Digital Commons Network^™

Causes Of Color Blindness: Function And Failure Of The Genes That Detect Color, Dylan Taylor

Senior Honors Theses

Color blindness affects nearly 10% of the entire population, with multiple types of color blindness from various genetic mutations. In the following sections, the nature of light and how the human eye perceives light will be discussed. Afterward, the major forms of color blindness and their genetic causes will be considered. Once these genetic causes have been established, the current method for diagnosing color blindness will be investigated, followed by a discussion of the current treatments available to those with color blindness. Finally, a brief discussion will address possible future work for color blindness with the hope of finding better …

Organizational Strategies To Promote Nurse Resilience In The Acute Care Hospital Inpatient Setting: An Integrative Review, Marcia A. Depolo

Doctoral Dissertations and Projects

Nurses practicing in acute care hospital environments are exposed to constant stressors from a variety of sources. Workplace stress can lead to unhealthy coping behaviors, illness, and burnout, with intent to leave the organization or the nursing profession altogether. Resilience-building strategies can be employed to foster coping, improve nurse wellbeing, increase job satisfaction, promote retention, and enhance quality patient outcomes. This integrative review provides a synthesis of scholarly publications on nursing resilience from January 2014 through October 2020. Themes to promote nursing resilience occurred at three levels: personal or individual, unit or group, and organizational. This paper will provide a …

Voluntary Hypoventilation At Low Lung Volume (Vhl) During Strength And Conditioning Training Increases Anaerobic Performance: A Pilot Study, Zachary Taylor Hundley

Masters Theses

To determine whether a VHL protocol implemented into an already existing strength and conditioning program could improve anaerobic conditioning more efficiently within the military population. Six active duty males completed a seven-week training cycle with VHL protocols implemented on each training day (2-4 days/week). Before (Pre) and after (Post) protocol implementation, the participants performed a multi-stage 20-m shuttle run test (MSRT). After incorporating VHL, participants significantly improved their MRST scores by an average of 50.3%. Additionally, Body Oxygen Level Test (BOLT) scores were improved across the duration of the study. This study showed employing VHL can improve anaerobic performance in …

Implementation Of A Fall Risk Assessment Tool In Primary Practice May Decrease Fall Frequency In The Aging Population, Regina M. White

Doctoral Dissertations and Projects

The purpose of this evidence-based project was to illustrate the benefits of utilizing a fall risk assessment tool during office visits for the aging population of a Midwestern U.S. primary care practice. Utilization of this tool helped minimize fall frequency, thus improved quality of health. The reduction in falls helped minimize unnecessary healthcare expenses. This manuscript identified a rationale for the project, specific tool utilization, outcome measures before and after implementation, limitations, and future application for practice. Provider compliance with tool utilization and frequency were measured. Multiple potential causes of falls and recommendations to minimize falls were identified with the …

A Microbiome Analysis Of The Relationship Among Crayfish Ectosymbionts And Their Environment, John Hoverson

Senior Honors Theses

The purpose of this project was to determine if there are differences present between the α-diversities of the crayfish microbiome and its surrounding water and sediment. Furthermore, this project sought to discover if these differences hold when microbiomes are evaluated between crayfish of first and second stream orders. Finally, this project sought to determine if the presence of branchiobdellidan ectosymbionts on the crayfish caused further differences in the crayfish microbiome. While the hypothesized patterns between crayfish, ectosymbionts, and stream order were not found to exist, a significantly different microbiome was observed between water, sediment, and crayfish, and the α-diversity of …

Dna Aptamer-Drug Targeting Chemotherapy: Investigation Of Cell Cycle Inhibition Via S15 Aptamer – Norcantharidin Complex, Shannon Fehr

Senior Honors Theses

Lung Cancer is the leading cause of cancer related death in both men and women in the United States (Bray et al., 2018). Cancer treatments are often non-specific and kill many dividing cells within a patient causing unwanted side effects. Norcantharidin (NCTD) is a synthetic FDA approved treatment for cancers including non-small cell lung cancers (NSCLC). NCTD suppresses cell proliferation by inhibiting cells from exiting the G2 phase of the cell cycle. Aptamers are short single-stranded DNA or RNA molecules with ligand directed self-annealing capabilities allowing selective binding to specific targets. This paper will discuss the hypothesized effects of using …

