Medicine and Health Sciences Commons^™

Prospective Evaluation Of Association Between Negative Emotions And Heart Failure Symptom Severity, Kyoung Suk Lee, Terry A. Lennie, Debra K. Moser

Nursing Faculty Publications

Background: Prior studies of symptoms in heart failure (HF) were largely cross-sectional and symptoms were measured using retrospective recall. Because negative emotions influence information processing, retrospective symptom reports by patients with depressive symptoms and anxiety may be biased. The purpose of this study was to determine whether there are differences in patterns of symptom changes, measured prospectively, over 15 days by levels of depressive symptoms and anxiety.

Methods: HF patients (N=52) rated daily symptom severity for shortness of breath (SOB), fatigue, sleep disturbance, and edema over 15 days on a 10-point visual analogue scale. Patients were grouped into higher vs …

High School Students As Citizen Scientists To Decrease Radon Exposure, Ellen J. Hahn, Craig Wilmhoff, Mary Kay Rayens, Nicholas B. Conley, Emily Morris, Angela Larck, Trista Allen, Susan M. Pinney

Nursing Faculty Publications

Residents in rural Kentucky (KY) and suburban Ohio (OH) expressed concerns about radon exposure and lung cancer. Although 85% of lung cancer cases are caused by tobacco smoke, radon exposure accounts for 10–15% of lung cancer cases. Academic and community members from the University of KY and the University of Cincinnati developed and pilot-tested a family-centered, youth-engaged home radon testing toolkit. The radon toolkit included radon information, and how to test, interpret, and report back findings. We educated youth as citizen scientists and their teachers in human subjects protection and home radon testing using the toolkit in the classroom. Youth …

Behavioral And Enhanced Perinatal Intervention (B-Epic): A Randomized Trial Targeting Tobacco Use Among Opioid Dependent Pregnant Women, Amanda Fallin-Bennett, Michelle R. Lofwall, Teresa M. Waters, Paul Nuzzo, Janine Barnett, Letitia Ducas, Andrea Mccubbin, Niraj R. Chavan, Lisa Blair, Kristin Ashford

Nursing Faculty Publications

Background

Opioid use during pregnancy is a significant public health issue. The standard of care for treating opioid use disorder during pregnancy includes medications for opioid disorder (MOUD). However, tobacco use often goes unaddressed among pregnant women on MOUD. In 2018, our team received a National Institute on Drug Abuse (NIDA) funded R34 to conduct a three year-randomized trial to test the feasibility of a novel tobacco intervention for pregnant women receiving MOUD.

Aims

The aims of this study are: (1) to determine the impact of the B-EPIC intervention on maternal tobacco use and stage of change; (2) to determine …

A Geologically Based Indoor-Radon Potential Map Of Kentucky, William C. Haneberg, Amanda T. Wiggins, Douglas C. Curl, Stephen F. Greb, William M. Andrews Jr., Kathy Rademacher, Mary Kay Rayens, Ellen J. Hahn

Faculty, Staff, and Affiliated Publications--KGS

We combined 71,930 short-term (median duration 4 days) home radon test results with 1:24,000-scale bedrock geologic map coverage of Kentucky to produce a statewide geologically based indoor-radon potential map. The test results were positively skewed with a mean of 266 Bq/m³, median of 122 Bq/m³, and 75th percentile of 289 Bq/m³. We identified 106 formations with ≥10 test results. Analysis of results from 20 predominantly monolithologic formations showed indoor-radon concentrations to be positively skewed on a formation-by-formation basis, with a proportional relationship between sample means and standard deviations. Limestone (median 170 Bq/m³) …

From Twisting To Settling Down As A Nurse In China: A Qualitative Study Of The Commitment To Nursing As A Career, Jiao Ye, Aimei Mao, Jialin Wang, Chizimuzo T. C. Okoli, Yuan Zhang, Huiqiong Shuai, Min Lin, Bo Chen, Linli Zhuang

Nursing Faculty Publications

Background

The nurse workforce shortage, partially caused by high work turnover, is an important factor influencing the quality of patient care. Because previous studies concerning Chinese nurse work turnover were predominantly quantitative, they lacked insight into the challenges faced by nurses as they transition from university to their career. A successful transition can result in new nurses’ commitment to the career. As such, this study sought to understand how new nurses commit to the career, and focused on identifying facilitators and barriers to such commitment.

