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Title: Advance Care Planning in Primary Care: A Quality Improvement Project.
Creator: Dennis, Amanda Lang
Abstract/Description: Purpose of the Project: Advance care planning (ACP) has been shown to reduce unwanted care at end of life. However, rates of documentation of advance directives (ADs) are low in most settings. The aim of this project was to increase the number of ACP discussions that occur in a primary care clinic between provider and patient. Methods: The setting for this project was a family medicine residency program in a health system-owned practice, which included 20 resident physicians, six faculty...
Show morePurpose of the Project: Advance care planning (ACP) has been shown to reduce unwanted care at end of life. However, rates of documentation of advance directives (ADs) are low in most settings. The aim of this project was to increase the number of ACP discussions that occur in a primary care clinic between provider and patient. Methods: The setting for this project was a family medicine residency program in a health system-owned practice, which included 20 resident physicians, six faculty physician providers and one advanced registered nurse practitioner (ARNP). The first phase was an evaluation of an educational program for providers on ACP with the goal of increasing provider willingness to engage in ACP. The second phase was a quality improvement (QI) initiative involving clinical and non-clinical staff in the primary care office, using the Plan-Do-Check-Act (PDCA) framework. Results: Through the initial stages of the PDCA, participants identified awareness of ACP among patients, staff, and providers to be the most important factor in improving rates of ACP. A month-long awareness campaign was initiated, with specific activities to promote ACP. No significant change was identified in the number of ADs scanned into the EMR or in the number of ACP procedure codes billed before and after initiation of the QI intervention. Discussion: Through the course of the QI initiative, participants recognized that both staff and provider education is essential in improving ACP. They also identified that more patient education and outreach is needed. An awareness campaign was successful in encouraging discussion of ACP and its importance, but did not have an overall impact on rates of ACP. Conclusions: Changing culture and attitudes about ACP requires a comprehensive, multi-level strategy to engage providers, staff, and patients.
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Date Issued: 2018-04-12
Identifier: FSU_libsubv1_scholarship_submission_1523550044_6c0b0a2c
Format: Citation

Title: Assessing the Relationship between Cultural Competence and Quality Care in Non-English Speaking Patients from Providers’ Perspective.
Creator: Ukaga, Anthonia
Date Issued: 2018-04-16
Identifier: FSU_libsubv1_scholarship_submission_1523871419_f1105560
Format: Citation

Title: Assessment and Screening of Depression in Heart Failure Patients: Nurses' Knowledge and Barriers.
Creator: Nguyen, Jimmy, Graven, Lucinda
Abstract/Description: Purpose: Heart failure (HF) is a devastating, progressive disease. Many HF patients have undiagnosed depression, increasing mortality and hospital visits. Nurses and providers often fail to recognize depression in this population. Therefore, this project aimed to explore current nurse knowledge base regarding depression; identify barriers to depression screening in HF patients; and introduce two depression screening tools, the Center for Epidemiologic Studies Depression Scale (CES-D-3) and...
Show morePurpose: Heart failure (HF) is a devastating, progressive disease. Many HF patients have undiagnosed depression, increasing mortality and hospital visits. Nurses and providers often fail to recognize depression in this population. Therefore, this project aimed to explore current nurse knowledge base regarding depression; identify barriers to depression screening in HF patients; and introduce two depression screening tools, the Center for Epidemiologic Studies Depression Scale (CES-D-3) and the Patient Health Questionnaire (PHQ-2). Methods: Using a quasi-experimental, pre/post design, an educational intervention was performed at a 300+ bed hospital, including a 15-minute educational intervention on depression and depression screening tools. Registered nurses completed a survey before (n = 51) and one month after (n = 31). Results: The sample was predominantly female (77%), 25-35 years old (67%), and cared for HF patients at least once a month (96%). The three largest barriers to depression screening reported included lack of time (100%), comfort level with patient (65%), and unsure how to assess (61%). Post-intervention, both nurses and patients responded better to the PHQ-2 versus the CES-D (77% versus 23%), with 74% of nurses using the tools at least once. This project observed a significant increase of comfort level and familiarity with depression (Z = -3.14, p < 0.04). Discussion: Although an improvement in comfort and familiarity with depression was noted, depression screens were not routinely used afterwards (74% used at least once). The intervention and/or the project duration may have been too short to notice a culture change. Conclusions: This project suggests that depression education can increase familiarity, comfort level, and knowledge of depression in nurses working with HF patients in acute care settings. The PHQ-2 may be a viable option to screening, given it was preferred over the CES-3, by both patient and nurses.
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Date Issued: 2018-04-26
Identifier: FSU_libsubv1_scholarship_submission_1524801870_41be20a3
Format: Citation

Title: Clinician Knowledge on Perinatal Mood and Anxiety Disorders in Florida.
Creator: Salib-Barrios, Margaret Kathleen
Abstract/Description: Purpose: To understand knowledge gaps and barriers among Florida healthcare providers in the assessment and treatment of Perinatal Mood and Anxiety Disorders (PMADs). The information gathered should assist in making future recommendations to improve early screening and treatment of women with PMAD. Methods: The study was designed as a needs assessment questionnaire. ARNPs, PAs, DOs, and MDs with email addresses listed in the Florida Health Care Practitioner Data Portal were sent an...
Show morePurpose: To understand knowledge gaps and barriers among Florida healthcare providers in the assessment and treatment of Perinatal Mood and Anxiety Disorders (PMADs). The information gathered should assist in making future recommendations to improve early screening and treatment of women with PMAD. Methods: The study was designed as a needs assessment questionnaire. ARNPs, PAs, DOs, and MDs with email addresses listed in the Florida Health Care Practitioner Data Portal were sent an investigator-developed survey. Following the survey, participants were provided a link to MothersMentalHealth.org, developed by the FSU College of Medicine, which provides resources and education for mothers, families and clinicians. Analysis was conducted using Statistical Packages for the Social Sciences (SPSS) to determine how clinicians identified areas where they lacked preparedness in addressing PMADs and to identify differences in provider characteristics. Results: A total of 552 respondents completed the survey. Clinicians lack preparedness in six significant areas: appropriate use of language, detection of PMADs, care development, time and resource management, awareness of community resources, and provision of culturally specific care. Significant differences in preparedness were observed between disciplines. Discussion: Barriers to effectively addressing PMADs are all modifiable. Efforts are needed to improve the confidence, knowledge and preparedness of clinicians, regardless of specialty area, in the early detection, appropriate treatment and long-term management of patients with PMADs. Conclusions: Successful management of PMADs is critical for the welfare of women and their families. To further this research, it would be valuable to have PMAD education built into the requirements for all health care providers (HCPs) across the state of Florida. Simply increasing the awareness of available resources could improve PMAD outcomes.
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Date Issued: 2018-04-27
Identifier: FSU_libsubv1_scholarship_submission_1524802543_c4536779
Format: Citation

