Digital Commons Network^™

Sterile Tubing Changes To Prevent Clabsis In The Nicu, Rachel Janson, Megan Meyer

Nursing Posters

Purpose Statement:

NICU patients have a decreased risk of CLABSI infections when two-person sterile central line changes are implemented into central line maintenance bundles compared to bundles that only use one-person clean line change techniques.

Background:

Neonates admitted to the neonatal care intensive care unit (NICU) often require the placement of central lines for the administration of medications, fluids, parental nutrition, and hemodynamic monitoring. Despite their many advantages, central lines can lead to serious infections, known as cental line associated bloodstream infections (CLABSI). These infections are not related to an infection from another site and develop within forty-eight hours of …

The Lived Experiences Of Icu, Med-Surg, And Er Nurses In The United States Attempting To Breastfeed During The Covid-19 Pandemic, Amy Seay

Dissertations

Breastfeeding is important to promote the health of both mothers and babies (Centers for Disease Control and Prevention [CDC], 2021). Many mothers experience workplace barriers and stress which negatively impact breastfeeding duration (McCardel & Padilla, 2020; Nagel et al., 2022). However, a gap in the literature exists surrounding specific barriers and the impact of stress on U.S. nurses who breastfeed. Specifically, workplace challenges and stress among nurses resulting from the COVID-19 pandemic lack exploration.

This interpretive phenomenological study explored the lived experiences of ICU, Med-Surg, and ER nurses who attempted to breastfeed during the COVID-19 pandemic. Roy’s adaptation model was …

Preoperative Skin Preparation Protocol For Patients Undergoing Abdominal And Spinal Surgery, Lia Moyer

The Eleanor Mann School of Nursing DNP Capstone Projects

Surgical site infections are an avoidable complication in surgical patients and one of the most common hospital-acquired infections. Adverse effects of surgical site infections include increased hospital length of stay, increased costs to patient and healthcare system, disability, morbidity, and mortality. The purpose of this quality improvement project was to design a protocol with the objective of decreasing surgical site infections in abdominal and spinal surgery patients. The protocol developed used targeted depilation and antisepsis with a chlorhexidine wipe to mitigate infection risk. Results of the project showed a static hospital length of stay, no increase in preoperative time, and …

Diabetes Type 2 Management, Thuy H. Trinh, Shannon Harris, Anthony Labady

Poster Presentations

Diabetes is a complex and chronic disease. Patients with diabetes may suffer complications such as microvascular and macrovascular diseases [1]. In 2018, the prevalence of diabetes was estimated to affect 34.2 million people, or 10.5% of the US population [2]. About 1 in 10 adults in Georgia has diabetes, a health condition that can be prevented with weight loss and lifestyle changes [3]. In 2018, diabetes-related emergencies accounted for 17 million emergency room visits, with 248,000 for hyperglycemia and 242,000 for hypoglycemia [4]. The purpose of this study was to implement a personalized, clinic-based diabetes management program with healthy lifestyles, …

Benefits Of Individualized Weight Loss Program In The Overweight Adult Population In Primary Care, Susan Mcguire, Shannon Harris, Nasir Asghar

Poster Presentations

The purpose of this project was to increase health by implementing a personalized, clinic-based weight loss program for overweight/obese patients leading to a decrease in weight, BMI, and waist circumference and an increase in muscle mass by using resistance training (RT) exercises as an adjunct to diet, therefore helping to decrease comorbidities associated with obesity. This project aimed to use strength training exercises as an adjunct therapy to lifestyle changes (diet, exercise, counseling) to decrease body weight by 8 pounds, decrease BMI by at least 1%, decrease waist circumference by at least 1 inch, and increase muscle mass percentage by …

Depression Screening In Hematology/ Oncology Outpatient Clinic, Nikki Marshall Msn, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Oncology patients have multiple factors that can lead to depression, such as treatments, end-of-life decisions, stressors from home, pain, financial responsibilities, and transportation needs. If depression goes unaddressed, it can diminish the quality of life in oncology patients.