Methods

This was a qualitative study using a grounded theory design. Through purposive sampling, clinical …

Generational Differences In Faculty And Student Comfort With Technology Use, Amanda Culp-Roche, Debra Hampton, Angie Hensley, Jessica L. Wilson, Amanda Thaxton-Wiggins, Jo Ann Otts, Sharon Fruh, Debra K. Moser

Nursing Faculty Publications

Background: Navigating through online education courses continues to be a struggle for some nursing students. At the same time, integrating technology into online courses can be difficult for nursing faculty.

Purpose: The purpose of this study was to assess faculty technology integration practices, student attitudes about technology use, and generational differences related to faculty and student technology use.

Methods: A descriptive cross-sectional survey design was used to obtain data for this study.

Results: Integration of technology into online courses and student attitudes about technology use were not significantly different by generation. Faculty and students from the Baby Boomer and Generation …

Risk And Protective Factors Of Dementia Among Adults With Post-Traumatic Stress Disorder: A Systematic Review Protocol, Karen A. Lawrence, Theresia M. Pachner, Molly M. Long, Stephanie Henderson, Donna L. Schuman, Brenda L. Plassman

Social Work Faculty Publications

INTRODUCTION: Post-traumatic stress disorder (PTSD) is associated with an increased risk of dementia. Individual epidemiological studies have controlled for several confounders of the relationship between PTSD and increased dementia risk, yet particular risk factors underlying this relationship have not been determined. This systematic review protocol aims to identify risk and protective factors of dementia among adults with PTSD.

METHODS AND ANALYSIS: We will conduct an electronic search of the databases: PubMed, CINAHL, PsychINFO, The Cochrane Library, Scopus and ProQuest Dissertation and Theses Global. After screening the studies, quantitative synthesis will be performed, if possible. Otherwise, a narrative synthesis will be …

Longitudinal Evaluation Of The Effects Of Illness Perceptions And Beliefs About Cardiac Rehabilitation On Quality Of Life Of Patients With Coronary Artery Disease And Their Caregivers, Patricia Thomson, Neil J. Angus, Federico Andreis, Gordon F. Rushworth, Andrea R. Mohan, Misook L. Chung, Stephen J. Leslie

Nursing Faculty Publications

Background

Patients’ negative illness perceptions and beliefs about cardiac rehabilitation (CR) can influence uptake and adherence to CR. Little is known about the interpartner influence of these antecedent variables on quality of life of patients with coronary artery disease (CAD) and their family caregivers. The aims of the study were: 1) to assess differences in illness perceptions, beliefs about CR and quality of life between patients with CAD and their family caregivers upon entry to a CR programme and at 6 months follow-up; and 2) to examine whether patients’ and caregivers’ perceptions of the patient’s illness and beliefs about CR …

Seeking Care At Free Episodic Health Care Clinics In Appalachia, Malerie Lazar, Sandra Thomas, Lisa Davenport

Journal of Appalachian Health

Background: People who live in rural Appalachia experience a wide variety of problems when seeking access to health care. Health care disparities continue to be one of the most complex and prevalent problems, and many barriers exist for impoverished men and women such as a lack of education, complications with health insurance, and personal distrust of healthcare providers.

Purpose: A critical gap in the literature is the unheard voice of persons in rural underserved areas. The purpose of this study was to explore the perspectives of persons in rural Appalachia who seek healthcare services at free episodic health care clinics, …

A Quantitative Comparison Of Arm Activity Between Survivors Of Breast Cancer And Healthy Controls: Use Of Accelerometry, Mary Insana Fisher, Claire C. Davies, Timothy L. Uhl

Physical Therapy Faculty Publications

Purpose

Survivors of breast cancer (BC) on the non-dominant side have more persistent deficits than those with cancer on the dominant limb. What is not known is whether those with BC use their involved upper limbs more, less, or at the same level as women without BC. Accelerometer use offers a quantifiable method to measure activity levels of upper limbs. The purpose of this study was to quantify the activity levels of the non-dominant involved limb among survivors of BC and compare these values to their dominant limb, as well as the non-dominant limb of a control group.

