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Addressing The Gaps: Pain Management, Multimodal Analgesia, And Crna Education, Hunter Niemeyer

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Opioid consumption, addiction, and narcotic-related deaths are a prevalent public health issue in the United States. Opioids are often administered throughout the perioperative period, and their utilization can lead to unwanted side effects and negative patient outcomes. Certified Registered Nurse Anesthetists (CRNAs) are strategically placed in hospital systems; these clinicians may advocate for the responsible administration of opioids and utilize multimodal pain strategies.

Purpose: This project assessed the knowledge and attitudes of CRNAs before and after the implementation of an educational program based on the prevention of operative pain, multimodal approaches, and the perioperative use …

Nurse Engagement In Antibiotic Time-Outs: The Collaborative Process Of Leveraging Design To Disseminate Research Findings, Mary Lou Manning, Maribeth Kradel-Weitzel

College of Nursing Faculty Papers & Presentations

INTRODUCTION: Research findings and knowledge translation are typically disseminated via presentations at professional meetings and publication in peer-review journals. However, other opportunities to translate research evidence into practice exist, including the use of visual cues.

AIM: The aim of this paper is to describe the collaborative process of translating key research findings into a clear and compelling visual communication tool.

DESIGN: As part of a multimodal research dissemination strategy, the researchers partnered with the University Health Communication Design Program faculty to develop a visual communication strategy to promote the use of antibiotic time-outs by nurses in a health system. An …

Nutrition-Related Experiences Of Women With Perinatal Depression During The Covid-19 Pandemic: A Qualitative Study, Dahlia Stott, Cynthia Klobodu, Lisa A. Chiarello, Bobbie Posmontier, Mona Egohail, Pamela A. Geller, June Andrews Horowitz, Brandy-Joe Milliron

College of Nursing Faculty Papers & Presentations

Women with perinatal depression are at a high risk for unhealthy dietary behaviors but whether the coronavirus disease 2019 (COVID-19) pandemic has exacerbated this risk is unknown. Here we report the findings of a qualitative study exploring the impact of the COVID-19 pandemic on nutrition-related experiences of women with perinatal depression. Using a qualitative descriptive approach, in-depth interviews were conducted with 18 women with a history of perinatal depression and 10 healthcare providers. A semistructured format elicited how food and nutrition-related behaviors of women with perinatal depression were affected by the COVID-19 pandemic. Thematic analysis identified 4 themes related to …

The Intersection Between Alcohol Use And Sexual Activity Among Young Adult Male U.S. Service Members, Lindsay M. Orchowski, Bryce M. Meerhaeghe, Amber R. Lane, Donna M. Kazemi Phd, Rn, Cne, Fiaan, Brian Borsari, Cristóbal S. Berry-Cabán

Publications

AIMS: The current study explores drinking habits, preferences for alcohol use before sexual activity, and alcohol-related sexual behavior among young adult male active duty service members in the United States. BACKGROUND: Hazardous alcohol use is a significant problem among United States military service members. Whereas the association between alcohol use and sexual assault is well documented in civilian samples, less is known regarding the intersection of alcohol use and sexual activity among soldiers. OBJECTIVE: Descriptive statistics were utilized to summarize drinking habits, preferences for alcohol use before sexual activity, and alcohol-related sexual behavior. METHODS: A sample of 338 active-duty male …

Burnout And Its Impact On Nurses And Doctors, Zahra Tharani, Abeer Musaddique, Syeda Humera Qutb

School of Nursing & Midwifery

No abstract provided.

Affective Domain Development In Virtual Education: Visual Thinking Strategies And Art Pedagogy, Jayne Josephsen

Nursing Faculty Publications and Presentations

Development of the affective domain is linked to increasing self-awareness of internal dialogue, such as biases and assumptions, which can affect the ability of nurses to engage in person-centered care and meet the identified patient outcomes. Through visual thinking strategies (VTS) paired with art-based pedagogy to examine grief, loss, and bereavement concepts in a hospice and palliative care nursing virtual education course, affective domain development was advanced. Foundational to this virtual educational intervention was using the VTS framework of questions and pairing them with art-based pedagogy promoting open-ended interpretation and response to the art presented. This assisted the students in …

Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster

Electronic Theses and Dissertations

Nurse turnover is prevalent among new graduate nurses. Many new graduate nurses feel unsupported by their peers, lack self-confidence, or feel overburdened due to the workload assigned to them. New graduate nurses with support systems are more likely to stay with an organization. Research suggests the creation of a supportive environment for new graduate nurses to help increase nurse retention in this demographic. A unit-based transition onboarding program was launched to create a supportive environment to help retain new graduate nurses on a medical-surgical unit. New graduate nurses with at least 1 to 3 years of experience completed a Likert-type …

A Scoping Review Of Diagnosis Of Autism Spectrum Disorder In Primary Care, Norah L. Johnson, Alissa V. Fial, Amy V. Van Hecke, Kim Whitmore, Katie Meyer, Sylvia Peña, Mary E. Carlson, Kathleen A. Koth

College of Education Faculty Research and Publications

Introduction

This scoping review was performed to collect, examine, and present literature on interventions promoting the diagnosis of Autism Spectrum Disorder (ASD) in U.S. primary health care settings.