Objectives: (1) The purpose of this evidence-based practice (EBP) project is to improve Hematology/ Oncology (HEM/ONC) patient quality, with improved screening (PHQ-9 screening tool) and identification as well as referral for adult patients (18 and older). (2) Assess the knowledge, perception of depression, and confidence level of utilizing the PHQ-9 screening tool in the hem/onc outpatient clinic staff. (3) To increase …

Use Of A Worksite Physical Activity To Improve Subjective Daytime Sleepiness Among Night Shift Healthcare Workers: A Quality Improvement Project, Marthe Sooh Nkongo

DNP Projects

Background and Significance: Shift work including work schedules beyond the typical "nine-to-five," causes the disruption of sleep-wake behaviors (Healy et al., 2021). The circadian misalignment is a potential pathway for the development of metabolic diseases, excessive daytime sleepiness, sleep deprivation, and declines in alertness and performance among night shift workers (James et al., 2017; McHugh et al., 2020; Parry et al., 2018). Emerging evidence suggests that physical activity synchronizes the sleep-wake cycles (Healy et al., 2021).

Purpose: This quality improvement project (QI) aimed to improve night-shift nurses ‘subjective daytime sleepiness by incorporating a 4-week worksite walking activity during working hours. …

Fitness Assessments Of Women With Polycystic Ovary Syndrome: A Prospective Process Feasibility Study, Pamela J. Wright, Cynthia F. Corbett Phd, Rn, Faan, Robin M. Dawson Phd, Rn, Cpnp-Pc, Michael D. Wirth Msph, Phd, Face, Bernardine M. Pinto Phd, Fapa, Fsbm, Fabmr

Publications

Background: Fitness is a marker of physiological and mental health. The purpose of this pilot study was to assess the feasibility of processes to recruit women with polycystic ovary syndrome (PCOS) during the Covid pandemic and collect their health and fitness data. Additionally, the data was used to explore possible associations between anthropometrics, PCOS biomarkers, health-related quality-of-life (HRQoL), and depressive symptoms with that of fitness and self-reported physical activity levels among women with PCOS. Methods: A convenience sample of women with PCOS (n = 15) were recruited via flyers and the snowball method. Participants completed surveys, anthropometrics, a dual energy …

Firefighter: 24/48 Versus 48/96; Sleep, Strain, And Recovery, Amy Sprague

Honors Theses

Firefighters provide important safety services for a 24-hour society. Sleep is very important to the human body. Without sleep a person can experience both short- and long-term side effects. These side effects not only put the sleep deprived person in danger but can also put the public in danger as well. There are many different shift schedules that fire departments can run on. While on duty firefighters must be ready to respond to any emergency call, they receive no matter the time. This can impact the amount of sleep they get while on duty. The current study used biometric straps …

Impact Of An Evidence-Based Order Set On Pneumonia Length Of Stay, Troy Wayne Spires

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Among adult patients admitted with pneumonia, what is the effect of Computerized Provider Order Entry (CPOE) sets for pneumonia, as compared to usual practice, on the length of stay over three months.

Purpose: The project aimed to determine if inpatient LOS related to pneumonia could be impacted by utilizing appropriately completed computerized physician order entry (CPOE). The current pneumonia order set was evaluated and updated to reflect the latest evidence-based standards of care. Pneumonia order sets with evidence-based practice treatment algorithms was the intervention focus as they have been shown to impact the length of stays …

Reducing Falls Among Adult Psychiatric Inpatients Using K-Cards With The Epi, Epfrat Factors, And Nursing Judgment, Katelyn Dunn

Doctor of Nursing Practice Scholarly Projects

In the United States, the highest rates of falls are in the psychiatric inpatient population. Fall reduction was as an organizational goal of the project site, a 352-bed hospital in the Southeastern United States. The Epic Predictive Index (EPI), an automated fall risk assessment tool, had recently been adopted. This project evaluated the impact of an enhanced fall reduction strategy involving the use of Kamishibai Cards (K-Cards), which are a compliance reminder for healthcare staff, to support additional evidence-based identification of fall risk among adults receiving inpatient psychiatric care at the facility. The use of K-Cards with each patient’s current …

Sunscreen Is Not Just For White People: Church-Based Sunscreen Education For Black Women, Lauren Mitchell

DNP Projects

Significance and Background: African American women are an undeserved population in healthcare, particularly regarding skin cancer prevention. The lack of education and misinformation surrounding skin cancer has resulted in general mistrust of the healthcare system amongst African Americans. Proper education on sunscreen use and skin cancer screening is essential to prevent late diagnosis of skin cancer and to promote prevention efforts.

Purpose: This quality improvement project utilized evidence-based practice to provide education on the proper use of sunscreen and skin cancer screening to African American women in a faith-based setting in Southern Connecticut.

