Digital Commons Network^™

Pancreatitis, Diabetes And Alcohol Intake: The Interrelationship And Effects On The Human Body, Crystal Marx

Nursing Capstones

No abstract provided.

Elevated Tsh And Obesity: Cause Or Consequence?, Ashley Rose

Nursing Capstones

No abstract provided.

Treating Latent Tuberculosis Infection In Newly Arriving Refugees: An Advanced Practice Nurse Initiative At The University Of Louisville Global Health Center, Linda Goss, Dawn Balcom, Karen Mutsch, Ruth Carrico, Rahel Bosson

Journal of Refugee & Global Health

Background: A review of newly arriving refugees referred to the local health department for latent tuberculosis infection (LTBI) treatment during 2013-2015 revealed a treatment gap of 73%, supporting the need to identify new approaches to treat vulnerable populations and mirrored results in the literature.

Objectives: 1) Describe an advanced practice registered nurse (APRN) led alternative approach to LTBI treatment in the refugee population; and 2) evaluate the impact of a 12-week regimen for LTBI on treatment acceptance, adherence and completion.

Methods: During the initial health screening visit, treatment options were provided for those identified with LTBI consisting of either a …

Risks And Benefits Of Administering Bisphosphonates With A Diagnosis Of Atypical Osteoporotic Fracture, Molly Beyer

Nursing Capstones

No abstract provided.

An Implementation Toolkit For Increasing Breastfeeding Sustainability, Regina Kirwin

Doctoral Projects

Introduction: African American women have the lowest rates of breastfeeding in the United States compared to other racial and ethnic groups (DHHS, 2016). Peer support increases breastfeeding rates (Shakya, 2017). An evidence-based implementation toolkit will provide key stakeholders the information and skill development needed to successfully implement and sustain peer support programs geared toward increasing breastfeeding rates for African American women in West Michigan. The purpose of this paper is to disseminate the quality improvement process used to develop an evidence-based toolkit guided by a secondary data analysis from research data collected in a previously implemented peer mentor program.

Objective: …

Improving Rural Pediatric Patient Management Through Streamlined High-Volume Patient Clinical Pathways Enhanced By Standardized Nursing Education For Care Confidence, Marie-Cassandre O. Macdonnell

Doctoral Projects

Rural America creates a challenging, poorly financed environment for pediatric health. More than 20 million Americans live in areas with physician shortages too great to meet basic health need (Petlz et al., 2013). In comparing rural versus urban data, rural population experience a 7% higher rate of chronic health conditions (44% versus 37%), increased inpatient costs ($8, 507 versus $7, 174) and higher odds ratios for pediatric 30-day readmission. Findings from Khan et al., (2015) note that hospital readmission rates have higher odds ratios in pediatric patients (95% CI); of Caucasian ethnicity 0.74 [0.65–0.84] to 0.88 [0.79–0.99]); when admitted to …

Nonalcoholic Fatty Liver Disease And The Pnpla3 Gene, Lori Houghton-Rahrig, Debra Schutte, Jenifer I. Fenton, Jennifer Awad

Peer Reviewed Articles

Nonalcoholic fatty liver disease (NAFLD) is a rapidly emerging worldwide public health concern strongly associated with obesity, insulin resistance/diabetes type 2, and the metabolic syndrome (Younossi et al., 2011). It is the most common cause of liver disease in the world (World Gastro - enterology Organisation [WGO], 2012). Defined as a total liver weight comprised of more than 5% fat, NAFLD can progress from simple fatty liver disease to nonalcoholic steatohepatitis with or without fibrosis, liver cirrhosis, liver cancer, or liver failure resulting in premature death (Levene & Goldin, 2012). The development and progression of NAFLD is influenced by genetic …

Nonpharmacologic Interventions And Lifestyle Modifications Resulting In Prevention And Reduction Of Osteoporosis, Alicia Crosby

Nursing Capstones

No abstract provided.

Marshallese Beliefs, Perceptions, And Practices Related To Child Feeding Among Marshallese In The United States: Implications For Childhood Obesity, Kelly Vowell Johnson, Allison L. Scott, Marilou Shreve, Britni L. Ayers, Victoria S. Seaton, Pearl A. Mcelfish

The Eleanor Mann School of Nursing Faculty Publications and Presentations

Obesity affects more than 40 million children globally. Efforts to promote proper nutrition in an attempt to reduce childhood obesity should consider maternal beliefs and cultural customs around food. Little is known regarding child feeding, including weaning practices and foods consumed in the first years of life among Marshallese children, a sub-group of Pacific Islanders, residing in the United States.

