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- Member of: Barrett, The Honors College Thesis/Creative Project Collection
- Member of: Doctor of Nursing Practice (DNP) Final Projects
- Member of: The Tiktaalik Collection: Science in Transformation
Description
Aim: To investigate the feasibility and efficacy of mindfulness as an intervention in reducing burnout and promoting joy in work for progressive care unit (PCU) nurses and nursing aides. Background: The Institute for Healthcare Improvement (IHI) describes a lack of joy in work and the resultant burnout as a serious threat to healthcare workers and organizations. Few studies have examined this phenomenon in PCU nurses and aides. Method: Pre- and post-intervention surveys with established instruments on three variables, mindfulness, burnout, and joy in work, were administered to ten PCU nurses and aides (N = 7) at a city hospital. The intervention was the virtual IHI's mindfulness course and was guided by Martin Seligman's PERMA Model and the Iowa Model for Evidenced Based Practice. A paired sample t-test was used to evaluate changes in the pre-post survey responses. Results: Significant increase in joy in work based on an alpha value of 0.05, p = .041. Slight increase in mindfulness practice based on an alpha value of 0.05, p = .398. Burnout remained the same based on an alpha value of 0.05, p = .766. Conclusion: PCU nurses and aides who practiced mindfulness for 12 weeks scored the same on burnout scales and higher on the joy in work scales. Implications for Nursing Management: Nurse managers can incorporate mindfulness exercises at strategic times during the shift to reduce burnout and promote joy in work for nurses and aides. Future EBP projects should assess the effectiveness of different mindfulness activities in promoting nurses' emotional and psychological well-being in various care settings.
ContributorsImanatue, Loveline (Author) / Sanborn Heidi (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-24
Description
Healthcare organization leaders greatly rely on evidence-based practice (EBP) to guide the delivery of care and support clinical decisions on patient care. EBP is a process of assessing and implementing best evidence, patient values, and clinical expertise to make clinical decisions on patient care. Engagement in EBP is an opportunity to overcome the barriers that lead to poor patient and system outcomes. However, EBP implementation can be difficult due to barriers such as lack of time, lack of EBP knowledge, lack of leadership support, and difficulty accessing resources. Several studies support educational programs for nurses to strengthen EBP beliefs and implementation. The purpose of this project was to increase participation in EBP for nurses practicing at Mayo Clinic Arizona. The project involved planning for redesign of existing EBP courses along with new types of support and educational sessions. DNP students participated in the initiative through searching for and synthesizing evidence, collecting and analyzing survey data, and presenting recommendations for program development and outcome measurement to nursing leaders in the organization.
Keywords: evidence-based practice, hospital, nurses, engagement, continuing education
ContributorsVea, Davina; Espinosa, Gloria (Author) / Hagler, Debra (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Description
Introduction: Pre-exposure prophylaxis (PrEP) is a critical development in HIV prevention, yet females at risk of contracting HIV have lower rates of PrEP use compared to their male counterparts. Insufficient knowledge on PrEP indications for women has been a key barrier in health care providers (HCP) utilization of PrEP in this population. Prior research has revealed educational interventions improved providers’ use of PrEP in at risk populations.
Methods: A 1-hour, educational session was developed for eleven HCPs at a university-based clinic. The educational session was guided by the Cognitive Learning Theory and included information on clinical practice guidelines for PrEP implementation in women. The effects of the intervention were analyzed using a pre/post-survey design, with post surveys delivered at two and eight weeks. The 16-item survey evaluated outcomes including provider discussion and prescription rates of PrEP with female patients and perceived knowledge and perceptions of PrEP in women, utilizing a Likert scale. All procedures were given exempt status by the university IRB.
Results: Paired sample t tests were used to analyze provider reported conversations and prescription rates, while matched ordinal data were analyzed utilizing Wilcoxon signed rank tests and descriptive statistics. At two-weeks post intervention there was a significant increase in provider’s reported likelihood of prescribing to at risk cis gender females in the next six months (Mdn= 2 [pre-survey], Mdn = 3 [post-survey], α= 0.05, V = 0.00, z = -2.53, p = .011). At eight weeks postintervention, there was a statistically significant decrease in provider’s beliefs that HIV risk assessment was an essential component of a primary care visit for female patients (Mdn = 3.00 [pre], Mdn = 2.00 [eight-week], α= 0.05, V = 10.00, z = -2, p = .046). The results of the data analysis have been shared with the leadership team of the health clinic and used to inform future practice on provider educational sessions on PrEP.
Conclusion: Women at risk of contracting HIV are a key demographic missed for the utilization of PrEP. Limited statistically significant findings from the intervention have prompted further research to focus on interventions that promote long-term behavior change and improve providers implementation practices of the preventive measure in at-risk female identifying patients.
ContributorsSnyder, Emily (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Evaluating the Efficacy of Calcium Chloride versus Calcium Gluconate in ECMO Initiation for Neonates
Description
Purpose: Neonates who require Extracorporeal Membrane Oxygenation (ECMO) are at risk for calcium derangements and associated adverse outcomes. A large children’s hospital in the Southwest changed their practice from using calcium gluconate in priming their neonatal ECMO to using calcium chloride. The impact of this change was not investigated.