Methods

Participants …

Health Insurance Literacy Among International College Students: A Qualitative Analysis, Adebola Adegboyega, Chigozie Nkwonta, Jean Edward

Nursing Faculty Publications

In this qualitative descriptive study, we examine health insurance literacy among a group of international college students. They were recruited from a public, co-educational Southeastern university in the United States during the fall semester of 2016 to participate in semistructured interviews. Data were gathered through a demographic questionnaire, two focus group discussions, and individual interviews. Interview sessions were audio-recorded, transcribed, and analyzed using a thematic analysis approach. Three themes emerged, including knowledge of health insurance options and benefits information, affordability, and unmet expectations. These findings show the need for higher education institutions to develop a plan to integrate international students …

Expression Of Cytokines And Chemokines As Predictors Of Stroke Outcomes In Acute Ischemic Stroke, Sarah R. Martha, Qiang Cheng, Justin F. Fraser, Liyu Gong, Lisa A. Collier, Stephanie M. Davis, Doug Lukins, Abdulnasser Alhajeri, Stephen Grupke, Keith R. Pennypacker

Institute for Biomedical Informatics Faculty Publications

Introduction: Ischemic stroke remains one of the most debilitating diseases and is the fifth leading cause of death in the US. The ability to predict stroke outcomes within the acute period of stroke would be essential for care planning and rehabilitation. The Blood and Clot Thrombectomy Registry and Collaboration (BACTRAC; clinicaltrials.gov NCT03153683) study collects arterial blood immediately distal and proximal to the intracranial thrombus at the time of mechanical thrombectomy. These blood samples are an innovative resource in evaluating acute gene expression changes at the time of ischemic stroke. The purpose of this study was to identify inflammatory genes and …

2019 Kentucky Board Of Nursing Workforce Update, Sydney P. Thompson, Frances J. Feltner, Melissa A. Slone

Center of Excellence in Rural Health Infographics

No abstract provided.

What Contributes To High Adolescent Pregnancy Rates In Ecuador? A Secondary Analysis Of A Qualitative Study, Isabel D. Gollmar, Hartley C. Feld

Posters-at-the-Capitol Presentations

Introduction: Ecuador has the second highest rates of adolescent pregnancy in South America. Adolescent pregnancy is associated with negative health implications, including miscarriage, neonatal and maternal demise, cephalopelvic disproportion, and illness throughout infancy. Additionally, adolescent pregnancy perpetuates the cycle of poverty and is associated with lower educational attainment and increased reliance on social services.

Purpose: The purpose of this study was to describe experiences that contributed to unintended adolescent pregnancy of Ecuadorian women living in a low-resource community. Specifically, this work aimed to identify barriers to seeking or utilizing birth control in sexually active adolescents. The long-term goal of this …

The Impact Of Clinical Reasoning Seminars On Medical-Surgical Specialty Hesi Exam Scores, Stephanie Fugate

DNP Projects

Abstract

Background: Clinical reasoning and clinical judgement have been identified as essential skills for the delivery of quality patient care. Nursing education relies heavily on standardized exams like the HESI to predict success on the national licensure exam.

Purpose The purpose of this study was to determine the impact of clinical reasoning seminars (CRS) on medical-surgical specialty HESI exam scores of first semester junior BSN nursing students.

Methods: A retrospective correlational design was used for this study, which involved a review of medical-surgical HESI scores for 115 junior level baccalaureate nursing students who were identified as academically high-risk and who …

College Campus Outreach To Increase Chlamydia Screenings, Elizabeth Kinney

DNP Projects

A common sexual health concern around the world is sexually transmitted infections (STI). Chlamydia is the most reported sexual health problem. The highest prevalence of chlamydia rates is among ages 15-24, which includes college age students (CDC, 2019). The lack of education provided to students prior to starting college by parents, health care providers and high school sources as well as inaccurate information obtained from peers and erroneous internet sources may lead to misconceptions about STIs and consequently the avoidance of routine screening among this high-risk population (Canan & Jozkowski, 2017).

The purpose of this project was to determine if …

The Effect Of A Sun Damage Simulation Photography App On The Skin-Protective Behavior Intentions Of Women With Children Age 18 Or Younger, James Bowlds

DNP Projects

Abstract

Background: Skin cancer is the most common form of cancer diagnosed in the U.S. annually, despite being a largely preventable disease through the limitation of ultraviolet radiation exposure. Attempts to decrease its incidence have focused on appearance-based interventions. These have been effective at improving sun-protective behaviors among various subpopulations including people of color. Anecdotal observations suggest mothers more frequently utilize sun protection for their children than on themselves.

Purpose: The purpose of this project was to gain an understanding of the sun protection practices and beliefs of Caucasian and African American mothers, to assess the response to an appearance-based …

Impact Of Nicu Design On Feeding-Related Outcomes In Preterm Infants, Emma Kate Calvert

Theses and Dissertations--Communication Sciences and Disorders

Many NICUs around the country are moving away from traditional open-bay designs in favor of single-family rooms (SFRs) as more is understood about the impact of the sensory environment on neurodevelopment in preterm infants. SFRs house one infant and their family for the length of the infant’s stay and are associated with improvements in numerous outcomes, including increased milk intake and weight gain and earlier transition to enteral feeding. Oral feeding remains a critical requirement for NICU discharge; however, the impact of NICU design on feeding outcomes remains unknown.

