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Title: EXPLORING THE FACTORS OF NATURAL SPACE ON WELL-BEING OF URBAN-DWELLING CHILDREN.
Creator: Nagata, Misako, Liehr, Patricia, Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
Abstract/Description: Research has suggested positive effects of nature immersion––a state of being or an act of doing in natural space––for urban children who were otherwise at risk of emotional or behavioral problems. However, few studies have systematically investigated natural space qualities that predict child well-being at the clinical level. The purpose of this study was to increase understanding of natural space qualities as factors of urban child well-being. Explanatory mixed-methods were used....
Show moreResearch has suggested positive effects of nature immersion––a state of being or an act of doing in natural space––for urban children who were otherwise at risk of emotional or behavioral problems. However, few studies have systematically investigated natural space qualities that predict child well-being at the clinical level. The purpose of this study was to increase understanding of natural space qualities as factors of urban child well-being. Explanatory mixed-methods were used. Quantitative data (N = 174) included a survey and two parental-reports of child wellbeing. Interviews provided qualitative data (N = 15). Data were analyzed using: Generalized Linear Model and Content Analysis. Both data streams were merged into a point of meta-inference that contributed to parental assessment of enhanced child well-being: 1) Parental valuing of nature connection (p < 0.001) as a soothing and safe resource and 2) Shorter and more frequent nature-child space-time immersion (p < 0.001). Integration of natural spaces into urban environments may be a costeffective and meaningful way to address urban child well-being.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/FA00013436
Subject Headings: Urban children, City children, Well-being--Children, Nature
Format: Document (PDF)

Title: PSYCHOMETRIC EVALUATION OF THE MORAL COMFORT QUESTIONNAIRE AMONG HOSPITAL-BASED DIRECT-CARE REGISTERED NURSES.
Creator: Bermudez, Natalie, Tappen, Ruth M., Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
Abstract/Description: Moral comfort, an emerging concept in nursing, is defined as an individual’s feelings of ease with decisions and actions related to a moral dilemma. Moral comfort for nurses is the positive outcome of a moral situation or dilemma, while moral distress, a widely explored issue in nursing, is the negative outcome. However, nursing literature on the concept of moral comfort is limited. While several instruments to measure moral distress exist, an instrument to measure moral comfort was not found...
Show moreMoral comfort, an emerging concept in nursing, is defined as an individual’s feelings of ease with decisions and actions related to a moral dilemma. Moral comfort for nurses is the positive outcome of a moral situation or dilemma, while moral distress, a widely explored issue in nursing, is the negative outcome. However, nursing literature on the concept of moral comfort is limited. While several instruments to measure moral distress exist, an instrument to measure moral comfort was not found. The Moral Comfort Questionnaire (MCQ) was theoretically developed. The purpose of this study was psychometric evaluation of this new 35-item instrument. Direct-care hospital-based registered nurses (n = 466) participated from February 2019 to September 2019 in this IRB-approved study. Participants completed demographic information, the MCQ, and the Moral Distress Scale revised (MDSR). Psychometric evaluation included a priori content validation and multiple statistical analyses: Cronbach’s alpha, Spearman’s correlation coefficient, weighted kappa, Bland- Altman analysis (B&A), discriminant validity, and confirmatory factor analysis (CFA).
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/FA00013445
Subject Headings: Nurses, Nursing, Nursing--Moral and ethical aspects, Nursing ethics
Format: Document (PDF)

