Prevalence And Predictors Of Urine Culture Contamination In Primary Care: A Cross-Sectional Study, Michael A Hansen, Marissa Valentine-King, Roger Zoorob, Matthew Schlueter, Jennifer L Matas, Samuel E Willis, Lisa C K Danek, Kenneth L Muldrew, Mohammad Zare, Forrest Hudson, Robert L Atmar, Andrew Chou, Barbara W Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

BACKGROUND: Antimicrobial resistance is a global health threat. To slow resistance and preserve antibiotics, stewardship interventions are increasingly promoted and mandated. Urine cultures are the most common microbiological test in the outpatient setting. Contamination most likely occurs during urine collection from surrounding vaginal, perineal, and epidermal flora. Sample contamination can lead to incorrect diagnosis, unnecessary or inappropriate treatment, poor patient outcomes, and higher costs. Therefore, ensuring proper collection of urinary samples serves as a prime diagnostic stewardship target, one that international nursing societies increasingly endorse as an opportunity for nurse involvement.

OBJECTIVES: Determine the prevalence, predictors, and antibiotic prescribing associated …

Do You Know The Pathophysiology Of Cytokine Storm During Covid-19?, Shameera Shaik Masthan, Deekshitha Turaka, Ahmed Abdelhaleem, Mounica Vorla, Steven B. Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Implementation Of An E-Learning Module To Increase Rn Knowledge And Skills Of Emergency Preparedness, Kaitlyn Hope Chung

Doctor of Nursing Practice Projects

Background

By failing to prepare, you are preparing to fail. —Benjamin Franklin, writer, philosopher, politician. Having education initiatives for mass casualty incidents and disaster preparedness that are concise and organized is of high importance. This issue is pertinent to the midwestern medical center where this project took place because in the event of a true mass casualty or disaster scenario, many lives could be saved if registered nurses (RNs) in the emergency department (ED) were better prepared. For a hospital to provide adequate and effective care during a crisis, healthcare workers must be effectively trained to do so. However, many …

Preadmission Testing For Covid-19 As A Screening Strategy: A Retrospective Chart Review From A Tertiary Hospital In Kenya, David Odada, James Ndai, Jemimah Kimeu, Jasmit Shah, Reena Shah

School of Nursing & Midwifery, East Africa

Background: Since COVID-19 was declared a pandemic in March 2020, hospitals and patient care facilities have faced challenges in protecting healthcare workers and patients from being exposed to the infection. The main challenge has been how exposure to COVID-19 can be controlled when asymptomatic patientscan transmit the infection. This study aims to evaluate pre-admission testing of COVID-19 in patients at the Aga Khan University Hospital, Nairobi as a screening strategy for understanding, preventing and controlling exposure to COVID-19.

Methods: This was a descriptive retrospective chart review study that analysed the incidence of COVID-19, incidental detection of laboratory-confirmed COVID-19 …

Improving Donor Bank Milk Administration Workflow In The Neonatal Intensive Care Unit, Davelyn M. Moffit

Master's Projects and Capstones

_Abstract

Problem: Improvement in the donor bank milk (DBM) administration workflows is required to reduce documentation errors and discrepancies. Increased awareness of errors and their impact on quality, safety, and risk management is imperative to optimize clinical, operational, and financial outcomes, as well as a hospital’s reputation.

Context: Research shows human milk is beneficial to the growth of premature and medically-diagnosed term infants. Regulatory agencies recommend standards and guidelines to handle human milk and to monitor compliance and safety practices of healthcare organizations.

Intervention: An audit tool and process map were created to internally monitor the current process for DBM …

Exploring Cultural Values, Beliefs, And Perceptions Of Human Papillomavirus Vaccine Acceptance In African American Men, Rashida Henderson

Electronic Theses and Dissertations

Introduction: African American (AA) /Black men have a higher rate of anal and rectal HPV-associated cancer, which the HPV vaccine can prevent. Purpose: This study aimed to understand the cultural values, perceptions, and beliefs of the HPV vaccine in African American/Black Men. Method: Through a focused ethnography, a semi-structured guide was utilized to interview 24 AA men. Inclusion criteria included identifying as AA/Black, aged 18-30 years, born and living in the United States, identify and born as male, and able to understand, read, and write English. Results: Through Leininger’s Four Phases of Analysis, three themes emerged: 1) lack of knowledge …

