View All Items

Title: Using a middle range nursing theory to individualize CKD education.
Creator: Hain, Debra J.
PURL: http://purl.flvc.org/fcla/dt/3183654
Subject Headings: Renal Replacement Therapy, Nursing Theory, Nursing, Education, Nursing, Renal Insufficiency, Chronic, Self Administration, Kidney Diseases, Kidney Diseases --Therapy, Kidney Diseases --Education, Patient Education
Format: Document (PDF)

Title: What matters most to carers of people with mild dementia as evidence for transforming care.
Creator: Hain, Debra J., Engstrom, Gabriella, Touhy, Theris A.
PURL: http://purl.flvc.org/fcla/dt/3183653
Subject Headings: Caregiver Burden, Caregivers --Psychosocial Factors, Dementia --Psychosocial Factors, Caregivers, Dementia
Format: Document (PDF)

Title: Cognition and adherence in older adults undergoing hemodialysis.
Creator: Hain, Debra J., Florida Atlantic University, Liehr, Patricia
Abstract/Description: Background. Adherence to the behavioral change component of the hemodialysis regimen is difficult for many reasons; when individuals fail to adhere, the nurses often become frustrated and individuals may be labeled nonadherent leading to inappropriate interventions. As the number of older adults starting hemodialysis increases, one contributing factor to nonadherence in this population may be cognitive impairment. Objective. The overall purpose of the study was to explore differences in...
Show moreBackground. Adherence to the behavioral change component of the hemodialysis regimen is difficult for many reasons; when individuals fail to adhere, the nurses often become frustrated and individuals may be labeled nonadherent leading to inappropriate interventions. As the number of older adults starting hemodialysis increases, one contributing factor to nonadherence in this population may be cognitive impairment. Objective. The overall purpose of the study was to explore differences in global cognition, in self-report cognition, and in language ability relative to adherence in a sample of older adults undergoing hemodialysis. Methods. This pilot study examined the differences in cognition and adherence of older adults (≥60 years) undergoing out-patient hemodialysis three times a week for at least one year. Nonprobability purposive sampling was used to obtain a sample from multiple centers which offered a diverse sample of study participants (n=63). Stories of the challenges of making life style changes were audiotaped and analyzed with linguistic analysis and word count (LIWC) software and various standardized instruments that measure global cognition (3MS and MMSE), self-report cognition (KDQOL-CF) and language ability (COWA, subsets of BDAE Reading: Sentence and Paragraph and BDAE Complex Ideation) were administered during hemodialysis. Determination of adherence or nonadherence (based on literature) was completed as the last activity of data collection. Results. Statistical significance was not achieved when exploring the difference of global cognition, self-report cognition, and language ability relative to adherence (p > .05). A relationship between structural elements of big words, cognitive process and insight words used in story and measures of adherence was revealed (p < .05). Although statistical significance was not reached the descriptive data supports that a relationship between cognitive impairment and measures of adherence were present across groups. The majority (64%) of nonadherent participants had cognitive impairment; 34% of the middle group and 5% of the adherent group had cognitive impairment. Discussion. Cognitive impairment is prevalent among older adults undergoing hemodialysis, however a relationship between cognitive impairment and adherence was not revealed in this study. This may be the result of the small sample size and adherence markers that were not sensitive in this population. This preliminary work offered a descriptive foundation which generated more questions that may be answered with further research.
Show less
Date Issued: 2006
PURL: http://purl.flvc.org/fcla/dt/12211
Subject Headings: Hemodialysis--Psychological aspects, Chronic renal failure--Patients--Rehabilitation, Adjustment (Psychology), Cognition in old age, Patient compliance, Clinical health psychology
Format: Document (PDF)

