Digital Commons Network^™

Identification And Treatment Of Sepsis In The Field, Jamie Roney

Books, Presentations, Posters, Etc.

No abstract provided.

Active Shooter Awareness Education And Training Using Best Practices For Nurses In Acute Care Facilities, Amanda Carol Dean

Nursing Theses and Capstone Projects

The thought of having an active shooter at your place of work is unimaginable. The thought of having an active shooter at a place of healing is terrifying and distressing for patients, families, and nursing staff. An active shooter event, as defined by Hauk (2018), is when at least one person is actively killing or trying to kill people in a confined populated space. If an active shooter event were to take place in an acute care facility, nurses must be educated on best practices of responding to an active shooter, including identifying the situation, notifying the appropriate personnel of …

Tuberculosis: Early Diagnosis And Treatment, Gloria Obeng

Nursing Student Class Projects (Formerly MSN)

Although there are measures in place to control tuberculosis (TB) cases in the U.S., TB is prevalent and has high morbidity and mortality rate. This issue is due to the failure to identify and treat the disease as early as possible, especially in the latent stage. The late diagnosis of the disease causes a delay in treatment which may result in complications or even death. Understanding the pathophysiological process of TB will aid in the control of the disease. Also, TB cases have been recorded among foreign-born and immigrants who are visiting the U.S. but some of these immigrants are …

Improving Hepatitis C Screenings In The 1945 To 1965 Birth Cohort In Outpatient Primary Care, Betina Muse Nakoda

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Hepatitis C virus (HCV) is a silent epidemic affecting a vulnerable patient population in our society. Among those considered high risk for having HCV are those individuals born between 1945 and 1965, termed the baby boomer population. Baby boomers are five times more likely to have and suffer mortality from HCV than any other patient population (CDC, 2018). HCV may not present with signs or symptoms until 20 to 30 years post contraction of the virus (CDC, 2018). In 2012, the Centers for Disease Control and Prevention (CDC) updated its recommendations for Hepatitis C screenings to include the baby …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

Strategies To Develop A New Nurse Residency Program, Casandra Allen

Walden Dissertations and Doctoral Studies

The ongoing shortage of registered nurses is a nationwide phenomenon. Many factors contribute to the dissatisfaction and stress of new graduate nurses during the initial transition phase of their career. The lack of peer and leadership support is among the many factors that lead to constant turnover. New nurses entering the workforce are caring for patients with more complex health problems. The Commission on Collegiate Nursing Education (CCNE) has developed standards for accreditation of entry-to-practice nurse residency programs (NRP). The purpose of this DNP project was to propose a formal evidenced-based nurse residency program to the stakeholders of an acute …

Increasing Uninsured Patients' Compliance With Return Primary Care Visits, Dorothy Clare Carleton

Walden Dissertations and Doctoral Studies

Patients who are unable to comply with their health care regimen are almost 3 times more likely to have an adverse health outcome and are more likely to suffer irreversible progression of a chronic disease process. Increasing patient return clinic visits is essential, not only to curtail rapidly rising costs of health care but also to improve patient outcomes. This project focused on an uninsured patient population of a clinic in a rural community in the southeastern United States. The purpose of the project was to conduct a systematic review of the literature and identify the barriers and motivating factors …

Implementing Guidelines To Improve Hand Hygiene Compliance, Doreen Millicent Currie

Walden Dissertations and Doctoral Studies

Hand hygiene is the term for removing microorganisms with disinfecting agents, alcohol-based rub, or soap and water. Evidence supported the low rates of hand hygiene compliance among health care workers. This project addressed this gap in practice at a large acute care facility through an educational training program. Data from the facility on hand hygiene compliance revealed a compliance rate of 63%. The problem question explored whether an educational program on hand hygiene improve compliance. The focus of the program was to provide education on the World Health Organization's My 5 Moments for Hand Hygiene and the 7-step technique for …

Increasing Communication Through Improved Nursing Education: The Histories, Policies, And Manufacturing Process Of Vaccines, Alyssa R. Gruich

Senior Honors Theses and Projects

Increasing nursing education of vaccines is incredibly important when nurses are attempting to educate families on the risks and benefits of many childhood vaccines. Through learning about the history of major vaccines, vaccine policies and the vaccine manufacturing process, nurses may better understand how to communicate with families.

