Title

Nursing (Doctor of Nursing Practice)

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Dissertations submitted for the degree of Doctor of Nursing Practice.

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Subtitle
The augmentative and alternative communication project.
Abstract
A social-learning group was used to train caregivers of school-age augmentative and alternative communication (AAC) users. Training was aimed at the caregiver of emergent AAC users and occurred in the home and community settings using a modeling strategy. Instruction was primarily delivered in three 15-minute training sessions using Facebook. In addition to social media instruction, the caregiver-child teams met with other participants to practice and implement newly learned skills during community activities. Meetings were approximately 1-hour in length and included coaching and feedback. A single subject AB design was used to evaluate the effects of community instruction on caregiver AAC modeling. Frequency of caregiver modeling is the dependent variable measured by direct observation. Module development utilized behavior skills training techniques consisting of (a) instruction (b) modeling (c) practice (d) feedback and coaching in the community setting.
Thesis advisor: Larson, Meg
Committee member: Ferraro, Meghan
Committee member: Gustavus, Brandy
Degree granting institution: Edinboro University of Pennsylvania
Degree granting institution: Clarion University of Pennsylvania
Department: Nursing
2019
Subtitle
Development and Strategies for Implementation
Abstract
Cardiovascular disease (CVD) is the number one killer of women. Surprisingly, only about half of women are aware of this risk. Statistically, heart disease kills about 1 in 5 African American and Caucasian women. Lifestyle behavior choices such as obesity, lack of exercise, consuming an unhealthy highly processed diet, smoking, and an intake of greater than 1 drink per day of alcohol increases a women’s risk for CVD. These risk factors are avoidable. These lifestyle behavior choices are modifiable and with improvements to each behavior they will decrease the women’s risk. Health and Wellness Coaching is a proven intervention to improve lifestyle behaviors that negatively impact chronic medical conditions. The development of a tailored lifestyle self-management intervention by a Nurse Practitioner in a Nurse Practitioner Wellness Clinic will address each of the lifestyle behavior choices to ultimately decrease the risk of cardiovascular disease and provide education that allows these changes to be enduring.
Committee member: Larson, Meg
Committee member: McLean, Elisabeth L.
Degree granting institution: Edinboro University of Pennsylvania
Degree granting institution: Clarion University of Pennsylvania
Department: Nursing
2020
Abstract
Surgical site infections (SSI’s) are a major concern for patients, providers, and healthcare organizations worldwide. SSI’s remain the costliest and most common of all hospital-acquired infections (HAI’s) (Septimus, 2019). It is estimated that SSI’s occur in 2 percent to 5 percent of all patients undergoing surgery, translating to 160,000 to 300,000 people annually at a cost of $3.5 to $10 billion (Ban et al., 2017). An SSI substantially increases morbidity and mortality as patients are twice as likely to die, are 60% more likely to be admitted to the
intensive care unit (ICU), and the readmission rate is five times higher than patients who do not have a hospital-acquired SSI (Darouiche, 2019).