Title: Coping with Pediatric Death in the Emergency Department Setting: Are Healthcare Providers Prepared?.
Creator: Wiggins, Travis
Date Issued: 2018-04-10
Identifier: FSU_libsubv1_scholarship_submission_1523372897_a0fbfb24
Format: Citation

Title: The Current State of Nurse Practitioner Postgraduate Training.
Creator: Vilches, Jacine
Abstract/Description: Purpose: Postgraduate training provides support to help new NPs adjust to their role during the first year of practice. These programs have grown in number over the years, yet there is a lack of comprehensive data. The goal of this study was to gather in-depth data to connect these programs with APRN students. Methods: This descriptive research study used an inventory tool to collect data from program directors. Data was analyzed using univariate statistics. Results: Of the 67 active programs...
Show morePurpose: Postgraduate training provides support to help new NPs adjust to their role during the first year of practice. These programs have grown in number over the years, yet there is a lack of comprehensive data. The goal of this study was to gather in-depth data to connect these programs with APRN students. Methods: This descriptive research study used an inventory tool to collect data from program directors. Data was analyzed using univariate statistics. Results: Of the 67 active programs, 30 directors responded (45%) with most respondents in the Northeast (33%) or the West Coast (27%). Fifty percent of the responding programs had a primary care focus and were operating for an average of 51.4 months (mode 36, range 12 – 120). A master's degree, APRN licensure in the program's state, and national board certification were required for admission to most (>80%) programs. The average monthly compensation was $5,729.16 (Mode $6,000) and all programs offered medical insurance. The programs boasted an estimated employment rate of 89% upon completion with 12 months being the most common. Programs offered access to a resource person 96% of the time and many (68%) of them trained residents at multiple training sites and included specialty rotations (86%). Discussion: Further studies to track the development of postgraduate training are necessary as these programs continue to grow. Studies that compare the performance outcomes between NP postgraduates and NPs with comparable years of practice should be performed to assist with meaningful appraisals of this training. Conclusions: Data obtained assists in the understanding of current postgraduate training. Postgraduate training provides useful supplementary education for newly graduated NPs and specialty care NPs.
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Date Issued: 2018-04-27
Identifier: FSU_libsubv1_scholarship_submission_1524876747_c4e0df79
Format: Citation

Title: Does an Educational Intervention for a Nurse-Driven Indwelling Urinary Catheter Protocol Increase Nurses’ Knowledge and Compliance to the Protocol?.
Creator: Miller, Meghan
Abstract/Description: Purpose: Catheter-associated urinary tract infections (CAUTI) are responsible for approximately 40% of all hospital acquired infections. Over the past several years, hospitals have developed tools attempting to decrease CAUTI rates. Research suggests that nurse-driven protocols are effective in reducing CAUTI rates. The purpose of this project was to evaluate the effectiveness of an educational intervention related to a nurse-driven urinary catheter protocol in increasing registered nurses’ ...
Show morePurpose: Catheter-associated urinary tract infections (CAUTI) are responsible for approximately 40% of all hospital acquired infections. Over the past several years, hospitals have developed tools attempting to decrease CAUTI rates. Research suggests that nurse-driven protocols are effective in reducing CAUTI rates. The purpose of this project was to evaluate the effectiveness of an educational intervention related to a nurse-driven urinary catheter protocol in increasing registered nurses’ (RN) knowledge and compliance to the protocol. Methods:This study utilized a quasi-experimental pre-test, post-test and compliance self-report, to assess RNs’ knowledge and compliance to a nurse driven-urinary catheter protocol at a Southwest Florida hospital. RNs attended a nurse-driven protocol educational intervention, in which they completed both pre and post surveys and a compliance self-reports. The surveys and compliance self-reports were administered through SurveyMonkey. RNs reported compliance to the protocol on a Likert-type scale from 1-5. A paired sample t-test was done to compare the pretest and posttest results. A second paired sample t-test was done to compare the compliance self-reports completed before and after the educational session. Results: Thirty-two RNs participated in the study. The mean compliance prior to the educational intervention was 4.2, which increased to 4.7 after the educational intervention. The mean score on the pretest was 77%, increasing to 92% on the posttest. Discussion: Overall, the educational intervention was successful in increasing RNs’ knowledge and compliance to the nurse-driven urinary catheter protocol. Conclusion: The results suggest that providing education to RNs is critical. Reported compliance to the nurse-driven urinary catheter protocol is a critical step in increasing patient safety and decreasing the risks of CAUTIs.
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Date Issued: 2018-04-24
Identifier: FSU_libsubv1_scholarship_submission_1524596940_51d3cd69
Format: Citation