Exploring The Lived Experiences Of New Graduate Nurses During The Covid-19 Pandemic, Julie Youn

2022 Southern California Nursing Research Conference

Background

New graduate nurses (NGNs) in acute care settings are particularly vulnerable to the stressors inherent in nursing, due to the immense amount of experiential learning required at the bedside during the first year of practice. The high amount of stress experienced by NGNs is reflected in high turnover rates. Nurses with less than two years of experience accounted for almost half (47.5%) of all nurse turnovers in 2019. Furthermore, the COVID-19 pandemic has caused much physical and emotional turmoil in the nursing profession due to the increased workload and emotional distress. However, there are limited studies exploring the experiences …

Influence Of Cultural Competency Program On Bias In A Community Volunteer Program, Melodie L. Anderson

Student Scholarly Projects

Practice Problem: Individuals may express hesitancy in volunteering in community health programs that directly interface with persons experiencing poverty due to poverty biases. Failure to understand the issues and needs of those experiencing poverty may factor into disparities and inequities along the social determinants of health, leading to poorer population health, well-being, and quality of life.

PICOT: The PICOT question that guided this project was in volunteers (mentors) of community health programs (P) how does a cultural competency program (I) compare to the standardized training program(C) influence bias (0) over 8 weeks (T)?

Evidence: An evidence review indicated …

Global Child And Family-Centered Care Fellowship, Education And Mentorship For Pediatric Healthcare Professionals: A Literature Review, Ashley Zheng, Bobbijo Pansier

Patient Experience Journal

Child- and family-centered care (FCC) is increasingly accepted and implemented to optimize the healthcare experience for patients, their families, and healthcare professionals. Standish Foundation for Children, a 501(c)(3) non-profit, has designed and piloted a fellowship to educate pediatric healthcare professionals in FCC & psychosocial care via an inquiry and mentorship model in Tbilisis, Georgia. This review aimed to evaluate and synthesize existing literature on psychosocial and FCC mentorship for pediatric healthcare professionals in four parts: ongoing need, effects on healthcare professionals, effects on children and their families and/or caregivers, and in cross-country healthcare settings. Reviewers searched open-source databases for articles …

Implementation And Evaluation Of Asthma Education Cell Phone Application: Asthmaxcel, Within An Allergy And Asthma Specialty Practice., Michael Stefan Swift

Doctor of Nursing Practice Papers

Abstract

Background: Asthma is the leading chronic illness among pediatric patients. One of the most significant obstacles facing asthma care is adherence to asthma management plans. In the pediatric population, adolescents (ages 12-17) traditionally have poor asthma management. Research shows that adolescents respond well to technology-based education and that improving adolescent healthcare literacy leads to better asthma control.

Environment: This project took place at an allergy and asthma specialists office. This private practice includes primary care allergy, asthma, and immunology services that follows roughly 120 adolescents with asthma.

Purpose: The purpose of this project was to provide the allergy and …

Performance Of Machine Learning Classifiers In Classifying Stunting Among Under-Five Children In Zambia, Obvious Nchimunya Chilyabanyama, Roma Chilengi, Roma Chilengi, Michelo Simuyandi, Caroline C. Chisenga, Masuzyo Chirwa, Kalongo Hamusonde, Rakesh Kumar Saroj, Najeeha Talat Iqbal, Innocent Ngaruye

Department of Paediatrics and Child Health

Stunting is a global public health issue. We sought to train and evaluate machine learning (ML) classification algorithms on the Zambia Demographic Health Survey (ZDHS) dataset to predict stunting among children under the age of five in Zambia. We applied Logistic regression (LR), Random Forest (RF), SV classification (SVC), XG Boost (XgB) and Naïve Bayes (NB) algorithms to predict the probability of stunting among children under five years of age, on the 2018 ZDHS dataset. We calibrated predicted probabilities and plotted the calibration curves to compare model performance. We computed accuracy, recall, precision and F1 for each machine learning algorithm. …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

Reducing The Incidence Of Clabsi Through Hand Hygiene, Bindu Paudel

Student Scholarly Projects

Practice Problem: Central line-associated bloodstream infections (CLABSI) account for most hospital-associated preventable infections in the United States and globally. Implementation of effective hand hygiene practices is considered to be highly effective in preventing CLABSIs if performed during insertion and every handling instance.

