Digital Commons Network^™

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

What Were The Information Voids? A Qualitative Analysis Of Questions Asked By Dear Pandemic Readers Between August 2020-August 2021, Rachael Piltch-Loeb, Richard James, Sandra S. Albrecht, Alison M. Buttenheim, Jennifer Beam Dowd, Aparna Kumar, Malia Jones, Lindsey J. Leininger, Amanda Simanek, Shoshana Aronowitz

College of Nursing Faculty Papers & Presentations

In the current infodemic, how individuals receive information (channel), who it is coming from (source), and how it is framed can have an important effect on COVID-19 related mitigation behaviors. In light of these challenges presented by the infodemic, Dear Pandemic (DP) was created to directly address persistent questions related to COVID-19 and other health topics in the online environment. This is a qualitative analysis of 3806 questions that were submitted by DP readers to a question box on the Dear Pandemic website between August 30, 2020 and August 29, 2021. Analyses resulted in four themes: the need for clarification …

Pressures To Comply Or Defy: How Social Values Influence Perceptions Of Healthcare Workers As Villains, James K. Beggan, Scott T. Allison

Heroism Science

During the Covid-19 pandemic, politicians, the media, and the public labeled frontline workers as heroes. The goal of this article is to examine how certain aspects of the Covid-19 pandemic—such as the nature of the Covid-19 virus, coupled with insufficient governmental and institutional responses—created a situation where it became possible for people to characterize healthcare workers as villains. This approach to medical professionals is rather novel in heroism studies and social sciences. A qualitative review of available data sources provided evidence that frontline healthcare workers were perceived negatively. Experiencing a lack of cooperation from patients and their families, healthcare personnel …

The Factors Associated With Caesarean Section At A Rural Hospital In Southwestern Uganda: A Cross-Sectional Study, Lilian Nuwabaine, Mathius Amperiize, Patience Annet Nakalega

School of Nursing & Midwifery, East Africa

Background

Globally, the overall prevalence of caesarean section (CS) is estimated at 18.6%, with 27% in high-income countries and 6% in low- and middle-income countries. There is an increase in trends of CS in Uganda from 8.5% in 2012 to 11% in 2016. No studies have been carried out to account for the high rates of CS at Kisiizi Hospital in Uganda. This study determined the proportion and factors associated with CS delivery at a rural hospital in southwestern Uganda.

Methods

This was a cross-sectional study of 321 immediate postnatal women in a rural hospital in southwestern Uganda. A structured …

The Lived Experience Of Patients With Clostridioides Difficile, Andrea Scherschel

Dissertations

Background: Clostridioides difficile (C. difficile) is the most common healthcare-acquired gastrointestinal infection in the United States. While there is a plethora of information on the treatment and diagnosis of C. difficile infection (CDI) in the literature, there is a paucity of research findings describing the lived experience of a person with the disease.

Objective: This study described the lived experience of patients who have had one or more CDIs.

Lines of Inquiry: There were two lines of inquiry for this study: (1) Describe the lived experience of having a CDI, and (2) determine if photo-elicitation as a research modality enhanced …

A Pilot Project For Tuberculosis Education In College Students, Sarah Williams

Doctor of Nursing Practice Final Manuscripts

Background: San Diego’s Tuberculosis (TB) incidence is more than double the national rate. The majority of cases of active TB are due to the progression of latent TB infection (LTBI).

Objectives: This evidence-based practice (EBP) project aimed to increase knowledge, awareness, and improve attitudes and practices regarding TB among college students.

Participants: Twenty Community College Students in San Diego participated in the project.

Methods: Students attended an in-person educational session. A pre-post knowledge, attitudes and practices (KAP) questionnaire measured the impact.

Results: The intervention improved knowledge and attitudes. The average post-intervention TB knowledge score was 95.8% compared to 57% …

Assessing Genomic Literacy In Advanced Practice Nursing Students Before And After An Intervention, Guiselle Palomera

Doctor of Nursing Practice Final Manuscripts

Introduction

The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to examine genetics and genomics literacy in advanced practice nursing students before and after an intervention.