Title: Evaluation of a Process Change Using SBAR to Reduce Inappropriate Patient Placement and Increase Nursing Satisfaction.
Creator: Hernandez, Michelle Lynn, Hauber, Roxanne
Abstract/Description: Purpose: To determine the impact of the implementation of a standardized report sheet, SBAR, to improve verbal patient handoffs, inappropriate patient placement, and nursing satisfaction. Methods: The project used a pre/post descriptive design that included: 1) review of retrospective data from two sources to determine the number of inappropriate patient placements pre- and post- implementation of the SBAR tool and 2) a survey to determine nursing staff’s satisfaction before and after...
Show morePurpose: To determine the impact of the implementation of a standardized report sheet, SBAR, to improve verbal patient handoffs, inappropriate patient placement, and nursing satisfaction. Methods: The project used a pre/post descriptive design that included: 1) review of retrospective data from two sources to determine the number of inappropriate patient placements pre- and post- implementation of the SBAR tool and 2) a survey to determine nursing staff’s satisfaction before and after implementation. Data collection took place in a 300-bed inpatient hospital in Florida for seven months pre- and post- implementation through retrospective review of PRISM reports and unit logs, as well as, pre- and post -implementation surveys completed by RNs and LPNs. Results: Frequencies were calculated on both PRISM and Unit log data. Due to small sample sizes, only cumulative unit log totals were analyzed using a t-test and revealed no statistically significant difference between the pre –and post implementation data. None of the participants identified the new process as completely successful. Discussion: The discrepancy between the data in the unit logs and the data reported into the PRISM was significant and inferred that a lack of clarity and communication in reporting methods that may have played a role in the outcomes for this project. Conclusion: The limitations identified in the project need to be considered and addressed when planning similar studies.
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Date Issued: 2018-04-26
Identifier: FSU_libsubv1_scholarship_submission_1524782494_89b0f520
Format: Citation

Title: An Exploration of Learning Needs: Identifying Knowledge Deficits among Hospitalized Adults with Heart Failure.
Creator: Raines, Erika M, Dickey, Sabrina
Abstract/Description: Purpose: The purpose of this study was to examine the learning needs of hospitalized patients with heart failure (HF) by identifying their current HF self-care behaviors and knowledge levels, while identifying relationships between clinical variables (sociodemographic data and health history) and their learning needs. Methods: A descriptive, cross-sectional design was utilized to examine a convenience sample of 42 hospitalized patients with HF. Self-care behaviors and knowledge levels were...
Show morePurpose: The purpose of this study was to examine the learning needs of hospitalized patients with heart failure (HF) by identifying their current HF self-care behaviors and knowledge levels, while identifying relationships between clinical variables (sociodemographic data and health history) and their learning needs. Methods: A descriptive, cross-sectional design was utilized to examine a convenience sample of 42 hospitalized patients with HF. Self-care behaviors and knowledge levels were measured using the Self Care of Heart Failure Index (SCHFI) V. 6.2., and the Japanese Heart Failure Knowledge Scale. Descriptive statistics were used to describe the learning needs and sociodemographic data. Pearson product moment correlation coefficient was utilized to examine relationships between the learning needs and clinical variables. Results: The mean scores of self-care were 38.6% (maintenance), 41.6% (management) and 17.8% (confidence). The participant’s mean knowledge level score was 74.9%. Multiple HF hospital readmissions had a significant negative correlation with HF knowledge scores (r = -.358, p = 0.020), suggesting the lower the knowledge score, the higher the prevalence of HF readmissions. There were significant positive correlations between self-care maintenance (r=.525, p<0.05), management (r=.435, p<.05), confidence (r=.366, p <.05), knowledge level (r=.752, p<.05) and not living alone. Thus, indicating that living with family support is correlated with better self-care and greater knowledge. The presence of multiple comorbidities revealed significant positive correlations (p<.05) with self-care scores (maintenance [r=.391], management [r=.438], and confidence r=.504]), indicating a higher number of comorbidities, yields lower self-care behaviors. Discussion: Findings reveal poor self-care behaviors in all three areas (maintenance, management, confidence). These findings suggest that patients have difficulty implementing knowledge into self-care. Conclusions: By identifying knowledge deficits and contributing factors to suboptimal self-care, the chronic care model can be used as a guideline for ideal HF education and management. Improving self-care behaviors can be obtained by initiating an active engagement between health care teams and the patient.
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Date Issued: 2018-04-27
Identifier: FSU_libsubv1_scholarship_submission_1524874859_831d78b8
Format: Citation

Title: Factors Influencing Parental Perception of Child's Weight Status.
Creator: Mauldin, Sabrina
Abstract/Description: Purpose: Childhood obesity is one of the most challenging and complex epidemics in today’s society. According to the World Health Organization, it is estimated the prevalence of childhood obesity will increase from 7% in 2012 to 11% in 2025. The purpose of the project is to identify factors that may influence parental perception of a child’s weight status. Methods: Parents of children aged 6-12 were surveyed regarding their child’s healthy behaviors, demographic information and perception of...
Show morePurpose: Childhood obesity is one of the most challenging and complex epidemics in today’s society. According to the World Health Organization, it is estimated the prevalence of childhood obesity will increase from 7% in 2012 to 11% in 2025. The purpose of the project is to identify factors that may influence parental perception of a child’s weight status. Methods: Parents of children aged 6-12 were surveyed regarding their child’s healthy behaviors, demographic information and perception of child’s current weight. Parents were also asked to select a body type they felt most accurately represented their child from a sketch which included 7 different body types. Children’s height and weight were measured and BMI was calculated. Parents were also asked to give a verbal description such as a little underweight, about the right weight, or overweight. Results: Thirty-two parents participated the survey. Nineteen out of 27 parents (70%) correctly perceived their children’s weight status. Common factors such as income, employment status, providing opportunities for physical activity and healthy eating habits were identified as impacting how a parent perceived their child’s weight status. Eighty percent of parents that provided an opportunity for physical activity to their child perceived their child to be about the right weight. Half of the parents that never/almost never provided an opportunity for physical activity perceived their child to be overweight. Discussion: If health care providers understand the elements affecting parental perception, there is an opportunity for change. Discussing healthy eating habits, limiting amount of screen time spent on electronics or television, and the importance of physical activity may heighten understanding. Conclusion: As a country with an increasing rate of childhood obesity it is imperative to identify causative factors prompting this epidemic. Although parents play an integral role in managing their child’s weight there are many other influences affecting obesity. Future research is needed to gain more insight and create a shared responsibility.
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Date Issued: 04/16/2018
Identifier: FSU_libsubv1_scholarship_submission_1523928001_5e75d773
Format: Citation