Parenting A Child With Autism Spectrum Disorder: Perspective Of Jordanian Mothers, Khulood Kayed Shattnawi, Wafa'a M. Bani, Saeed, Ahlam Al-Natour, Mohammed M. Al-Hammouri, Manar Al-Azzam, Rachel Joseph

Faculty Publications and Presentations

Introduction: Parenting a child diagnosed with autism spectrum disorder (ASD) is challenging for mothers because of concerns related to behavior, difficulties in accessing specialized care, and lack of community acceptance, yet their stories in Jordanian context are still unknown. Common challenges in Jordan include financial burdens, lack of public awareness, and lack of specialized knowledge even among health care providers, which may lead to delays in obtaining the diagnosis and interventions for ASD.

Method: A phenomenological descriptive approach was used to explore and understand the mothers’ everyday lived experiences of raising a child with ASD. Semistructured interviews were conducted with …

A New Era: Utilizing Technology Tools To Enhance Elder Independence, April Lisa Phelps

Doctoral Dissertations and Projects

The goal of this integrative review was to examine the multitude of technology tools and the evidence which supports their use to enhance elders’ independence when residing at home. Multiple journal articles and books published between July 2015 and July 2020 were examined using the PRISMA model for evidence to support or oppose the use of technology to enhance the elders’s independence. A total of 27 articles were included in the final review. An exploration of gaps in knowledge related to the issue of elders using technology tools such as wearable sensors, artificial intelligence, home monitoring, robots, mHealth, Internet of …

Determining The Effectiveness Of System-Based Solutions To Improve Fragmented Care For Oncology Patients Living In Rural And Remote Regions: An Integrative Review, Andrea Nicole Fulmer

Doctoral Dissertations and Projects

The purpose of this integrative review is to review, critique, and synthesize the current literature to determine the state of the science related to the established systems approach for improving healthcare management and care coordination of the oncology patient population in rural and remote regions. The oncology patient population with co-existing chronic disease living in rural and remote regions experience fragmented health care. New cancer diagnoses take precedence over other existing comorbidities and require focused and specialized care for lengthy periods of time. Research is significantly limited for the current state of science for the identified patient population living in …

The Role And Function Of A Hospital Chaplain In An Interdisciplinary Team, Joseph Richard Jeffries

Doctoral Dissertations and Projects

Healthcare workers provide quality of care to patients who enter the hospital. However, to provide the holistic care, patients need interdisciplinary teams who meet and collaborate on a plan of care. There are various skills sets required on an interdisciplinary team including chaplains. However, members of an interdisciplinary team do not necessarily understand how to utilize the chaplain’s multifaceted training for the best holistic care of the patient. The purpose of this study is to review the interdisciplinary team in the hospital context and address the understanding of the chaplain’s role and function. The study will utilize a qualitative research …

Contraceptive Methods In The United States: The Question Of Abortive Mechanisms, Tara Ferenczy

Senior Honors Theses

This thesis reviews the many methods of contraception available in the United States. Although society’s understanding of women’s health has become a major topic, there is still a significant deficit of information regarding how the accessible methods affect women’s bodies, specifically reproductive tissue. The thesis analyzes numerous contraceptive options focusing specifically on the mechanisms of action to determine whether options have abortifacient properties so that readers may develop educated opinions regarding medical and ethical uses. Information involving strengths and limitations of each technique and the effects on both the female body and the reproductive material assist in understanding the process …

Nurses' Knowledge And Practices Of Physical Restraints In Intensive Care Units: An Observational Study, Maysa H. Almomani, Wejdan A. Khater, Baha'a Aldin Abdel-Latif Qasem, Rachel Joseph

Faculty Publications and Presentations

Aim

To investigate the knowledge and practice of physical restraints (PR) among Jordanian intensive care unit (ICU) nurses.

Design

A descriptive, observational design was used.

Methods

A convenience sampling was used to recruit participants. We examined the knowledge of PR in 301 nurses (knowledge check) and the real‐time practice of PR in 81 nurses (direct observation) in ICU. A knowledge questionnaire was used to collect data on knowledge about PR use, and data on their practice of PR were observed and documented using an observation checklist.

