Implementing a D/Deaf Educational Module for Graduate Nursing Students

Pauley, Brenda J ProQuest Dissertations & Theses University of Miss 2022 해외박사(DDOD)

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums. Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a modified version of Greene and Scott’s (2021) and Ruesch’s (2018) published instruments. Additionally, the post-education survey included two Likert questions to rate the education and its inclusion in the graduate curriculum. Results: Students’ mean pre-education knowledge score (71%) was below Ruesch’s (2018) 75% benchmark score, indicating a need for educational intervention. A statistically significant increase in students’ D/deaf perception and knowledge scores were seen after completing the D/deaf focused educational online module (p <.001 for both measures). The majority of the students (n=35) agreed the online module was helpful, and all recommended including the module into the graduate curriculum. Implications for Practice: The D/deaf-focused online module provided foundational education on how to effectively approach D/deaf individuals, and the results suggest the online module could be valuable for future graduate cohorts. Further research is needed to evaluate how successful students are in translating knowledge into clinical practice.

Screening for Social Determinants of Health in a Comprehensive Pediatric Sickle Cell Disease Clinic

Turner, Marie N ProQuest Dissertations & Theses University of Miss 2022 해외박사(DDOD)

Problem: Social determinants of health (SDOH) affect health outcomes across the lifespan. The American Academy of Pediatrics recommends routine screening for SDOH. Poverty is a SDOH affecting health outcomes in children, especially in children with a chronic disease such as sickle cell disease (SCD). Children with sickle cell disease have a high burden of SDOH. This project sought to describe the SDOH barriers experienced by pediatric patients with SCD.Methods: A descriptive survey/observational design, using a convenience sample of pediatric patients ages 0-19 years old in a comprehensive SCD clinic at a large, urban, Midwestern academic medical center was utilized for this project. The validated, self-reported, WE CARE screener, assessing eight domains of SDOH, was given to patients/families to fill out during a routine clinic visit. Any patient that endorsed one or more SDOH was given a community resource sheet with their After Visit Summaries (AVS). Data taken directly from these screeners was analyzed.Results: During the pilot period (February – April 2022), 102 (75%) of 136 eligible unique patients/families were screened. A large majority of patients, 83% (68), endorsed at least one or more needs; 17% (34) patients/families did not endorse any needs. The most frequent needs endorsed were food at 21%, followed by the desire for more education at 17% and difficulty paying utilities at 16%.Implications for Practice: Screening for SDOH should be universal/routine in comprehensive sub-specialty clinics that become medical homes for patients to allow for early referral and intervention to mitigate the effects of endorsed SDOH.

The Color of Conduct: a S.I.S.T.A.’S Tale of Race, Housing, and Higher Education

Gibson-Winston, Natasha' S ProQuest Dissertations & Theses University of Miss 2022 해외박사(DDOD)

S.I.S.T.A., suffering in silence to be acknowledged, is an acronym that symbolizes the hidden voices of Black women in higher education and abroad. This study examined the experiences of a graduate student woman of color impacted by university housing policies and practices as a judicial student conduct officer at a historically white institution. Using autoethnography as a methodology, grounded in critical race theory (CRT) as a theoretical framework, this qualitative study aims to highlight the ways Black women can and have been harmed in predominantly white spaces and processes within higher education. The application of the aforementioned frameworks found the major themes: (a) power vs. resistance, (b) shifting in the Black body, (c) humanizing Black students and staff, and (d) I AM MORE than melanin to be critical in uncovering Black women voices and moving the field of higher education forward.

Degree Completion of Underrepresented Minorities Majoring in Mathematics as a Function of Undergraduate Student Programs

Anthony, Marnice ProQuest Dissertations & Theses University of Miss 2020 해외박사(DDOD)

Students with disabilities, minorities, and women are underrepresented in the critical demand courses of study in Science, Technology, Engineering, and Mathematics (STEM) undergraduate college enrollment. Institutions of higher education in the United States of America are challenged with a continuous need for undergraduate students to choose and earn a STEM degree. The 2019 annual report of Women, Minorities, and Persons with Disabilities in Science and Engineering indicated these groups continue to be disproportionately underrepresented relative to the U.S. population. In 2014, the U.S. Department of Education reported that upon graduation students studying mathematics in college have higher employment rates and salaries as compared to other college majors. National, federal, state, nonprofit, and private programs aimed at increasing underrepresented minority (URM) undergraduate degree completion and integrating student involvement through delivery of targeted programs are active in trying to meet this demand for STEM college to career. A causal comparative quantitative research design was utilized to analyze the program and degree completion of African American students at colleges and universities seeking an undergraduate degree in mathematics. The researcher used Alexander W. Astin’s theory of student involvement (1984) to examine elements of program delivery. The analyses indicate a statistically significant finding for degree completion at the colleges and universities which completed proposals and were awarded funding to initiate a program. The results of the independent samples t-test p < 0.001 and a Hedges’ g large effect size = 0.8 suggests that colleges and universities advocate to access and implement the Historically Black Colleges and Universities Undergraduate Program to increase URM degree completion integrating as core the student involvement. Based on the results of the study, the future research of comparable programs for other underrepresented groups, such as students with disabilities and undergraduate majors, such as engineering are recommended.