Title: Improving Cervical Cancer Screening Rates in a Community Health Center: A Quality Improvement Project.
Creator: Balaji, Anusuyadevi Rajeevi
Abstract/Description: Purpose: The purpose of this quality improvement (QI) project was to increase the rates of routine cervical cancer screening (CCS) in eligible women of ages 21-64 years in an Adult Health Clinic (AHC) at a Community Health Center (CHC). The specific aim of this project was to determine the effect of a new CCS protocol and “Pap & Physical” appointments on cervical cancer screening incidence rates (CCSIRs). Methods: A QI committee developed a new CCS protocol and provided staff training on it....
Show morePurpose: The purpose of this quality improvement (QI) project was to increase the rates of routine cervical cancer screening (CCS) in eligible women of ages 21-64 years in an Adult Health Clinic (AHC) at a Community Health Center (CHC). The specific aim of this project was to determine the effect of a new CCS protocol and “Pap & Physical” appointments on cervical cancer screening incidence rates (CCSIRs). Methods: A QI committee developed a new CCS protocol and provided staff training on it. Pap & Physical appointments were also implemented along with client and provider reminder/recall interventions. A pretest/posttest design was used to determine effectiveness of these interventions. Results: The sample (N = 3354) consisted of all women of ages 23-64 years who presented for care during the pre- and post-intervention periods. The chi-square test did not reveal a significant association between the screening status and the pre- and post-intervention periods. The effect size was small (χ2 = 2.89, df = 1, p = 0.089, φ = 0.067). The overall CCSIRs did not improve from the pre- to post-intervention period (23% and 19.6% respectively). Discussion: There was no improvement in CCSIR from the pre- to post-intervention period despite interventions that targeted multiple barriers. Patients, staff, and system related factors affected CCSIRs. Information gleaned from this preliminary study should be used in further PDSA cycles and this has the potential to streamline processes and improve CCS rates in the AHC. Conclusion: To meet Healthy People 2020 goal for CCS, healthcare environments should evaluate their current CCS rates and implement evidence-based interventions in a manner that is adaptable to the healthcare environment’s workflow. Effective training and post-training assessment should be provided to staff. Providers should administer Pap smears on the same day as physical exams to reduce the need for multiple appointments. Studies addressing provider unwillingness to perform Pap smears are needed.
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Date Issued: 2018-04-23
Identifier: FSU_libsubv1_scholarship_submission_1524536894_2efa2cb3
Format: Citation

Title: Improving Patient Safety and Minimizing Alarm Fatigue through Effective Alarm Management.
Creator: De Leon, Jizzel Anne Velasco, Little, Barbara B.
Abstract/Description: Abstract Purpose: The purpose of this quality improvement (QI) project was to develop, implement and evaluate an Alarm Management QI Program in an intensive care unit (ICU) of a community hospital. The specific aims of the project were to reduce the number of ECG and pulse oximetry nuisance alarms, increase RN knowledge of alarm management and improve RN competency in management of ECG and pulse oximetry alarms. Methods: An online education program was developed and required for all ICU...
Show moreAbstract Purpose: The purpose of this quality improvement (QI) project was to develop, implement and evaluate an Alarm Management QI Program in an intensive care unit (ICU) of a community hospital. The specific aims of the project were to reduce the number of ECG and pulse oximetry nuisance alarms, increase RN knowledge of alarm management and improve RN competency in management of ECG and pulse oximetry alarms. Methods: An online education program was developed and required for all ICU nursing staff. In addition, RN alarm management competency was validated through a peer review process. A descriptive comparison design was used to examine the effectiveness of this quality improvement program. Results: The number of alarms elicited during the period of study significantly improved (p < 0.05) as a result of the educational program. Pre and posttest scores also showed improvement from a mean score of 57% to 78%. Competency validation results confirmed the majority of the peer review participants performed the expected practices. Conclusions: The Alarm Management Quality Improvement Program demonstrated positive changes to staff knowledge and competency, as well as the overall alarm occurrences in the unit after the intervention. Healthcare facilities can improve patient safety and minimize alarm fatigue by establishing alarm management policies, providing education and utilizing peer review to assure staff competency.
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Date Issued: 2018-04-16
Identifier: FSU_libsubv1_scholarship_submission_1523563144_99236d7d
Format: Citation

Title: Long Acting Reversible Contraceptives: An Educational Tool to Improve Awareness.
Creator: Adams, Tracy, Greenhalgh, Jolynn
Abstract/Description: Purpose: The aim of this study was to increase awareness of contraceptive methods and measure the likelihood that participants request a more effective method, including long-acting reversible contraceptives (LARCs), than they are currently using. Methods: This project was a quazi-experimental, cross-sectional designed study. The intervention consisted of one-on-one time with an experienced family planning nurse using the Centers for Disease Control and Prevention (CDC) “Effectiveness of...
Show morePurpose: The aim of this study was to increase awareness of contraceptive methods and measure the likelihood that participants request a more effective method, including long-acting reversible contraceptives (LARCs), than they are currently using. Methods: This project was a quazi-experimental, cross-sectional designed study. The intervention consisted of one-on-one time with an experienced family planning nurse using the Centers for Disease Control and Prevention (CDC) “Effectiveness of Family Planning Methods” handout as a teaching tool (CDC, 2017). A post-survey measured how likely women were to ask about more effective contraceptives including LARC. Results: Data was collected over a four day period, resulting in 17 participants. Six women (35.3%) were using no method. Post intervention, three (50%) stated they would talk with their practitioner about a more or most effective method of birth control. Three women were using a less effective method. One hundred percent of these women were likely to ask about most effective methods. Five participants (29.4%) were using a moderately effective method. Three of these five (60%) were interested in a most effective method. Three participants (17.6%) were already using a most effective method. Discussion: Nine of the 17 participants (52.9%) were likely to ask their practitioner about LARC. This demonstrates a positive correlation between contraceptive education and increased interest in LARC. Conclusion: LARC family planning methods, although proven safe and effective methods of birth control, are underutilized in the United States. When provided education on all available methods, women are better equipped to choose a method that not only fits their lifestyle, but also offers a high level of efficacy. More research with larger numbers of study participants is needed to determine best practices for improving LARC usage in the United States.
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Date Issued: 2018-04-06
Identifier: FSU_libsubv1_scholarship_submission_1524061692_aea16f4e
Format: Citation