This study aims to explore the influences on introduction of complementary foods among Marshallese mothers and caregivers residing in the United States, to serve as the basis for promotion of improved nutrition. Focus groups and demographic surveys were conducted with …

Outcomes Comparison Of Enculturating Advance Directives Process At A Health System, Rose Allen, Tanya Cohn, Christine Edozie, Susan Howard, Patricia Mccrink

All Publications

The Center for Medicare and Medicaid Services requires organizations to comply with the Patient Self-Determination Act by having processes that inform patients about their rights to execute an advance directive (AD) and engage in shared decision-making. The aim of this study was to compare AD data from a previous study (1999–2002) to a postenculturation (2011–2015) of a structured process for documented patient’s preferences. Second, to conduct a descriptive, bivariate analysis of the enculturated structured ADs process during 2011 and 2015. This descriptive, comparative analysis included 500 random patients from four hospitals, and the enculturated descriptive analysis included 302 patients …

Managing Severe Tbi In The Icu Setting Using A Three Tier Approach, Mary Kay Bader

Books, Presentations, Posters, Etc.

Objectives:

• Assess the effects of injury to the brain in the neurologic injured patient and implement a tiered approach to manage severe TBI
• Evaluate TBI patients using multimodality monitoring
• Apply interventions to manage brain injury & integrate the complex multi-system issues and manage these patients using an actual case study.

Fast And Furious: Stroke Update 2019, Mary Kay Bader

Books, Presentations, Posters, Etc.

This lecture focuses on the AHA guidelines and how the Acute Stroke Team focuses the efforts in the first few hours after presentation. Audience will be made up of physicians, nurses and EMT/EMS personnel. The aims of the event include providing a couple ‘cutting edge’ key note speakers with varying expertise from different parts of the acute stroke care continuum.

Impact Of Donor Milk On Short- And Long-Term Growth Of Very Low Birth Weight Infants, Rebecca Hoban, Michael E. Schoeny, Anita Esquerra-Zwiers, Tanyaporn K. Kaenkumchorn, Gina Casini, Grace Tobin, Alan H. Siegel, Kousiki Patra, Matthew Hamilton, Jennifer Wicks, Paula Meier, Aloka L. Patel

Faculty Publications

Mother’s own milk (MOM) reduces the risk of morbidities in very low birth weight (VLBW) infants. When MOM is unavailable, donor breastmilk (DM) is used, with unclear impact on short- and long-term growth. This retrospective analysis compared anthropometric data at six time points from birth to 20–24 months corrected age in VLBW infants who received MOM supplements of preterm formula (n = 160) versus fortified DM (n = 161) during neonatal intensive care unit (NICU) hospitalization. The cohort was 46% female; mean birth weight and gestational age (GA) were 998 g and 27.3 weeks. Multilevel linear growth models assessed changes …

Exploring Medical-Surgical Nurse Turnover And Stratagies, Amber D. Weaver

Nursing Theses and Capstone Projects

This study explored the issue of medical-surgical unit nurse turnover and strategies to create nurse retention. The goal of this study was to provide nursing administrators with data that shows the cause of nurse turnover in this nursing specialty. The hypothesis was that there will be findings to indicate that medical-surgical nurses are at increased risk for employment turnover due to increased patient load and patient turnover. To study this concept, the Revised Casey-Fink Nurse Retention Survey was utilized. The results of the survey were revealed, and recommendations were made that may lead to nurse retention on the medical-surgical unit.

Epidural Analgesia Effect In Labor And Delivery, Deka A. Abdulle

All Electronic Theses and Dissertations

Epidural analgesia has an impact on duration of labor, type of delivery and the neonate. Good research data supports epidural analgesia shorts first stage of labor, lengthens second stage, increases instrumental delivery but no increased risk for cesarean delivery. Epidural analgesia has no effect on neonatal Apgar scores but decreases initiating and duration of breastfeeding.