The Mission System: An Electronic Health Record for Medical Treatment in Guatemala

Curry, Tawniece M ProQuest Dissertations & Theses University of Miss 2022 해외박사(DDOD)

Problem: The introduction of an electronic health record (EHR) system has become an essential component in monitoring and tracking patient information in most developed countries but are difficult to implement in underdeveloped countries. Guatemala is a country with poor health care and limited resources for patient tracking and monitoring. An organization in Guatemala, Nursing Heart Inc. (NHI), provides care to over 40 underserved rural communities but lacks the ability to monitor and track patient information. In order for NHI to properly monitor and evaluate their programs and track patients’ continuity of care, the introduction of an EHR system is necessary. Methods: A system development framework was used to help identify the elements necessary for successful EHR workflow development for NHI. Focused interviews were conducted using structured interview guides with questions targeted towards EHR system design from first-hand observation from volunteers and staff members. Results: All the participants agreed that an EHR system would benefit NHI and will provide the ability to monitor patient trends over time, but will need to be simple, and have the ability to use in areas with no Wi-Fi. Implications for Practice: Using the information obtained from the structured interview guides, first-hand observation, aggregate data from NHI, and IT considerations, a set of elements and data were identified, and a series of recommendations established for a more streamlined method of collecting patient data for NHI.

Impact of Meaningful Recognition on Work Environment Perception of Critical Care Nurses

Meinershagen, Kristin ProQuest Dissertations & Theses University of Miss 2020 해외박사(DDOD)

Problem: Absence of nursing staff recognition can lead to compassion fatigue, burnout, job dissatisfaction, and increased turnover rate resulting in high costs for hospitals. Meaningful recognition has been found to decrease compassion fatigue and reduce burnout. A meaningful recognition program was implemented over a 3-month period for staff nurses in an Intensive Care Unit (ICU) at a large midwestern, metropolitan hospital to determine its effect on nurse’s perception of work environment and turnover rate in the ICU.Methods: This was an observational, descriptive, cohort design utilizing the AACN Healthy Work Environment Survey instrument for assessing results before and after implementation of a 3-month meaningful recognition program. Results of the initial survey revealed that most nurses did not feel that they were receiving meaningful recognition in the workplace. Participants were 27 staff nurses (N=27). After implementation, the survey was re-distributed. Results: Staff turnover rates were tracked throughout the process. Pre and post intervention survey results were compared. Aggregate scores were lower on the post intervention survey; results for the meaningful recognition specific indicator were higher than on initial survey, although results weren’t statistically significant. Implications for Practice: Despite not being statistically significant, the meaningful recognition program did increase staff nurse’s awareness of meaningful recognition in the workplace. Staff turnover rates decreased during the 3-month study interval, although unrelated to program intervention based on minimal variations in the pre and post survey data.

Evaluation of an Education Program Implementation for Adults with Stage 4 and 5 Chronic Kidney Disease

Carter, Dana ProQuest Dissertations & Theses University of Miss 2022 해외박사(DDOD)

Problem: Patients with long-term medical conditions represent a significant public health issue. Therefore, patients diagnosed with a chronic illness must have a high level of health literacy (HL) to manage their condition effectively. This Quality Improvement (QI) project evaluated the impact of an existing education-based program for stage 4 and 5 chronic kidney disease (CKD) patients and its effect on laboratory values compared before and after an NP-led education program that included vascular access, and modality choices.Methods: A retrospective chart review was completed on 20 patients with an inclusive diagnosis of CKD stage 4 or 5 from October 21, 2019, through January 21, 2020, using a descriptive observational design and paired sample t-test analysis.Results: The paired sample t-test revealed only two laboratory results: globular filtration rate (GFR) (Pre) M=16.15, SD=3.86, (Post) M=10.35 SD=3.86 t (19)5.949, p=.000 and phosphorus level (Pre) M=4.161, SD=1.288, (Post) M=5.26, SD=1.293 t (19) 2.796, P=.012. showed a significant difference. All other remaining laboratory values did not reach a significant difference.Implications for Practice: QI project findings revealed improving HL slows the course of CKD and prepares patients for optimum dialysis start. Therefore, future dialysis population studies should include all nephrology services as part of their scope. Additionally, a comprehensive instructional program for all chronic kidney disease patients is needed, not only for those in stages 4 and 5.