Title: Managing Urinary Retention: A Quality Improvement Project.
Creator: Dorenko, Tatiana
Abstract/Description: Abstract Purpose: The purpose of this quality improvement project was to develop, implement and evaluate the impact of an Urinary Retention Management protocol on indwelling urinary catheter utilization and incidence of bladder overdistention. The specific aims of the study were to decrease indwelling urinary catheter utilization and decrease the incidence of bladder volumes greater than 600 ml. Methods: The new protocol was implemented on inpatient medical-surgical, rehabilitation, and...
Show moreAbstract Purpose: The purpose of this quality improvement project was to develop, implement and evaluate the impact of an Urinary Retention Management protocol on indwelling urinary catheter utilization and incidence of bladder overdistention. The specific aims of the study were to decrease indwelling urinary catheter utilization and decrease the incidence of bladder volumes greater than 600 ml. Methods: The new protocol was implemented on inpatient medical-surgical, rehabilitation, and intensive care units. An online education module was required for all nurses. A descriptive comparison design was employed to evaluate the impact of the protocol utilizing de-identified retrospective electronic medical record data to compare the Urinary Catheter Utilization ratio and the incidence of bladder volumes above 600 ml pre- and post-implementation of the new protocol. Results: The data for pre-implementation period included 655 bladder scans with 295 volumes above 600 ml and 1125 bladder scans with 489 volumes above 600 ml for post-implementation period. The mean Catheter Utilization ratio decreased from 0.225 to 0.437, but the z-score 1.60 was not statistically significant. The ratio of incidences of bladder overdistention decreased from 0.450 to 0.437. There was a statistically significant decrease in mean bladder volumes above 600 ml from 786.72 ml to 765.51 ml in the pre-and post-implementation periods. The ratio of documented bladder scans increased from 1.9 to 3.20. Discussion: The implementation of a standardized urinary retention management protocol improved the monitoring of urinary retention, decreased severity of bladder overdistention and incidence of bladder volumes above 600 ml. Conclusions: This study reflected a modest positive effect on reducing the Indwelling Urinary Catheter Utilization ratio and incidences of bladder overdistention. Regardless of challenges associated with managing of urinary retention, implementation of evidence-based urinary retention management protocols can lead to early recognition and treatment of urinary retention for improving patient safety.
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Date Issued: 2018-04-11
Identifier: FSU_libsubv1_scholarship_submission_1523497769_7495ff4e
Format: Citation

Title: Music Therapy and Post-Operative Pain.
Creator: Radcliffe, Jessica Anne, Porterfield, Susan
Abstract/Description: Purpose: The purpose of this project was to investigate music as an adjunct therapy to pain management in the post-operative setting. More specifically, the study was intended to explore the impact of self-selected music on individual pain level as well as patient satisfaction during the recovery period. Methods: Participants in this study underwent elective outpatient surgery. Subjects were selected using a convenience sampling technique. Participants listened to pre-recorded music of their...
Show morePurpose: The purpose of this project was to investigate music as an adjunct therapy to pain management in the post-operative setting. More specifically, the study was intended to explore the impact of self-selected music on individual pain level as well as patient satisfaction during the recovery period. Methods: Participants in this study underwent elective outpatient surgery. Subjects were selected using a convenience sampling technique. Participants listened to pre-recorded music of their choice on a personal music device in the post-operative period. Data was gathered using the Numerical Rating Scale for pain (0-10), a post-intervention discharge survey, and a demographical questionnaire. Results: A p value of 0.001 demonstrated a statistically significant reduction in patient’s pain levels after listening to music. In addition, 50% of the patients expressed satisfaction with overall pain control and 59% felt that listening to music was extremely effective in decreasing their pain. Of the 12 eligible participants in the study, 11 said they would recommend music as an adjunct therapy. Discussion: The results of the study showed that music can indeed be beneficial in the post-operative period for the reduction of patient pain. Furthermore, music can enhance patient satisfaction. Conclusions: The incorporation of music into the post-operative recovery area is a viable option. Music can be considered as an adjunctive therapy to traditional nursing care.
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Date Issued: 2018-04-23
Identifier: FSU_libsubv1_scholarship_submission_1524522463_c06dae03
Format: Citation

Title: Nurses' Knowledge and Attitude Toward Chronic Pain Management in the Emergency.
Creator: Kostic, Michelle Noel
Abstract/Description: Purpose: The purpose of this project was to assess registered nurse’ knowledge and attitudes toward chronic pain in the ED. Methods: This project employed a non-experimental, descriptive design with use of an online electronic survey. The convenience sample included volunteer participants who completed two survey tools (The Chronic Pain Myth Scale and the KnowPain-12) and demographic information. Data analyses were performed with version 2.0 IBM SPSS software, using descriptive statistics,...
Show morePurpose: The purpose of this project was to assess registered nurse’ knowledge and attitudes toward chronic pain in the ED. Methods: This project employed a non-experimental, descriptive design with use of an online electronic survey. The convenience sample included volunteer participants who completed two survey tools (The Chronic Pain Myth Scale and the KnowPain-12) and demographic information. Data analyses were performed with version 2.0 IBM SPSS software, using descriptive statistics, and ANOVA. Results: The most common negative belief was that people suffering from chronic pain become dependent on their medications, like drug addicts (64%, n=323). There was also evidence that respondents believed that the severity of pain was exaggerated. In addition, findings revealed that respondents had an understanding of the biopsychosocial impacts of CP, yet demonstrated a limited opioid knowledge. Discussion: The knowledge gaps identified suggest that ER nurses need targeted pain management education, to enhance nurse’s knowledge, skills and attitude towards chronic pain. Reducing pain management disparities, by providing effective, safe and timely pain relief, requires sufficient knowledge, and ability to perform a thorough, unbiased pain assessment. Educational interventions should also be focused on CP’s pathophysiology, accurate assessment, non-opioid analgesia, and opioid treatment which includes information on state guidelines and regulations. Additionally, with considerable attention on the opioid crisis, ER nurses have a formidable task to ensure that chronic pain is not synonymous with drug addiction.
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Date Issued: 2018-04-27
Identifier: FSU_libsubv1_scholarship_submission_1524850027_68b86e27
Format: Citation