PICOT: The PICOT question guiding this project is as follows: Among intensive care unit employees (P), implementation of hand hygiene awareness program and practice (I) compared to current practices (C) in reducing CLABSI incidences (O) among adult inpatients in 10 weeks (T)?

Evidence: The evidence from a rigorous literature review showed that the appropriate education …

Newborn Weight Change And Predictors Of Underweight In The Neonatal Period In Guinea-Bissau, Nepal, Pakistan And Uganda, Valerie J. Flaherman, Amy S. Ginsburg, Muhammad Imran Nisar, Muddassir Altaf, Khushboo Liaquat, Benazir Baloch, Najeeb Rehman, Yasir Shafiq, Shabina Ariff, Fyezah Jehan

Department of Paediatrics and Child Health

In low- and middle-income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea-Bissau, Nepal, Pakistan and Uganda. In this cohort of 741 infants, the mean birth weight was 3036 ± 424 g. For 721 (98%) infants, weight loss occurred for a median of 2 days (interquartile range, 1-4) following birth until weight nadir was reached 5.9 ± 4.3% below birth …

Implementation Of An Evaluation Of Davita Clabsi Protocol To Reduce Bloodstream Infections In Acute Hemodialysis Patients, Emmy Le

Dissertations

Abstract

Problem: Central line-associated bloodstream infection (CLABSI) is the primary cause of morbidity and mortality in End-Stage Renal Disease (ESRD) patients on hemodialysis. It is associated with severe medical conditions, prolonged hospitalization, and financial burden. Despite its convenience and simple operation, central venous catheter (CVC) account for 70% of all CLABSI occurrence and increase the risk for septicemia and death.

Methods: This quality improvement (QI) project utilized a descriptive observational pilot design to identify the effect of DaVita CLABSI Protocol on CLABSI occurrence rate. Quantitative data was collected retrospectively and prospectively via electronic medical record (EMR) review before and …

What About Anosmia From Covid-19 ?, Sharanya S E Santhi, Sara Elnour, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

Initiation Of Procalcitonin Screening As A Marker In Antibiotic Therapy De-Escalation, Briana Kile

Dissertations

Problem: The overuse of antibiotics has created antimicrobial resistance (AMR)

resulting in treatment failure for bacterial infections. To combat AMR, clinicians should

only prescribe antibiotic therapy when clinically warranted. It is easy to misdiagnose a

viral infection. However, any delay in the initiation of antibiotic therapy in a bacterial

infection may lead to increased morbidity and mortality. These patients with non-specific

clinical symptoms may be misdiagnosed without a rapid and definitive diagnostic test.

Methods: This quality improvement (QI) initiative utilized an evidence-based clinical

guideline for procalcitonin (PCT) levels for antibiotic therapy de-escalation. WBC counts

were collected two-days and one-day before …

Reducing Catheter-Associated Urinary Tract Infections In The Pediatric Intensive Care Unit, Maria Smith

Dissertations

Problem: CAUTIs (catheter-associated urinary tract infections) are a common hospital-acquired condition (HAC) that increase length of hospital stays, hospital costs, and risk for patient mortality. CAUTI rates in a PICU increased in 2021 from the year 2020. A rapid cycle PDSA revealed nurses were not using soap and water for foley catheter care, which is the recommended cleanser by the Centers for Disease Control and Prevention (CDC).