Addressing Climate Change: We Can’T Afford Not To, Elizabeth Schenk

Articles, Abstracts, and Reports

No abstract provided.

Alpha Amylase As An Emerging Biomarker Of Microaspiration In Mechanically Ventilated Patients: An Integrative Review Of The Literature, Chloe Chase

Honors Undergraduate Theses

Aims: The purpose of this thesis was to synthesize the current literature on alpha amylase as an emerging biomarker of microaspiration in mechanically ventilated patient.

Methods: The methodology included a review and synthesis of pertinent research articles from 1981-2018, written in English language. Criteria for inclusion in the review were all articles that evaluated α- amylase in tracheal secretions or bronchoalveolar lavage fluid (BAL) as a diagnostic tool for identifying microaspiration. The search yielded 11 studies that were reviewed.

Findings: The findings suggest that once aspiration occurs, the duration of α-amylase in the lungs requires further exploration to assist in …

The Nursing History Of Ngala Since 1890: An Early Parenting Organisation In Western Australia, Elaine Bennett, Selma Alliex, Caroline Bulsara

Nursing Papers and Journal Articles

Background: This study was the first phase of a larger study which explored the past, present and future of nursing in early parenting services in Australia.

Aim: The aim of this paper is to describe the history of nursing within an early parenting service in Western Australia (WA).

Methods: Triangulation of multiple data sources was used to summarise the nursing role over 120 years. The history was discovered through a document analysis of archives, including oral histories, organisational documents, focus groups, nurses’ diaries and interviews with nurses.

Findings: The nursing role and context is described over three time periods: 1890–1960; …

Development Of Nursing Staff Education For Central Line Maintenance, Doreen Lynn Farley

Walden Dissertations and Doctoral Studies

Patients with cancer who receive bone marrow transplants (BMT) are at increased risk for central line-associated blood stream infections (CLABSI), a serious complication leading to increased costs, length of stay, and even death. Recognition of an increased CLABSI rate at one BMT unit in the southwestern United States prompted development of an evidence-based staff development education program to improve nurses’ knowledge of central line maintenance and CLABSI prevention practices. Guided by Lewin change theory, the program was developed based on a nurse-led analysis and synthesis of the evidence, and a formative evaluation of the educational program conducted by a 3-member …

Improving Nurses' Knowledge Of Central Line-Associated Bloodstream Infection, Misty Cooper

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections (CLABSI) are usually attributable to suboptimal line insertion, care, or maintenance and are associated with poor patient outcomes. Nursing plays a pivotal role in preventing CLABSI, because nurses are generally responsible for the routine care and maintenance of central lines. The purpose of this project was to determine if CLABSI nursing education and demonstration-based competency could improve nurses' knowledge on a neurology unit as compared to current practice of an annual e-learning module as the sole source of nurse education. This project was informed by Lewin's planned change theory and involved changing behaviors, attitudes, and practices …

Hand Hygiene And Compliance Rates In An Acute Care Setting, Ilona Lungui

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs) are a significant problem faced by healthcare organizations globally. The Centers for Disease Control reported that in 2014, 722,000 patients acquired an HAI, and of those, 75,000 died as a result. This project focused on reeducating healthcare staff on hand hygiene practices to prevent HAIs. Preintervention hand hygiene compliance rates were compared to postintervention hand hygiene compliance rates on 2 units in an acute care setting to evaluate if reeducation of healthcare staff on hand hygiene protocols and practices would increase hand hygiene compliance rates. The evidence-based practice model used for this project was Nightingale's environmental theory. …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

A Pilot Of Emergency Department-Initiated Buprenorphine For Opioid Withdrawal And Opioid Use Disorder: A Quality Improvement Project, Jason Lucey

DNP Scholarly Projects

Background: Emergency department (ED) visits for opioid related visits have increased dramatically during the opioid epidemic. Buprenorphine is an evidence-based therapy for treating opioid use disorder (OUD) and withdrawal. Unfortunately, lack of access to pharmacotherapy for OUD, including buprenorphine, remains a challenge. Research supports ED-initiated buprenorphine as a practical, cost-effective strategy which engages patients in treatment better than non-pharmacologic alternatives.