Title: Perceived HIV/AIDs Related Stigma Among Black Men Who Have Sex with Men.
Creator: Hawthorne, Kenara Ja' Nay, Whyte, James
Abstract/Description: The transmission of HIV is increasing around the world and BMSM are at in increased risk for transmission because of the associated stigma related to HIV. The purpose of this study is to determine the impact of HIV stigma, HIV status disclosure, and BMSM ability to access healthcare for prevention and treatment. A descriptive, correlational study examined the relationship between perceived stigma, HIV/AIDs disclosure, and access to healthcare. This study utilized a convenience sample for...
Show moreThe transmission of HIV is increasing around the world and BMSM are at in increased risk for transmission because of the associated stigma related to HIV. The purpose of this study is to determine the impact of HIV stigma, HIV status disclosure, and BMSM ability to access healthcare for prevention and treatment. A descriptive, correlational study examined the relationship between perceived stigma, HIV/AIDs disclosure, and access to healthcare. This study utilized a convenience sample for recruitment of participants on Facebook and Craigslist. A total of 30 young BMSM participated in this study. Feelings regarding knowledge of others regarding disease and the likelihood of disclosure were regressed. There was a statistically significant correlation between the participant’s feelings and likelihood of disclosure (p=0.37). The study indicated that perceived stigma affected BMSM undesirably, which in return decreased the likelihood of disclosure to others. Additionally, HIV-related stigma was considered to be a significant barrier for disclosure. Lastly, a total of 90% of the participants visited their HIV doctor. Many of the participants took antiretroviral medications despite the associated stigma that is surrounded by BMSM who are HIV positive. Additional educational interventions will need to be developed to decrease the rate of transmission in HIV positive BMSM.
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Date Issued: 2018-04-24
Identifier: FSU_libsubv1_scholarship_submission_1524622203_032f23ff
Format: Citation

Title: Potential Predictors of Disposition and Recidivism in Emergency Department Visits: A Regression Analysis.
Creator: Gaillard, Garrett L
Abstract/Description: Background: Recidivism in the Emergency Department (ED) is often used as a measure of efficiency, quality of care, and ED performance. Additionally, disposition of the emergency department patient is an important decision that influences the patients follow up as well as future ED visits. Objective: This study examined: age, gender, marital status, ethnicity, payer status, principle diagnoses, triage acuity as predictors of ED disposition and recidivism. The primary aim was to establish a...
Show moreBackground: Recidivism in the Emergency Department (ED) is often used as a measure of efficiency, quality of care, and ED performance. Additionally, disposition of the emergency department patient is an important decision that influences the patients follow up as well as future ED visits. Objective: This study examined: age, gender, marital status, ethnicity, payer status, principle diagnoses, triage acuity as predictors of ED disposition and recidivism. The primary aim was to establish a model and assesses the predictability of different variables on incidence of admission or discharge and return to the ED. Method: A retrospective secondary analysis took place analyzing patient encounters from October 2015 to September 2016 at a 772-bed acute care hospital. A binary logistic regression was used to analyze variables and their correlation with disposition while a multinomial regression was used to correlate recidivism. Results: An analysis of 84,712 patient visits revealed that a binary logistic regression model containing all predictors was statistically significant at the level of p<.000 CI=95%. The model distinguished between those patients that were admitted and discharged from the ED. The model accurately classified 81.7% of cases. The model correctly classified patients who were discharged with a sensitivity of 93.5% and those who were admitted with a specificity of 38.5%. A mulitnomial model showed little significance in using socio-demographic variables as predictors of recidivism. Discussion: The model supports the use of socio-demographic variables and acuity of visit as predictors of disposition in the ED population. However, only single independent socio-demographic variables were useful in prediction of recidivism. These variables contribute to the development of care models in the ED. Additionally, implementation into the ESI triage index may help to further classify an accurately delineate patients during the triage process.
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Date Issued: 08/01/2018
Identifier: FSU_libsubv1_scholarship_submission_1524503836_e3b429ce
Format: Citation

Title: Predicting Hospital Readmissions for Pneumonia in a Single Center.
Creator: Frehn, Marcelle Laurene
Abstract/Description: PURPOSE: In a North Florida hospital, 20% of patients with pneumonia are readmitted within 30 days of discharge, exceeding the national average of 17%. These patients have higher rates of morbidity and mortality. The Centers for Medicare and Medicaid Services reduce Medicare payments when a hospital’s readmission performance for pneumonia falls below the national average. Identifying those patients would improve care and reduce costs. METHODS: A retrospective chart review of 136 adults with a...
Show morePURPOSE: In a North Florida hospital, 20% of patients with pneumonia are readmitted within 30 days of discharge, exceeding the national average of 17%. These patients have higher rates of morbidity and mortality. The Centers for Medicare and Medicaid Services reduce Medicare payments when a hospital’s readmission performance for pneumonia falls below the national average. Identifying those patients would improve care and reduce costs. METHODS: A retrospective chart review of 136 adults with a primary discharge diagnosis of pneumonia unspecified organism (ICD-10: J8.9) who were then readmitted within 30 days of discharge from their initial hospitalization was completed for 2017. De-identified data points of age, substance abuse, comorbidities, BMI, total hospital 2017 registrations, original length of stay, and discharge disposition were extracted pre- and post-readmission and were analyzed using the Mann-Whitney U and Chi-square tests. RESULTS: The Mann-Whitney U test revealed significant differences between frequent users of hospital services and readmission; however, there were no significant differences in hospital length of stay, age, or BMI. The Chi-Square test indicated significant associations between substance abuse, discharge location, and the number of comorbidities and readmission. DISCUSSION: The finding that readmissions were more likely with those who were frequent users of hospital services, substance abuse, discharge location and the number of co-morbidities was consistent with the literature. However, the finding that those who were > 65 years of age was not associated with readmission rates was the opposite of what was found in the literature. CONCLUSIONS: In this setting, those younger than 65 years of age were as likely to be readmitted within 30 days than those 65 years of age or older. This may be due to the fact that chronic diseases seem to be occurring in the younger populations. However, generalizability is limited due to the small, single-site sample.
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Date Issued: 2018-04-30
Identifier: FSU_libsubv1_scholarship_submission_1525113603_440f61d0
Format: Citation