Methods: An observational descriptive design was used to evaluate foley catheter cleaning and CAUTI rates. PICU nurses completed behavior surveys regarding foley catheter cleaning practices. An education intervention occurred when nurses answered anything …

Left Ventricular Assist Device (Lvad) Driveline Infection Rates Between Two Different Dressing Methods, Gretchen Compton

Dissertations

Problem: Heart failure has a growing impact on Americans, and this contributes to an increased number of patients requiring treatment for advanced heart failure. Typical treatment options may include cardiac transplant or the implantation of a left ventricular assist device (LVAD). The use of an LVAD requires sterile management of an external driveline site. Driveline infections are a common complication in this patient population and can lead to chronic complications. There are no published guidelines on the management of the driveline site. This project aimed to provide evidence that can be used in the establishment of standardized guidelines for driveline …

An Investigation Of Anti-Intellectualism Among Nurses, Jamie Davis-Tubbs

Dissertations

Anti-intellectualism is often offered as an explanation for irrational actions, especially in the grips of uncertainty. The effects of the COVID-19 pandemic have uncovered the consequences of anti-intellectualism within the healthcare system. Nurses, the most identifiability trusted healthcare professionals, have been used to illustrate a healthcare paradox regarding COVID-19. The healthcare paradox presents nurses as highly trained healthcare professionals who do not believe in their own science and reject scientific expertise. Furthermore, nursing anti-intellectualism has been used to spread misinformation during a major health crisis. Yet, we do not know the depth in which anti-intellectualism exists within the nursing profession. …

Effects Of Education On Correcting Misconceptions And Acceptance Of The Influenza Vaccination Among A College Campus, Travis E. Fairbanks

Doctor of Nursing Practice Scholarly Projects

Educating patients on the influenza vaccination is an important goal for health care providers. It fosters a working relationship between provider and patient and allows patients to make an informed decision on their health care needs. The percentage of individuals who receive the influenza vaccine in the United States has been consistently below goals set by the committee for Healthy People 2020. This DNP scholarly project aimed to determine whether the introduction of education was effective at increasing individuals’ choice to vaccinate against the influenza virus among college campus students. The study was a non-experimental, non-randomized control trial that utilized …

Assessment Of The Cleaning And Disinfection Practices Among Healthcare Workers In Intensive Care Units (Icus) Post-Patient Discharge, Tincy Varghese Ms, Radhika R. R Pai, Roseminu Varghese Mrs

Manipal Journal of Nursing and Health Sciences

Introduction: Patients being admitted to the intensive care unit (ICU) pose a risk of developing common healthcare acquired infections. Healthcare workers (HCWs) must be well-equipped and knowledgeable to deliver effective cleaning and disinfection protocols to reduce the chances of hospital-acquired infections. Objective: This study aimed to assess the knowledge and practice of cleaning and disinfection after the discharge/death of patients among the HCWs in selected ICUs. Methods: A cross-sectional descriptive survey was conducted in selected ICUs of a tertiary care hospital. A purposive sampling technique was used to select the participants which included 106 staff nurses and 47 housekeeping staff …

Implementation And Evaluation Of A Syphilis Screening Tool To Increase Patient Testing For Syphilis Among Adults 18 Years And Older In A Rural Primary Care Clinic, Valeria S. Wiggins

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STIs) are an increasing epidemic in the United States (U.S.) that need immediate interventions to reverse the effects of syphilis on the sexual health of adults in rural populations. Many are unaware of the growing rate of syphilis and the overall impact it causes nationally. When syphilis is detected early, it can be easily treated and cured. Rural primary care providers are ideal candidates for implementing education, screening, testing, and treatment.

Purpose: The Doctor of Nursing Practice (DNP) project aims to increase the frequency of screening patients in rural primary care clinics for high-risk sexual behaviors. …

Clabsi’S: Reducing The Rates In An Urban Intensive Care Unit By Consistent Use Of The Central Line Maintenance Evaluation Tool (Clmet), Bridget Smith

Doctor of Nursing Practice Projects

Background: Quality improvement efforts from an urban facility have observed a need for staff education on the central line maintenance bundle and consistent surveillance with the Central Line Maintenance Evaluation Tool (CLMET).

Purpose: To address the practice gap of central line maintenance bundle usage at the bedside by utilizing the CLMET consistently.

Methods: A voluntary didactic program offered to staff and encouraging daily utilization of the CLMET that included real-time feedback by the supervisors.