Background

As genomics continue to play an emerging role in healthcare, and advancements are introduced into clinical practice, it is critical that nurses be competent in genetics and genomics concepts. There is a fundamental need to incorporate genomics education into nursing school curriculum. However, studies have shown that the majority of faculty across nursing schools in the United States are ill-equipped to teach genetics and genomics concepts. Furthermore, many interventions to …

Improving Outcomes In Persons Who Inject Drugs: A Multidisciplinary Healthcare Initiative, Carla S. Martin

Doctor of Nursing Practice (DNP) Projects

Background: Outpatient parenteral antimicrobial therapy is the standard of care for patients who require long-term antimicrobial therapy but is not considered a safe discharge option for persons who inject drugs (PWID). Many PWID leave against medical advice before completing therapy, resulting in high emergency department utilization and frequent readmissions.

Local Problem: A 646-bed academic and Level I trauma center where opioid overdoses are 6.5 times higher than the state average experiences disproportionately high PWID admissions. Prolonged hospitalization for the duration of antimicrobial therapy increases costs and reduces access for other acute care patients.

Methods: A prospective cohort of PWID discharged …

Increasing Compliance Through Nurse Education On The Bundle, Zachary Harrison-Evans

Master's Projects and Capstones

In an effort to decrease complications and events connected to sepsis in the ED, there is room for improvement with relation to sepsis care and compliance rates. Timely sepsis management and gains in compliance/adherence rates are hindered by SEP-1 fallouts and requirements related to knowledge gaps concerning sepsis bundle procedures, nurses' attitudes about implementing the protocols, and disparities in nurse/physician order sets. It has been determined that the use of standardized protocols and order sets are not being utilized. This is a process gap and a critical area for improvement. Inadequate fluid and lactate documentation, a lack of education, and …

Implementation Of A Decision Aid To Increase The Rate Of Routine Breast Cancer Screening Among Women Between 50 To 74 Years Old At A Federally Qualified Health Center, Dana Mars

Doctor of Nursing Practice Scholarly Projects

Background: Breast cancer is the most prevalent form of cancer in the U.S. Cancer screenings can result in prompt treatments and positive health outcomes. Disparities in screening rates are prevalent among vulnerable populations. At a Federally Qualified Health Center (FQHC), where the project occurred, the rate of breast cancer screening in 2021 (64%) was lower than the target set by the Healthy People 2030 (77%). This quality improvement project aimed to increase the rate of routine breast cancer screening among women aged 50-74 years old in the FQHC.

Methods: Previous studies have reported that decision aids on breast cancer screening …

Introducing Motivational Interviewing Skills To Community Health Workers, Stella Antony

DNP Qualifying Manuscripts

Abstract

Background: Rural population accounts for 15% of the population in the United States of America. Rural residents have a higher risk of health disparities than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, unhealthy eating habits, lack of access to health care, poor socioeconomic status, lack of health insurance, cultural and language barriers, and lack of health literacy. Local Problem: The population in Fresno and Tulare Counties in Central Valley, California is underprivileged, lacks access to proper health care and has higher rates of …

Center Based Cardiac Rehabilitation Outcomes Associated With Covid-19 Pandemic: A Retrospective Comparative Cohort Study, Haley Williams, Kayla Woodworth

Doctor of Nursing Practice Projects: College of Nursing

Background: Traditional cardiac rehabilitation (CR) is a multidisciplinary, multifaceted program for cardiac patients. Throughout the Covid-19 pandemic, health care, including center-based CR (CBCR) programs, were closed to in-person sessions. Even with the return to CBCR participation, patient outcomes may have been affected by this disruption in care. The goal of this study was to determine if CR participation outcomes differed before and after CBCR program closure due to Covid-19.