The purpose of this study was to compare feeding outcomes between …

Health-Related Quality Of Life And Ptsd-Symptoms In Survivors Of Extracorporeal Membrane Oxygenation (Ecmo) Support, Jennifer Bauman

DNP Projects

Background: Extracorporeal membrane oxygenation (ECMO) survivors have shown to have poor physical and mental health outcomes post decannulation and hospitalization; thus leading to an overall decreased quality of life. Identifying and managing the psychological components of care in this patient population can improve their physical, emotional, and mental well-being.

Purpose: To assess the incidence of impaired health related quality of life (HRQOL) and posttraumatic stress disorder (PTSD) like symptoms in survivors of ECMO; identify which constellation of patients (respiratory vs. cardiac) have poorer HRQOL outcomes post ECMO; and compare the tools used to measure post procedural outcomes in this patient …

Increasing Adherence To A Light Sedation Protocol By Increasing Nurses’ Knowledge And Confidence, Katie Rust

DNP Projects

Abstract

BACKGROUND: Oversedation in the mechanically ventilated patient can cause long- and short-term adverse side effects. Light sedation practices provide patients with relief from agitation and pain and still allows them to actively participate in care. A light sedation protocol was introduced to bedside ICU registered nurses (RNs) at the University of Kentucky Medical Center (UKMC), but deep sedation is still commonplace. Reeducating bedside RNs and increasing their knowledge and confidence is a proposed strategy for increasing adherence to light sedation protocols.

PURPOSE: The purpose of this quality improvement project was to gain understanding of bedside RNs knowledge and perceived …

Implementing A Multicomponent Intervention To Improve Nursing Knowledge Of Delirium And Interprofessional Communication Of Delirium In Intensive Care Patients, Daniel Bryan Williams

DNP Projects

PURPOSE: The purpose of this project is to evaluate the implementation of a standardized delirium education program, delirium assessment protocol, and a standardized CAM-ICU reporting method. The goal of the project is to improve nursing delirium knowledge, CAM-ICU documentation compliance, and interdisciplinary discussion of patient’s delirium status during Multidisciplinary Rounds (MDR). This project has four distinct objectives. 1) Implement a standardized delirium assessment and communication protocol within the Lexington VAHCS ICU. 2) Increase the nursing knowledge and self-confidence of assessing ICU delirium, by 50% using a multifaceted educational approach. 3) Achieve a 90% documentation compliance rate for the CAM-ICU delirium …

Evaluation Of A Concussion Management And Discharge Education Training Module For Emergency Department Nurses, Carmen Frede

DNP Projects

Purpose: The purpose of this project was to improve the Emergency Department (ED) nurses’ knowledge on identifying patients at risk for concussions and delivering effective concussion discharge education using an educational training intervention.

Methods: This project used a descriptive, non-randomized pre-post survey design. Participation involved three stages: a pre-education survey to assess baseline concussion education knowledge, an educational intervention consisting of a narrated PowerPoint presentation, and a post-education survey to evaluate knowledge on concussion discharge education. The intervention was delivered online via the UK Canvas educational platform.

Results: The majority of nursing staff participants were female (97%) and had a …

Multifaceted Interventions To Improve Hand Hygiene Compliance Among Nurses, Christopher Hoffman

DNP Projects

The WHO has identified hand hygiene as the single “most important measure to avoid the transmission of harmful germs and prevent healthcare-associated infections” (World Health Organization [WHO], 2009) and subsequently created guidelines specifically focused on hand hygiene and prevention of hospital-acquired infections (HAIs). Nurses know and understand the importance of performing hand hygiene before and after patient contact, but often compliance is subpar. An extensive literature review was conducted for methods and interventions to improve hand hygiene compliance. The review of literature found seven systematic reviews which helped shape this study. The purpose of this study is to examine the …

The Effect Of A Nursing Knowledge Practice Improvement Project For Icu Acquired Weakness (Icuaw) And Mobility Protocols To Increase Knowledge And Self-Confidence In Icu Nurses, Renee Rogers

DNP Projects

Objective: The purpose of this project is to conduct a knowledge improvement program about ICU acquired weakness (ICUAW), mobility protocols, and self-confidence for ICU nurses at the University of Kentucky's Trauma & Surgical service.