Title: Program Evaluation of Target BP within a Community Health Center.
Creator: Geevarughese, Stephanie, Hain, Debra, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Despite aggressive efforts to help people achieve target blood pressure goals, currently in the US, only 52% of patients with hypertension have achieved blood pressure goals as established by JNC 8 (Low et al., 2014). Hypertension correlates with a greater risk of myocardial infraction, heart failure, stroke, and kidney disease (Low et al., 2014). Early detection and intervention is essential to reduce mortality and morbidity (Beune et al., 2014). Target BP is a national initiative formed by...
Show moreDespite aggressive efforts to help people achieve target blood pressure goals, currently in the US, only 52% of patients with hypertension have achieved blood pressure goals as established by JNC 8 (Low et al., 2014). Hypertension correlates with a greater risk of myocardial infraction, heart failure, stroke, and kidney disease (Low et al., 2014). Early detection and intervention is essential to reduce mortality and morbidity (Beune et al., 2014). Target BP is a national initiative formed by the American Heart Association (AHA) and the American Medical Association (AMA) in response to the rising incidence of uncontrolled blood pressure (BP). The program established protocols including teaching patients how to measure blood pressure accurately as well as partnering with families, patients, and communities to promote self-management goals in hypertension. The Target BP program was implemented by the staff at one primary care practice in South Florida to improve blood pressure in their patient population. This health center serves hundreds of thousands of patients in the South Florida area to meet the needs of primary care in the community. The intention of this doctoral project was conduct a program evaluation of Target BP within this community health center in order to understand if the program should be adopted, adapted, or abandoned. All 114 patients enrolled in the Target BP program at the community health center where evaluated for improvement in hypertension during a four-month period. Twenty-five patients had blood pressures collected for all four months. The community health center exceeded their goal of 10% decrease in in the patients with uncontrolled hypertension within the organization. In total, 47 (41%) patients showed improvement in blood pressure to normal limits according to JNC8 standards over the 4 months. Program interventions were implemented per protocol when patient’s blood pressures were out of range. Staff nurses and healthcare providers provided interventions to address diet, exercise, monitoring blood pressure on logs, as well as taking medication for hypertension to encourage achievement of Target BP goals.
Show less
Date Issued: 2019
PURL: http://purl.flvc.org/fau/fd/FA00007534
Format: Document (PDF)

Title: Implementation of a Community Prevention Program to Reduce Cardiovascular Risks.
Creator: Evans, Altavia, Hain, Debra, Walters, Debby, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Cardiovascular disease is a serious health condition that affects the blood flow to and from the heart. It is currently one of the leading causes of death globally as it accounts for approximately 32% of deaths each year (WHO, 2021). In Palm Beach County, cardiovascular disease is the leading cause of death accounting for 23.7% of overall deaths (Palm Beach County, 2022). The risk for developing this disease increases when other comorbidities exist such as diabetes, hypertension,...
Show moreCardiovascular disease is a serious health condition that affects the blood flow to and from the heart. It is currently one of the leading causes of death globally as it accounts for approximately 32% of deaths each year (WHO, 2021). In Palm Beach County, cardiovascular disease is the leading cause of death accounting for 23.7% of overall deaths (Palm Beach County, 2022). The risk for developing this disease increases when other comorbidities exist such as diabetes, hypertension, hyperlipidemia, or an elevated Body Mass Index (BMI). With proper knowledge and lifestyle modifications, risks from complications are lowered. It is for this reason that a QI project was implemented, to see if a community prevention program (CPP) could help improve knowledge and behavior changes within a population. Overall, six participants completed the program, three males, and three females. Results showed that 83% of participants lowered their HgA1c while there was a 100% increase in blood pressure. Results also showed a decrease in BMI for 33% of participants, and an increase in BMI for 17% of participants. Overall cholesterol decreased by 66%. Based on the self-efficacy survey that participants took, it appeared that they were more confident and likely to identify healthy food choices and increase their aerobic exercise and activities. Although initial goals were not fully met, the implications of this project showed that a CPP can improve certain biomarkers that could help reduce the risk of cardiovascular disease. A longer period of time and larger sample size might yield much different results. It would also be beneficial to trend certain biomarkers such as BMI and blood pressure multiple times throughout the duration of the program to determine if a change occurs over a longer period.
Show less
Date Issued: 2022
PURL: http://purl.flvc.org/fau/fd/faudnp000075
Format: Document (PDF)

Title: Evaluation of an Established In-Home, Palliative Care Program and its Impact on Improving Patient Health Outcomes.
Creator: Guillaume, Keishan, Hain, Debra, Kennedy, Karen, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Background and Review of Literature: Palliative care has a high potential to increase quality of life for patients with serious illnesses through symptom management and providing care and support. There are various settings and organizations where individuals can receive such care. Still, many people prefer staying at home in a familiar environment. The problem is that palliative care programs should be effective to justify the resources invested and maintain patients' quality of life....
Show moreBackground and Review of Literature: Palliative care has a high potential to increase quality of life for patients with serious illnesses through symptom management and providing care and support. There are various settings and organizations where individuals can receive such care. Still, many people prefer staying at home in a familiar environment. The problem is that palliative care programs should be effective to justify the resources invested and maintain patients' quality of life. Moreover, as literature review shows they should involve advanced practice registered nurses (APRN) to achieve better outcomes since these specialists have considerable skills and competencies, but their potential is not used to the fullest. Purpose: The current DNP project is aimed at evaluating the palliative care program provided by Prospero Health to confirm its compliance with the goals of adequate care. Moreover, the project assesses the strengths and weaknesses of the project, identifies barriers to its implementation, and assesses the effectiveness in a decrease of hospitalizations. Another goal is to provide recommendations to improve the performance of the Prospero Health program based on the evaluation results.
Show less
Date Issued: 2022
PURL: http://purl.flvc.org/fau/fd/faudnp000063
Format: Document (PDF)