Purpose: The aims of this improvement project were to 1) develop a pilot process in an ED for providing buprenorphine to patients in opioid withdrawal or for OUD; 2) recruit and train a cohort of ED staff on the process; …

Nurse Practitioner Attitudes, Perceptions And Knowledge About Antimicrobial Stewardship, Evelyn C. Fabian

Walden Dissertations and Doctoral Studies

Resistance to antibiotics has increased dramatically in the United States, with serious associated medical, social, and economic consequences. The purpose of this project was to assess nurse practitioners' attitudes, perceptions, and knowledge about antimicrobial stewardship and knowledge in the management of anaerobic infections as well as resistant gram-negative bacteremia. Data were collected using a web-based survey in a hospital facility. The practice question explored whether nurse practitioners' attitudes, perceptions, and knowledge about antimicrobial stewardship significantly increased after an education program on antimicrobial stewardship. The project was framed by Knowles's adult learning theory. A 16-item survey was administered before and after …

Strategies For Nursing Staff Working In A Correctional Facility., Ima James

Walden Dissertations and Doctoral Studies

As primary care providers in correctional facilities, correctional nurses are expected to balance inmates' healthcare needs with the security demands of the facility. This project explored whether an evidence-based education program could provide strategies for promoting health, a healthy work environment, and a sense of well-being to improve the knowledge, coping skills, and well-being of nurses working in a correctional occupational setting. Twenty nurses participated in an educational intervention project that was guided by the transactional theory of stress. Using a pretest/posttest design, data were collected over a 2-week period and calculated using means and percentages. The descriptive statistics using …

Barriers And Facilitors Of Healthcare Use Among People Who Inject Drugs, C. Brooke Kuns-Adkins

Theses and Dissertations--Nursing

Hepatitis C Virus (HCV) is an infection that can have grave consequences when left untreated. Hepatitis C can be easily eradicated with direct acting antiviral therapy. People who inject drugs (PWID) and inmates are among those with the highest incidence of HCV. However, cure rates among this population remains low. This is, in part, related to an interruption in the HCV care cascade such that only 30% of PWID are linked to care and only 8% of those receive treatment. Inadequate screening and failure to be linked to HCV care remain the largest impediments to treatment success. There is limited …

Nursing Staff Development For Novice Nurse Practitioners In Acute Care, Carolyn Berglund

Walden Dissertations and Doctoral Studies

An acute care practice site reported 75% turnover of novice nurse practitioners (NPs),

which indicated a gap in the transition from student to practitioner within the first year of

clinical practice. This gap can leave novice NPs unprepared to manage patients

effectively and contribute to high turnover. The practice-focused question addressed

whether an evidence-based staff development program for novice NPs at an acute care

site could be developed. The purpose of this project was to create a framework based on

evidence to transition novice NPs successfully into practice. Benner's skill-acquisition

in-nursing theory informed this project. Evidence was obtained by searching …

Increasing Depression Screening And Treatment For Adults Living With Hiv/Aids, Velma Asneth Frasier

Walden Dissertations and Doctoral Studies

The lifetime prevalence of clinical depression in patients living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is approximately 22% compared to 3% to 10% in the primary care population. The nursing practice problem at the project site concerned nurses' lack of knowledge and understanding of procedures to help ensure that all patients living with HIV/AIDS were properly screened for depression and referred for further evaluation and treatment. The purpose of this project was to implement a staff education module to address the use of the PHQ-9 screening tool to identify depression in people diagnosed with HIV/AIDS. The theoretical framework …

2019-2020 Nursing Undergraduate Student Handbook, Morehead State University. Nursing Department.

Nursing Department Publications Archive

2019-2020 Undergraduate Student Handbook of the Department of Nursing at Morehead State University.

Improving Sexual Orientation And Gender Identity Knowledge In Convenient Care Clinics: A Toolkit And Competency Training For Caregivers, Elizabeth M. Gallagher

Doctor of Nursing Practice Projects

It is well documented that transgender individuals experience higher rates of discrimination than non-transgender, also known as cis-gender, individuals (Scandurra, Amodeo, Valerio, Bochicchio, & Frost, 2017). This discrimination extends into the healthcare system, a place where all individuals should be treated with dignity and respect (Bauer, Scheim, Deutsch, & Massarella, 2014). Over the last few decades, cultural humility has been promoted in health care professional training (Fisher-Borne, Cain, & Martin, 2015; Tervalon & Murray-Garcia, 1998). However, transgender care is rarely included. This lack of training can lead to a decreased confidence in providing care to transgender individuals and poor experiences …

The Effect Of Narrative Medicine Combined With Medication Assisted Treatment On Decreasing The Desire To Use Intravenous Substances In Hospitalized Patients With Infective Endocarditis, Paula Works

DNP Projects

Substance abuse is a significant problem that spans the nation. Of particular concern is the growing population of patients at UK HealthCare who have endocarditis as a complication from IV substance abuse.