Title: FLEEING ONE’S HOMELAND: HEALTH CHALLENGE OF CUBAN REFUGEES FROM THE MARIEL BOATLIFT.
Creator: Rodriguez, Mercedes L., Liehr, Patricia, Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
Abstract/Description: The decision to flee one’s homeland is a complex event that can have a life-long impact. The diaspora of the Cuban people has occurred throughout the United States since 1959. Their stories can shed light on the health challenge of leaving one’s homeland and can contribute to a body of knowledge that can inform nursing and health care. This study presents the qualitative findings from the stories of 13 participants who arrived in the U.S. from Cuba during the Mariel Boatlift of 1980. A story...
Show moreThe decision to flee one’s homeland is a complex event that can have a life-long impact. The diaspora of the Cuban people has occurred throughout the United States since 1959. Their stories can shed light on the health challenge of leaving one’s homeland and can contribute to a body of knowledge that can inform nursing and health care. This study presents the qualitative findings from the stories of 13 participants who arrived in the U.S. from Cuba during the Mariel Boatlift of 1980. A story inquiry research design, grounded in the theoretical underpinnings of story theory (Smith & Liehr, 2014), was utilized to explore the dimensions of the health challenge of fleeing one’s homeland, turning points and movement to resolve. Deductive and inductive analysis of the health challenge of fleeing one’s homeland revealed the dimensions of trauma related to the pre-migration, migration, and post migration experience, associated losses, and stigma. The upheaval induced stress in the lives of the participants tested their ability to cope. Managing day-to-day and utilizing internal and external resources, the participants moved to resolve the challenge of fleeing their homeland over time. Many turning points shaped the direction of their experience over decades and contributed to their ability to find meaning by becoming self-sufficient, recreating home, and reconstructing a sense of self-identity. Their unique experiences and stories have provided a voice to empower future studies to expand nursing science, influence empathy and understanding through education, foster awareness in practice, and inspire the potential for policy change for the well-being of refugee populations.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/FA00013546
Subject Headings: Refugees--Cuban, Mariel Boatlift, 1980, Refugees--Health aspects, Nursing, Caring
Format: Document (PDF)

Title: DIET COACHING TO IMPROVE PROTEIN INTAKE IN MIDDLE!AGED WOMEN.
Creator: Jackson, Kelley, Gropper, Sareen, Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
Abstract/Description: The loss of muscle (mass, strength, and function) occurs in many individuals in their 40’s and begins to accelerate after 50 years of age resulting from multiple understood mechanisms. While many factors are thought to contribute to the changes that are observed in muscle with aging, one significant, yet modifiable factor is dietary protein intake. This study proposed to improve dietary protein intake in a group of middle-aged women living in South Florida over a 12-week period using...
Show moreThe loss of muscle (mass, strength, and function) occurs in many individuals in their 40’s and begins to accelerate after 50 years of age resulting from multiple understood mechanisms. While many factors are thought to contribute to the changes that are observed in muscle with aging, one significant, yet modifiable factor is dietary protein intake. This study proposed to improve dietary protein intake in a group of middle-aged women living in South Florida over a 12-week period using individualized per-meal protein prescriptions (1.2 g protein/kg body weight evenly distributed for all three meals) provided by a Registered Dietitian, followed by weekly diet coaching from a Nurse Practitioner (coach). Aims included: (1) An examination of the effect of diet coaching on protein intake, nutrition knowledge, muscle mass, strength, and function and (2) An understanding of how diet coaching sessions help in the process of making dietary changes. A parallel mixed methods research design allowed for a synthesis of inferences from each aim resulting in a meta-inference highlighting interdisciplinary collaboration.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/FA00013545
Subject Headings: Middle-aged women, Dietary Proteins, Muscles--Aging
Format: Document (PDF)