Title: Continued Support Following a Diabetes Self-Management Program on Adherence to Self-Management Behaviors, Distress Levels and Measurable Health Outcomes for Patients with Type II Diabetes Mellitus.
Creator: Stala, Olivia, Hain, Debra, Schroeder, Kristen, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Type II diabetes mellitus (T2DM) is a complex and multifactorial disease that can negatively affect a person’s physical and mental health. This disease is rapidly becoming one of the worst healthcare problems in America as rates are predicted to increase by 54%, impacting more than 54.9 million, by the year 2030 (Rowley, et al., 2017). Therefore, it is imperative that the health care system focuses attention on evidence-based measures that can improve diabetes control and prevent disease...
Show moreType II diabetes mellitus (T2DM) is a complex and multifactorial disease that can negatively affect a person’s physical and mental health. This disease is rapidly becoming one of the worst healthcare problems in America as rates are predicted to increase by 54%, impacting more than 54.9 million, by the year 2030 (Rowley, et al., 2017). Therefore, it is imperative that the health care system focuses attention on evidence-based measures that can improve diabetes control and prevent disease-related complications. Providing in-depth diabetes self-management education and support (DSME/S) to patients is necessary for them to successfully manage their chronic illness at home. The following Doctor of Nursing Practice quality improvement project aimed to improve diabetes outcomes in the community in collaboration with a local hospital organization, Holy Cross Health, located in Fort Lauderdale, Florida. This evidence-based change in practice project involved the implementation of additional in-person follow-up education and support following the completion of a diabetes program. The education and support provided was based on program content and current evidence in diabetes management and treatment. An in-depth synthesis of current evidence on DSMP and DSME/S was utilized for this project. This paper outlines the steps involved in measuring the impacts of continued support following completion of a program on diabetes control. A data analysis is described involving paired samples t-test and mean differences between baseline and post-intervention for health outcome measurements of weight, waist circumference, self-reported fasting blood glucose, self-reported serum hemoglobin A1C levels. In addition, a Diabetes Self-Management Questionnaire (DSMQ) and a Diabetes Distress Scale (DDS) were utilized comparison measurement tools.
Show less
Date Issued: 2022
PURL: http://purl.flvc.org/fau/fd/faudnp000067
Format: Document (PDF)

Title: Increasing Patient Activation at Caridad Center.
Creator: Cruz, Isabel, Hain, Debra, Lavernia, Frank, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Type 2 diabetes is a public health challenge. Researchers at the center of disease control and prevention (CDC), report more than 34 million Americans have diabetes (about 1 in 10) (CDC, 2019). Uncontrolled diabetes over a long period of time can result in end-organ damage. End results of poor glycemic control can result in diabetic retinopathy, neuropathy, kidney disease and kidney failure (Sacks, 2017). In type 2 diabetes (T2D) cells do not respond normally to insulin, a condition known as...
Show moreType 2 diabetes is a public health challenge. Researchers at the center of disease control and prevention (CDC), report more than 34 million Americans have diabetes (about 1 in 10) (CDC, 2019). Uncontrolled diabetes over a long period of time can result in end-organ damage. End results of poor glycemic control can result in diabetic retinopathy, neuropathy, kidney disease and kidney failure (Sacks, 2017). In type 2 diabetes (T2D) cells do not respond normally to insulin, a condition known as insulin resistance. These results set the stage for pre-diabetes and type 2 diabetes. Type 2 diabetes often develops in people over age 45, but more recently children, teens, and young adults are also developing type 2 diabetes. Type 2 diabetes in children are rising due to obesity rising. According to the CDC, more than 75 % children with type 2 diabetes have family members who also have it (CDC, 2019). With this being said, many evidence based research studies reveal how diabetes self- management is influenced by one’s confidence and willingness to manage diabetes. The patients desire to enhance their knowledge, skills and confidence is referred as “Patient Activation.” Increasing patient activation will help people manage their diabetes more effectively and be active in self-management behaviors (Regeer, Van Empelen, & Bilo, 2021).
Show less
Date Issued: 2022
PURL: http://purl.flvc.org/fau/fd/faudnp000050
Format: Document (PDF)