PURPOSE: The aims of this study were

1. To assess the effect of narrative medicine combined with MAT, compared to MAT alone, on desire to use in hospitalized patients with a history of IV substance use
2. To examine the changes in quality of life before and after the introduction of narrative medicine in hospitalized patients with a history of IV substance abuse using The Quality of Life Scale (QOLS). …

Incidence And Treatment Of Acute Sinusitis In Two Outpatient Primary Care Settings And Provider Challenges In Treating Adult Sinusitis, Britney Nicole Perkins

DNP Projects

Abstract

BACKGROUND: Nationally, approximately one third of antibiotics are currently being prescribed unnecessarily. Antibiotic misuse can result in disability, longer hospital stays, increased costs to organizations, antibiotic resistance and death.

PURPOSE: The purpose of this project was two-fold: (1) explore current management of acute adult rhinosinusitis in an outpatient setting (2) assessing providers perceptions on the barriers to preventing antibiotic misuse.

METHODS: A retrospective chart review of 150 charts was performed to examine prescribing practices by providers treating rhinosinusitis at two primary care practices. An interview was conducted with the practice providers on barriers for compliance in antibiotic stewardship.

RESULTS: …

Vagal Mediated Heart Rate Variability And Cognitive Impairments In Hiv-Seropositive Women, William C. Nicholson

All ETDs from UAB

Regardless of sufficient viral suppression, HIV exerts an ongoing inflammatory process that promotes chronic autonomic nervous system (ANS) dysfunction, accelerates physiological aging, and increases the risk of developing a spectrum of cognitive disorders (known as HIV-associated neurocognitive disorders [HAND]). Given this, identifying pathological mediators of this inflammatory response could provide insight into the mechanisms driving HAND. The vagus nerve (indexed by vagal-mediated heart rate variability [vmHRV]) could provide such a mediator as it regulates ANS activity via reciprocal cardio-neural pathways, which regulate inflammation and homeostasis. Vagal dysfunction is associated with persistent inflammatory signaling (e.g., stress or inflammatory-based disorders [such as …

U.S. Public Health Service Nurse Officers Working In Disaster Settings, Ingrid Stamand

Walden Dissertations and Doctoral Studies

The National Response Plan (NRP) was developed to provide support during national disasters. The U.S. Public Health Service (USPHS) Corps is 1 of the 7 uniform services and contributes to the mission of the (NRP). The USPHS Commissioned Corps (CC) Officers may be deployed for national disasters at any time and they must be ready to deploy. The purpose of this phenomenological qualitative study was to explore the lived experiences of USPHS CC Nurse Officers who have deployed in response to disasters in the United States. This study addressed the gap in literature related to the deployment perception of USPHS …

Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Despite most common transmission, HPV immunization in adolescents remains below target rates of 80% as outlined by Healthy People 2020 Objectives. Nearly all individuals will contract HPV during their lifetime. The purpose of this project was to educate providers on successfully promoting HPV immunization in adolescents utilizing evidence-based methods. The health belief model (HBM) was the theoretical underpinning utilized to teach providers on discussions about 9vHPV immunization with parents of adolescents. The practice focused question explored whether an education program using concepts from the HBM would …

Predicting Decision-Making In Relation To Health-Risk Behavior In College Freshmen, Anne Bijumon Luckose

Dissertations

Method/Measurements: A cross-sectional correlational design explored the relationships between decision-making, health-risk behaviors and social support systems in college freshmen. The aims of the study were: 1) to explore the relationship between decision-making and health-risk behaviors among college freshmen; 2) to determine whether or not family support and social support jointly predict decision-making among college freshmen; and 3) to ascertain whether or not the effect of family support on decision-making is different for male and female college freshmen. Measurement was collected at one time-point and participants in this study completed on-line questionnaires through a web-based online survey software application with measures …