Barriers And Strategies To Life-Style And Dietary Pattern Interventions For Prevention And Managment Of Type-2 Diabetes In Africa., Hirut B. Bekele

All Electronic Theses and Dissertations

Background: Diabetes mellitus is the major chronic illness in Africa that requires lifelong life-style interventions and pharmacological therapy. The main contributing factors for the rise of diabetes in Africa are urbanization, population changes, and life-style changes (Kengne, Amoah & Mbanya, 2005). Diabetes is the fourth leading cause of mortality in the world and accounts for 80% of the deaths that occur in underdeveloped countries. Life-style change is the most important aspect of diabetes care and includes diabetes self -management education and support (DSMES), medical nutrition therapy (MNT), physical activity, smoking cessation counseling, and psychosocial care. Purpose: The purpose of this …

Effects Of Labor Support From Doulas On Birth Outcomes, Mattea Jo Otten

All Electronic Theses and Dissertations

Background/Purpose: Women using a doula for support during labor and childbirth is increasing, with 6% of women in 2012 utilizing doulas (Dekker, 2017). The American College of Obstetricians and Gynecologists [ACOG] recommends one-to-one labor support to improve labor outcomes. The purpose of this literature review was to determine the effects of labor support from doulas on birth outcomes. Theoretical Framework: Kolcaba's Theory of Comfort can be used during childbirth. This theory focuses on relief, ease, and transcendence, allowing women the opportunity to rise above the pain and experience comfort, even when their pain is not gone. Doula support is intended …

Collaborating To Develop And Implement A Family Bike Program., Jamie Hunsicker

Nursing Faculty Scholarship

No abstract provided.

Population Based Patient Navigation : 24-Hour Personalized Cancer Care For The Entire Cancer Continuum, Jenna Cowan, Jennifer Kerkvliet

College of Nursing Faculty Publications

Cancer One word that bears immense significance for so many individuals For some, it is the word that took them by surprise, imposing new routines and adjustments to daily life as quickly and succinctly as it rolls off the tongue For others, the word evokes complex and multifaceted emotions fear, strength, apathy, gratitude, anger, hope, grief, determination the list is endless and ever changing The impact of this diagnosis extends far beyond the patient to their family, their care team, their community and more In 2017 there will be an estimated 1 688 780 new cancer cases diagnosed in the …

Iron Deficiency Anemia, Heather Weaver

Nursing Student Class Projects (Formerly MSN)

“Iron deficiency anemia (IDA) is the most common type of nutritional disorder worldwide, occurring in both developing and developed countries and affecting as many as one-fifth of the world population” (Huether & McCance, 2018, p. 934). There are many causes including bleeding (usually intestinal or menstrual), pregnancy, malnutrition, and malabsorption. Some of the signs and symptoms include fatigue, dizziness, headaches, exertional shortness of breath, cold intolerance, and paler than normal skin tones. The American Society of Hematology (2019) reports iron is important in the production of hemoglobin and maintenance of healthy cells. The topic of IDA was chosen as a …

Understanding The Autism Spectrum Disorder Population: An Opportunity To Improve Patient Care, Jean A. Timmons

Nursing Theses and Capstone Projects

There is a documented need for caring education regarding patients with autism spectrum disorder (ASD) for nursing students and nursing staff. The autism spectrum population is increasing, one in 59 children in the United States as reported by the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network (as cited in Baio et al., 2018). Nurses are expected to provide appropriate care, showing respect and understanding at all times to both the client and family. Through lack of knowledge and misunderstanding the ASD population has not been given this care. Based on Watson’s Theory of Caring, an educational ASD caring program …

The Evaluation Of Video Teaching On Preoperative Anxiety In The Outpatient Pediatric Surgical Patient, Jennifer Glenn

Nursing Theses and Capstone Projects

Preoperative anxiety is common among pediatric surgical patients. Numerous studies have evaluated measures to reduce preoperative anxiety in both adult and pediatric patients; however, limited research exists on the impact of preoperative video teaching in pediatric outpatient surgical patients. Purpose: The purpose of this study was to evaluate the effect of preoperative video teaching on preoperative anxiety in pediatric patients age seven to 14 undergoing outpatient surgery.