Methods: A retrospective comparative cohort design was used to examine CR participant outcome data before and after the Covid-19 pandemic. Convenience sampling of CR participants at a large, urban …

Icu Nurses’ Adherence To The Cdc’S Central Line Bundle: A Qualitative Study, Cherie Burke, Cherie Burke

Electronic Theses and Dissertations

Background: Central line associated bloodstream infections (CLABSIs) are one of the most common healthcare associated infections and result in prolonged hospital stays, significant morbidity, and increased costs to the healthcare system. Adherence to the CDC central line maintenance bundle has been shown to be effective in decreasing CLABSI yet these infections continue to be a problem. ICU nurses play a vital role in managing central lines and adhering to the maintenance guidelines, however different situations may arise during the care that may impact CLABSIs.

Objectives: 1) To determine nurses’ adherence to the CDC’s maintenance central line

bundle; 2) To determine …

Introducing A Trauma-Informed Care Model To Address Racial Disparities In Perinatal Outcomes Among African American Women, Mariah K. White

Honors College Theses

Racial disparities in maternal and infant health have remained an issue within the United States despite efforts to advance and improve our health system. Most maternal deaths are preventable, especially with early and adequate maternal care. Infant mortality occurs for several reasons, but inadequate care usage increases the risk for adverse outcomes. Prenatal care usage within the United States has been inadequate for numerous years, most commonly among African American women, despite its known benefit. Low prenatal care usage among African American women can be attributed to community barriers, social injustices, trauma, discrimination, and health care mistrust. Trauma is common …

Noninvasive Screening Of Nonalcoholic Fatty Liver Disease Among People Living With Hiv, Essi M. Havor

Dissertations and Theses (Open Access)

Background: Nonalcoholic fatty liver disease (NAFLD) disproportionately affects up to 75% of people living with HIV (PLWH). Given the high HIV prevalence in Houston and Harris County, knowledge of the prevalence of NAFLD in PLWH is needed to inform prevention efforts. In addition, such knowledge is required to raise awareness among at-risk individuals and healthcare professionals.

Specific Aims: This cross-sectional study aimed (1) to examine the demographic, behavioral, clinical, and psychosocial characteristics of PLWH in Houston/Harris County, Texas, and to estimate the prevalence of NAFLD, (2) to determine factors associated with the severity of NAFLD, and (3) to identify specific …

Cbt Technology Implementation With Pediatric And Adolescent Populations, Tracey W. Kreipe, Heath Gage, Sandra Obiebi

Doctor of Nursing Practice Projects

Abstract

Digital therapy is a growing healthcare intervention improving limited access to specialty care for specific populations and geographic areas. Cognitive Behavioral Therapy (CBT) applications focus on treating anxiety and depression and assist pediatric and adolescent patients in learning behavioral techniques as they wait for 3-6 months or longer to see a mental health provider. Such delays are attributed to the national shortage of mental health practitioners and the further scarcity of fewer psychiatric providers in rural areas, causing the potential for adverse patient outcomes. The setting for this 8-week quality improvement project was a pediatric care clinic that sees …

Telehealth Monitoring For Non-Hospitalized Covid-19 Positive Patients In A Rural Setting, Rebekah Leann French

Doctor of Nursing Practice Scholarly Projects

Purpose

This quality improvement project evaluates the efficacy of an outpatient COVID-19 telehealth monitoring program intended to increase access to care, decrease emergency room/urgent care visits, and hospital admissions among telehealth observed adult patients in a rural area while providing safe home monitoring during acute illness.