Methods: A pre-survey was conducted to assess …

The Role Of Intraoperative Esmolol Vs Ketamine In Laparoscopic Cholecystectomy, Rebekah Bitar

Nurse Anesthesia MSNA Student Capstones

As the understanding of opioid dependence mechanisms and origins in the adult population continues to evolve in the United States, so does the pursuit of alternative avenues for analgesia. Many opioid substance-use disorder patients can trace the origins of their dependence to routine prescription and administration of opioids during surgical procedures (Bohringer et al., 2020). One such procedure where opioids are frequently utilized for intraoperative and postoperative analgesia is laparoscopic cholecystectomy. Incidence of gall bladder disease is closely related to obesity (Hines & Marschall, 2018). Gallstone disease continues to be a common and costly health problem affecting 10 to 20% …

The Jackson/Cubbin Skin Risk Assessment Tool: Implementing An Evidence-Based Practice Change Initiative In The Intensive Care Unit, Andrew Riddle Msn, Rn, Npd-Bc, Ccrn-K

Doctor of Nursing Practice Projects

Background: Pressure injuries in acute care patients cause thousands of deaths and billions of losses annually. The Braden Scale has been an American standard of pressure injury risk assessment yet demonstrates poor predictability in the Intensive Care Unit (ICU) population. Recent evidence indicates that the Jackson/Cubbin Scale performs similarly or superiorly to the standard.

Purpose: To compare the Jackson/Cubbin Scale to the Braden Scale in assessing ICU patients’ risk for pressure injuries and resulting nursing interventions. Methods: Using a pretest-posttest and comparative design, trained nurses in two ICUs applied both Jackson/Cubbin Scale and Braden Scale to assess patients’ risks twice …

Addressing Verbal Aggression To Reduce Workplace Violence Against Nurses, Rebecca Harris

Doctor of Nursing Practice Projects

Background: Almost three-quarters of non-fatal workplace violence-related injuries requiring time away from the workplace occur in the healthcare and social services sector. More than 90 percent of assaults against nurses are from patients. Verbal aggression was correlated with physical violence and could contribute to nurses’ stress and dissatisfaction and compromise patient care. Policies and guidelines addressing verbal aggression against nurses are often unclear and not well-supported by evidence. This can leave nurses unprepared to recognize and respond to verbal aggression or threats of physical harm without compromising their safety.

Aim: This health policy analysis aimed to explore a range of …

Benchmark: Impact Of Weight Loss Education On Obese Patients, Tabitha A. Moorehead

MSN Capstone Projects

Objective: With an epidemic as severe as obesity, it is paramount that healthcare professionals be aware of the overarching negative effects the disease can contribute to the human body. If constructive dialogue can be achieved between patient and provider without suspicion of bias or judgment, we would potentially experience an elevated willingness of patients to follow treatment steps.

Background: According to the World Health Organization (WHO), worldwide obesity has nearly tripled since 1975. “Most of the world's population live in countries where overweight and obesity kills more people than underweight” (WHO, 2021). “More than 4 in 10 Americans are …

Covid-19 Lockdown: Impact On College Students’ Lives, Wendy C. Birmingham, Lori L. Wadsworth, Jane H. Lassetter

Faculty Publications

Objective: In light of COVID-19, leaders issued stay-at-home orders, including closure of higher-education schools. Most students left campus, likely impacting their employment and social network. Leaders are making decisions about opening universities and modality of instruction. Understanding students' psychological, physiological, academic, and financial responses to the shut-down and reopening of campuses can help leaders make informed decisions. Participants: 654 students from a large western university enrolled during the pandemic shutdown. Methods: Students were invited via email to complete an online survey. Results: Students reported stress, depression, loneliness, lack of motivation, difficulty focusing on schoolwork, restless sleep, appetite changes, job loss …

A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe

Posters

Introduction: Propionic Acidemia (PA) is a disorder related to abnormal protein and lipid metabolism resulting in progressive neurological injury and dilated cardiomyopathy (DCM). Interventions for PA and secondary disease manifestations can require multi-organ transplantation. Herein we report the case of a child with PA and end-stage DCM requiring left ventricular assist device (LVAD) support with eventual heart-liver transplant. Case Report: A 17 year old male diagnosed in childhood with PA developed chronically progressive DCM culminating in end stage heart failure with acute decompensations. In a recurrent admission, he progressed to require dual inotropic support and systemic anticoagulation for new LV …

