Digital Commons Network^™

Estimating Body Mass Through Bone Mineral Density Studies Using Dexa (Dual-Energy X-Ray Absorptiometry), Kaitlin Harstine

Master's Theses

Identification of a decedent is one of the primary goals of forensic anthropologists. In order to do this, one must build a biological profile based on the remains that are provided. Sex, age, ancestry, and stature are four of the most common, however a fifth addition piece of information that could be beneficial is body mass. The goal of this research is to explore the relationship between bone mineral density (BMD) and body mass, using data collected from dual x-ray absorptiometry (DEXA) scans of 107 collegiate football athletes. Athletes are a good fit for this study because they have achieved …

The Usage And Impact Of Outpatient Commitment Orders On Suicide And Suicide Attempt Rates In Mississippi, Sam Mauldin

Dissertations

Rates of self-harm and suicide in the United States have not decreased since 1980 and remained relatively constant through the start of the 21^st Century. The most recent data indicate that suicide rates in the United States have risen by about 2% a year from 2006 through 2016, although suicide rates have decreased in other countries during the same timeframe. Finding a viable intervention to slow rates of self-harm and suicide is needed in the United States. The need for closer patient observation has been cited as an underutilized intervention for the reduction of attempts of self-harm and suicide. …

A Quality Improvement Project To Determine The Incidence And Prevalence Of Obstructive Sleep Apnea, Best Practice Anesthesia Guidelines, And The Incidence Of Perioperative Cardiac And Respiratory Complications After The Implementation Of The Stop-Bang Questionnaire, Bradly Diamond, Gregory Guerrier, Cody Holliman, Robert Marrero, Tyler Nelson

Doctoral Projects

Patients with obstructive sleep apnea (OSA) are at risk for perioperative respiratory and cardiovascular compromise (Opperer et al., 2016). Unfortunately, almost 90% of patients with moderate-to-severe OSA are not diagnosed and unaware of their disorder; however, they remain at increased perioperative risks (Singh et al., 2015). The STOP-BANG questionnaire was developed to meet the need for a reliable, concise, and efficient screening tool for OSA risk. The facility at which this project was conducted did not utilize a prescreening OSA risk tool. The facility not using a prescreening OSA risk tool is especially important because the State of Mississippi currently …

Opioid Abuse Among Student Registered Nurse Anesthetists In The United States: A Policy Change Proposal, Ifeoma P. Anakor

Doctoral Projects

Opioid abuse among Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs) is an epidemic that is growing in numbers yearly. The number of deaths from opioid abuse is also increasing. The specialty of anesthesia primarily has increased instances of opioid abuse cases (Wright et al., 2012). The reason for the increase in opioid abuse occurrences is because anesthesia providers regularly administer opioids in patient care. Opioid abuse commonly results in injury or death. While abusing, anesthesia providers are not only putting their lives in jeopardy but also the lives of their patients.

The project observed the opioid …

Implementation Of A Self-Care And Wellness Educational Program Addressing Job Stress Among Child Protective Service Workers, Natonya Murray

Doctoral Projects

Job stress attributed to secondary exposure to trauma and the high work demands put child protective service workers at high risk of developing physical and psychological health problems. The purpose of the project was to develop and implement a self-care and wellness educational program addressing job stress among child protective service workers (CPS) guided by Substance Abuse and Mental Health Science Administration’s (SAMSHA, n.d.b) educational toolkit, Promoting Staff Wellness and Preventing Vicarious Trauma and other Work Force Concerns, the Centers for Disease Control and Prevention’s (CDC, 2019c) section on Adverse Childhood Experiences, and the National Council for Community Behavioral …

Impact Of Best Practice Guideline Statement On Anesthesia Practice In Rural Mississippi Hospitals With Obese Patients Undergoing Total Knee Arthroplasty, Steven Hodnett