Title: Screening and Treatment Methods for Postmenopausal Osteoporosis by Florida’s Advanced Registered Nurse Practitioners.
Creator: DeCastro, Brittany
Abstract/Description: The state of Florida has the largest number of people over the age of 65 in the country; a cohort that continues to increase. Florida’s Advanced Registered Nurse Practitioners (ARNPs) play an integral role in providing health care for this cohort which often includes managing their comorbid conditions. This project was designed to identify existing knowledge gaps among Florida’s ARNPs regarding the screening and treatment methods of postmenopausal osteoporosis. The assessment tool, focused on...
Show moreThe state of Florida has the largest number of people over the age of 65 in the country; a cohort that continues to increase. Florida’s Advanced Registered Nurse Practitioners (ARNPs) play an integral role in providing health care for this cohort which often includes managing their comorbid conditions. This project was designed to identify existing knowledge gaps among Florida’s ARNPs regarding the screening and treatment methods of postmenopausal osteoporosis. The assessment tool, focused on four areas including: current screening and treatment practices for postmenopausal OP, prescription of Calcium, Vitamin D and anti-OP medications, referrals for bone density scanning and endocrinology, and fall prevention and education. A convenience sample of 24,115 active licensed Florida ARNPs was employed over a one-month period using an online needs assessment survey. Based on the analysis of data, 60% of the participants had never used a screening tool for postmenopausal women and 62% had never used a treatment algorithm for postmenopausal OP. Additionally, two of the focus areas were correlated with specific demographic variables. Findings from the project identified important knowledge gaps related to screening and treatment of individuals with postmenopausal OP.
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Date Issued: 2018-04-26
Identifier: FSU_libsubv1_scholarship_submission_1524772642_d50dcbf2
Format: Citation

Title: Self-Perception of Interpersonal Communication Competency and its Relationship to Job Satisfaction among Nurses in Florida.
Creator: Carroll, Myeshia La'tway, Dickey, Sabrina
Abstract/Description: Purpose: The purpose of this study was to determine if there was a relationship between self-perceived interpersonal communication competency and job satisfaction amid nurses in Florida. Methods: The study used a descriptive, cross-sectional design to obtain a convenience sample of nurses in the state of Florida. Surveys were dispensed electronically using Qualtrics, to active, licensed nurses listed within the publicly-accessible email database of the Florida Board of Nursing. Nurses of all...
Show morePurpose: The purpose of this study was to determine if there was a relationship between self-perceived interpersonal communication competency and job satisfaction amid nurses in Florida. Methods: The study used a descriptive, cross-sectional design to obtain a convenience sample of nurses in the state of Florida. Surveys were dispensed electronically using Qualtrics, to active, licensed nurses listed within the publicly-accessible email database of the Florida Board of Nursing. Nurses of all educational backgrounds were invited to rate self-reported levels of communication competency and job satisfaction. Data analysis included descriptive statistics, analysis of variance (ANOVA), chi-square, t-tests, and Spearman correlation coefficients. Results: There were a total of 1,997 participants. The majority of nurses (50.2%) reported to “almost always” achieve their communication goals. Most participants (28.3%) indicated being “satisfied” on the job. On average the nurses who reported consistent achievement of their communication goals also indicated high levels of job satisfaction (31%). Chi-square analysis revealed a significant association between accomplishing communication goals and job satisfaction, χ2 (18, n=1559) =100.18, p<.05. However, Spearman correlation coefficient showed that there was a negative relationship between those accomplishing communication goals and job satisfaction, r(1502)= -0.15, p<.05. Discussion: Most participants reported to “often” achieve high levels of interpersonal communication competency. There was a significant association between this variable and job satisfaction. This study provides insight on the role of self-perceived interpersonal communication competency regarding job satisfaction among a sample of active Florida nurses. Conclusions: Effective communication seems to play a role in the levels of job satisfaction. Health care institutions should consider incorporating ways to cultivate introspective communication skills to help improve levels of satisfaction in the work environment.
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Date Issued: 2018-04-27
Identifier: FSU_libsubv1_scholarship_submission_1524840242_95949f9a
Format: Citation

Title: Senior Nursing Students’ Early Recognition of Sepsis.
Creator: Powell, Zacharey A, Hauber, Roxanne
Abstract/Description: Problem Statement: Sepsis continues to be a major problem in many hospitals and healthcare settings throughout the United States. The effectiveness of early recognition accompanied by evidence-based treatment can make the difference between life and death. Nursing students must possess the knowledge and needed training to recognize early onset of sepsis in order to implement protocols for earlier resuscitation. Purpose: Apply educational interventions coupled with prep-test and post-test...
Show moreProblem Statement: Sepsis continues to be a major problem in many hospitals and healthcare settings throughout the United States. The effectiveness of early recognition accompanied by evidence-based treatment can make the difference between life and death. Nursing students must possess the knowledge and needed training to recognize early onset of sepsis in order to implement protocols for earlier resuscitation. Purpose: Apply educational interventions coupled with prep-test and post-test questions to evaluate nursing students’ requisite knowledge to identify and address early signs of sepsis. Methods: Employed a pre and post-test comparative design to measure the effectiveness of an educational session given to two groups of senior nursing students on the topic of early recognition and treatment of sepsis. Participation: ASN students (N=19 pre/post test) from a rural public state college in southeastern United States and BSN students (N= 72 pre-test) (N=73 post-test) from a large public state university in the southeastern United States. Results: N= 91 ASN and BSN students completed the pre-test and N = 92 ASN and BSN students completed the post-test. Majority of students were female 87.4%. The average age of participants largely fell within the age group of 18-25. ASN pre-test proportion of 0.36 pre-test, BSN proportion of correct answers on pre-test was 0.38 pre-test. ASN proportion of correct answers on post-test was 0.93 post-test and BSN proportion of correct answers on post-test was 0.90. Confidence interval of p < .001. Conclusions: There was a positive correlation between the sepsis educational session and post- test results in both the ASN and BSN cohorts.
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Date Issued: 04/26/2018
Identifier: FSU_libsubv1_scholarship_submission_1524775052_0f5d5cce
Format: Citation