Far From Home: The Role Of Travel Distance And Care Fragmentation In Surgical Outcomes For Inflammatory Bowel Disease, Alexander Booth, Henry Colorado, Gayenell Magwood Phd, Rn, Faha, Faan, Erin Forster, Robert N. Axon, Thomas Curran

Publications

BACKGROUND: Fragmented care for inflammatory bowel disease (IBD) is known to correlate negatively with outcomes, but it is unclear which aspects of care fragmentation are relevant and potentially modifiable. Furthermore, there is little data on the relationship between travel distance and the benefits of integrated care models. Hypothesizing care coordination in the preoperative period may have a significant impact on surgical outcomes, we explored associations between integrated care, travel distance, and surgical outcomes. METHODS: A single-center retrospective cohort study of patients undergoing index abdominal surgery was done to compare the rate of surgical complications with and without long travel distance …

Dnp Final Report: Preventing Critical Care Nurse Burnout: An Evidence Based Approach To Raising Awareness, Trendalyn S. King

DNP Final Reports

Burnout has affected nurses nationally and globally for decades. Burnout in nurses is characterized by emotional exhaustion, depersonalization, and lack of feelings of personal accomplishment. Consequences of burnout include physical and emotional suffering in nurses, poorer patient outcomes, and lost revenue and increased cost in healthcare organizations. Burnout is prevalent in many healthcare settings, but 81% of critical care nurses have reported severe symptoms of burnout, Because of the high risk of burnout in critical care nurses, raising awareness about burnout and its prevention in those nurses was imperative. The following PICOT question guided the search for evidence to support …

Child Abuse From A Nursing Perspective: Assessment And Implications, Ashtyn Spring

Senior Honors Theses

Nurses experience the relationship dynamics between pediatric patients and their families firsthand. Being informed by the goals of holistic care, nurses should be assessing for unhealthy dynamics among pediatric patients and their caregivers so they can respond appropriately when a potential for abuse is present. Healthcare workers have the duty to provide safety and healing to their patients. Through the unique contact nurses have with patients, their training for accurate assessment skills, and their responsibility as healthcare workers, nurses are placed with the opportunity to help children out of abusive situations. Prompt identification of the potential for abuse can prevent …

On Site Healthcare, Amy Roden

Electronic Theses and Dissertations

A productive workforce and retention of employees is an essential part of a company’s reputation and elevation of the company to be the best to the workforce. Healthy and present employees are a key to this productive workforce. Transient workers in the pipeline construction are away from their families and loved ones and can struggle to stay healthy and find quality healthcare while working long hours multiple days a week. Employers on these job sites can help their employees by providing onsite healthcare. The research shows there is a lack of healthcare providers available, especially in more rural areas. The …

Risk Factors For Hypertension Among Adults Living In A Rural Area, Minahasa, Cindy Debora, Cindy Tolimba, Shekina Palunggi, Deborah Siregar, Lenny Harefa

Jurnal Keperawatan Indonesia

Hypertension is a major public health issue in Indonesia due to its high prevalence and the fact that it is a risk factor for heart disease, kidney failure, and stroke. Age, gender, family history, alcohol consumption, smoking, iodine consumption, physical activity, and obesity are all risk factors for hypertension. Adults with undiagnosed hypertension can face an increased risk of morbidity and mortality if it is left untreated. Early detection and knowledge about the risk factors for hypertension in adults are important. This cross-sectional study aimed to investigate the risk factors for hypertension in adults in Mapanget Village, North Minahasa. The …

Non-Pharmacological Management Of Nausea And Vomiting In Cancer: A Scoping Review, Santi Wahyuningsih, Yati Afiyanti, Agung Waluyo, Margaret I. Fitch

Jurnal Keperawatan Indonesia

Prevention and management of nausea and vomiting are important in cancer treatment. Effective management requires both pharmacological and non-pharmacological interventions. Patients and family members have important contributions to achieve effective control of nausea and vomiting through self-management. The objective of this review is to explore and synthesize the scientific literature about self-management strategies as a type of non-pharmacological intervention for managing nausea and vomiting in cancer patients. The articles were searched in PubMed, Science Direct and ClinicalKey databases using keyword combinations of "cancer", “non-pharmacological”, "intervention", "management", "nausea" and "vomiting". The inclusion criteria were articles that were free; full text; published …

Utilizing Telehealth To Decrease Hospital Readmissions For Heart Failure Patients, Madison Geib, Jo Loomis

DNP Qualifying Manuscripts

Abstract

Background: Without proper education, heart failure (HF) is very difficult to manage. A lack of education and proper management of HF can lead to frequent hospital readmissions, decreased quality of life, and early morbidity and mortality.