Doctoral Projects

The aim of this best practice guideline (BPG) was to be a resource for anesthesia providers practicing with obese patients undergoing total knee arthroplasty (TKA) and to measure the knowledge of these providers. After dissemination of an executive summary to anesthesia providers in two hospitals in rural Mississippi, an anonymous online survey was provided via Qualtrics software for voluntary participation. The survey consisted of 10 questions. The data collection period was five weeks. Respondents are noted at N=2, and the data was reviewed and categorized into one of three domains (i.e., knowledge, practice, and safety). In the domain of knowledge, …

Increasing Patient Satisfaction Survey Response Rate At An Ambulatory Surgery Center, Carlee Nicholson

Doctoral Projects

In an effort to increase distribution rate and response rate of the patient satisfaction survey at this ASC, adjustments were made to current processes. These interventions included accentuating the option of a paper or emailed survey, providing pre-operative and post-operative response prompts, as well as adding a cover letter to the existing survey. The purpose of these interventions was to ensure a 100% distribution rate of the survey as well as to increase the response rate by 20%.

Results were obtained by collecting forms to monitor distribution of the survey. The response rate was calculated by the number of responses …

Implementation Of A Psychiatric Admission Acuity Tool In The Pediatric Behavioral Health Unit, Tyler T. Wansley

Doctoral Projects

Staffing, patient ratios, and acuity are not new concepts in health care. While these are popular concepts in medical units, inpatient psychiatric facilities are lacking the tools to correctly quantify patient acuity. An even considerably larger gap exists in the literature regarding the quantification of acuity in pediatric behavioral health units.

A needs assessment was conducted to determine if an existing psychiatric acuity tool would prove useful after implementation in a pediatric behavioral health unit. A need for such a tool was found which led to the purpose of this doctoral project, which was to measure nurse satisfaction with the …

Implementing Screening To Assess Readiness To Change In Overweight And Obese Patients At A Patient-Centered Medical Home, Jarrod Gant

Doctoral Projects

Obesity is at epidemic levels within the United States (U.S.), but the Southern U.S. has some of the most obese states. Mississippi (MS) is the most obese state in the country (Robert Wood Johnson Foundation, 2018). Factors such as diet, sedentary lifestyle, cultural influences, and socioeconomic status contribute to the state’s citizens being overweight and obese.

Contributing to the state’s obesity is the fact that MS has more people living in poverty than any other state (Center for American Progress [CAP], 2018). Lacking the ability to afford healthy foods and the ability to afford quality healthcare adds to the state’s …

Developing A Local Anesthetic Systemic Toxicity Protocol In A Mississippi Hospital, James Dearman, Terry J. Tieman

Doctoral Projects

Local anesthetic systemic toxicity (LAST) is a rare complication of administering local anesthetic medications. However, this complication is potentially deadly, especially without prompt and correct treatment. Due to the rarity of LAST and the fact that its treatment differs from the conventional treatment of cardiac arrest, the authors sought a best practice recommendation to guide its treatment. While the most effective treatment for LAST has been well established, a thorough review of literature and survey of clinical preceptors demonstrated that most providers have not encountered LAST in clinical practice. Additionally, lipid emulsion therapy is a somewhat controversial treatment among some …

A Market Analysis Of Pay Rates For New Graduate Certified Registered Nurse Anesthetists, Zachary Halliwell

Doctoral Projects

The profession of Certified Registered Nurse Anesthetists (CRNA) is a thriving occupation. In their national Occupational Outlook Handbook, the Bureau of Labor Statistics (U.S. Department of Labor, 2018), reported the national market for CRNAs is predicted to continue its steady growth through 2026. The Bureau of Labor Statistics (BLS) provides numerous statistics, as previously mentioned, on their website. However, the stats available include CRNAs of varying experience levels. The Mississippi Department of Employment Security (MDES) has a few statistics, online, regarding the market for CRNAs. The data provided by MDES, while appreciated, is lacking in numerical significance, given the minuscule …

