<p> Despite concerted efforts to improve the process of shift-to-shift hand-off report (SHR), challenges and barriers continue to threaten the integrity of information shared between nurses. Research studies have demonstrated that vulnerabilities in SHR have been associated with clinical practice demographic factors, lack of a standardized process and tools, and differences in perceived value of SHR. </p><p> A quantitative, descriptive, cross-sectional study was conducted to identify nurse perception of SHR processes, factors that influence nurse perception of SHR, and nurse perception of bedside shift report (BSR) versus alternative SHR methods. Participants included a convenience sample of registered nursing students (n=49) enrolled in RN-BSN or MSN programs at a private southwestern Pennsylvania university. Descriptive statistics, ANOVA, and two independent t-Tests were used to analyze data collected from the Handover Evaluation Scale. </p><p> Study results revealed there was no statistically significant difference between nurse perception of SHR processes, demographic factors that influence SHR, and the locality of SHR (BSR). In addition, the majority of nurses identified a reluctance to change current practice of conducting the SHR process. There was no identified association between nurse perception of the quality of information (<i>p</i>=.22), interaction and support (<i>p</i>=.96), or efficiency (<i>p</i>=.17) of SHR. </p><p> As nurses are key stakeholders in the transfer of crucial up-to-date patient care information, nurse perception of the SHR needs to be further examined and evaluated to improve patient care outcomes. Quality assurance measures are the hallmark of standardized processes to ensure the delivery of safe and effective care.</p><p>

<p> <b>Background:</b> Diabetes mellitus (DM) affects more than 29.1 million Americans. Standardized clinical practice guidelines recommended by regulatory healthcare agencies are the standard of care for diabetic patients and must be adhered to by healthcare professionals providing care. </p><p> <b>Purpose:</b> The purpose of this quality improvement project was to identify Centers for Medicare and Medicaid Services&rsquo;, Joint Commission on Accreditation of Healthcare Organization&rsquo;s, and other professional healthcare organizations&rsquo; guidelines for nurses&rsquo; knowledge of evidence-based discharge practices; determine level of nurses&rsquo; knowledge on evidence-based discharge practice process; develop a quality improvement plan, including development of an evidence-based guideline for diabetic discharge instructions; present guideline to stakeholders; implement the guideline in fall of 2017; and evaluate nursing compliance with the guideline at a for-profit adult care hospital in South Florida. </p><p> <b>Theoretical Framework:</b> The chronic care model was utilized as the framework. This model has been used for improving practice and preventing many chronic illnesses. </p><p> <b>Methods:</b> Two quantitative nonparametric descriptive designs were used, the Wilcoxon signed- rank test and a paired <i>t</i> test. An online demographic survey and pre- and posttest surveys were administered to determine nurses&rsquo; knowledge of diabetes discharge guideline practices. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) evaluation tool evaluated the guideline, and data were analyzed with Wilcoxon and paired <i>t</i> tests. </p><p> <b>Results:</b> A statistically significant difference was found in the pre-posttest survey responses for question 5 (<i>p</i> = 0.046 Wilcoxon; <i>p</i> = 0.041<i>t</i> test), and question 13 (<i>p</i> = 0.022 Wilcoxon; <i>p</i> = 0.018 <i> t</i> test), indicating improvement. With the AGREE II tool, the multidisciplinary team evaluated the guideline at 100%, and 76% of Advanced Practice Registered Nurses (APRNs) and Registered Nurses (RNs) demonstrated compliance with guideline use. </p><p> <b>Conclusion:</b> A standardized diabetic discharge guideline incorporated into the hospital&rsquo;s discharge process provided APRNs and RNs with tools for educating and providing diabetic patients for increase in quality of life after discharge. The guideline was recommended by the administrative team for continued use throughout the hospital. Implementation of an evidence-based standardized diabetic discharge guideline to promote nurses&rsquo; adherence results in effective nursing practices and an informed patient population. </p><p>