Methods: A retrospective chart review of 56 neonates who required ECMO support one year prior to and one year following the practice change was conducted. Descriptive data was collected along with the first ionized calcium measured following ECMO initiation.
Results: Upon review of the data, the post-ECMO calcium levels were not significant between the calcium gluconate and calcium chloride groups using a Mann Whitney U test (U = 315.5, z = -1.25, p = .213). However, a Chi-square test was significant (χ2(1) = 4.94, p = .026) for having calcium values outside of a normal range in the calcium gluconate group. Fisher’s exact test revealed an odds ratio of 3.43 for the first calcium being outside normal range in the calcium gluconate group.
Implications: While comparison of the first measured ionized calcium post-ECMO between the two groups was not statistically significant, there was a significant correlation with normal post-ECMO calcium in the calcium chloride group. This suggest that both calcium gluconate and calcium chloride are appropriate for use in priming the neonatal ECMO circuit, however calcium chloride may provide tighter control of calcium during ECMO initiation in neonates.
ContributorsStravitz, Stacy (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Description
Background: Traumatic brain injury (TBI) is a leading cause of death and long-term disability among children. The Brain Trauma Foundation (BTF) guidelines integrate initiation of early enteral nutrition which is essential for achieving best clinical outcomes. Gaps in knowledge, consistency, and collaboration when managing these patients hinder adherence to the guidelines and puts the patient at risk.
Objective: This project purpose was to review the updated BTF guidelines and implement a rounding checklist to increase the early initiation of enteral feeding following a TBI.
Methods: This quality improvement project was conducted in the pediatric intensive care unit (PICU) at a level one pediatric trauma center and included all patients admitted with severe TBI. A pre- and post-test accompanied education regarding the guidelines and instructions for checklist completion. The checklists included all BTF guidelines, with a primary focus on early initiation of feeds. Checklist data was presented by the bedside nurse during rounds.
Results: Using descriptive statistics, the average pre-test score was 69% and average post-test score was 93%. Prior to the education, 82% of registered nurses believed a bedside checklist would help manage patients with severe TBI and increased to 95% after education. The checklist was used on 7 (100%) patients and 43% had feeds initiated within 72 hr post-injury (n = 3).
Conclusions: Early initiation of feeding in critically ill patients impacts patient outcomes. A rounding checklist can improve interprofessional communication and healthcare quality by delivering standardized pediatric TBI care. Research regarding enteral nutrition is needed to ensure nutrition is provided in a safe, timely manner.
ContributorsMichael, Holly N. (Author) / Sebbens, Danielle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Description
All-terrain vehicles (ATVs) are a leading cause of pediatric trauma. Children may experience a range of injuries from concussion and fractures to severe traumatic brain injury and even death. ATV safety is a priority. Research emphasizes the importance of helmet use while riding an ATV and adhering to manufacturing guidelines for ATVs. These findings have led to the initiation of an evidence-based project to identify behavioral changes within the pediatric population, specifically children 12-18 years of age who are on the Trauma Service of Phoenix Children’s Hospital. Each patient was given a pre-test survey to assess their knowledge regarding ATV safety. After the pre-test survey was completed, an educational component was implemented, the participant used teach-back to the project personnel to demonstrate understanding, and a post-test survey immediately followed. The posttest had several open-ended questions that identified the patient’s intention to follow the safety recommendations when riding their ATV in the future.
ContributorsO'Donnell, Elly (Author) / Sebbens, Danielle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Description
Abstract: Abstract
Completion of advance directives (AD) prevent unwanted care. It is clear that systematic integration of AD documentation in primary care practices can lead to less intrusion of patient autonomy, and remove a source or moral injury and ethical ambiguity for providers, family and caregivers. The purpose of this project was to examine the effect of an evidence-based AD completion activity on AD completion rates in a rural, primary-care clinic. The theory of self-determination (SDT) guided the project as SDT describes why and how persons are motivated to engage in acts of self-determination. Recruitment was self-selective as all clients aged 18 years or older had access and opportunity to available PREPARE.org materials to complete a state specific AD in English or Spanish on site. Each patient of the clinic signed the site-specific consent form authorizing release of information for study use. Project data was collected via chart audits using a pre/post intervention design. Results indicate that passively providing AD materials, even in a multiple languages and formats is not enough to engage self-motivation to complete an AD. This attempt to improve AD completion in primary care reflects the larger body of knowledge; interpersonal communication is needed to stimulate relatedness and improved competence, the two precursors of acts of self-determination, as outlined by SDT.
ContributorsSipe, Erica (Author) / Rauton, Monica (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
DescriptionThis paper details my journey into children's publishing (as a Supply Chain major fairly unfamiliar with the industry) and culminates with my attempt at writing a picture book.
