<p> <b>Purpose:</b> The purpose of this project was to educate wound care patients from a rural wound care clinic about the importance of diet in healing chronic wounds. The aim of this Doctor of Nursing Practice project was to increase the patients&rsquo; knowledge of nutrition and its role in wound healing. </p><p> <b>Background:</b> Wounds become chronic if after three months the wounds fail to undergo appropriate systematic repair to produce purposeful reparations of the body tissues. Chronic wound patients constitute about 15% of the United States Medicare patients. Chronic wound conditions affect the quality of life of patients and take about $20 billion yearly from the national economy. The healing of wounds is the response of the natural body to an injury to restore the structure and function of the human body. The three primary essentials of wound healing are pressure relief and nursing care; dressings; and nutrition. Nutrition is essential in wound healing with macronutrients and micronutrients playing important roles in wound healing. The role of protein in the provision of the necessary components for tissue growth, cell repair and renewal make protein an essential component in all phases of wound healing. </p><p> As hospitals and healthcare professionals are considered the primary source of patient education for chronic wound management, it becomes necessary for hospitals to re-evaluate their patient education with emphasis on education delivery methods. In this project, the shift in emphasis was facilitated by the available information that identified Just-in-Time education method as an effective and efficient patient information delivery model. Adopting a Just-in-Time education model will promote the delivery of wound healing information to patients and also emphasize the importance of nutrition to wound healing. The project sought to determine whether using the Just-In-Time Teaching would help increase patient&rsquo;s understanding of the importance of nutrition to chronic wound healing. The project used pretests and posttests to collect data from 13 chronic patients with chronic wounds in a rural hospital wound care center. The educational intervention was presented in PowerPoint. Results of the analysis show that the patients&rsquo; knowledge of the importance of nutrition to wound healing increased following the educational intervention. </p><p> <b>Method:</b> Patients 30- to 75-years old who have had a chronic wound for more than three months were invited to participate. The Model for Improvement guided this project in delivering the education and evaluating improvement in the nutrition knowledge of the participants using a pretest, educational presentation, and post-test design. The evidence-based educational intervention was created by the student in collaboration with providers at the site. </p><p> <b>Outcomes Achieved:</b> Data collection was conducted in one week and analyzed with Qualtrics. The analysis showed that there was an increase in the patients' knowledge of the role of nutrition in chronic wound healing as shown in the attached graph and tables. </p><p> <b>Conclusion:</b> The week-long implementation was successful in increasing nutritional knowledge among the participants. The result of this project provided some significant new information about the importance of education to patients with chronic wounds.</p><p>

<p> Effective communication ensures patient safety and quality care. Shift report is multi-faceted, and if not conducted in a consistent manner, can be a source of errors. Implementing bedside report places focus on the patient&rsquo;s values and needs and meets Quality and Safety Education for Nurses (QSEN) competencies, including patient-centered care. Bedside reporting with an established template improves patient safety, as well as nurse and patient satisfaction. The investigator expected that by implementing nurse and patient education while establishing a bedside reporting template, there would be an increase in nurse and patient satisfaction, improved bedside reporting frequency, and a decrease in patient safety alerts. </p><p> This advanced scholarly project was conducted at a Midwest hospital including approximately 160 nurses in various departments. A nonrandomized control pretest and posttest assessed nurse satisfaction with bedside report frequency. The requirements of the reporting template were established by the Council for Nursing Excellence (CFNE). Education on the template included nurse training and patient brochures before implementation. Additional assessments examined patient satisfaction scores and safety alerts. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores provided details on patient satisfaction, while Iris alerts offered information on patient safety as it related to communication or a lack thereof. </p><p> HCAHPS scores revealed inconsistencies throughout the various units while Iris alerts provided minor quantities of data. Nurse survey results demonstrated a decrease in nurse satisfaction with the new template, as well as a reduction in the verification of report; however, there were improvements in satisfaction for all other areas examined including the frequency of report while including the patient, sufficiency of report, the ease of including the patient in report, as well as the belief that information is not lost during the reporting process.</p><p>