Title: Education, Screening, and Follow Up to Reduce Obstructive Sleep Apnea in a Prison Reentry Residential Community.
Creator: Lazcano, Amanda, Wiese, Lisa, Hain, Debra, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Obstructive sleep apnea affects an estimated 936 million people worldwide (Pivetta, 2021). Untreated OSA can lead to adverse metabolic, cardiovascular, and neurocognitive consequences, possibly reducing one’s lifespan. Education and screening can spread awareness among a community which typically has limited access to resources and may promote early recognition and treatment. In a Christian-based prison reentry residential community, a pre-test survey was provided to a total sample of 19...
Show moreObstructive sleep apnea affects an estimated 936 million people worldwide (Pivetta, 2021). Untreated OSA can lead to adverse metabolic, cardiovascular, and neurocognitive consequences, possibly reducing one’s lifespan. Education and screening can spread awareness among a community which typically has limited access to resources and may promote early recognition and treatment. In a Christian-based prison reentry residential community, a pre-test survey was provided to a total sample of 19 participants to measure baseline knowledge of OSA. After administration of the pre-survey, education was provided in a group setting, using a detailed brochure the DNP student created. After participants read through the material and questions were answered, the post-survey was administered to measure if knowledge regarding OSA increased. Screening using the STOP-Bang questionnaire occurred after the post-surveys. The DNP student followed up with participants found to be at high risk for OSA patients over a 3-month period. A 37% of participants scored high risk for OSA, 37% scored intermediate risk, and 26% scored low risk. The p-value calculated to measure pre-and-post OSA knowledge using the survey total score was statistically significant (< .001.). Of the seven total participants who scored high risk, two were newly diagnosed with OSA after referral to a PCP for a sleep study with the help of the telephonic phone sessions. Education and screening demonstrated to be beneficial, resulting in positive outcomes. Project partakers were successfully able to define OSA, list risk factors, and describe how to diagnose and treat the condition. Participants who were newly diagnosed, previously diagnosed, or refused the sleep study managed to adjust modifiable risk factors over the summer such as weight loss, diet, and management of chronic conditions.
Show less
Date Issued: 2023
PURL: http://purl.flvc.org/fau/fd/faudnp000079
Format: Document (PDF)

Title: Program evaluation of the detox protocol for patients with Alcohol Use Disorder.
Creator: De Freitas, Aisha, Hain, Debra, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Background: Alcohol use disorder (AUD) is a serious problem that has affected countless of people in the United States. This disorder is difficult to treat and despite evidence-based treatments, there continues to be a problem. Treatment centers often attempt to address AUD with personalized detox protocol based on tradition and evidence that attempt to target pertinent factors that may increase the likelihood of sustained abstinence. Purpose: To conduct a program evaluation of thedetox...
Show moreBackground: Alcohol use disorder (AUD) is a serious problem that has affected countless of people in the United States. This disorder is difficult to treat and despite evidence-based treatments, there continues to be a problem. Treatment centers often attempt to address AUD with personalized detox protocol based on tradition and evidence that attempt to target pertinent factors that may increase the likelihood of sustained abstinence. Purpose: To conduct a program evaluation of thedetox protocol for patients diagnosed with AUD at a treatment center in south Florida. This program evaluation will yield important information regarding the outcomes of an established program. This project identified strengths, opportunities for improvement, and opportunities to support current practice at this facility.
Show less
Date Issued: 2023
PURL: http://purl.flvc.org/fau/fd/faudnp000094
Format: Document (PDF)