<p> Posttraumatic stress disorder (PTSD) is a serious issue for post-deployment United States Marine Corps (USMC) veterans, especially because PTSD can increase the risk of suicide. Marines are screened post-deployment, yet little is known about Marine veterans&rsquo; perceptions of the PTSD screening process. The purpose of this phenomenological study was to explore USMC male veterans&rsquo; perceptions of the Post- Deployment Health Reassessment (PDHRA). The social cognitive theory constructs of a triadic relationship among person, environment, and behavior were the framework for understanding this population&rsquo;s perceptions of the PDHRA and potential stigma. Two research questions focused on how people, culture, and behavior affect Marines perception of the PDHRA and PTSD attached stigma. Interviews were conducted with 10 Marine veterans&rsquo; participants and transcribed interview responses were input into NVivo 11 software to retain a reliable database and Colaizzi&rsquo;s strategy to identify emerging themes. Key findings revealed potential positive social change to military chaplains and veterans&rsquo; health service providers. This knowledge might inform about the perceptions of Marines through informed understanding and may help develop an updated evaluation tool. Future researchers might focus on the forthcoming answers and treatment of PTSD and the attached stigma among Marines by alleviating repercussions for Marines&rsquo; answers on the PDHRA. An understanding of the study&rsquo;s findings may elicit strategies for health care administrators to expound on the PDHRA and provide educational programs to assist in future screening environments and processes through Marines perspectives.</p><p>

<p> Today&rsquo;s emerging patient centered health movement is focused not on a specific condition or demographic, but rather on shifting the balance of power and enabling access to information to drive decision-making in healthcare. This takes place through electronic health records as well as more generalized sources. The uptake of social media is contributing to an innovation in patient centered healthcare: information and support on a global scale is coming not only from the formal healthcare system, but also within online social networks. Today, through computer-mediated interactions, patients are not only seeking information, they are curating and sharing information. Subsequently, patients are also creating information, establishing a novel ecosystem of engagement that has the potential to disrupt the current healthcare system. </p><p> This dissertation explores an online health community, BCSM (which stands for &ldquo;breast cancer social media&rdquo;), established using Twitter, a largely public and searchable social media platform. Drawing primarily from social network theory, disruptive innovation, and ecological systems theory, this research identifies essential characteristics within the community that may inform future development and support for patient centered healthcare. To conduct this research, a blended approach of netnography &ndash; referring to the approach of ethnography applied to the study of online cultures and communities &ndash; and in-depth interviews with BCSM participants were employed. </p><p> Data collected via interviews and tweets using the hashtag #bcsm provide evidence of clinical support, emotional support, information sharing, and knowledge translation. Underpinning this activity is the opportunity to associate not only with peers, but also with individuals of varying roles (including patients, providers, advocates, researchers, and caregivers). As evidenced by the data collected, educational opportunities flow in both directions. </p><p> This work contributes to the larger corpus of health-related literature in the identification and naming of a significant community element that has seen little focused attention: cross-peer engagement, a term used to highlight the interaction amongst individuals of differing status, ability, or rank. This research also documents the formation of microspurs, defined as relationships that form as a result of community participation. These come in many forms and range from expanding a personal support network to participation in federal policy work. Findings suggest that the future of healthcare will not revolve around hospitals and bounded systems. Instead, patients will demand an expanded set of entry points for health information sharing, knowledge transfer, condition management, and general support.</p>

<p> The purpose of this study was to compare and contrast four age cohorts to determine: (a) if they have any preexisting knowledge about The Blue Zones Power 9 lessons for longevity, (b) if they are currently practicing any of the Power 9 lessons, and (c) to what extent they intend to adopt all or some of the Power 9 lessons in the future. The Transtheoretical Model of Behavior Change (DiClemente &amp; Prochaska, 1982) guided exploration of the respondents&rsquo; adoption of the Power 9 lessons. There were four significant findings in this study. Physical activity and stress relief had similar results in that both the youngest and oldest age cohorts&rsquo; expressed higher frequencies than the two middle age cohorts. Wine consumption and adoption/intention to adopt the Power 9 also had similar results, demonstrating that as age increased, so did the frequency of wine consumption and adoption/intention to adopt the Power 9.</p>