Aim: The aim of this project is to improve the ICU nurses’ knowledge about ICUAW, mobility protocols/charting, and nursing self-confidence performing the knowledge within clinical practice. As well as assess if there is any correlation between the years of nursing experience and ICU location on knowledge and self-confidence.

Background: A condition that is under recognized in critical care, is ICU acquired weakness (ICUAW), which is muscle …

Increasing Medication Compliance In Pediatric Asthma Patients By Implementing A Home Medication Dosing Chart, Lindsey K. Shader

DNP Projects

Background: There are 6.2 million children under the age of 18 years who have an asthma diagnosis (Center for Disease Control and Prevention, 2017). Only 60% of children ages 7-17 years with persistent asthma maintain their prescribed inhaled corticosteroid (ICS) controller medication regimen (Arnold, Bixenstine, Cheng, & Tschudy, 2018). The purpose of this paper is to discuss a practice inquiry project that incorporated the implementation of an asthma medication dosing chart to increase compliance in pediatric asthma patients.

Method: The quasi-experimental pretest-posttest design evaluated the daily use of a medication dosing chart, which was to serve as a physical reminder …

Engaging Patients To Prevent Harm: Implementation Of Hospital Acquired Pressure Injury Prevention Education Videos, Sarah Buschmann

DNP Projects

PURPOSE: The purpose of this proposal is to evaluate the introduction of pressure ulcer prevention videos to at risk adult patients in the intensive care unit within the acute care health setting.

METHODS: The study design is a retrospective chart review to analyze the effect of the pressure ulcer prevention videos on the number of pressure ulcers and incidence rate while comparing Jackson/Cubbin scores. As pressure ulcers continue to rise, patient education through the Get Well Network is a required intervention. This project is relevant in reducing pressure ulcers and increasing patient safety. Data collection took place from July 1 …

Evaluating Colorectal Cancer Screening Rates In An Urban Primary Care Practice, Kristen Makowski

DNP Projects

Colorectal cancer accounts for 8% of all cancer deaths and can be prevented through timely removal of colon polyps. Despite recommendations for routine screening, approximately 31.2% of patients go unscreened for this disease (Centers for Disease Control and Prevention, 2018). The purpose of this project was to determine screening rates and documentation mechanisms for colorectal cancer in an urban primary care practice, to determine how many patients completed the screening, and to present findings to the practice providers along with exploring ways to increase screenings. An additional purpose of this project was to determine and identify patient demographics which can …

Effectiveness Of A School-Based Asthma Education Program For 8-10-Year-Old Children, Laura Hunt

DNP Projects

Background: Asthma is the most common chronic condition to affect children in the United States Five million children throughout the United States and approximately 112, 000 children in Kentucky are living with the diagnosis of asthma (CDC, 2017; CHFS, 2017). Based on current rates 1 out of 10 elementary school-age students will likely have asthma (CDC, 2019). Educating elementary-age students about asthma and symptoms of an asthma exacerbation is very important and could save a life.

Methods: A school-based asthma education program targeting children in third and fourth grades was implemented at two elementary schools in Central Kentucky. The asthma …

Improving First Dose Administration Of The Hpv Vaccine For Adolescents In A Pediatric Primary Care Clinic, Scarlett Mikesell-Pierce

DNP Projects

BACKGROUND: Nationwide more than 90% of cervical cancer cases are caused by the human papilloma virus (HPV). Cervical cancer can be largely prevented by administration of the HPV vaccine for children before becoming sexually active. However, vaccination rates in the United States, remain low at 60%, and only 39.7% through series of completion, despite the strong evidence to support the effectiveness of the HPV vaccine. Research indicates a clinician’s recommendation, providing information and opportunity for discussion about the vaccine are strong motivators for parents to vaccinate their children, regardless of ethnicity. This study addresses the barriers to parent/caregiver intent to …

Nurse Driven Enteral Nutrition Protocol For Mechanically Ventilated Patients, Deena Shewekah

DNP Projects

Introduction: Delayed enteral nutrition in critically ill patients increases the risk of complications and poor outcomes. Current evidence-based guidelines recommend initiation of enteral nutrition within 24-48 hours of intensive care unit (ICU) admission. The quality improvement (QI) project aim was to examine whether enteral nutrition was initiated within 24- 48 hours of mechanical ventilation after implementation of QI intervention in order to determine practice change.

Methods: The QI protocol was introduced to the Cardiovascular ICU (CVICU) at UK Chandler Hospital (UKHC) nurses via an education session. A post-education electronic survey identified the nurse’s understanding of the protocol. To identify nursing …