Title: Effects of a Story-Sharing Intervention on Depression and Well-Being in Older Adults Transitioning to Long-Term Care.
Creator: Sullivan, Gail J., Hain, Debra J., Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: The purpose of this randomized control trial (RCT) was to investigate the effects of a story-sharing intervention on older adults transitioning to long-term care (LTC). The specific aims were (1) to determine the effects of story sharing on the health transition outcomes of depression and well-being of adults transitioning to LTC; and (2) to determine if the sociodemographic characteristics (age, gender, ethnicity, marital status, level of education (LOE), months living at LTC facility,...
Show moreThe purpose of this randomized control trial (RCT) was to investigate the effects of a story-sharing intervention on older adults transitioning to long-term care (LTC). The specific aims were (1) to determine the effects of story sharing on the health transition outcomes of depression and well-being of adults transitioning to LTC; and (2) to determine if the sociodemographic characteristics (age, gender, ethnicity, marital status, level of education (LOE), months living at LTC facility, choice to move, and health problem(s) that may have resulted in the move) predict depression and/or well-being. Story sharing was defined as the respectful space where one tells and listens to stories of others (Heliker, 2009) while being guided by another (the investigator). Meleis’ middlerange theory of transitions (MMRTT) (Meleis et al., 2000) was used as a guide to understand the transitioning process. A convenience sampling design was used to recruit 100 participants from 11 LTC facilities in Broward County, located in Southeast Florida. The sample included adults, age 65 years and older, who were transitioning to a LTC facility within the past two years. Participants were randomly assigned to the control group (n = 52), who received standard care, or to the intervention group (n = 41), who received story-sharing and standard care. The results indicated there was no significant greater improvement to suggest an Intervention and Time effect for depression and/or well-being. Overall, predictive ability of the sociodemographic variables for depression and well-being were not statistically significant. However, LOE (junior college) did account for a significant portion of unique variance for increased depression, and time, marital status, ethnicity, LOE, and choice to move did account for a significant proportion of unique variance for well-being. Months living in LTC (more months) and marital status (all but divorced) were significant for improved well-being while ethnicity (Hispanic), LOE (high school and junior college), and choice to move (no choice) were significant for reduced well-being. Similar studies using a larger sample size, including non-English speaking participants; lengthier storysharing sessions; and measuring for pain, health, and bereavement may offer additional insights to healthy transition outcomes for this population.
Show less
Date Issued: 2017
PURL: http://purl.flvc.org/fau/fd/FA00004827
Subject Headings: Loneliness--Psychological aspects., Depression in old age., Older people--Communication., Older people--Mental health services., Nursing home patients--Mental health., Nursing homes--Recreational activities., Recollection (Psychology)
Format: Document (PDF)

Title: The Effect of a Heart Failure Nurse Navigator on 30-Day Hospital Readmissions of Older Adults.
Creator: Leavitt, Mary Ann M., Hain, Debra J., Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Across the US, 22% of Medicare patients hospitalized with a diagnosis of heart failure (HF) will be readmitted within 30-days of discharge. There is no one costeffective process identified to help patients transition home and maintain their own selfcare. The aim of this study is to compare readmission rates, HF knowledge, self-care, and quality of life for patients who transition home from the hospital under the care of a Heart Failure Nurse Navigator (HFNN) with patients who receive usual...
Show moreAcross the US, 22% of Medicare patients hospitalized with a diagnosis of heart failure (HF) will be readmitted within 30-days of discharge. There is no one costeffective process identified to help patients transition home and maintain their own selfcare. The aim of this study is to compare readmission rates, HF knowledge, self-care, and quality of life for patients who transition home from the hospital under the care of a Heart Failure Nurse Navigator (HFNN) with patients who receive usual care. The HFNN is a home health RN with specialized training in HF care. The HFNN visited intervention group (IG) participants once in the hospital, followed by weekly home visits for one month. Control group (CG) participants received usual care, consisting of discharge teaching by their primary nurse and follow-up with their primary care provider (PCP) or cardiologist. Using a sequential mixed methods research design, this experimental randomized controlled trial measured HF knowledge, HF self-care, and HF quality of life (QOL) at enrollment and one month after discharge. Hospital readmissions and/or ED visits were tracked in both groups. IG participants were interviewed using semi-structured questions, findings of which were analyzed using conventional content analysis. There were fewer all-cause hospital readmissions in the IG (3 of 19) than the CG (6 of 21.) CG participants were 2.2 times more likely to be readmitted than the IG participants. [x(1)=.935, p=.334 O.R.=2.2219]. Due to limited enrollment, these results were underpowered and not statistically significant. There was improvement in HF knowledge (p=.06) and HF self-care maintenance (p=.07), approaching significance. HF self-care maintenance improved in both groups, although the IG was not significantly better (p=.48). There was significant improvement in the IG for HF confidence (p=.002) and HF QOL (p<.001). The qualitative findings revealed two main categories from the IG: (1) personal clarification of patient education, especially related to diet, exercise, and medications and (2) feelings of support, reassurance, and safety. The HFNN may be one role to meet the triple aim of improving patient quality care and health outcomes at a reduced cost, especially in areas where a comprehensive HF management program is not available.
Show less
Date Issued: 2017
PURL: http://purl.flvc.org/fau/fd/FA00004986, http://purl.flvc.org/fau/fd/FA00004976
Subject Headings: Dissertations, Academic -- Florida Atlantic University, Heart failure--Nursing., Hospitalization--economics., Home Health Nursing.
Format: Document (PDF)