Results

The mean scores of nurses' knowledge and practices were 61.5 (SD = …

Use Of Delirium Protocols In Decreasing Falls Among Adults In Acute Care: An Integrative Review, Shelly Steverson Thornton

Doctoral Dissertations and Projects

Delirium in elderly hospitalized adults continues to be a common and costly issue in health care today. Various delirium protocols and strategies are available to reduce negative outcomes of delirium such as falls, increased length of stay, pressure ulcers, hospital readmissions, the need for transferal to long-term care, and mortality rates. However, many hospitals have still not implemented routine delirium protocols. Because falls in older hospitalized adults are often linked to delirium, this integrative review was undertaken to examine delirium protocols and approaches that specifically decrease falls among older adults in acute care settings. Several multicomponent, multidisciplinary delirium protocols were …

Cdsss For Cvd Risk Management: An Integrative Review, Elisabeth Mary Campbell

Doctoral Dissertations and Projects

Cardiovascular disease (CVD) is a preventable disease affecting almost half of adults in the United States (U.S.) and can have significant negative outcomes such as stroke and myocardial infarction, which can be fatal. Utilizing clinical decision support systems (CDSSs) in the primary care and community health setting can improve primary prevention of CVD by supporting evidence-based decision making at the point of care. This integrative review synthesizes the most up-to-date literature on the use of clinical decision support (CDS) tools to support guideline-based management of CVD risk. Using Whittemore and Knafl’s framework for integrative reviews, a systematic search of CINAHL, …

Investigation Of Undocumented Heart Disease In Cadaveric Donors, Crystal Danae Passburg

Doctoral Dissertations and Projects

For nearly a century, heart disease has been the leading source of death and disease in the United States, causing the deaths of hundreds of thousands of individuals every year and burdening millions more with diminished health and severe disability. However, despite the significant known prevalence of heart disease, studies suggest that many more individuals—and particularly those within the female and elderly populations—may possess undiagnosed heart disease which remains undetected even after death due to the lack of autopsy examination. In the absence of autopsy, many cases of heart disease may never be identified, resulting in a skewed understanding of …

Self-Management Education For Prevention, Early Detection, And Treatment Of Hypoglycemia: An Integrative Review, Chinedum Rosemary Ikwueme

Doctoral Dissertations and Projects

Hypoglycemia is a major complication from poor diabetic care management. Available literature indicates that it is the underlying cause of mortality in over 258,000 deaths reported in 2017. That notwithstanding, it remains a phenomenon that is given less attention than it deserves, particularly in adults with type 2 diabetes. Aside from the huge annual financial costs to the health care system (about $327 billion) in 2017, patients with hypoglycemia complications risk many cardiovascular and neurological complications, including skipped time from work in middle aged adults, dementia, falls, hospitalization and death. The purpose of this integrative review is to educate nurses …

Addressing Prescription Opioid Misuse Through The Increased Reporting Of Prescription Monitoring Program (Pdmp) Data: An Integrative Review, Claudia Hannah Georgestone

Doctoral Dissertations and Projects

Opioid misuse relating to prescription pain killers have claimed the lives of many Americans, posing an escalating nationwide public health crisis. Prescription opioid overdose and death can impair an individual’s functionality, destabilizes family, and impose a significant financial burden. In 2014, the U.S. had an estimated 36 million people ages 12 years and older who had used prescription opioids for non-medical reasons. In that same year, there were “28,647” (61%) of 47,055 prescription and non-prescription opioid overdose deaths, indicating an increase from previous years (Center for Disease Control (CDC, 2020). Several measures to address the opioid crisis have been implemented, …

Improving Identification Of High-Risk Obstructive Sleep Apnea Patients In Primary Care: An Integrative Review, Lauren Ashley Paulson

Doctoral Dissertations and Projects

Obstructive sleep apnea continues to be an area that is underdiagnosed and therefore undertreated. Left untreated, the condition is associated with increased morbidity and mortality as it can amplify the risk of multiple health conditions. Due to the negative impact of obstructive sleep apnea it is necessary for healthcare providers to provide timely detection. Primary care providers are in a position to identify high-risk individuals and refer them for further follow up testing. High-risk identification can be accomplished by integrating validated screening tools into patient assessments. This integrative review provides an overview of current screening tools for use in the …