Did the intervention of preoperative nasal decolonization using the Profend Nasal Decolonization Kit, 10% povidone-iodine (PVP-I), reduce surgical site infections in patients undergoing an orthopedic surgery with implantation, to include total joint arthroplasty (TJA) and an orthopedic fracture repair, in a 12-month period preintervention compared to a 12-month period post-intervention?
Committee member: Larson, Meg
Committee member: Bressoud, Shelly
Committee member: Price, Gwyneth
Degree granting institution: Edinboro University of Pennsylvania
Degree granting institution: Clarion University of Pennsylvania
2021
Abstract
Background: Substance use disorders have increased in the U.S. in the past 20 years, with opioid abuse causing over 70,000 deaths from 1999 to 2019. The growing public health problem necessitates developing a patient-centered educational toolkit. Patients on benzodiazepines who are at increased risk of morbidity and mortality are not engaged in their benzodiazepine management and need a specific educational tool to provide the necessary knowledge for medication management. In addition, there is currently no patient education to improve benzodiazepine safety or evidence-based program to enhance the partnership between the prescriber and the patient in many offices. Method/Design: The investigator developed an evidence-based patient education toolkit to enhance patients' knowledge about the safe use of Benzodiazepines and the risks of chronic Benzodiazepine use. Forty-one participants completed a voluntary pre, and post-survey focused on benzodiazepine-related knowledge and willingness to decrease or cease use. This improvement project aimed to (i) educate and improve the patients' understanding of safe Benzodiazepine use. (ii) Increase patient's readiness to decrease or ease long-term Benzodiazepine use. Participants: A convenient sample of 41 patients prescribed benzodiazepines at the behavioral health clinic was selected. Results: Results of linear regression indicated that patients improved their knowledge regarding safe benzodiazepine use after using the patient-centered toolkit. However, no statistically significant changes were observed in patient willingness to decrease or cease benzodiazepine use. Conclusion: The patient-centered toolkit is useful in improving patient knowledge regarding safe usage of benzodiazepines. However, the toolkit was not beneficial in changing the patients’ willingness to cease or decrease benzodiazepine usage. Nevertheless, findings are helpful in nursing practice and should be used to inform current practice. Future investigators should improve the toolkit by completing projects focused on how the toolkit can be made more effective or used in more focused interventions.
Author: Larson, Meg
Thesis advisor: Larson, Meg
Committee member: Masry, Allen
Committee member: Odoemene, Thelma
Degree granting institution: Edinboro University of Pennsylvania
Degree granting institution: Clarion University of Pennsylvania
Department: Nursing
2021
Abstract
This researcher described the current Fee for Service (FPS) Model to gain information regarding Nurse Practitioner Service awareness in Pennsylvania and introduced the practice model of Direct Primary Care (DPC). The respondents provided information related to the research question of: What are community members' knowledge of alternative pay models for primary care services provided by a Nurse Practitioner? What are community members' willingness to participate in alternative pay models for primary care services rendered by a Nurse Practitioner? The research showed access problems as >70% of respondents indicated difficulty to scheduling an appointment taking more than 24 hours. It was determined that >28% of respondents found the DPC model more attractive than their current care model, an example of perceived value. This research showed scalability potential meaning other Nurse Practitioners who wish to pursue the DPC practice model in their geographical area could reproduce similar data collection efforts to learn the perception in their state or locality. It is believed that burnout associated with healthcare providers is high and DPC provides an alternative practice model to curb burnout, engage patients and heighten health outcomes while focusing efforts on a smaller practice size., Copyrights are retained by the author. Please contact Neal Garverick for further use of this material.
Thesis advisor: Stiller, Catherine
Committee member: Rodgers, Jill
Committee member: Bassetti-Barrett, Colleen
Degree granting institution: Edinboro University of Pennsylvania
Degree granting institution: Clarion University of Pennsylvania
Department: Nursing
2020
Subtitle
Can Education Improve What is Important to Senior Citizens in Regard to the Annual Wellness Visit
Abstract
Can seniors learn what is included in an AWV through an educational presentation, thus leading to an increase in participation and possible improving of overall health? This study aims to investigate if an educational presentation will be effective in increasing the knowledge of an AWV for senior citizens through a pre and post-test. The pre- test and post test will assess their level of knowledge. It will be a quantitative study using a 10 question survey. The seniors will take the survey once before the presentation and then again after the presentation. The participants will be using a Likert scale to rate the importance of a variety of questions that are included in an AWV. Participants over the age of 65 will be eligible for the study, regardless of sex, gender, religious affiliation, or cultural background.
Thesis advisor: Falsetti, Donna
Committee member: Rodgers, Jill
Committee member: Mokeba, Carmen Hill
Degree granting institution: Edinboro University of Pennsylvania
Degree granting institution: Clarion University of Pennsylvania
Department: Nursing
2018