Title: THE IMPACTS OF LIVING ARRANGEMENTS, HEALTHY AGING, AND WELL-BEING AMONG OLDER THAI ADULTS.
Creator: Suragarn, Usar, Hain, Debra, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: The purpose of this exploratory-descriptive study was to compare the different living arrangements of older Thai adults on healthy aging and well-being in those attending the elderly school. The specific aims of this study were (1) to describe demographic characteristics, and (2) to identify differences between the outcomes the Thai Healthy Aging Instrument (HAI) and the Personal Wellbeing Index (PWI) in older Thai adults 60 years and older based on the types of living arrangements. The...
Show moreThe purpose of this exploratory-descriptive study was to compare the different living arrangements of older Thai adults on healthy aging and well-being in those attending the elderly school. The specific aims of this study were (1) to describe demographic characteristics, and (2) to identify differences between the outcomes the Thai Healthy Aging Instrument (HAI) and the Personal Wellbeing Index (PWI) in older Thai adults 60 years and older based on the types of living arrangements. The Convoy Model of Social Relations was used as a guide for understanding the multifactorial nature of the social connection (Kahn & Antonucci, 1980). A convenience sampling design was used to recruit 139 participants living in Tambon Hua Ngom, Chiang Rai province, Thailand, for at least a year. The sample included adults age 60 years and older who read and spoke Thais and had been participated in the elderly school at least once a month for one year. Among the participants (N = 139), 30 lived alone, and 109 lived with others. The findings of this study indicated that there were no statistically significant relationships between demographic characteristics between those who lived alone and those living with others, except for marital status. The participants living alone were more likely to be widowers compared to those living with others (p < .05).
Show less
Date Issued: 2019
PURL: http://purl.flvc.org/fau/fd/FA00013417
Subject Headings: Thais, Healthy Aging, Well-being, Social Support, Older people
Format: Document (PDF)

Title: The Impact of a Blood Pressure Monitoring Wellness Program on Adults with Hypertension.
Creator: Wilcox, Jasmine, Hain, Debra, Kinlaw, Nakeisha, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Hypertension is a national health concern that can increase the risk for cardiovascular disease. Healthy People 2020 recommends improving cardiovascular health by increasing the number of adults who check their blood pressure and understand whether it is high or low. In an effort to improve outcomes in adults with hypertension, this quality improvement project was implemented at a primary care setting aimed at improving blood pressure control through self-care behaviors. The intervention...
Show moreHypertension is a national health concern that can increase the risk for cardiovascular disease. Healthy People 2020 recommends improving cardiovascular health by increasing the number of adults who check their blood pressure and understand whether it is high or low. In an effort to improve outcomes in adults with hypertension, this quality improvement project was implemented at a primary care setting aimed at improving blood pressure control through self-care behaviors. The intervention included providing staff education on the HBPM program called IHEALTH, an educational counseling session for recruited participants (adults ages 21- 85 with a diagnosis of HTN within the last year or uncontrolled HTN) in which a pre-test blood pressure knowledge and self-care scale on hypertension were administered. There were statistically significant improvements in BP from pretest to posttest on the average the Mean Arterial Pleasure (MAP) and Systolic BP. The MAP decrease from an average of 105.7 to 100.4 [t(7)=2.32, p=.027, Cohen’s D=1.76] whereas the SBP decrease from an average of 142.9 to 128.4 [t(7)=2.74, p=.015, Cohen’s D=2.07]. There was a small but nonsignificant decrease in DBP from an average of 87.1 to 86.4 [t(7)=0.17, p=.868, Cohen’s D=0.129]. The preintervention knowledge scale rose from a mean score of 69 to a mean score of 88 on the post test. The post intervention pre-intervention self-care score rose from an average of 44 to a post intervention average score of 75. The project showed that the implementation of a quality improvement project in a primary care setting with staff involvement can lead to participant blood pressure control through promotion of participants self-care behaviors. Therefore, implications for practice include incorporating HBPM programs into practice due to the high potential for improving blood pressure control through self-care behaviors. In addition, the implementation of a HBPM program in addition to office blood pressure is important for diagnosis and monitoring HTN (Kairo et. al., 2019).
Show less
Date Issued: 2021
PURL: http://purl.flvc.org/fau/fd/faudnp000023
Format: Document (PDF)