Title: THE INFLUENCE OF MENTAL, PHYSICAL, AND SOCIAL ACTIVITY ON EPISODIC MEMORY OF PERSONS AGED 50 AND ABOVE IN THE UNITED STATES.
Creator: Malatyali, Ayse, Gordon, Shirley C., Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
Abstract/Description: The purpose of this study was to describe the relationship between mental, physical, and social activity, and episodic memory (EM) of cognitively intact older persons. The specific aims were (a) to describe the relationship between EM and mental, physical, and social activity, (b) to describe the role of gender, marital status, and race on EM, (c) to describe the moderating effects of each activity on the relationship between each of the remaining two activities and EM, and (d) to describe...
Show moreThe purpose of this study was to describe the relationship between mental, physical, and social activity, and episodic memory (EM) of cognitively intact older persons. The specific aims were (a) to describe the relationship between EM and mental, physical, and social activity, (b) to describe the role of gender, marital status, and race on EM, (c) to describe the moderating effects of each activity on the relationship between each of the remaining two activities and EM, and (d) to describe the moderating effects of gender, marital status, and race on the relationship between each activity and EM. Two theoretical frameworks: Cognitive Reserve Theory (Stern, 2002) and Theory of Nursing as Caring (Boykin & Schoenhofer, 1993) guided the study. This study was designed as a correlational and retrospective secondary analysis of data sets from the Health and Retirement Study. The sample consisted of 3,903 cognitively intact persons who were 50 years and older and completed immediate and delayed recall tests in the 2016 HRS and the 2015 Consumptions and Activities Mail Survey. Descriptive statistics included the means for age: 67 (SD 9.54), education:13.85 (SD 5.89), and total cognition 16.86 (SD 3.11). The sample was predominantly Caucasian (78.3%), female (59.8%), and married (60.9%).
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/FA00013564
Subject Headings: Older people--United States, Episodic memory, Cognition--Aged, Lifestyles--Health aspects
Format: Document (PDF)

Title: The Lived Experiences of Adolescents with Food Allergies During a Usual Weekday.
Creator: Martinez, Laurie Ann, Opalinski, Andra, Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
Abstract/Description: Global research on psychosocial factors related to food allergies and youth have increased significantly over the last decade. A plethora of countries provide literature indicating adolescents with food allergies experience social isolation, depression, anxiety, and fear. Most of the literature however favors parental perspectives with limited studies exploring adolescent subjective perspectives. The purpose of this hermeneutic phenomenological study was to explore the lived experiences of...
Show moreGlobal research on psychosocial factors related to food allergies and youth have increased significantly over the last decade. A plethora of countries provide literature indicating adolescents with food allergies experience social isolation, depression, anxiety, and fear. Most of the literature however favors parental perspectives with limited studies exploring adolescent subjective perspectives. The purpose of this hermeneutic phenomenological study was to explore the lived experiences of adolescents living with food allergies; the goal was to bring awareness to the ascribed meaning of food allergies from the perspective of adolescents and the impact of living with food allergies from day-to-day. Watson’s caring science and Erikson’s psychosocial theory were guiding frameworks for the study with story theory used to guide individual semi-structured interviews (n=14) (11-14 years). Analysis of data entailed various steps congruent with Interpretive Phenomenological Analysis. Four superordinate themes emerged from the data: (1) Living with Restraints: A Way of Life, (2) Managing Exposure, (3) Experiencing Stigma, and (4) Experiencing Lack of Knowledge. Results indicated adolescents living with food allergies have unique experiences that contribute to psychosocial upheavals and that traditional biological management may be too simplistic for promoting whole adolescent well-being and healthy development. Study findings may contribute to evidence-based interventions that nurture care for the whole adolescent.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/FA00013566
Subject Headings: Adolescents, Food allergy, Hermeneutics, Phenomenology
Format: Document (PDF)