Identification Of Human Trafficking Victims In The Health Care Setting: An Integrative Review, Jami Leigh Castellucci

Doctoral Dissertations and Projects

Most victims who have escaped trafficking report that during their captivity they were taken to health care facilities. Though health care–based trafficking reporting has increased over the last few years, studies show that private practices and most hospitals within the country do not have a human trafficking protocol, policy, nor educational intervention for their frontline staff to be able to identify and refer victims for short- and long-term support. The United States health care system is poised to play a large role in the fight against human trafficking. This integrative review describes the current status of human trafficking victim identification …

Diabetes Health Literacy In The Rural Community: An Integrative Review, Shannon M. Elrod

Doctoral Dissertations and Projects

Health literacy is paramount for successful management of health and prevention of disease. Yet a majority of adults have low health literacy. The impact of low health literacy on chronic disease management effects health outcomes and health care costs. With six out of 10 adults in the US diagnosed with a chronic disease such as diabetes, health literacy is a serious concern. Diabetes impacts over 30.3 million Americans. Since diabetes is one of the most common chronic diseases in the country, it is imperative that health literacy be addressed as part of this population’s health management. Diabetes health literacy plays …

High Reliability In Medication Administration, Bradford White Jensen

Doctoral Dissertations and Projects

This research was designed to test the theory of Robust Process Improvement (RPI) as it has been applied to the problem of medication error at Navy medical treatment facilities (MTFs). Medication error is the greatest cause of patient injury in America. In an effort to duplicate the success of High Reliability Organizations (HROs), leaders of the Joint Commission advocated the application of Lean Six Sigma (LSS) as the key elements of RPI and the best way to increase safety and improve the quality of healthcare. The specific problem was that very little empirical evidence existed supporting the theory. The research …

Nighttime Quiet In The Intensive Care Unit: An Integrative Review, Heather Rae Smith

Doctoral Dissertations and Projects

Excessive environmental noise in the ICU often negatively impacts patient sleep. The World Health Organization (WHO) and Environmental Protection Agency (EPA) have published recommendations for hospital decibel levels, but the literature indicates that noise levels in the ICU often exceed these values. Patients experience disturbed sleep and rarely enter into N3 and REM sleep. The integrative review examined both the patients’ and healthcare workers’ perception of noise in the ICU environment to identify contributors and suggested interventions to mitigate these occurrences. In addition, this study evaluated objective measurements of patient sleep to further determine how well patients were sleeping in …

Bystander Cpr Training For Laypersons And Caregivers Of Those At High Risk For Sudden Cardiac Arrest: An Integrative Review, Ragan Scott

Doctoral Dissertations and Projects

Sudden Cardiac arrest (SCA) is the leading cause of death in the United States (U.S.) with approximately 475,000 deaths annually (AHA, 2018). Approximately 70% of these deaths occur as out-of-hospital cardiac arrests (OHCA; AHA, 2018). Currently, the survival rate for OHCA is 10% with the lack of bystander CPR being a large contributor to the high mortality rate (AHA, 2018). This project evaluated the literature related to bystander CPR training to determine if this training improves willingness to perform bystander CPR and overcomes common barriers that inhibit the initiation of bystander CPR in OHCA. The projected outcome for this project …

Improving Survival Rates In Patients Suffering Cardiac Arrest With Specialized Resuscitation Teams: An Integrative Review, John Campbell Holcomb

Doctoral Dissertations and Projects

Over 300,000 hospitalized patients suffer a cardiac arrest requiring a Code Blue activation each year in the United States. These patients have an extremely high mortality rate. These rates are not uniform across all hospitals and facilities that employ specialize Code Blue resuscitation teams have a higher percentage of patients that survive resuscitation events. This Integrative Review shows that these teams are essential to patient survival but are prone to barriers that must be overcome to provide effective teamwork. Quality improvement projects centered around Code Blue teams can be created at the local level and have been found to be …

Increasing New Orienting Emergency Department Nurses' Awareness Of Mass Casualty Incident Emergency Preparedness And Disaster Response Core Competencies To Improve Mass Casualty Incident Response, Christopher C. Deramo Ii