Cost-Efficiency Of Sugammadex Versus Neostigmine/Robinul In Reversing Neuromuscular Blockade, Joel Fryfogle

Doctoral Projects

As healthcare costs in the United States continue to rise, healthcare providers must do their part to negate the expenses incurred by hospitals and patients. However, some treatments or medications may be more beneficial than others but come at a higher price. Such is the case with sugammadex, a medication approved for use in 2015 that can effectively and reliably reverse paralysis brought about by aminosteroidal induced neuromuscular blockade with rocuronium. Neostigmine/robinul combinations have traditionally been used for neuromuscular blockade reversal but with less efficient results than sugammadex (Abad-Gurumeta et al., 2015). Hence, a cost analysis was conducted at a …

Evidence-Based Best Practice Policy Recommendation For Postoperative Sore Throat, Corey Gambrell

Doctoral Projects

Airway management is a fundamental aspect of patient care when general anesthesia is being administered. Unfortunately, tracheal intubation can lead to the development of postoperative sore throat (POST) in the recovery room. POST is a minor yet preventable consequence of manipulation and injury of the airway mucosa. POST is routinely considered a minor postoperative complication; however, the occurrence of POST can have a negative influence on patient satisfaction as well as their perception of the perioperative experience. The etiology of POST is multifactorial, but evidence indicates that prevention is possible when evidenced-based practices are employed by anesthesia providers. A targeted …

Acute Cardiovascular Response To Low-Load Unilateral, Bilateral, And Alternating Resistance Exercise With Blood Flow Restriction In The Lower Body, Daphney Stanford

Master's Theses

Resistance exercise with blood flow restriction (BFR) has been suggested to exaggerate the exercise pressor response over traditional non-BFR exercise. While applying BFR relative to an individual’s arterial occlusion pressure (AOP) and exercising at low-loads seems to produce a comparable cardiovascular response to traditional moderate or high-load training, it is beneficial to identify modifications for reducing the cardiovascular response to BFR exercise. PURPOSE: To determine if unilateral (UNI), bilateral (BI), or alternating (ALT) exercise modalities elicit different cardiovascular responses during BFR exercise. METHODS: 18 participants (13 male and 5 female) performed four sets of UNI, BI, and ALT knee-extensions at …

The Diffusion Of Telehealth: System-Level Conditions For Successful Adoption, Danika Tynes

Dissertations

Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory. System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using multiple logistic regression.

Analyses included data from 84 states leveraging data from the World Health Organization, World Bank, ICT Index, …

Posture Affects Affordance Perception Of Reachability In Virtual Reality, Hannah Masoner

Master's Theses

Tasks such as standing and reaching require differing levels of postural stability. Postural equilibrium is necessary to perceive the location of objects (Lee, Pacheco, & Newell, 2018). Visual perception of whether an object is within reach was investigated while standing upright. Participants viewed a 3D virtual reality (VR) environment with a stimulus object (red ball) placed at different egocentric distances. Participants made affordance judgements while in a standard stance condition as well as two separate active balance conditions (yoga tree pose, and toe-to-heel pose). Feedback on accuracy was not provided, and participants were not allowed to attempt to reach. Response …

Learning Style Preferences In Undergraduate Speech-Language Pathology And Audiology Students, Callahan Shirk

Honors Theses

Learning styles can be described as an individual’s unique way of assimilating new information based on his/her preferences and methods of acquiring knowledge. The awareness of a student’s learning style preference can be beneficial to both students and instructors. The goal of this project was aimed at identifying the learning style preferences of undergraduates in the Speech-Language Pathology and Audiology programs within the state of Mississippi. The researchers surveyed 137 participants involved in this study by utilizing the Kolb Learning Style Inventory and the VARK Questionnaire. Results from this study revealed that students enrolled as undergraduates in Speech-Language Pathology and …

