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Nurse Management Communication Training Pilot Study
No full textThis quantitative pilot study investigated the impact of structured communication training on nursing leaders' self-evaluated confidence and competence within a health system in the Upper Midwest. Eleven nursing leaders participated in in-person sessions utilizing evidence-based communication strategies, including delivering feedback and change management. Pre- and postintervention surveys assessed changes in confidence and competence with communication skills,
analyzed using descriptive statistics and independent t-tests. Results demonstrated positive changes across all variables, with the most significant gains observed in effectively communicating with staff (16.4%) and communication skills (17%), both approaching statistical significance. The intervention was grounded in Bandura's self-efficacy theory, utilizing all four tenets. Although limited by a small sample size and voluntary participation, findings highlight the value of incorporating communication training into nursing leader orientation and ongoing professional development. Enhancing communication competencies among nursing leaders has the potential to improve quality of care, support staff retention, and foster healthy work environments. Future research employing larger, more diverse cohorts is recommended to validate and extend these findings
Microbiome Composition of Individuals With Obesity Compared to Those With Neurodevelopmental Disorders: A Dual Meta-analytic Approach
No full textThe gut microbiome is increasingly implicated in both metabolic disorders such as obesity and neurodevelopmental disorders (NDD), including autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD). This thesis conducted two meta-analyses to assess whether alpha diversity, a measure of within-sample microbial richness, differs in individuals with obesity or NDD when compared to healthy controls. Three eligible studies (I = 0%) showed a small, non-significant trend of higher alpha diversity in obesity (SMD = 0.28, p = 0.051). For NDD (three comparisons, I = 0%), the pooled estimate was near zero (SMD = 0.02, p = 0.8852), indicating no meaningful group-level difference in diversity. A qualitative synthesis of included studies highlighted that both obesity and NDD often involve specific, shifts in gut bacteria rather than a uniform gain or loss in overall species richness. Certain taxa involved in short-chain fatty acid production and inflammation tend to be altered in obesity, whereas microbiome changes in NDD can be more heterogeneous and appear sensitive to dietary habits and comorbid GI symptoms. Accordingly, no universal ""obesity microbiome"" or ""NDD microbiome"" emerged. These results suggest that interventions aimed at modulating the microbiome, particularly through improved diet quality, may benefit both metabolic and neurodevelopmental health by supporting beneficial gut ecosystems and the gut brain axis. Limitations include the small number of pooled studies and heterogeneous methods, underscoring the need for larger, more standardized research. Nonetheless, this thesis shows that alpha diversity alone may not robustly differentiate obesity or NDD populations from controls. Future work should therefore focus on deeper profiling of functional and compositional features to inform individualized, microbiome-targeted strategies for prevention and treatment in both metabolic and neurodevelopmental contexts
Evaluation of a Pediatric Needle-Related Pain Reduction Guideline
No full textFor pediatric patients, needle-related procedures cause pain and anxiety and lead to long-term consequences when untreated. At one midwestern inpatient hospital setting, during a previous Doctor of Nursing Practice project, a guideline was implemented with age-appropriate interventions to understand if using these methods together better supported pediatric patients during needle-related procedures. This previous project faced barriers during its implementation phases, but the findings suggested that using the guideline was beneficial for needle-related pain management. The goal of this project was to determine if the use of this previously implemented guideline by the nurses was effective and efficient. Data were collected through surveys, interviews, unit surveillance, document review, and informal meetings with interdisciplinary team members. Although evidence of the former implemented guideline was not found during data collection, the survey results indicated that about half of the participants were somewhat aware of the previously implemented guideline. The survey results also indicated that all participants utilized pain-reduction methods in their practice and were motivated to provide pain management for pediatric patients. In addition, during interviews with nurses, utilizing pain-reduction methods during needle-related procedures was frequently mentioned as part of their typical processes. It was concluded from the findings that the use of the guideline itself was not effective and efficient, however, the actions occurring reflected the guideline's intentions. The results of this project could lead to positive long-term implications and sustainability for pediatric and PICU patients undergoing needle-related procedures
A Journey from Trauma to Love-based Leadership: An Autoethnographic Study
No full textThis dissertation explored my personal journey from trauma to the study, teaching, and practice of love-based leadership using autoethnography, a qualitative research method that connects personal story to cultural phenomena. I spent a year and a half revisiting and reflecting on personal journals, photographs, and artifacts. The stories of my life that I shared in this dissertation were often messy, fragmented, and even heartbreaking. My sister once told me, "It's amazing we even survived." Yet, the vast majority of people, both children and adults, have experienced trauma. This would imply a need for love-based leadership to not only help heal individual and collective trauma but also to transfigure traumatic experiences toward greater meaning and purpose because we are all put into positions where leadership is required, and we are all capable of leading with love. Not everyone who has experienced trauma will become a love-based leader. But if we lead with love, we can touch the hearts of those who have experienced trauma and not only help them to see their potential, their greatness, and their ability to change lives in positive and productive ways but also see those things in ourselves. Even though this dissertation was intended as a healing journey aiming to stimulate further discussion and study of trauma and love-based leadership, it also allowed for reflection on relationships not only between love and leadership, but also between loved-based leadership and storytelling, trauma, vulnerability, and healing
Evaluating the Effectiveness of Infant-Driven Feeding on Advancing Oral Feeds in Noenates