Healthcare-Associated Pressure Injury Prevention in the Intensive Care Unit

Quinton, Ross ProQuest Dissertations & Theses University of Miss 2022 해외박사(DDOD)

Problem: Healthcare-associated pressure injuries (HAPIs) occur when prolonged pressure is on the sacrum, coccyx, elbows, and heels, during a hospital stay. HAPIs can result in increased morbidity and mortality, and prolonged hospital stays, which consequently requires excess expenditure on treatment. Early specialty mattress placement can prevent HAPI acquirement.Methods: This quality improvement (QI) pilot project aimed to increase specialty prevention mattress usage in the intensive care unit (ICU). A sleep surface decision tree was implemented into the admission process in a 30-bed ICU. A retrospective record review was used to examine demographics, comorbidities, HAPI risk, length of stay, and when patients were placed on specialty prevention mattress. Data collection was from June to August 2021, pre-implementation, and from September to November 2021, post-implementation using a z-score to examine proportional differences. Descriptive statistics identified differences and similarities between patients. Logistic regression correlated comorbidities and HAPI acquirements.Results: Patients were placed on a specialty prevention mattress within an average of 1.52 days resulting in a 50% reduction in HAPIs post-implementation. Each day there was an 8.38% risk for acquiring a HAPI which is statistically significant (p=0.006). The results of this project increased supply of specialty mattresses in the ICU, which increased early intervention and HAPI prevention. A sleep surface decision tree and early interventions can mitigate HAPI events.Implication to practice: A collective examination of all HAPI preventative methods for higher acuity patients (ventilator, continuous dialysis, and extracorporeal membranous oxygenation). A sleep surface decision tree consideration upon admission to the hospital.

We Eat, We Live, We Repeat: Reimagining Food Heritage through Foodways and Sustainable Food Practices in St. Louis

Tate Beaugard, Brittany ProQuest Dissertations & Theses University of Miss 2022 해외박사(DDOD)

The purpose of this co-authored, mixed methods descriptive research study was to examine how the intersection of foodways and sustainable food practices helps define the food heritages of St. Louis area residents. While prior research examines these concepts separately and even shows connections with other factors such as health and discrimination, none looks at all of these concepts together—a gap this research fills. To that end, this dissertation describes the intersection of cultural foodways and connection to sustainability in seeking a definition of food heritage and a path towards sustainable food heritage for St. Louis residents. Purposeful sampling using the Food Heritage and Sustainability Survey, completed by 621 St. Louis area residents, and interviews from 14 community leaders provided the dataset for this study. Survey results were analyzed using both univariate and multivariate statistical tests and interview transcripts were interpreted using thematic analysis. The quantitative results showed that an egoistic value orientation played a major role in how food heritage is defined. The qualitative results produced three major themes: Foodscapes and foodways are founded upon inequity, Food is about human connection, and Sustainable food practices help people reimagine their food heritage. When taken together, the quantitative and qualitative results both showed that actions surrounding sustainable food practices and awareness of foodways, including food injustices, were major contributors to St. Louis residents’ definition of food heritage. However, the qualitative and quantitative results differed in their conclusions of whether foodways influenced food heritage or vice versa. These results provide substantial material for future research, including a further examination into the connection between an egoistic value orientation and food heritage, and using heritage-aligned interventions to increase sustainable food practices.

We Eat, We Live, We Repeat: Reimagining Food Heritage Through Foodways and Sustainable Food Practices in St. Louis

Williams, Darius ProQuest Dissertations & Theses University of Miss 2022 해외박사(DDOD)

The purpose of this co-authored, mixed methods descriptive research study was to examine how the intersection of foodways and sustainable food practices helps define the food heritages of St. Louis area residents. While prior research examines these concepts separately, and even shows connections with other factors such as health and discrimination, none look at all of these concepts together—a gap this research fills. To that end, this dissertation describes the intersection of cultural foodways and connection to sustainability in seeking a definition of food heritage and a path towards sustainable food heritage for St. Louis residents. Purposeful sampling using the Food Heritage and Sustainability Survey, completed by 621 St. Louis area residents, and interviews from 14 community leaders provided the dataset for this study. Survey results were analyzed using both univariate and multivariate statistical tests and interview transcripts were interpreted using thematic analysis. The quantitative results showed that an egoistic value orientation played a major role in how food heritage is defined. The qualitative results produced three major themes: Foodscapes and foodways are founded upon inequity, Food is about human connection, and Sustainable food practices help people reimagine their food heritage. When taken together, the quantitative and qualitative results both showed that actions surrounding sustainable food practices and awareness of foodways, including food injustices, were major contributors to St. Louis residents’ definition of food heritage. However, the qualitative and quantitative results differed in their conclusions of whether foodways influenced food heritage or vice versa. These results provide substantial material for future research, including a further examination into the connection between an egoistic value orientation and food heritage, and using heritage-aligned interventions to increase sustainable food practices.