Title: Thriving in Healthcare Providers: Relationship to Emotional Exhaustion & Impact on Primary Care Population Health Outcomes.
Creator: Constantinides, Shannon M., Hain, Debra, Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
Abstract/Description: In 2014 Bodenheimer and Sinsky published the Quadruple Aim model, which argued that healthcare provider wellbeing was the missing link to improving patient and population health outcomes, as well as cost containment. Rather than treating burnout, however, experts in fields outside healthcare are finding validity in promoting thriving at work as a means to prevent burnout and improve employee satisfaction, engagement, and productivity. The purposes of this study were to investigate the...
Show moreIn 2014 Bodenheimer and Sinsky published the Quadruple Aim model, which argued that healthcare provider wellbeing was the missing link to improving patient and population health outcomes, as well as cost containment. Rather than treating burnout, however, experts in fields outside healthcare are finding validity in promoting thriving at work as a means to prevent burnout and improve employee satisfaction, engagement, and productivity. The purposes of this study were to investigate the relationship between thriving and emotional exhaustion (which is widely considered a core element of burnout) in healthcare providers, and the impact thriving had on primary care population health outcomes as measured by quantifiable value-based quality performance metrics. Using Georges' (2013) Emancipatory Theory of Compassion and Bodenheimer and Sinsky's Quadruple Aim as conceptual frameworks, this descriptive, non-experimental study used advanced applied biostatistical techniques to analyze archival data from the December 2018 UCHealth Physician and Advanced Practice Provider Voice Survey as well as provider performance scores from the same time period. Results of the study were mixed, showing that while there is an inverse relationship between thriving and emotional exhaustion in healthcare providers, thriving did not predict population health outcomes. By evaluating thriving in healthcare providers in relation to emotional exhaustion and in context of value-based health care delivery systems, this study was the first of its kind.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/FA00013524
Subject Headings: Primary care (Medicine), Outcome Assessment, Health Care, Medical personnel, Well-being, Exhaustion
Format: Document (PDF)

Title: IDENTIFYING HEALTH PRIORITIES FOR A VULNERABLE UNDERSERVED COMMUNITY IN UGANDA, AFRICA USING COMMUNITY BASED PARTICIPATORY RESEARCH AND A PHOTOVOICE APPROACH.
Creator: Wallin, Cheryl Finch, Barry, Charlotte D., Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
Abstract/Description: The purpose of this descriptive phenomenological study was to give voice to an underserved and vulnerable population in Uganda, Africa to advocate for health priorities. Nineteen members of the village of Namagera, identified as a leper colony, were selected by community members and volunteered to participate in every element of this study. Descriptive phenomenology was the guiding philosophy and community-based participatory research methods and photovoice provided the lens for social action...
Show moreThe purpose of this descriptive phenomenological study was to give voice to an underserved and vulnerable population in Uganda, Africa to advocate for health priorities. Nineteen members of the village of Namagera, identified as a leper colony, were selected by community members and volunteered to participate in every element of this study. Descriptive phenomenology was the guiding philosophy and community-based participatory research methods and photovoice provided the lens for social action. Leininger’s theory of culture care diversity and universality (Leininger & McFarland, 2006) anchored the study in cultural caring and the community nursing practice model (Parker et al., 2020) kept the researcher grounded in the purpose of advancing the science of caring in community nursing. The research team included the researcher, the 19 participants, and six research assistants, who also served as language facilitators. Using photovoice methods, participants identified strengths and needs and used digital cameras to capture health concerns in the community. Eighty photos were analyzed by the participants and priorities were determined. The selected photos were placed on a photo board and shared with the whole community for input. Community members selected the health priorities and ranked them in importance: access to clean water, sanitation, disease, challenges for the elderly and disabled, lack of medical treatment, transportation, unemployment, and protection of the environment. The participants categorized the health priorities into three clusters of themes: basic needs, safety, and social/environmental. The themes were further incorporated into action plans identifying impeding factors for which the community would require outside assistance and promoting factors for which the community could solve themselves. Findings of this study illuminate the emergence of community empowerment: Community members found their voices, identified health priorities, and advocated for solutions.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/FA00013562
Subject Headings: Phenomenology, Uganda, Vulnerable Populations, Health Priorities, Community-Based Participatory Research, Caring
Format: Document (PDF)