Title: Reduce Psychotropic Medication Use for Nursing Home Residents with Alzheimer’s/Dementia: A Quality Improvement Project.
Creator: Guerda, Joseph Valere, Hain, Debra, Gupta, Shobha, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: There is an increase in residents with dementia receiving care in Skilled Nursing Facilities (SNFs). As the person's dementia progresses there is an increased risk of behavioral and psychological symptoms of dementia (BPSD) which include aggressive behaviors, screaming, and yelling. Frequently, psychotropic medications are used to treat behaviors, but it is associated with several risks, including risks of falling, high hospitalization rate, adverse events, and even deaths of the nursing home...
Show moreThere is an increase in residents with dementia receiving care in Skilled Nursing Facilities (SNFs). As the person's dementia progresses there is an increased risk of behavioral and psychological symptoms of dementia (BPSD) which include aggressive behaviors, screaming, and yelling. Frequently, psychotropic medications are used to treat behaviors, but it is associated with several risks, including risks of falling, high hospitalization rate, adverse events, and even deaths of the nursing home residents. The Centers for Medicare and Medicaid Services (CMS) are monitoring use and providers caring for individuals in SNFs will have to justify reasons for prescribing psychotropic medication (CMS, 2020). There is evidence of many interventions to treat BPSD. There is a need to translate this evidence into practice to see if we can reduce the use of psychotropic medications.
Show less
Date Issued: 2021
PURL: http://purl.flvc.org/fau/fd/faudnp000026
Format: Document (PDF)

Title: Early Detection and Management of Acute Kidney Injury in Long Term Care Residents: Increasing Nursing Staff Knowledge, Confidence, and Competence.
Creator: Jamero, Fredeline, Hain, Debra, Speranza, Janet, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: The incidence of acute kidney injury AKI (also known as acute renal failure) is an emerging public health concern worldwide and it is associated with high healthcare cost, prolonged hospital stays, progression to chronic kidney disease and end-stage renal disease and higher mortality. Advanced age increases the vulnerability to AKI due to both structural and functional degeneration over time affecting many older adults living in long term care facilities. The literature shows AKI is...
Show moreThe incidence of acute kidney injury AKI (also known as acute renal failure) is an emerging public health concern worldwide and it is associated with high healthcare cost, prolonged hospital stays, progression to chronic kidney disease and end-stage renal disease and higher mortality. Advanced age increases the vulnerability to AKI due to both structural and functional degeneration over time affecting many older adults living in long term care facilities. The literature shows AKI is preventable with early detection and management. The purpose of this quality improvement project was to assess if the implementation an evidence-based education presentation to a group of nurses in a long-term care facility on early detection and management of AKI while improving the staff’s knowledge, confidence and competence will prevent the AKI in the facility, decrease AKI related hospitalizations and ultimately improve health outcomes. The plan, do, study, act (PDSA) method was used, and descriptive statistics were utilized to analyze the data of this project obtained from a pre-post survey questionnaire. A retrospective chart review of hospitalization data was utilized to record pre and post intervention hospital discharges. Results indicated that the education presentation improved knowledge and management of AKI; therefore, recommendations for practice change are necessary.
Show less
Date Issued: 2021
PURL: http://purl.flvc.org/fau/fd/faudnp000020
Format: Document (PDF)

Title: Cardiovascular Disease (CVD) Awareness Program and CT Coronary Artery Calcium Scores Affect on Patient Perception of CVD Risk and Behavior Modifications.
Creator: St. Philippe, Theresa, Hain, Debra, Orringer, Carl E., Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Cardiovascular disease continues to be a medical concern affecting millions globally. 17.9 million people die each year from cardiovascular disease (CVD), representing 32% of all deaths worldwide, (World Health Organization, 2021). Despite medical evidence and continuous awareness efforts in treating CVD, people continue to engage in behaviors and lifestyles that ultimately increase their risk of developing CVD. In effort to help curtail the incline of heart disease, the aim of this quality...
Show moreCardiovascular disease continues to be a medical concern affecting millions globally. 17.9 million people die each year from cardiovascular disease (CVD), representing 32% of all deaths worldwide, (World Health Organization, 2021). Despite medical evidence and continuous awareness efforts in treating CVD, people continue to engage in behaviors and lifestyles that ultimately increase their risk of developing CVD. In effort to help curtail the incline of heart disease, the aim of this quality improvement project was to increase CVD awareness, knowledge of personal atherosclerosis cardiovascular disease (ASCVD) risk profile and encourage behavior modifications that lead to overall risk reduction. This was achieved by individualized educational sessions on cardiovascular health, discussion of lifestyle modification that reduces risk of developing ASCVD and undergoing CT CAC scores. Pre-test scores of CVD knowledge tool improved from a mean score of 40.66 to post-test mean score of 100, demonstrating that 100% of all participants showed increased knowledge of CVD, based on an alpha level of .05, [F(1, 48) = 55.02, p < .001]. In addition, risk modifying behaviors such as dietary choice improved after undergoing CAC scores and attending educational sessions. The mean of Unhealthy/Processed Food-Pre-Test was 3, denoting consumption of beverages with added sugars, fried and/or processed foods, at least 1-2 times per week, whereas post interventions mean score was 1.17, corresponding to consumption of unhealthy foods once per month or less, based on an alpha level of .05, [V = 168.00, z = -3.66, p < .001]. Lastly, the project demonstrated that understanding cardiovascular disease and associated ASCVD risk obtained by CT CAC scores led to increase in exercise and medication adherence.
Show less
Date Issued: 2022
PURL: http://purl.flvc.org/fau/fd/faudnp000071
Format: Document (PDF)