Objective: Through literature review, this paper aims to identify the benefits of implementing telehealth education for HF patients in order to decrease hospital readmissions.

Methods: A range of relevant articles were analyzed and summarized in this literature review. An extensive literature search was performed and systematic reviews, meta-analyses, critically appraised research studies, qualitative, and peer-reviewed research studies were included.

Results: Ten articles met …

Differences In Birth Weight Between Immigrants' And Natives' Children In Europe And Australia: A Lifecycle Comparative Observational Cohort Study, Sandra Florian, Mathieu Ichou, Lidia Panico, Stéphanie Pinel-Jacquemin, Tanja G. M. Vrijkotte, Margreet W. Harskamp-Van Ginkel, Rae-Chi Huang, Jennie Carson, Loreto Santa Marina Rodriguez, Mikel Subiza-Pérez, Martine Vrijheid, Sílvia Fernández-Barrés, Tiffany C. Yang, John Wright, Eva Corpeleijn, Marloes Cardol, Elena Isaevska, Chiara Moccia, Marjolein N. Kooijman, Ellis Voerman, Vincent Jaddoe, Marieke Welten, Elena Spada, Marisa Rebagliato, Andrea Beneito, Luca Ronfani, Marie-Aline Charles

Research outputs 2022 to 2026

Objective:

Research on adults has identified an immigrant health advantage, known as the 'immigrant health paradox', by which migrants exhibit better health outcomes than natives. Is this health advantage transferred from parents to children in the form of higher birth weight relative to children of natives?

Setting:

Western Europe and Australia.

Participants:

We use data from nine birth cohorts participating in the LifeCycle Project, including five studies with large samples of immigrants' children: Etude Longitudinale Française depuis l'Enfance - France (N=12 494), the Raine Study - Australia (N=2283), Born in Bradford - UK (N=4132), Amsterdam Born Children and their Development …

Isolation: The Experience Of Adolescent Motherhood In Laos, Souksamone Thongmixay, Dirk Essink, Taewee Kahrs, Viengnakhone Vongxay, Pamela Wright Phd, Ms, Med, Rn, Cen, Vanphanom Sychareun, Jacqueline E. Broerse

Publications

BACKGROUND:Teenage pregnancy is a persistent public health problem with pervasive socio-economic consequences, particularly in in low- and middle-income countries, often related to low social participation and low economic security. The experiences of adolescent pregnancy and motherhood have seldom been described from a personal point of view. This study aimed to gain insights into how adolescent mothers in Laos experience their motherhood, how they perceive their situation and try to cope with it.

METHODS: This qualitative study was undertaken with 20 pregnant adolescents and young mothers living in peri-urban areas in two of the 18 provinces in Laos. Data were collected …

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …

Impact Of Emr/Ehr And Computer Decision Support Systems On Nursing Homes And Long-Term Care, Wendy Trzyna, Brian Cox, Alberto Coustasse

Management Faculty Research

Long-Term Care (LTCs) facilities and nursing homes have been an essential part of the healthcare industry to meet the needs of older adults. However, Electronic Medical Records (EMRs/ EHR within LTC facilities and nursing homes have lagged more than in other healthcare sectors. This research analyzed the impact of implementing EMR/EHR and Computerized Decision Support Systems within LTC facilities and nursing homes. In nursing homes and LTC facilities where EMR/EHR has been implemented, patient outcomes improved by reduced pressure ulcers and increased identification of patients at risk for malnutrition and falls. Integration of CDSSs with EMR/EHR improved documentation and prescribing …

Medical Device-Related Pressure Injury (Mdrpi) Prevention In The Intensive Care Unit (Icu): An Evidence Based Practice Quality Improvement Project, Sana Shah

DNP Projects

Introduction: All intensive care unit (ICU) patients utilize various medical devices for care and treatment, placing them at high-risk for medical device-related pressure injuries (MDRPIs), which can lead to life-threatening infections, wounds/scars, and consumption of additional time and products to rectify these issues. Lack of appropriate decompression measures and improper bedside handoff report was recognized in the ICU at a hospital in Connecticut (CT).

Method: A literature search using CINAHL, MEDLINE, and the Cochrane Database of Systematic Reviews was conducted, restricting the search to the period between 2018-2022. The keywords searched were: “pressure injuries,” “adult patients,” “intensive care …