Results: Pretest grade for the unit (n=13, 82.06) and the post-test grade (n=13, 86.33), which is + 4.27 points after education. Pre-implementation, January 1st through 31st, …

Implementing Antimicrobial Stewardship For Healthcare Providers In An Urgent Care Setting To Reduce Antibiotic Misuse For Respiratory Infections, Ashley Pauldin

Doctor of Nursing Practice Projects

Background: Antimicrobial resistance has been identified as a major threat by the World Health Organization (WHO), and antimicrobial stewardship is a key strategy to overcome resistance. A major contributing factor to this crisis is the inappropriate use of antibiotic prescriptions in outpatient settings. Although evidence-based guidelines on appropriate treatment for acute upper respiratory infections (URIs) have been developed, the need for improving provider and patient awareness and knowledge in the urgent care setting is critical.

Purpose: The purpose of the DNP project was to implement antimicrobial stewardship guidelines in the urgent care facility to decrease the misuse of antibiotic prescribing …

The Use Of The Centers For Disease Control (Cdc) Outpatient Antibiotic Stewardship Program To Reduce Unnecessary Antibiotic Prescriptions Written For Sinusitis In A Rural Urgent Care Clinic Setting, Melanie Maddox

Doctor of Nursing Practice Projects

Background: The discovery of antibiotics has been a significant success in fighting bacterial infections. According to the Centers for Disease Control (CDC), in 2018, inappropriate prescribing of antibiotics contributed to antibiotic-resistant conditions, which led to 2 million infections, and has killed about 23,000 Americans annually (Chaney, 2018: CDC, 2019). By 2050, 10 million people are expected to die globally due to bacterial resistance, with the cost potentially reaching $100 trillion (WHO, 2019).

Purpose: The purpose of the DNP Project is to decrease unnecessary antibiotic prescriptions for the diagnosis of sinusitis in a rural urgent care clinic and increase provider awareness …

Addressing Factors That Lead To Job Dissatisfaction Among U.S. Hospital Nurses And Poor Health Outcomes In Patients: An Integrative Review, Folayan J. Morehead

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify factors that lead to job dissatisfaction among nurses working in U.S. hospitals and learn how patients experience poorer health outcomes as a result. Many factors including inadequate staffing, workplace bullying, violence, low pay, and hostile working conditions within hospital systems influence nurses’ intent to leave and affect the care quality provided to patients. In turn, the poorer care delivery leads to unsafe working conditions and thus poorer health outcomes in patients. Along with job dissatisfaction, nurses often feel the effects of moral distress and burnout which lessens their resilience. Nurses comprise …

‘If The Partner Finds Out, Then There’S Trouble’: Provider Perspectives On Safety Planning And Partner Interference When Offering Hiv Pre-Exposure Prophylaxis (Prep) To Women Experiencing Intimate Partner Violence (Ipv), Noelene K. Jeffers, Jessica L. Zemlak, Lourdes Celius, Tiara C. Willie, Trace Kershaw, Kamila A. Alexander

College of Nursing Faculty Research and Publications

Pre-exposure prophylaxis is an effective women-controlled HIV prevention strategy but women experiencing intimate partner violence fear partners’ interference and subsequent violence could limit its utility. This study explores provider perceptions of safety planning strategies to prevent escalating violence, mitigate partner interference, and promote daily oral PrEP adherence. We conducted interviews (N = 36) with healthcare providers (n = 18) and IPV service providers (n = 18) in Baltimore and New Haven. Using the Contextualized Assessment for Strategic Safety Planning model we organized data into two categories: the appraisal process and strategic safety planning. Themes revealed during …

Prevalence And Geo-Clinicodemographic Factors Associated With Hepatitis B Vaccination Among Healthcare Workers In Five Developing Countries, Precious Adade Duodu, Ernest Darkwah, Pascal Agbadi, Henry Ofori Duah, Jerry John Nutor

College of Nursing Faculty Research and Publications

Background

There is a four-fold risk for hepatitis B infection among healthcare workers compared to the general population. Due to limited access to diagnosis and treatment of hepatitis B in many resource-constrained settings, there is a real risk that only few healthcare workers with viral hepatitis may get screened or diagnosed and treated. Studies on hepatitis B vaccination among healthcare workers in developing countries are sparse and this bodes ill for intervention and support. The aim of the study was to estimate the prevalence and explored the associated factors that predicted the uptake of the required, full dosage of hepatitis …