Design and Methods: The study operated as a two group, post-test comparison study, in which a convenience sample of 60 patients were randomized to either the control (30 patients) or study (30 patients) …

Perceived Effects Of Faith Community Nursing On Quality Of Life And Overall Health, Vicie Renee Rutherford

Nursing Theses and Capstone Projects

Faith Community Nursing (FCN) is a nursing practice specialty that focuses on the intentional care of the spirit, the promotion of an integrative model of health, and the prevention and minimization of illness. The FCN nursing specialty is believed to be an effective specialty to reverse the trend for declining health by aiding in the improvement of quality of life (QoL) and overall health for increasing numbers of people with multiple health problems; however, minimal research data and literature was available to substantiate the claim. This MSN thesis explored the relationship between FCN ministries and QoL and health by conducting …

Gender Differences In Harmful Use Of Alcohol Among Korean Adults, Eunok Park, Yeon Sook Kim

Nursing Faculty Publications

Objectives: Harmful alcohol consumption is associated with considerable social and economic damage to individuals and society. Because gender and ethnic background influence alcohol intake differently, examining gender specific factors influencing harmful drinking is necessary. This study investigated gender differences in alcohol consumption, harmful drinking, and the associated factors among Korean adults. Methods: We analyzed the data from the 2012–2015 Korean National Health and Nutrition Examination Survey. Data from survey participants aged 20–64 years (N = 18,581) were included. The Alcohol Use Disorders Identification Test was used for alcohol dependence, and pooled weights were used. Chisquared tests and multiple logistic regression …

Video Education: A Quality Improvement Project For Patients With Type Ii Diabetes, Brandon Lipscomb

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

Abstract

Background: Quality diabetes education is a key to successful diabetes treatment. Factors that hinder quality diabetes education include: allotted time for appointments, provider-patient communication, inter-personal relationship between provider and patient, and patient’s educational level. Locally speaking, the Central Virginia area has a higher rate of diabetes then compared to the average rate of diabetes in the State of Virginia. To complicate this more, the local area has a higher percentage of poverty when compared to the average poverty level of the state. Combining these two characteristics places these individuals at a higher risk for disease complications and expresses a …

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 …

The Impact Of A Revised Discharge Process From Acute Care To Home Care On Hospital Utilization In Children With Single Ventricle Heart Disease, Brian M. Stahulak

Doctor of Nursing Practice Projects

Problem Description: It is estimated that approximately ~0.5%, or ~400,000, of all U.S. children, are identified as having complex chronic conditions (CCC) and account for as much as one-third, or ~$100 billion, of health care spending for all children. The goal of this quality improvement (QI) project was to identify the impact of a revised discharge process for children with Single Ventricle Heart Disease (SVHD) on hospital utilization rates and the parent’s perception of discharge readiness during the interstage period. The QI project was conducted in a 44-bed cardiac care unit within a 336-bed freestanding pediatric, academic medical center in …

The Critical Review Of Overuse Of Medication In The Geriatric Population, Sophia A. Allwood

All Electronic Theses and Dissertations

Background: The overuse of medications is of concern among the geriatric population, especially in various settings including in-home and community-based (assisted living and independent living). This review found that older individuals take nine or more medications daily. The overuse of medications has an increased tendency to cause problems for older patients and creates adverse consequences. The adverse consequences cause problems and injuries, such as broken bones, head trauma, and death. Purpose: The purpose of this critical review of the literature is to investigate the issues related to the overuse of medication in the geriatric population and the negative impact of …

The Heart Of Atrial Fibrillation: Integrating Yoga For Holistic Care, Jessica Lee Mcalpine

Theses and Graduate Projects

Atrial fibrillation (afib) is a chronic disease with no reliable cure that is caused by a chaotic heart rhythm. The heart has both metaphysical and physical meaning as the place where the spirit resides, a symbol of love, and as an organ that provides life. Yoga can be integrated as a holistic modality that has both physical and metaphysical benefits. Literature demonstrates that yoga can reduce self-assessed symptoms of afib, secondary outcomes, and objective episodes of afib. Negative emotional states can increase afib frequency. Yoga has been found to improve emotional states, ability to cope with chronic disease, perceived wellness, …

Ethical Patient Care Overview For Doctoral Nursing Students, Courtney Reinisch

School of Nursing Faculty Scholarship and Creative Works

Clinical care is guided by knowledge, competency, and the maintenance of ethical standards. Maintenance of ethical standards is necessary by all care providers across disciplines. Attention should be paid to the following ethical tenets: autonomy, beneficence, non-malfeasance, justice, veracity, and confidentiality. Avoiding paternalism is a goal for providers to optimize outcomes for individuals and families. Providers who demonstrate a thorough understanding of ethical principles best serve individuals, communities, and populations by strengthening trust with adherence to ethical standards.