and perceived stigma followed by an educational intervention to evaluate whether the education is a positive critical element that can help to reduce stigma and improve negative attitudes nurses may hold toward caring for patients with AUD. This research is a quality improvement project to collect and use data that is meant to drive change that has practice and policy changing implications. The Seaman-Mannello Survey was used as a pre-and post-survey to measure the efficacy of the interventional education video. A convenience sampling of 76 registered nurses from three Northwestern Pennsylvania hospitals was used. The goal of this research study was to investigate the effectiveness of an educational intervention that, if significantly effective, can be used on a larger scale to decrease stigma and improve attitudes of nurses toward patients with AUD. The results found no significant relationship between the provided educational intervention and reduced stigma or improved attitudes of nurses while working with patients with AUD. Although a positive relationship could not be established, it was inferred from the pre-and post-survey scores, ongoing education is still needed and may impact the care of individuals with AUD., Copyrights are retained by the author. Please contact Jennifer Peterson for further use of this material.
subject: Nursing
Educational evaluation
Alcohol use
Alcoholism

Title: Evaluating the financial impact of a heart failure transitional care program
Description: Background: Heart failure (HF) readmissions are incredibly burdensome to hospitals across the country. In 2020, approximately $563 million in penalties from the Center for Medicaid and Medicare Services (CMS) were assigned based on higher than average admission rates (Allen, 2019) with a significant portion related to HF. Our facility has consistently had readmission rates higher than the CMS national benchmark. This is both detrimental to our patients and the cause of assessed yearly CMS reimbursement penalties, which significantly impacts payment for care delivered. There has historically been a very incomplete and disjointed care transition post-discharge for our HF population. Methods: The Transitional Heart Failure Program was designed to target gaps in care and decrease readmissions through comprehensive, holistic transitional care interventions. Financial data were pulled and comparatives reviewed between the 3rd quarters of 2019 and 2020 to determine correlations between financial data and improvements in care delivery. Results: Productivity data were obtained and analyzed to determine differences in volumes and work RVUs (wRVUs) for Advanced Practice Providers (APPs) designated to provide post-discharge and HF care in the outpatient setting. CMS reimbursement penalties were analyzed and compared year over year, and future penalties were extrapolated based on available information. APP wRVUs were positively impacted by the program implementation and reimbursement penalties are projected to decline substantially based on readmission rate improvements. Conclusions: Ongoing evaluation would be beneficial to determine the long-term impact of the HF discharge program, but data suggests that there is a significant financial benefit to continuing current efforts., Copyrights are retained by the author. Please contact Bonnie Nye for further use of this material.
subject: Hospital -- Prospective payment
Heart failure
Transitional care
Nursing
Home care services -- Prospective payment

Title: Identifying adverse outcomes from insufficient sleep in the hospitalized non-critical older adult population:: A systematic review.
Description: Laura Liggett defends the dissertation "Identifying adverse outcomes from insufficient sleep in the hospitalized non-critical older adult population." (Voice over Power Point)., Copyright is retained by the author. Contact Laura Liggett for further use of this material.
subject: Sleep deprivation
Side effects
Hospital care

Title: Identifying adverse outcomes from insufficient sleep in the hospitalized non-critical older adult population:: A systematic review.
Description: On average, humans spend one-third of their lives fulfilling basic sleep needs (Cirelli, 2019). Theories suggest that sleep improves immune responses, reduces energy, allows for the recuperation of cognitive functions, and removal of waste; however, the exact function is unknown (Zielinski, McKenna & McCarley, 2016). Research has revealed when sleep is chronically disrupted the individual experiences a reduction in their quality of life, an increased risk for mortality as well as cerebrovascular and cardiovascular events (Chattu, Sakhamuri, Kumar, Spence BaHammam & Pandi-Perumal, 2018). Ever changing variables that affect sleep in the hospital setting have created a need to ask the question, what happens when such disruptions occur in an environment like the hospital? Therefore, the primary purpose of this study was to identify adverse outcomes associated with insufficient sleep experienced by hospitalized non-critical older adults in literature., Copyright is retained by the author. Please contact Laura Liggett for future use of this material.
subject: Sleep deprivation
Older people
Hospital care
Side effects

Title: Improving Clinic Attendance Through Text Message Reminders To Homeless Patients With Chronic Health Conditions
Description: Judith Foyabo presents research for the dissertation titled, "Improving Clinic Attendance Through Text Message Reminders To Homeless Patients With Chronic Health Conditions.", Copyright is retained by the authors. Please contact the authors for further use of this material.
subject: homelessness
clinic attendance
missed appointments
no-shows
text message
short message service
SMS
appointments