Title: Improving Medication Adherence for Chronic Hypertension through Education and Self-Management Support: A Quality Improvement Project.
Creator: Hoyumpa, Rebecca H., D’Avolio, Deborah, Duhaney, Michelle, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: In the primary care setting, management of hypertension is the most common reason for office visits (Basile & Bloch, 2020). Uncontrolled hypertension accounts for 76% of persons with hypertension (CDC, 2020). This quality improvement (QI) project was conducted to improve medication adherence through education and self-management support in the management of chronic hypertension in a private family practice site in southeast Florida. The project addressed this by utilizing the Health Literacy...
Show moreIn the primary care setting, management of hypertension is the most common reason for office visits (Basile & Bloch, 2020). Uncontrolled hypertension accounts for 76% of persons with hypertension (CDC, 2020). This quality improvement (QI) project was conducted to improve medication adherence through education and self-management support in the management of chronic hypertension in a private family practice site in southeast Florida. The project addressed this by utilizing the Health Literacy Universal Precautions Toolkit, 2nd Edition (Agency for Healthcare Research and Quality [AHRQ], 2015a) to frame evidence-based interventions. UpToDate (Basile & Bloch, 2020) was utilized to provide patient education materials on hypertension, patient specific medications and home blood pressure monitoring. The conceptual framework was guided by the Health Literate Care Model (HLCM) (Koh et al., 2013a) systems approach scaffolded with Orem’s Self-Care Deficit Nursing Theory and underpinned with the Theory of Nursing as Caring.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000009
Format: Document (PDF)

Title: Increasing the Recommendation of Probiotics Through Provider and Patient Education for the Treatment of Recurrent Vaginitis.
Creator: Sicard, Jasmine, Spicer, Nia, Gordon, Shirley, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Recurrent and chronic vaginitis affects women’s self-esteem, sex life and overall well-being. The underestimation of the impact of recurrent and chronic vaginitis on women warrants further research into interventions and treatments. While bacterial vaginosis and vulvocandidiasis are among the most common gynecological diagnoses associated with vaginitis, there is no clear resolution in the literature. The path to finding a treatment plan that provides better and longer lasting relief may lie...
Show moreRecurrent and chronic vaginitis affects women’s self-esteem, sex life and overall well-being. The underestimation of the impact of recurrent and chronic vaginitis on women warrants further research into interventions and treatments. While bacterial vaginosis and vulvocandidiasis are among the most common gynecological diagnoses associated with vaginitis, there is no clear resolution in the literature. The path to finding a treatment plan that provides better and longer lasting relief may lie within the addition of probiotics supplementation. The use of probiotics has been widely explored in topics pertaining to gut health, however creating a more balanced flora of bacteria within the vagina could also lead to advancements in women’s health. This doctoral project was designed and implemented to increase the knowledge of providers and patients about the long-term use of probiotics for vaginal health while decreasing symptomatology at a women’s and family practice in South Florida.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000014
Format: Document (PDF)

Title: Initiation of the Reducing Antibiotic Misuse Prescribing (RAMP) Program to Enhance Evidence-based Management of Acute Bronchitis in the Urgent Care setting.
Creator: Ortiz, Doris, Harris, Nancy, Bradley, Gary, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: The inappropriate use of antibiotics to treat non-bacterial infections has contributed to one of the public health problems resulting in antibiotic resistance (CDC, 2019). The purpose of this DNP project was to analyze providers’ awareness and beliefs regarding antibiotic use and resistance and to evaluate the effect of an antibiotic stewardship program on urgent care providers’ antibiotic prescribing for acute bronchitis. The overall goal is to decrease antibiotic resistant infections by...
Show moreThe inappropriate use of antibiotics to treat non-bacterial infections has contributed to one of the public health problems resulting in antibiotic resistance (CDC, 2019). The purpose of this DNP project was to analyze providers’ awareness and beliefs regarding antibiotic use and resistance and to evaluate the effect of an antibiotic stewardship program on urgent care providers’ antibiotic prescribing for acute bronchitis. The overall goal is to decrease antibiotic resistant infections by reducing inappropriate antibiotic prescribing for a viral infection. To achieve this goal, a quality improvement initiative was conducted with five participating urgent care providers. Pre-RAMP intervention there was an average of 64% of over prescribing antibiotic for acute bronchitis, post-RAMP intervention was 18% which was a 71.8% reduction of over prescribing for acute bronchitis. With continuation of the RAMP intervention, at a greater scale, it will produce a sample size with enough data to fully support the cause for awareness of antibiotic prescribing for safe and quality patient care.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000006
Format: Document (PDF)