ContributorsGillmore, Lauren Emily (Author) / Brooks, Dan (Thesis director) / Gopalakrishnan, Mohan (Committee member) / Mokwa, Michael (Committee member) / Barrett, The Honors College (Contributor) / Department of Supply Chain Management (Contributor)
Created2013-05
Description
The main purpose of this thesis was to further explore factors that render particular children more susceptible to bullying and peer victimization. Race, age, and the activities that the children participated in were considered potential predictors of bullying and victimization. Self- and peer-reported data were gathered on 437 first and third grade children (234 boys and 203 girls, M age = 7 years, 6 months), including the frequency of peer victimization and the extent of their engagement in gender-typed activities. Activities were identified as either masculine (e.g., watching sports on television, playing with tools) or feminine (e.g., playing house, cheerleading) according to which sex was mostly likely to engage in them. Mixed support was obtained for the hypothesis that boys are at greater risk for being targets of peer aggression. Specifically, while peer-reports of victimization supported this hypothesis, self-reports revealed no sex differences. Support was obtained for the hypotheses that engaging in cross gender-typed activities would be a stronger risk factor for peer victimization for boys than for girls.
ContributorsAboud, Lauren Ashley (Author) / Ladd, Becky (Thesis director) / Eggum, Natalie (Committee member) / Ladd, Gary (Committee member) / Barrett, The Honors College (Contributor) / Department of English (Contributor)
Created2013-05
Description
Sentencing reform has been the subject of much debate in the 21st century and has resulted in a great deal of consternation in state and federal systems of government (Chesney-Lind, 2012). The public does not view incarceration as an important topic needing attention or requiring change, which makes invisible the needs and histories of prisoners as a consequence of not addressing them (Connor, 2001). Through an analysis of the spectrum of women’s crime, ranging from non-violent drug trafficking to homicide, I conclude within this paper that the criminal justice system was written as a male-oriented code of addressing crime, which has contributed to women being made into easier targets for arrest and female imprisonment at increasing rates for longer lengths of time.
In the last decade, California’s imprisoned population of women has increased by nearly 400% (Chesney-Lind, 2012). The focus of this thesis is to discuss the treatment—or lack thereof—of women within California’s criminal justice system and sentencing laws. By exploring its historical approach to two criminal actions related to women, the Three Strikes law (including non-violent drug crimes) and the absence of laws accounting for experiences of female victims of domestic violence who killed their abusers, I explore how California’s criminal code has marginalized women, and present a summary of the adverse effects brought about by the gender invisibility that is endemic within sentencing policies and practice. I also discuss recent attempted and successful reforms related to these issues, which evidence a shift toward social dialogue on sentencing aiming to address gender inequity in the sentencing code. These reforms were the result of activism; organizations, academics and individuals successfully raised awareness regarding excessive and undue sentencing of women and compelled action by the legislature.
By method of a feminist analysis of these histories, I explore these two pertinent issues in California; both are related to women who, under harsh sentencing laws, were incarcerated under the state’s male-focused legislation. Responses to the inequalities found in these laws included attempts toward both visibility for women and reform related to sentencing. I analyze the ontology of sentencing reform as it relates to activism in order to discuss the implications of further criminal code legislation, as well as the implications of the 2012 reforms in practice. Through the paper, I focus upon how women have become a target of arrest and long sentences not because they are strategically arrested to equalize their representation behind bars, but because the “tough on crime” framework in the criminal code cast a wide and fixed net that incarcerated increasingly more women following the codification of both mandatory minimums and a male-oriented approach to sentencing (Chesney-Lind et. al, 2012).
In the last decade, California’s imprisoned population of women has increased by nearly 400% (Chesney-Lind, 2012). The focus of this thesis is to discuss the treatment—or lack thereof—of women within California’s criminal justice system and sentencing laws. By exploring its historical approach to two criminal actions related to women, the Three Strikes law (including non-violent drug crimes) and the absence of laws accounting for experiences of female victims of domestic violence who killed their abusers, I explore how California’s criminal code has marginalized women, and present a summary of the adverse effects brought about by the gender invisibility that is endemic within sentencing policies and practice. I also discuss recent attempted and successful reforms related to these issues, which evidence a shift toward social dialogue on sentencing aiming to address gender inequity in the sentencing code. These reforms were the result of activism; organizations, academics and individuals successfully raised awareness regarding excessive and undue sentencing of women and compelled action by the legislature.
By method of a feminist analysis of these histories, I explore these two pertinent issues in California; both are related to women who, under harsh sentencing laws, were incarcerated under the state’s male-focused legislation. Responses to the inequalities found in these laws included attempts toward both visibility for women and reform related to sentencing. I analyze the ontology of sentencing reform as it relates to activism in order to discuss the implications of further criminal code legislation, as well as the implications of the 2012 reforms in practice. Through the paper, I focus upon how women have become a target of arrest and long sentences not because they are strategically arrested to equalize their representation behind bars, but because the “tough on crime” framework in the criminal code cast a wide and fixed net that incarcerated increasingly more women following the codification of both mandatory minimums and a male-oriented approach to sentencing (Chesney-Lind et. al, 2012).
ContributorsD'Souza, Kristin Tessa (Author) / Gomez, Alan (Thesis director) / Fonow, Mary Margaret (Committee member) / Leone Hamm, Donna (Committee member) / Barrett, The Honors College (Contributor) / School of Social Transformation (Contributor)
Created2013-05