Title: Improving Clinic Attendance Through Text Message Reminders To Homeless Patients With Chronic Health Conditions
Description: Background: Homeless people with chronic disorders need routine follow up to control chronic diseases and prevent exacerbations. Returning to the clinic for appointments or other interdisciplinary collaboration without a reminder is challenging. An intervention that involves automatic text message reminders could increase the return to the clinic for follow-ups, minimize ‘no shows’, and improve the overall health of homeless people with chronic diseases. Research question: What is the effect of text message reminders on clinic attendance for homeless patients who attend two Los Angeles Christian Health Centers (LACHC) clinics in Los Angeles, California. Objective: The objective of this study is to determine the effectiveness of short message service (SMS) for healthcare appointments to increase clinic follow-up attendance of homeless people in these two clinics Methods: This was a pilot study using a quasi-experiment designed to measure clinic attendance after the initiation of SMS reminders for clinic visits. The study evaluated the impact of text message reminders to homeless patients by using pre/post testing design. All patients visiting the LACHC clinics during a 3-month time period were included in the sample if they had a functional mobile phone. A text-messaging intervention process enabled from the electronic health record (EHR) called eClinical Works (eCW) was used to send out two text message reminders. The study compared homeless patient clinic attendance before and after the implementation of text message reminders for follow-up appointment. Results: The no-show rate reduced from 31.6% to 21.6%, a 10% reduction in one clinic (goal met) and the no-show rate went up from 10.8% to 22.8% (a 12 % increase) in the other clinic (goal not met). However, combining both sites the no-show rate reduced from 22.6% to 16.5%: 6% reduction. Overall attendance in the two clinics increased by 46%, p< .000 more in 2019 than in 2018. No significant difference in attendance between males and females. Conclusion: The SMS text reminders significantly increased the follow-up attendance and reduction in no-show rates. Cutting down on the number of clinic absences and improving clinic attendance through text messaging could increase health care access for the homeless. This may eventually increase continuity of care, reduce complications from chronic illnesses, improve medication compliance, and lower healthcare cost., Copyright is retained by the authors. Please contact the authors for future use of this material.
subject: homelessness
missed appointments
no-shows
text message
short message service
SMS
clinic attendance
appointment

Title: Improving mental health recovery following crisis on a college campus through policy development
subject: Mental health

Title: Improving mental health recovery following crisis on a college campus through policy development
Description: Crisis events, both manmade and natural, could materialize at any time on the campus of a higher education institution, and often have a detrimental impact to the mental health of those experiencing the event. There is already a high prevalence in mental health disorders in college-age individuals and crisis events can often precipitate immediate and long-lasting effects to mental health regardless of an individual’s mental state. Educational institutions have a duty to develop comprehensive crisis management plans that address safety of mental health, as well as physiological, before, during, and after crisis events., Copyrights are retained by the author. Please contact Andrea Chelton for further use of this material.
subject: Mental health
Crisis intervention (Mental health services)
Mental health policy
Education, Higher

Title: Improving Parental Monitoring of Social Media Behaviors to Reduce Negative Health Outcomes: Dissertation Defense
Description: Jennifer Sheaffer provides a defense presentation for the dissertation "Improving Parental Monitoring of Social Media Behaviors to Reduce Negative Health Outcomes.", Copyrights for this presentation are retained by the presenter. Please contact Jennifer Sheaffer for further use of this material.
subject: Nursing
Health sciences
Adolescence
Parental monitoring
Social media
Cyberbullying

Title: Improving Parental Monitoring of Social Media Behaviors to Reduce Negative Health Outcomes
Description: Social media plays a significant part in the lives of many teens. Inappropriate use of social media can cause negative consequences. Studies show that cyber-bullying, lack of family interaction, lower self-esteem and depression are among these consequences. Unfortunately, studies also show that many parents lack the knowledge to monitor their children’s social media use., Copyrights are retained by the author. Please contact Jennifer Sheaffer for further use of this material.
subject: Nursing
Health sciences
Adolescence
Parental monitoring
Social media
Cyberbullying

Title: Incidence of Clostiridum Difficile Infection in Skilled Nursing Facility Residents Treated with Antibiotics Compared to Treatment with Antibiotics and Probiotics
Description: Clostridium difficile is a microbe that may cause a severe intestinal infection in vulnerable individuals such as those who are ill and taking antibiotics, or the elderly living in skilled care facilities. Use of probiotic supplements have shown in some studies to decrease the incidence of Clostridium difficile infection (CDI). Does the use of probiotic supplements in residents of a skilled nursing facility in western Pennsylvania receiving antibiotic therapy reduce the incidence of CDI? This retrospective study reviewed electronic medical records of 164 residents in a skilled nursing facility, including residents receiving antibiotics, and those receiving antibiotics and probiotics. Limitations included the size of the study sample, the age and condition of the patient including possible previous CDI history, and the time frame of transposition of laboratory analysis results to the electronic medical record. Results revealed a statistically significant difference in the rate of antibiotic-related diarrhea between patients receiving antibiotics and those receiving antibiotic therapy with probiotic supplements. In this study, no patients receiving probiotics and antibiotics were positively diagnosed by laboratory analysis with CDI. This study indicates the need for further studies related to use of probiotic supplements in patients receiving antibiotic therapy., Robin Sue Bilan, 2019.
subject: Clostridium difficile infection
Probiotics
Diarrhea

Title: Increasing HCV Screening Utilizing Electronic Medical Records in a Family Practice Setting
Description: James Condon presents on research for the dissertation titled, "Increasing HCV Screening Utilizing Electronic Medical Records in a Family Practice Setting"
subject: Hepatitis C
Centers for Disease Control and Prevention
CDC
infectious disease
family practice
baby boomers

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