Hiv-1 Integrase Multimerization By Quinoline Based Drugs, Samer Beauti

Honors Theses

Human Immunodeficiency Virus Type 1 (HIV-1), a single stranded RNA retrovirus, affects over 30,000,000 people world-wide1. The virus works by infecting and promoting destruction of CD4 immune cells. and thus, suppressing proper immune functions2. Contrary to DNA viruses, the absence of extensive proofreading mechanisms in RNA viruses makes HIV latency a major obstacle in the discovery of long-term, effective treatments. Moreover, the importance of exploring novel therapeutic targets and designing complimentary inhibitory molecules remains steadfast in HIV research3 Recently, HIV-1 Integrase (IN) multimerization, the core enzyme used for integration of the viral DNA into an invaded host chromosome, has been …

When Saliva Is A Crime: Reforming Mississippi’S Hiv Criminalization Law Utilizing The Center For Disease Control And Prevention’S Policy Analytical Framework, Anastasia Walrod

Honors Theses

Mississippi is currently experiencing an HIV/AIDS crisis. The state is ranked in the top 10 for diagnoses of HIV infection, with Jackson, Mississippi ranked sixth in the nation for HIV diagnoses and fourth in the nation for AIDS diagnoses. Despite antiretroviral treatment allowing for persons with HIV to lead healthy lives, Mississippians continue to die from AIDS in large part because of stigma, misinformation, and lack of resources. This is furthered by Mississippi’s HIV criminalization law. HIV criminalization laws are used to penalize HIV exposure, but HIV-specific criminal laws are considered largely ineffective public health policies because these statutes further …

The Effects Of Meditation In Lowering Blood Pressure And Reducing Symptoms Of Stress In Baccalaureate Nursing Students, Isabella Fleming

Honors Theses

Hypertension and stress are two conditions that have the capability to cause extensive and long-term damage to both mental and physical health. Baccalaureate nursing students report high levels of stress while in the process of obtaining a degree. This population is at risk for consistently high stress levels; therefore, they are also at risk for physiologic complications of stress such as hypertension.

In this study, all participants were asked to complete two short surveys: one assessed their stress, and one survey assessed their perceptions of meditation. The blood pressure (BP) of all participants was measured as well. Once the surveys …

Validation Of A Scale To Measure Phonological And Morphological Knowledge And Skill Of Speech-Language Pathologists And Elementary Teachers, Susan S. Perry

Dissertations

Phonological and morphological skills are crucial to the process of reading. Speech-language pathologists (SLPs) have received advanced trained in these basic foundations of language and could be an untapped resource in our school systems for teaching beginning reading skills. The purposes of this research were to examine SLPs’ and general education elementary (K-6) teachers’ attitudes toward SLPs taking part in reading instruction, to compare the differences in phonological and morphological knowledge and skill among SLPs and teachers, and to assess the performance of the Revised Basic Language Constructs Surveywhen administered to SLPs and teachers.

Results indicated that, although fewer …

Resilience And Coping In Mothers Of Children With Sickle Cell Disease, Holly Carter

Dissertations

Sickle cell disease (SCD) is a prominent chronic illness in the United States. The Centers for Disease Control and Prevention (2016) estimated that one child out of every 365 African-American births will have SCD, affecting approximately 100,000 Americans. Supporting and promoting the integrity of the family and its’ members when a child has SCD is important for each family member’s well-being. Specific family characteristics, such as resilience and coping are important to understand because they can mitigate stress and create positive family outcomes (Brown et al., 1993; Cousino & Hazen, 2013; Hildenbrand, Barakat, Alderfer, & Marsac, 2015; O’Hanlon, Camic, & …

Attitudes Of New Graduate Rns Regarding Their Readiness For Practice Before And After Hospital Orientation, Diane Young

Dissertations

The acuity level of patients continues to increase making it more vital than ever that new graduate Registered Nurses (RNs) be prepared to give safe, quality care when leaving their hospital’s orientation program (Spector et al., 2015). Today, new graduate RNs need orientation programs that will ensure a smooth transition into nursing practice. This involves the ability to apply higher-level knowledge and skills in everyday practice situations, thereby, maintaining quality care (Henderson, Ossenberg, & Tyler, 2015).