Rationale/Background

Prior to COVID-19 pandemic, healthcare systems within the United States encountered several challenges including healthcare inequality and decreased healthcare access, particularly in rural communities. These gaps became more apparent when a novel COVID-19 pandemic emerged straining healthcare systems in the United States and throughout the world. Challenges ranged from overwhelmed emergency room (ER) …

Introduction Of Hiv Point-Of-Care Testing In Adolescent Primary Care: A Quality Improvement Project, Jennifer Quinn Belfry

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: HIV, first identified in 1981, remains a persistent public health problem affecting 1.1 million Americans today. Detection is a critical first step to ending the HIV epidemic and the CDC recommends universal HIV screening for all patients 13-64 years of age regardless of risk factors. HIV screening rates are suboptimal especially in adolescent and young adult populations who face unique barriers to screening. The aim of this project was to improve HIV screening rates in adolescent and young adult patients at a large, urban FQHC.

LOCAL PROBLEM: In the state of Rhode Island, 1 in 10 persons living with …

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

Reducing Urinary Catheter Usage In The Intensive Care Unit Setting And Education Related To Preventing Cautis: A Qi Project, Kristina Diurno

DNP Projects

Significance and Background: Catheter-associated urinary tract infections (CAUTIs) are common but preventable hospital-associated infections. The inappropriate and prolonged use of indwelling urinary catheters can pose a significant risk for patients and healthcare organizations. The Centers for Disease Control and Prevention identified that the most important factor related to an increased risk of CAUTI is the length of time an indwelling catheter remains in place. This DNP (Doctor of Nursing Practice) project assessed the barriers to removing indwelling catheters in the intensive care unit (ICU) while providing encouragement of prompt removal.

Purpose: Three aims were developed for this quality improvement project: …

Implementation Of A Standardized Universal Protocol Process At A Large Academic Medical Center, Lisa Ann Heard

Doctor of Nursing Practice Scholarly Projects

Background: Decreasing the risk of wrong site, wrong procedure and wrong patient surgery is an essential healthcare safety initiative. The Joint Commission’s Universal Protocol along with the World Health Organization (WHO) Safe Surgery Checklist were designed to aid in this patient safety effort and have been implemented in hospitals worldwide.

Local Problem: Perioperative and procedural areas at the project hospital areas have adopted the Universal Protocol and Safe Surgery Checklist. Despite agreement in their importance, there is a lack of uniform application of all components. This leads to variation in practice which may impact team compliance with the protocol and …

The Covid-19 Pandemic And On-Time Vaccine Completion In The Childhood Population: A Strategic Plan, Chris Elaine Mariano

UNLV Theses, Dissertations, Professional Papers, and Capstones

In March 2020, the entire world was placed into lockdown due to the COVID-19 virus, which impacted everyday life, including healthcare. People were scared to leave their homes and obtain preventative services, including vaccinations from birth to adulthood. There was a significant decrease in childhood vaccinations due to the COVID-19 pandemic. A strategy mix is defined as an intervention utilized for vaccination improvement. Strategy mixes were implemented to improve vaccination administration, and ultimately, vaccination rates. However, due to the COVID-19 pandemic, these strategy mixes or interventions were placed on hold causing immunization administration to decrease which could cause vaccine-preventable diseases …

Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus

Doctoral Projects

Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …

Identification Of Molecular Markers Associated With Copd In Non-Smokers And Smokers: A Bioinformatics Analysis, Agede O. Ayodele, Isa M. Wasagu, Ademola E. Fawibe, Alakija K. Salami

The University of Louisville Journal of Respiratory Infections

Background

Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential.

Methods

Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively.

Results

In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The …

Speak Up For Hand Hygiene And Decrease Healthcare Associated Infections, Bernadette Priya Pandya-Orozco

Doctoral Projects

Background: Hand hygiene (HH) is one of the most cost-effective and simplest ways to reduce healthcare associated infections (HAIs). Incorporating Speak Up for hand hygiene enables healthcare workers (HCW) to communicate without fear when they observe noncompliance with HH requirements.
Objective: To increase HH compliance by utilizing Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS education to encourage Speak Up for HH and lead to reduction in HAIs.
Methods: The researcher provided educational training on “Speak Up for Hand Hygiene” and performed regular audits to examine its effects on one hospital unit in a California Bay Area healthcare system. A …