Title: The PEACH Project: Improving Provider Education for HPV Vaccination.
Creator: Eisenberg, Rachel L., Stein, Elizabeth R., Goodman, Rhonda, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: In the United States, the most common sexually transmitted infection (STI) is human papillomavirus (HPV) and although it is estimated that in the United States, 79 million people currently have HPV and an estimated 14 million people will become infected each year, vaccination rates to decrease HPV and associated cancers remains low (Jones et al., 2017). The Provider Education Achieving Community HPV Prevention (PEACH) program was created to enhance provider knowledge and understanding of the...
Show moreIn the United States, the most common sexually transmitted infection (STI) is human papillomavirus (HPV) and although it is estimated that in the United States, 79 million people currently have HPV and an estimated 14 million people will become infected each year, vaccination rates to decrease HPV and associated cancers remains low (Jones et al., 2017). The Provider Education Achieving Community HPV Prevention (PEACH) program was created to enhance provider knowledge and understanding of the HPV vaccine and improve vaccination rates through a provider education program. The qualitative improvement project was conducted at a non-profit family planning clinic in West Palm Beach and a primary care pediatric outpatient facility in Atlantis, Florida. The project leaders utilized Icek Ajzen’s Theory of Planned Behavior to provide a framework to further understand the mindset and decision-making process patients and parents go through while deciding to vaccinate against HPV.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000007
Format: Document (PDF)

Title: The Use of Spinal Cord Stimulator for Chronic Pain Management and Opioid Use – A Program Evaluation.
Creator: Alexis, Florine, Echeona, Xochil, France, Nancey E. M., Forte, Alyzza De La UZ, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Chronic pain is defined by the International Association of the Study of Pain as, “pain that persists beyond normal tissue healing time, which is assumed to be three months” (CDC, 2018 p.2). Chronic pain can be in any part of the body, but is most commonly experienced in the mid-back, lower back, leg, and head, in the form of headache. It is estimated that 80 percent of the U.S. population has experienced at least one episode of back pain in their lifetime.
Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000002
Format: Document (PDF)

Title: Evaluating a Virtual Program of Therapeutic Interactive Pets to Improve Behavioral and Psychological Symptoms and Cognitive Status Among Older Adults Experiencing Alzheimer’s Disease and Related Dementias.
Creator: Johnston, Melissa, Wiese, Lisa, Ordoñez, Maria, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Nearly 6 million Americans of all ages are living with Alzheimer’s dementia or related dementias (ADRD), and the prevalence is only expected to increase as our population ages (Gaugler, et al., 2019). Recent estimates indicate that ADRD may be moving from the sixth most common cause of death in older adults to the third, after heart disease and cancer (National Institute on Aging, [NIA] 2019). Currently there is no cure for Alzheimer’s disease or related dementias.
Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000011
Format: Document (PDF)

Title: Hypertension: Improving Outcomes through Enrollment in a Walking Exercise Program.
Creator: Almonord, Bernice, Brennen, Marlene, Dorval, Julina T., Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Hypertension is a major health care challenge. Uncontrolled hypertension is a huge financial burden in the United States. Strict medication adherence and lifestyle modifications such as incorporating a low sodium diet and increasing daily aerobic physical activity have been proven to be effective in managing hypertension. However, uncontrollable hypertension continues to be one of the most leading causes of cardiovascular disease and death worldwide. When compared to other groups, Haitians...
Show moreHypertension is a major health care challenge. Uncontrolled hypertension is a huge financial burden in the United States. Strict medication adherence and lifestyle modifications such as incorporating a low sodium diet and increasing daily aerobic physical activity have been proven to be effective in managing hypertension. However, uncontrollable hypertension continues to be one of the most leading causes of cardiovascular disease and death worldwide. When compared to other groups, Haitians have a higher disproportionate risk of morbidity and mortality from chronic disease. The purpose of this quality improvement project was to evaluate the effectiveness of physical activity through a walking exercise program and hypertension self-management education on blood pressure in Haitian adults aged 35 to 84 diagnosed with hypertension in the primary care setting. The project was an 8-week online/remote walking exercise program designed to provide bi-weekly hypertension self-management education sessions (moderate-intensity physical activity, low salt diet management, and medication adherence teaching), weekly self-adjusted step goals, and weekly one-on-one physical activity nurse counseling via telephone/video teleconference. The study results showed that participants who were fully engaged in the walking exercise program were able to manage their blood pressure by increasing their physical activity level, adhering to a low sodium diet, and increasing medication adherence.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000003
Format: Document (PDF)