<p> Self care is more than a requirement for life. Working in a high stress hospital environment lends itself to having many personal and professional stressors that go beyond medical professionals job requirements. The purpose of this study was to explore how hospitals support medical staff through self care programs. Data was collected through semi-structured interviews of five medical professionals who work in various specialties. Results of this study indicated that self care was represented in various unstructured formats. Additionally, this study demonstrates the need for more support in the medical field to allow for more opportunities for self care to take place. Furthermore, this analysis of self care explains the importance of this practice to be implemented by medical professionals as it helps to reduce the high rates of burnout and compassion fatigue.</p><p>

<p> This study was the result of a quantitative methods research design, which assessed: athletic training services, injury prevention at the time of the study, and intervention protocols for high schools within the Gateway Athletic Conference (GAC). This study explored the impact of injuries and concussions on student athletes. The study also examined the types of athletic training facilities, resources for rehabilitation, and procedures for athletic training programs available at the high school level in the GAC. The study uncovered some significant findings between the groups who were surveyed. The participants surveyed represented athletic trainers, athletic directors, and coaches. There were differences in how these groups viewed emergency care procedures, injury policies, and protocols. The differences ranged from views of job descriptions, written policies and procedures for emergency transportation, reporting and submitting accident reports, and regular review of the effectiveness of athletic training services. The groups did agree on most legal duties and responsibilities, general policies and procedures, injury management protocol and procedures, training room facilities, and operation questions. Blood-borne pathogens were an area in which notable improvement is needed, and there were some concerns with some of the data reporting injury statistics. Overall, the participants agreed with one another, but there were some differences throughout the study, as reported in this dissertation.</p>

<p> Global explosion of mobile technology has engendered a new instrument to address the challenges in public health and to revolutionize the paradigm of healthcare access and delivery system. Today mobile phone coverage has increased to a significant 90% of the world&rsquo;s population. The rising ubiquity and infiltration of mobile phones has kindled the beginning of a new era in healthcare, mobile health (mHealth). mHealth is the amalgamation of mobile telecommunication and multimedia into an on the go mobile health care delivery system. </p><p> Pediatric Pal is a mHealth application targeted to care for children and help build a healthier tomorrow for them. Pediatric Pal is designed to be the &ldquo;Drive Thru&rdquo; for the pediatric healthcare system. The mhealth app focuses on giving patients access to a highly sophisticated medical diagnosis tool. By using latest searching technologies, the system can take a pattern of symptoms in everyday language and instantly compute from our vast database. The app design and development will be outsourced to a web design Hyperlink solutions agency. Database for the app will be maintained in house and test runs will be run within the house. </p><p> The main source of revenue for the app will be from user subscription and upfront cash payment. Premium downloads will bring in the extra revenue as well. </p><p> Pediatric Pal puts world&rsquo;s medical knowledge at the patients fingertips and enables them to make sense of your symptoms. It will change the way patients speak to their doctor forever.</p><p>

<p> Through advancements in modern medicine, human beings worldwide are living longer. The increase in life expectancy creates a need for a more qualified and knowledgeable nursing workforce for the delivery of quality geriatric health care. Although nurses are the primary care providers for vulnerable older adults, they are generally not well trained or prepared in geriatric care. Therefore, the purpose of the project was to develop an education program aimed at improving nursing knowledge of geriatric care in the long-term care (LTC) setting. The goal of the project was to answer the research question: What impact would attendance in the program have on improving nursing geriatric knowledge, retention, and job satisfaction by project end? Guided by the advancing research and clinical practice through close collaboration (ARCC) model for evidence-based practice (EBP), the learning needs of nurses in the LTC setting were assessed. The 6-week education program was designed to provide education on the basics of geriatric care, pharmacology and aging, symptom evaluation, dementia care, and geriatric physical assessment. Project participants consisted of 8 nurses who volunteered to take part in the program. The program was evaluated using a pre-test and post-test method to examine nurse&rsquo;s knowledge before and after the education program. Using a paired <i>t</i> test, the results indicated a significant increase (<i>p</i> &lt; .05) between the mean pre-test (3.75) and mean post-test (4.25) scores of nurse knowledge of geriatric care. The education program improved participant knowledge of geriatric care. Positive social change will be achieved with this scholarly project as nurses with greater knowledge gain confidence, strengthen decision making and clinical skills, and improve patient outcomes in the LTC setting.</p><p>