<p> The purpose of this qualitative research study with an existential phenomenological approach was to generate an understanding of the lived experiences of a shared central phenomenon of RN-to-BSN graduates and determine their perceptions of the value of their BSN degree. RNs may have begun their education journey at the diploma or associate degree level, and their insights into how obtaining their degree changed their professional and personal goals may contribute greatly to this study. The theory of planned behavior guided this study. The experiences, perceptions, and value that affect RNs&rsquo; educational journeys were the framework for this qualitative research study with an existential phenomenological approach. The data collection procedure was open-ended, semi-structured, which was consisted of one-on-one interviews with 12 nurses who are licensed in Massachusetts and who are graduates of RN-to-BSN programs. The findings identified seven major emerging themes, a) job requirement, b) promotion, c) professional growth, d) personal growth, e) family obligations, f) time and energy, and h) compensation. The themes were incomparable through all emerging themes. The future implications of this study have the potential to add to the body of knowledge for nursing education and RN-to-BSN programs because it has provided opportunities for non-BSN RNs to continue their education for job requirements and promotions for career opportunities. </p><p>

Obesity, a public health issue in the United States, has been linked to numerous chronic diseases. A gap exists in the literature related to racial and cultural etiology of body satisfaction for obese women. The purpose of this qualitative phenomenological study was to describe the racial and cultural etiology of body satisfaction for obese Black women and White women residing in a rural area of the state of North Carolina. Social comparison theory provided the theoretical underpinning for this examination. The central research question was how do obese, young adult Black women and White women describe their perceptions about and experiences of the racial and cultural etiology of their body satisfaction. One-on-one interviews were used to collect data from 6 obese young adult women (3 Black women and 3 White women) between the ages of 18 and 29 years residing in a rural area of North Carolina. Braun and Clarke's 6-phase method for thematic analysis was used to analyze the data. Six themes emerged from the data analysis: (a) Black participants viewed the media through a lens of body positivity, (b) White women related media influences as confrontation with the media, (c) Black women related peer influences to include shaming and denial, (d) White women viewed peer influences as including negative comparisons and positive examples, (e) Black women related family influences to include normalizing obesity, and (f) White women related family influences as including one welcoming the outcast. The results of the study foster positive social change, as deeper understanding of racial and cultural differences regarding body satisfaction of Black women and White women could lead to positive body image and greater body satisfaction among these groups.

The lack of access to improved toilet sanitation remains a major health and environmental hazard in developing nations in the world. Despite global leadership efforts at the level of the United Nations and nongovernmental organizations around the world, diarrhea-related diseases disproportionately affect children. Evidence from the literature suggests that competent and sustained leadership is central to resolving the problem. From a historical perspective, leadership advocacy and engagement prompted the sanitary revolution in the West in the 18th and 19th century that led to the eradication of preventable infectious diseases such as cholera. Integrated leadership that made use of sanitation and water institutions at the national, state, and local levels and structured, skilled, and financial capability helped create an enabling environment for better and sustainable hygiene sanitation in the West. A qualitative approach was used to explore the role of collaborative leadership in enhancing the demand for toilet hygiene in rural Njinikom and the community's perception of the state of sanitation. One-on-one interviews were conducted with 25 adults aged 18 years and above with knowledge and exposure to poor toilet sanitation. Content analysis was used to develop themes and patterns from the data. The findings revealed barriers such as inefficient leadership and limited financial resources that impede adequate feces disposal and motivating factors for better sanitation. The results provided support for a partnership approach that is inclusive, relevant, useful, and sustainable. The implication of the study includes renewed interest in improving toilet sanitation and health and increase understanding of the importance of adequate feces disposal in preventing and eliminating associated fecal-oral diseases.

The incidence and prevalence of food safety practices among food staff working in food establishments in Manitoba is underrepresented and has not been adequately reviewed and researched. Uncertified food staff are at higher risk of not following food safety practices that can cause contamination of food and result in foodborne illness. The purpose of this quantitative study was to determine the prevalence of food safety practices among food staff in Manitoba and to determine the relationship between food safety certification and routine health inspections. Pender's health promotion model and Bandura's social cognitive theory were used to explain the relationships and associations between variables. Archived data dating from 2012 to 2014 of health inspection reports on 558 food establishments were collected and analyzed using the Manitoba Health Hedgehog database. Chi Square, Pearson Correlation Coefficients, and Fisher's Exact Tests revealed the association of food safety practices, routine health inspections, and food safety certification. Results indicated no statistical difference between food safety practices and routine health inspections. Pearson's r analysis revealed a weak relation between routine inspections, internal temperature, thermometer use, and food storage/food protection noncompliance. Logistic regression analysis revealed that food safety certification was not a predictor of food safety practice compliance. This study can provide a bridge to reevaluate current health policies pertaining to food safety practices in Manitoba. This study adheres to the need for social change in establishing and creating prevention programs for food staff. Food safety programs can safeguard the food industry and protect public health from foodborne illnesses.