Doctoral Dissertations and Projects

Mass casualty incidents (MCI) impose a substantial threat to healthcare. Despite the increasing frequency of MCIs many healthcare organizations and nursing programs do not adequately prepare nurses to be effective responders during an MCI. This evidence-based practice pilot project was purposed to increase new orienting emergency department nurses’ confidence and ability to effectively respond to an MCI. This project involved implementing an MCI educational program consisting of a disaster nursing framework to educate new orienting emergency department nurses on emergency preparedness and disaster response core competencies. The project leader utilized a quasi-experimental design to collect data pre- and post-intervention utilizing …

Preventing Polypharmacy Amongst The Elderly In An Acute Care Setting Through The Integration Of The Deprescribing Tools Start, Stopp, And Beers Criteria, Samantha Bonita Wilkins-Copeland

Doctoral Dissertations and Projects

A significant percentage of medications prescribed in the United States are prescribed to elderly adults, which is due to the increase in chronic illness as Americans age. This increase in the use of medications amongst the elderly population has led to the issue of polypharmacy, which can lead to negative patient outcomes. An evidence-based practice pilot project was performed at a large tertiary care facility in Virginia. The aim of the scholarly project was to integrate three deprescribing tools into the everyday practice of pharmacists at the facility. Three outcomes were achieved: (1) Pharmacists understood how to accurately utilize the …

Ask, Advise, Assist And Follow: An Evidence Based Project To Address Unhealthy Alcohol Use In A Free Clinic Setting, Lisa K. Floyd

Doctoral Dissertations and Projects

Preventative care in free clinic settings aims to mitigate health risks for vulnerable populations. Heavy alcohol intake is a major threat to physical and mental health. Wellness care for free clinic patients must include regular screening for alcohol use in accordance with national guidelines. The purpose of this project was to implement and evaluate an evidence- based practice change to improve alcohol screening and intervention in a free clinic setting. The NIH/NIAAA screening, brief intervention, and referral for treatment (SBiRT) process was implemented. A convenience sample of de-identified patient charts was reviewed to assess alcohol screening before (n = 38 …

Walking Through Smoke: Implementation Of The 5a'S For Smoking Cessation Counseling In Rural Virginia, Cristina Maria Minotti

Doctoral Dissertations and Projects

Tobacco use represents a significant cause of morbidity and mortality in the U.S. and is a contributing risk factor for multiple pulmonary, cardiovascular, and oncologic diseases. Despite documented evidence of these health hazards, use of tobacco products remains high, particularly in rural America. While providers may frequently question patients regarding tobacco use and inform patients of associated health hazards, a standardized, structured process for delivering smoking cessation counseling (SCC) is rarely established in practice settings. One such method for standardization of SCC is the 5A’s (Ask, Advise, Assess, Assist, Arrange) model which has a robust body of evidence to support …

Health Care Financial Literacy Among Nurses: A Qualitative Intrinsic Case Study, Kory Scott Holt

Doctoral Dissertations and Projects

Nurses have to perform many clinical services that require efficient decision-making processes in support of quality patient care. Alongside staff nurse clinical literacy, health care financial literacy was described as an important, but vaguely defined component of the nursing role. The significance of having financially competent nurses to efficient hospital operations and financial management continues to increase. However, the topic of health care financial literacy and financial decision-making among nurses remains disproportionately represented in existing scholarly research. To address this knowledge gap, this study integrated a single-site instrumental case study research design to examine health care financial literacy among nurses …

Evaluating The Utilization Of A Combination Therapy To Improve Self-Efficacy And Glycemic Control In Patients With Type Two Diabetes Mellitus And Low Health Literacy, Crystal Manus Masling

Doctoral Dissertations and Projects

Type 2 diabetes mellitus is a significant health issue, as it requires patients to perform daily self-management activities. One in every three Americans with Type 2 diabetes has limited or low health literacy skills. Limited or low health literacy skills can impact a patient’s overall health outcome; therefore, a critical element for disease management and patient adherence is health literacy. The purpose of this three-month scholarly project was to determine if the utilization of an educational intervention specific to one’s level of health literacy, combined with a short message service reinforcement tool, could improve glycemic control and self-efficacy in Type …