Evidence-Based Approaches To Lowering Uti Rates In Skilled Nursing Facilities: A Review Of The Literature And Application To A Local Skilled Nursing Home, Hailey Griffin

Undergraduate Honors Capstone Projects

The purpose of this paper may be divided into two parts. The first part was a literature review that sought to determine the most common risk factors for developing a urinary tract infection in nursing homes, as well as to identify evidence-based practice interventions for decreasing UTI rates within that specific patient population. The second part consisted of a case study that sought to apply the principles gathered from the literature review to the UTI logs of a deidentified local nursing home. It was found that indwelling urinary catheters and age are the two most common precipitating risk factors for …

Effects Of Reporting Fever Sessions And Caresense On Fever Reporting By Gastrointestinal Cancer Patients Receiving Chemotherapy, Odasy Elejarde

Doctor of Nursing Practice Projects

Patients with cancer who undergo chemotherapy are at risk of immune system compromise. Fever in a patient with cancer who receives chemotherapy can indicate presence of an infection. In patients with a compromised immune system, an infection requires immediate further evaluation and management. Thus, patients receiving chemotherapy must understand when to notify physicians of a fever for prompt evaluation and management.

Purpose. This project aimed to increase the number of fevers gastrointestinal oncology patients receiving chemotherapy reported within 24 hours of detection to MyChart messaging, CareSense, or by calling the physician's office.

Methodology.All gastrointestinal oncology patients who underwent chemotherapy …

Medication Compliance And Decreases In Viral Load Status In Patients With Hiv, Tangela Woodland- Ballard

Doctor of Nursing Practice Projects

Background: The human immunodeficiency virus (HIV) epidemic has been a worldwide challenge for several decades. Proper medication adherence, following the Centers for Disease Control guidelines, has proven effective in decreasing patients’ viral load, thus improving their quality of life, and reducing the spread of the disease. The current literature identifies a lack of knowledge, support, and resources as barriers to medication compliance.

Purpose: To increase medication compliance among persons with HIV.

Methods: This evidence-based practice project utilized the Modified Morisky Scale to help minority HIV patients adhere to strict medication regimens. Repeated measures analysis of variance was conducted to …

Dnp Final Report: Translation Of Evidence-Based Practice: Developing Nurses' Ability To Recognize And Respond To Clinical Deterioration, Bryan Stephen Jordan

DNP Final Reports

Clinical deterioration is a serious physiologic disturbance or a sudden worsening patient condition increasing the risk of morbidity and mortality (Jones et al., 2013). Clinical deterioration compromises hemodynamic stability and produces marked physiological decompensation (Padilla & Mayo, 2017). Patients often exhibit physiological signs several hours or more before decompensation is readily apparent (Andersen et al., 2016; Khanna et al., 2019). The need for early recognition of clinical deterioration has been well-identified and documented (Ashbeck et al., 2021). Increasing time duration from the onset of clinical deterioration to intervention is associated with increased resuscitation and critical care requirements, the presence of …

Determination Of Individuals’ Attitudes Toward Covid-19 Vaccines And Health Fatalism: A Cross-Sectional Study From Turkey, Emre Erkal, Bedriye Cansu Demirkiran, Şerife Köleoğlu, Sevgi Demir Çam

Makara Journal of Health Research

Background: Vaccines have positive effects on the course of epidemics. This study was conducted to determine individuals’ attitudes toward coronavirus disease-2019 (COVID-19) vaccines, their health fatalism, and factors affecting these.

Methods: This cross-sectional study included 944 participants living in Turkey, who were included in the study by snowball sampling, one of the nonprobability random sampling methods. Participant information form, attitudes toward the COVID-19 vaccine scale, and religious health fatalism scale were used to collect the study data. Independent sample t-test, one-way analysis of variance and Pearson correlation analysis were used in the data analysis.

Results: Participants had …