Sexually transmitted diseases (STD) are preventable conditions for which treatment failure (specifically in gonorrhea) is becoming problematic. U.S. young adults (20-29 years) have high rates of STD incidence and prevention of these diseases, but reaching them to provide primary prevention educations is challenging due to low perceived susceptibility to infection and lack of knowledge about how young adults seek health information. The purpose of this quantitative survey study was to assess the association between perceived susceptibility to STDs, sexual risk behavior, and the acquisition of health information as it pertains to sexual health topics in young adults. The Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) were used in combination as the theoretical foundation of this study. Data collection was done using an adapted version of the Health Information National Trends Survey (HINTS), the Condom Use Self Efficacy Scale (CUSES), and an adapted version of the Marin County (California) Health Department's Sexual Risk Survey. There were 128 eligible participants and analysis of the data showed that the internet was the primary source of both general health information (87.5%) and STD specific health information (75.8%). A multiple regression analysis showed that there was no statistically significant correlation between perceived susceptibility and health information seeking or sexual risk (p > .05). This can aid in positive social change by prompting additional research on the subject of STD prevention in young adults through the design and dissemination of tools for education that may reduce the rate of STDs or other health ailments.

Limited knowledge exists about sexual orientation and intimate partner violence among women who have sex with women. These women are at risk for adverse physical and mental health hygiene outcomes that may result from unhealthy lifestyles secondary to intimate partner violence. The purpose of this study was to examine the association between sexual orientation and intimate partner violence among women who have sex with women. The constructs of the biopsychosocial model guided the study and examination of the relationships among biological factors (sexual orientation), social contexts (support of family and friends and use of community services), and psychological influence (mental health status) on intimate partner violence among women who have sex with women. The study was a quantitative cross-sectional analysis of archived data from the 2010 National Intimate Partner and Sexual Violence Survey. Forward stepwise logistic regression indicated a statistically significant relationship between sexual orientation and intimate partner violence victimization (p < .05) Annual household income, race, family/proximal support, and support of community were significant predictors of intimate partner violence victimization. The social change implications of the study are that findings may inform design and implementation of policies, services, and interventions that target the diverse needs of female same-sex intimate partner violence victims.

Health literacy, defined as the ability to understand and use health information to make informed decisions, is critical to maintaining health; however, not all U.S. states mandate strategies to improve adolescents' health literacy. Moreover, many middle school teachers are often unaware of how their roles could improve the health literacy of their students. Multimodal literacies help students to create meaning through viewing print-based resources and using digital technologies. The purpose of this study was to investigate teachers' perceptions of the effectiveness of multimodal literacies on adolescents' overall health literacy via the introduction of health literacy programs into the curriculum. This qualitative research data were gathered, analyzed, and categorized using unstructured narrative interviews and the research was guided by the socioecological model. A phenomenological approach was used to conduct in-depth interviews with 6 middle school teachers. These interviews yielded 4 common themes: efficacy of multimodal literacy, health literacy, blending cultures, and responsibility. The results suggested that (a) multimodal literacies with adolescent literacy components can be used in the middle school curriculum, and that (b) these literacies can help inform policy changes. Understanding teachers' perceptions about multimodal literacy could help to improve adolescent health literacy in the middle school system. Positive social change could occur if school systems understand the utility of incorporating adolescent health literacy in the present curriculum. Doing so could help reduce future health care costs and improve the future health of students.

Access to and receipt of health care is an essential human right; however, transgender people often have negative health seeking experiences that give way to the many health disparities seen in the transgender community. Using the social ecological model, this study determined, through multiple logistic regressions, that correlations existed between socioeconomic, health behaviors, and sociocultural variables and 6 measures of health seeking experiences among transgender African Americans. Secondary data from the 2010 National Transgender Discrimination Survey were used, yielding a sample size of 253 transgender African Americans. Those in the African American transgender community at most risk for negative health seeking experiences had the following characteristics: (a) earned high school diplomas and beyond, (b) were in the workforce or looking to be in the workforce, (c) earned an annual salary exceeding $10,000, (d) did not want hormone therapy, (e) abused alcohol and drugs, (f) attempted suicide, (g) were uninsured or had public insurance, (h) were out in a medical setting, (i) were homosexual, (j) had family support, (k) were homeless, (l) were older in age, (m) self-identified as transgender before 18, (n) received first transgender related medical treatment after 17 years old, (o) lived outside of the New England region, and (p) preferred other health settings than emergency rooms. Exploring this aspect of transgenderism and health care has potential for positive social impact as results from this study could improve the lives of transgender African Americans by combating transphobia among health professionals and promoting culturally competent health care.