No full textThis quality improvement project evaluated the implementation of Dr. Brown's Infant-Driven Feeding (IDF) program at a large Midwest referral center's Level III and IV Neonatal Intensive Care Units (NICUs). The IDF program standardizes neonatal cue-based feeding to align with the neurodevelopmental stages of preterm infants, shifting the focus from volume-driven to quality based feeding practices. Research has shown that IDF reduces length of stay (LOS), accelerates the time to full oral feeds, enhances breastfeeding rates, and improves satisfaction for both staff and parents. The sample included NICU infants who met specific respiratory and feeding readiness criteria, with data collected through a retrospective chart review spanning 6 months after implementation. Nurse satisfaction was assessed through a post-implementation survey. Key stakeholders included patients and nurses. The primary outcome measure was LOS, analyzed using a Mann-Whitney U test. This project highlights the feasibility of integrating structured, cue-based feeding protocols in the NICU. While the quantitative results did not show a reduction in LOS, the IDF program's potential benefits for infant feeding progression and nursing practice warrant further evaluation
Impact of Nurse-led Diabetic Education on Hemoglobin A1C in a Residency Clinic
No full textDiabetes is a prevalent and costly chronic disease, with type 2 diabetes constituting approximately 90-95% of all cases in the United States (Centers for Disease Control and Prevention, 2023a). Effective management is crucial to preventing complications such as cardiovascular disease, kidney failure, and neuropathy (World Health Organization, 2023). The American Diabetes Association (ADA, 2023) recommends a multidisciplinary approach, including patient-centered education and regular monitoring of hemoglobin A1C (HbA1C) levels. However, registered nurses (RNs) remain underutilized in chronic disease management despite their potential to enhance patient outcomes through education and support (Bodenheimer & Mason, 2017; Smolowitz et al., 2014). This quality improvement (QI) project evaluated the impact of a nurse-led diabetes education program on HbA1C levels among patients aged 18-75 with type 2 diabetes and an HbA1C of 8% or greater. Conducted in a Midwestern Family Medicine Residency Clinic, the intervention involved one face-to-face education session followed by biweekly telephone follow-ups over six months. A total of four patients participated in the intervention, with HbA1C levels measured before and after the program. Results indicated a reduction in HbA1C levels in both the intervention and control groups, though statistical significance was limited due to a small sample size. Despite this, qualitative feedback suggested increased patient accountability and self-efficacy, consistent with previous findings on nurse-led interventions (Changsieng et al., 2023; Kundury et al., 2023; Yu et al., 2022). Departmental quality metrics for A1C control improved by 2.86% during the intervention period, though causality could not be definitively established. Challenges included low participation and study attrition, emphasizing the need for broader implementation and further research with a larger sample. This study highlights the potential benefits of nurse-led diabetic education in improving glycemic control and enhancing the role of RNs in chronic disease management. Future research should focus on scaling the intervention and incorporating behavioral assessments to optimize patient outcomes
Nutrition Content in Minnesota High School Health Education: A Program Review
No full textPoor dietary habits among adolescents are leading to increased rates of obesity and chronic disease development. A culinary medicine approach to delivering nutrition education among high school students has the potential to improve individual and population health. This program evaluation aimed to examine the effectiveness and efficiency of the current nutrition content with the health curriculum at three high schools. This project included a culinary medicine lecture implementation with the goal of improving nutrition education among adolescents. A combination approach of student surveys and health teacher interviews was utilized for quantitative and qualitative data analysis. Results indicated that participants were receptive to the lecture implementation, supporting its effectiveness and efficiency. Participant responses identified deficiencies in the current health curriculum and supported the desire to increase nutrition content. More research is needed to understand how to improve the effectiveness and efficiency of nutrition content in high school health course
Impact of Probiotic Supplementation in Endurance Athletes Ages 18 to 45: A Meta-analysis
No full textPrevious research demonstrates that endurance athletes commonly experience gastrointestinal (GI) health issues. Studies have suggested that probiotic supplementation may decrease GI issues and increase performance measures. However, articles on the effects of probiotic supplementation are limited and show varied results. This meta-analysis was to determine if probiotic supplementation improved performance among endurance athletes. A literature search involving PubMed, Google Scholar, and the Viterbo University Database was performed to identify primary research articles that used the VO2 Max (maximum oxygen consumption) test and venous blood samples of Interleukin 6 (IL-6) to measure changes in performance. Probiotics have been shown to influence inflammation and performance through gut microbiota interactions, therefore, studies that included probiotic supplementation and its effects on IL-6 levels and VO2 Max test scores were analyzed. Four studies with 123 participants were analyzed. The Cochrane Risk of Bias tool was utilized to screen the included studies for bias. The standard mean difference (SMD) was used as the effect size. The SMD was analyzed along with a 95% confidence interval (CI). To determine the effect size, VO2 Max outcomes and serum IL-6 levels, from baseline to completion, were assessed in the control and intervention groups. Results showed no statistical differences between the VO2 Max test scores or the serum IL-6 levels at either baseline or completion for the control group nor the intervention group (SMD = -0. 43; 95% CI: -0.87, -0.00; P = 0.32 and SMD: -0.15; 95% CI: -0.96, 0.66; p = 0.6038). Results of this meta-analysis suggest there is no significant difference in performance measure outcomes between the control and intervention group at baseline versus the intervention's completion. Further research is needed to determine the effects between probiotic supplementation and endurance performance. As there is a wide range of endurance sports, future research should focus interventions on specific subpopulations to better address the relationship between probiotic supplementation and endurance aerobic capacity