The purpose of this study was to identify differences between new graduate RNs’ opinions on readiness for practice, as measured by the Casey-Fink Readiness …

Mississippi Registered Nurse Perceptions When Communicating With Limited-English-Speaking And Non-English-Speaking Patients, Mary Pipper Widdig

Dissertations

Communication serves as the foundation for safe and effective healthcare practice. Effective nurse-patient communication is the cornerstone of the nurse-patient relationship and is vital for the delivery of safe and effective healthcare. Research has shown patients who are communication impaired are at a greater risk of medical error and poorer health outcomes. A review of the literature revealed various nurse perceptions of barriers when providing care for limited-English-speaking patients and non-English-speaking patients. LEP and NEP patients also identified similar perceived barriers when receiving care. Both nurses and patients revealed a distrust for interpreters and interpreter services. The literature review revealed …

Simulation As Replacement For Traditional Clinical In Pre-Licensure Nursing Education: Outcomes Of Different Ratios Of Replacement Time For Traditional Clinical With Simulation, Tiffany Zyniewicz

Dissertations

The use of simulation in nursing education has grown over the last 30 years. The National Council of State Boards of Nursing National Simulation Study indicated that up to 50% of traditional clinical hours can be replaced with simulation at a 1:1 replacement ratio and produce the same outcomes. A review of the literature indicated that there is no standard replacement ratio for simulation time to traditional clinical time being used in pre-licensure nursing education in the United States. The purpose of this study was to explore the outcomes of utilizing a 1:1 simulation-to-traditional clinical time replacement ratio and a …

Providing Preventive Health Education And Developing A Referral Policy And Toolkit To Increase Access To Primary Care For Individuals With Mental Illness, Phaedra Mclin, Stephanie Myers

Doctoral Projects

Treatment rates in primary care for the mental health population is traditionally low. Individuals with mental illnesses were at a higher risk for the development of chronic health problems (Ross et al., 2015). Substance Abuse and Mental Health Services Administration (SAMHSA) indicated that many people with serious mental illness die from preventable diseases. People with serious mental illness also have a higher mortality rate than those in the general population (SAMHSA, 2017b).

The purpose of this Doctor of Nursing Practice (DNP) project was to determine if educational training regarding specific chronic disease conditions influenced the attitude and knowledge of the …

Does The Use Of An On-Q Pump Improve Postsurgical Outcomes In Patients With Secondary Chronic Shoulder Pain?: A Retrospective Study, Deborah Thompson-Spencer

Doctoral Projects

Orthopedic shoulder surgery is a common therapy for many medical conditions, but the healing process for orthopedic shoulder surgery can be adversely impacted by chronic shoulder pain. Frequently, chronic pain is not adequately controlled by opioid analgesics provided to patients during the surgical healing process, resulting in greater pain and diminished postsurgical mobility. The focus of this Doctor of Nursing Practice project was to examine the question of whether, among male and female adult patients (40-64 years of age) with a history of secondary chronic shoulder pain lasting three or more months who have undergone orthopedic shoulder surgery, the use …

Actualizing Best Care Practices At A Psychiatric Treatment Center To Validate The Asset Of An On-Site Electrocardiogram, Pamela Metts

Doctoral Projects

Considerations to be contemplated in daily health delivery systems are complex and require varied approaches to deliver best-care processes that produce optimal patient outcomes. Specialty practice sites not only require the capability but also necessitate proficiency and dedication in meeting and exceeding essential healthcare competencies. A psychiatric treatment center specialty practice was the setting for this DNP project. The focus of this project included: (1) care resourcefulness, (2) safety initiatives, (3) increased privacy and confidentiality compliance, and (4) cost-efficiency measures.

Technology use beyond the security of the safety available within the treatment complex is a current policy at the psychiatric …