Title: Identifying Barriers and Facilitators to Medication Adherence Among Underserved Adults with Hypertension in Miami-Dade County.
Creator: Carry, Coeurlande, Darville, Simone, Kelly, Tracian, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: African American (AA) and Hispanic American (HA) adults with hypertension have a higher risk of developing stroke, heart disease, and diabetes and have higher mortality rates from related complications. In the United States, more than 50% of patients with chronic conditions do not take their medication as prescribed (Kelly et al., 2014). Nonadherence is known to contribute to complications and difficulties in managing chronic diseases like hypertension and increased morbidity and deaths ...
Show moreAfrican American (AA) and Hispanic American (HA) adults with hypertension have a higher risk of developing stroke, heart disease, and diabetes and have higher mortality rates from related complications. In the United States, more than 50% of patients with chronic conditions do not take their medication as prescribed (Kelly et al., 2014). Nonadherence is known to contribute to complications and difficulties in managing chronic diseases like hypertension and increased morbidity and deaths (Ashoorkhani et al., 2018). This paper intends to address hypertension among AA and HA adults at Community Health of South Florida Incorporated (CHI) in Miami-Dade County.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000004
Format: Document (PDF)

Title: Implementation of Pain Assessment Tool for Patients with Dementia.
Creator: Sommer, Stephanie, Longo, Joy, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: According to the World Health Organization (2019) approximately 50 million people worldwide have dementia. Pain in patients with dementia who are unable to verbalize discomfort may lead to unnecessary suffering and a poor quality of life. Accurate pain evaluation by the nurse is of critical importance, yet pain is often inappropriately assessed and undertreated. The purpose of this quality improvement project was to implement a pain assessment tool for the assessment and management of pain in...
Show moreAccording to the World Health Organization (2019) approximately 50 million people worldwide have dementia. Pain in patients with dementia who are unable to verbalize discomfort may lead to unnecessary suffering and a poor quality of life. Accurate pain evaluation by the nurse is of critical importance, yet pain is often inappropriately assessed and undertreated. The purpose of this quality improvement project was to implement a pain assessment tool for the assessment and management of pain in patients with dementia. The project took place at an assisted living facility in Boca Raton, Florida. The Swanson middle-range Theory of Caring (SCT) served as the theoretical framework and the Plan, Do, Study, Act model supported the translation of evidence into practice.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000015
Format: Document (PDF)

Title: Implementation of a Postpartum Depression Screening Program to Increase Detection and Referral of Women Experiencing Postpartum Depression (PPD).
Creator: Eziafa, Chinye, Longo, Joy, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Postpartum depression is a common and serious mental disorder seen in 10% to 20% of postpartum women. It is the most undiagnosed and undertreated condition in obstetrics. It can affect mother-infant bonding, the mother’s wellbeing, and the infant’s development. The aim of this project is to implement a postpartum depression (PPD) screening program that will include early screening and referral for treatment. This manuscript will describe the results of the project and the importance of early...
Show morePostpartum depression is a common and serious mental disorder seen in 10% to 20% of postpartum women. It is the most undiagnosed and undertreated condition in obstetrics. It can affect mother-infant bonding, the mother’s wellbeing, and the infant’s development. The aim of this project is to implement a postpartum depression (PPD) screening program that will include early screening and referral for treatment. This manuscript will describe the results of the project and the importance of early screening for PPD. A practice change for a focused outcome was implemented in a practice. This change included a new protocol on PPD screening. A ten-item Edinburg postnatal depression scale (EPDS) was used to screen every woman during the postpartum visit. Data was collected between June 2020 and September 2020. Thirty women visited the clinic for a postpartum check within the 3-month period. Twenty-eight (93.3%) were screened for PPD. One (4%) of the twenty-eight women was detected to have symptoms of PPD and 100% of those who were detected with symptoms were referred. Two women (6.7%) were not screened. Prior to implementation of the protocol, education was provided to staff, and the 22-item revised depression attitude questionnaire (R-DAQ) was administered pre and post education to evaluate the knowledge and attitude of the staff. The independent sample T- Test was used to analyze the knowledge of staff pre and post educational sessions. The results showed an increase in knowledge, but it was not statistically significant. Also, the implementation of the practice change in the project site is still under assessment. In conclusion, implementing EPDS into practice will help improve PPD screening, early detection and treatment of PPD.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000005
Format: Document (PDF)