Title: A Complementary and Integrative Care Educational Needs Assessment of Advanced Practice Registered Nurses in Outpatient Settings.
Creator: Glynn, Amanda L., Hain, Debra, Wilson, Candy, Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description: Deficits in patient and provider knowledge in the use of complementary and integrative care (CIC) methodologies resulted in the planned creation of a future CIC educational course for outpatient advanced practice registered nurse practitioners (APRNs) who often serve as a primary source of health education for their patients. A survey, which was based upon the Theory of Bureaucratic Caring and the Canadian Institutes of Health Research’s (CIHR) knowledge-to-action (KTA) cycle, and...
Show moreDeficits in patient and provider knowledge in the use of complementary and integrative care (CIC) methodologies resulted in the planned creation of a future CIC educational course for outpatient advanced practice registered nurse practitioners (APRNs) who often serve as a primary source of health education for their patients. A survey, which was based upon the Theory of Bureaucratic Caring and the Canadian Institutes of Health Research’s (CIHR) knowledge-to-action (KTA) cycle, and incorporated elements of the Complementary and Integrative Health Assessment for Practitioners (CIAHP) and the Complementary and Alternative Medicine Beliefs Inventory (CAMBI), was created to assess the CIC educational needs of APRNs employed in primary care/outpatient settings. Survey participants identified their preferred method of instruction, top areas of CIC topics of interest and occupational applicability, and preferences for CIC educational course design and delivery. A low ratio of survey respondents versus completion rate and the lack of participant occupational and demographical diversity were observed challenges. Survey data supported the need for the creation and implementation of a pending CIC educational course with a goal of mirroring the educational needs of advanced practice registered nurses.
Show less
Date Issued: 2023
PURL: http://purl.flvc.org/fau/fd/faudnp000098
Format: Document (PDF)

Title: Gaining Insight into the Experiences of Women with Premenstrual Dysphoric Disorder (PMDD) and Improving Outcomes.
Creator: Reyes, Margaret Mary, Hain, Debra, Bhatia, Padam, Florida Atlantic University, Christine E. Lynn College of Nursing
Date Issued: 2023
PURL: http://purl.flvc.org/fau/fd/faudnp000102
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.
Show less
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)

Christine E. Lynn College of Nursing Doctor of Nursing Practice (13)	+ -
FAU Theses and Dissertations (7)	+ -
FAU College Collections (2)	+ -

Dementia (2)	+ -
Well-being (2)	+ -
Adjustment (Psychology) (1)	+ -
Attitude (Psychology) (1)	+ -
Caregiver Burden (1)	+ -

Caregivers (1)	+ -
Caregivers --Psychosocial Factors (1)	+ -
Chronic renal failure--Patients--Rehabilitation (1)	+ -
Clinical health psychology (1)	+ -
Cognition in old age (1)	+ -
Dementia --Psychosocial Factors (1)	+ -
Depression in old age. (1)	+ -
Diabetes (1)	+ -
Dissertations, Academic -- Florida Atlantic University (1)	+ -
Education, Nursing (1)	+ -
Exhaustion (1)	+ -
Health education (1)	+ -
Health literacy (1)	+ -
Healthy Aging (1)	+ -
Heart failure--Nursing. (1)	+ -
Hemodialysis--Psychological aspects (1)	+ -
Home Health Nursing. (1)	+ -
Hospitalization--economics. (1)	+ -
Kidney Diseases (1)	+ -
Kidney Diseases --Education (1)	+ -
Kidney Diseases --Therapy (1)	+ -
Loneliness--Psychological aspects. (1)	+ -
Medical personnel (1)	+ -
Nursing (1)	+ -
Nursing Theory (1)	+ -

Doctor of Nursing Practice (DNP) (13)	+ -
Electronic Thesis or Dissertation (7)	+ -

Florida Atlantic University (20)	+ -
Christine E. Lynn College of Nursing (19)	+ -
Hain, Debra (17)	+ -
Hain, Debra J. (5)	+ -
Almashni, Ibtisam Y. (1)	+ -

Search In

Pages

Pages

Sort Results By:

Narrow results by:

Collection

Topical Subject

Genre

Type of Resource

Language

Creator

Format

Owner