Title: Sleeping Safe: A Review of Safe Infant Sleep in Florida.
Creator: Daniels, Tessa Maria
Abstract/Description: Purpose: The purpose of this study is to determine the impact sleep related infant deaths have in the state of Florida by determining sleep related infant mortality rates for each county. Methods: Maternal and infant health data obtained from FLHEALTHCHARTS between 2010 and 2015 was analyzed for trends in infant sleep mortality related to maternal characteristics including race, maternal country of origin, and timing of prenatal care status were evaluated. Results: There are six counties...
Show morePurpose: The purpose of this study is to determine the impact sleep related infant deaths have in the state of Florida by determining sleep related infant mortality rates for each county. Methods: Maternal and infant health data obtained from FLHEALTHCHARTS between 2010 and 2015 was analyzed for trends in infant sleep mortality related to maternal characteristics including race, maternal country of origin, and timing of prenatal care status were evaluated. Results: There are six counties where the SIDS rate exceeds the state average indicating that an educational intervention to increase compliance with the AAP safe sleep recommendations would be most beneficial. Analysis of the Kotelchuck index (KI) shows there is statistically significant evidence to demonstrate initiation of adequate prenatal care results in a decrease in infant mortality related to unsafe infant sleeping. Discussion: Healthy People 2020 identified infant mortality as a key factor in overall poor maternal and infant health. National and statewide statistics continue to indicate that SUID is a significant killer of infants and SIDS is the third leading cause of infant death nationally. Review of literature indicates that providing better prenatal and postnatal safe sleep education for infant caregivers is a key component in improving overall infant mortality. Conclusions: The knowledge that improved education can have an impact on infant mortality is a key finding in the continued quest to improve overall U.S. maternal and child health. Specifically, targeted educational interventions in the acute care setting can be effective at improving compliance with the AAPs recommendations and decrease overall infant mortality. Further research is needed to develop a tool to utilize in the acute care setting to streamline education received by infant caregivers.
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Date Issued: 2018-04-24
Identifier: FSU_libsubv1_scholarship_submission_1524617792_47dcd496
Format: Citation

Title: Supporting the Second Victim.
Creator: Bryant, Shara
Abstract/Description: The purpose of this study was to examine “Second victim” phenomenon. Second victim phenomenon relates to healthcare providers’ response to an unanticipated adverse patient event, a medical error, or a patient related injury. The provider becomes a victim in the sense that the provider is traumatized by the event. The clinical question is: What physical and psychological effects do adverse event/medical errors have on second victims?
Date Issued: 2018-03-23
Identifier: FSU_libsubv1_scholarship_submission_1521927412_8fab3b52
Format: Citation

Title: Unprofessional Conduct In Nursing and its Impact in Nurse Retention and Job Satisfaction.
Creator: Komolafe, Genevieve Uchechukwu, Porterfield, Susan
Abstract/Description: Purpose: This study was designed to examine the existing gaps and awareness among nurses regarding unprofessional conduct and its impact on job retention and satisfaction as well as devising an intervention to alleviate this behavior. Methods: A descriptive study design with a convenience sample of 51 active licensed nurses in long term care facility in North Florida was used over a period of three months using a hand delivered needs assessment survey questionnaires. Results: This study...
Show morePurpose: This study was designed to examine the existing gaps and awareness among nurses regarding unprofessional conduct and its impact on job retention and satisfaction as well as devising an intervention to alleviate this behavior. Methods: A descriptive study design with a convenience sample of 51 active licensed nurses in long term care facility in North Florida was used over a period of three months using a hand delivered needs assessment survey questionnaires. Results: This study reveals that neither level of education, nor years of experience increased nurse’s confidence level to avoid workplace inactivity. The “putdown” syndrome is the most common misconduct experienced by the nurses in their workplaces, it occurs in multiples with other types of unprofessional conduct, in most cases, on hourly and daily basis. Additional findings showed that the put down syndrome were more common between certified nursing assistants and licensed nurses. Discussion: This research indicates that disruptive clinician behavior exist in the workplace and it is key in undermining the organizations mission and culture. There can be overt and direct disruptive behavior by physician and nurses that are more passive-aggressive and are directed more at peers. In addition, reports from certified nursing assistants revealed that the “putdown syndrome” continues to exist largely between certified nurse assistants and licensed nurses and is very harmful to patient care. This is strong call for another study to investigate “put down syndrome” between licensed nurses and certified nurse assistants and its impact on patient care outcome.
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Date Issued: 4/26/2018
Identifier: FSU_libsubv1_scholarship_submission_1524231616_2eac3fd6
Format: Citation

text (25)	+ -
research report (18)	+ -
other (5)	+ -
working paper (2)	+ -

Dickey, Sabrina (2)	+ -
Hauber, Roxanne (2)	+ -
Porterfield, Susan (2)	+ -
Adams, Tracy (1)	+ -
Balaji, Anusuyadevi Rajeevi (1)	+ -

Bryant, Shara (1)	+ -
Carroll, Myeshia La'tway (1)	+ -
Daniels, Tessa Maria (1)	+ -
De Leon, Jizzel Anne Velasco (1)	+ -
DeCastro, Brittany (1)	+ -
Dennis, Amanda Lang (1)	+ -
Dorenko, Tatiana (1)	+ -
Frehn, Marcelle Laurene (1)	+ -
Gaillard, Garrett L (1)	+ -
Graven, Lucinda (1)	+ -
Greenhalgh, Jolynn (1)	+ -
Hawthorne, Kenara Ja' Nay (1)	+ -
Hernandez, Michelle Lynn (1)	+ -
Komolafe, Genevieve Uchechukwu (1)	+ -
Kostic, Michelle Noel (1)	+ -
Little, Barbara B. (1)	+ -
Mauldin, Sabrina (1)	+ -
Miller, Meghan (1)	+ -
Nguyen, Jimmy (1)	+ -
Powell, Zacharey A (1)	+ -
Radcliffe, Jessica Anne (1)	+ -
Raines, Erika M (1)	+ -
Salib-Barrios, Margaret Kathleen (1)	+ -
Ukaga, Anthonia (1)	+ -
Vilches, Jacine (1)	+ -

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