Title: Implementing a Male Breast Cancer Screening Protocol with a Medically Underserved Population.
Creator: Gonzalez, Haizea Lee, Bulfin, Susan, Klause, Karin, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: This Doctor of Nursing Practice (DNP) project describes a quality improvement (QI) project to address the problem of male breast cancer (MBC) in a medically underserved population in the southeastern United States. The purpose of this project was to implement a practice protocol to increase breast cancer screening rates to potentially improve early identification and management of men at risk for breast cancer in an outpatient safety net clinic. The Six Sigma DMAIC methodology guided the...
Show moreThis Doctor of Nursing Practice (DNP) project describes a quality improvement (QI) project to address the problem of male breast cancer (MBC) in a medically underserved population in the southeastern United States. The purpose of this project was to implement a practice protocol to increase breast cancer screening rates to potentially improve early identification and management of men at risk for breast cancer in an outpatient safety net clinic. The Six Sigma DMAIC methodology guided the development, implementation, and evaluation of the project. A pre and post intervention survey was utilized to measure nurse practitioners’ knowledge, attitude, and practice (KAP) about MBC screening and a chart audit tool was utilized to measure adherence to the protocol. The results revealed statistical significance. The nurse practitioners demonstrated improved KAP of male breast cancer screening recommendations based on responses to the pre and post questionnaires. The implementation of the male breast cancer screening protocol led to a significant increase in the nurse practitioner’s MBC screening rates. The findings reinforce continued education of nurse practitioners for male breast cancer prevention. Public education is also pertinent for early detection and prevention of male breast cancer worldwide.
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000012
Format: Document (PDF)

Title: Improving Care for Patients with Diabetes through Enhanced Patient Provider Adherence to the Diabetes Engagement Checklist.
Creator: Hackenberg, Kendall, Rizkallah, Rayyana, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: The DNP project, hereafter referred to as the Diabetes Engagement Checklist (DEC) project entailed improving care for patients with diabetes in order to enhance patient adherence to selfmanagement. The project was based locally, in the primary care setting and the participants were clinic patients that were diagnosed with T2DM (Type 2 Diabetes Mellitus). The clinical question is as follows: In (P) adult primary care patients (18-99 years) diagnosed with T2DM (ICD11.9) what is the effect of...
Show moreThe DNP project, hereafter referred to as the Diabetes Engagement Checklist (DEC) project entailed improving care for patients with diabetes in order to enhance patient adherence to selfmanagement. The project was based locally, in the primary care setting and the participants were clinic patients that were diagnosed with T2DM (Type 2 Diabetes Mellitus). The clinical question is as follows: In (P) adult primary care patients (18-99 years) diagnosed with T2DM (ICD11.9) what is the effect of implementation of a diabetes screening quality of care checklist with provider and patient engagement (I) on patient outcomes and self-management (BMI, BP, LDL, HbA1c, PHQ-9) (O) compared to usual standard of care (C) over 3-month period (T)?
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Date Issued: 2020
PURL: http://purl.flvc.org/fau/fd/faudnp000008
Format: Document (PDF)

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