Method

The literature searched was from 2011–2022, in the English language, in PubMed, CINAHL, Psych INFO, Cochrane, and Web of Science, for persons with autism or ASD aged ≤ 18 years.

Results

Six studies met the search criteria, including a quality improvement project, a feasibility study, a pilot study, and three primary care provider (PCP) intervention trials. Measured outcomes included: accuracy of diagnosis (n = 4), practice change maintenance (n …

Nursing Perspectives On Intimate Partner Violence Screening In The Emergency Department, Justin Cabrera

Dissertations, Theses, and Capstone Projects

Using descriptive and quality descriptive (QD) analysis, emergency department nurses from around the country completed a modified version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool to gain insight on their attitudes, knowledge, and preparedness about working with patient survivors of intimate partner violence (IPV) regarding their willingness to and comfort in engaging in IPV screening practices. In total, 1,523 responses were received from emergency department nurses currently or formerly in practice.

Findings show that there was no correlation between emergency department nurses’ education and training on IPV and willingness and comfort with IPV screening with …

Cross-Cultural Adaptation And Psychometric Properties Of The Arabic Version Of The Academic Nurse Self-Efficacy Scale, Junel Bryan Arre Bajet, Jonas Preposi Cruz, Ejercito Mangawa Balay-Odao, Jennifer Mesde, Nahed Alquwez, Khalaf Alotaibi, Sheerween Cacanando

Makara Journal of Health Research

Background: Students’ academic self-efficacy is greatly associated with their academic performance. An effective instrument is needed to assess academic self-efficacy in the Saudi context. This study assessed the psychometric properties of the Academic Nurse Self-Efficacy Scale-Arabic version (ANSE-A) given to student nurses and the associations between the students’ demographics and overall ANSE-A scores.

Methods: Quantitative and descriptive methods were applied. The study was conducted from January to July 2022 at Shaqra University with 200 nursing students as the convenience sample. For content validity, the item-level content and scale-level content validity indices were utilized following the averaging method. We …

Complementary And Integrative Therapies Available For Treating Veterans With Ptsd: An Integrative Review, Kelly Ann Greene

Doctoral Dissertations and Projects

PTSD is described as the resulting from exposure to threatened or real injury, death, or sexual violence. Its symptoms have four different clusters: avoidance, re-experiencing, hyperarousal, and negative alterations in mood. PTSD is a widespread diagnosis among U.S. military veterans. This is a way of daily life for many veterans, and not all therapy is successful. The Veterans Health Administration (VA) recognizes that conventional therapy is not always appropriate for each veteran with PTSD. The VA has developed the Whole Health approach, which represents a move toward more person-driven health care, which the VA characterizes as proactive, patient driven, and …

The Lived Experiences Of Nursing Students Spiritual Well-Being During The Covid-19 Pandemic: A Phenomenological Research Study, Pamela Williams-Jones

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to examine the concept of the spiritual well-being of senior-level nursing students during the COVID-19 pandemic. This research was reinforced by Parse's (1992) human becoming theory which contains the construct of spirituality. Student nurses are “knowing beings" with a sense of purpose, constantly propelling themselves toward possibilities and freely choosing personal meaning in situations in an intersubjective process of relating value priorities. This study will also be reinforced by the conceptual framework of the spiritual framework of coping by Gall et al. (2005). This framework was used to guide the nursing students' …

Association Between Chronic Disease And Substance Use Among Older Adults In Tennessee, Manik Ahuja, Jessica Stamey, Johanna Cimilluca, Kawther Al Skir, Mary K. Herndon, Kathleen Baggett, Thiveya Sathiyasaleen, Praveen Fernandopulle

ETSU Faculty Works

Background:

Design and methods:

Utilization Of Wellness Practices For Burnout And Stress During Covid-19 Among An Interdisciplinary Cohort Of Emergency Healthcare Workers, Michael J. Zdradzinski, Sheri-Ann O. Kaltiso, Roslyn Seitz, Timothy P. Moran, Jennifer Clements, Sheryl L. Heron, Michelle D. Lall

Journal of Wellness

Introduction: The Coronavirus Disease (COVID-19) introduced additional stress to the baseline occupational stressors of emergency care workers. The objectives of this study were to evaluate perceived stress and burnout and the utilization and perceived benefit of wellness practices among emergency healthcare workers (EHCWs), including: emergency physicians, advanced practice providers (APPs), nurses, and departmental administrative staff during the COVID-19 pandemic.

Methods: A cross-sectional 28-item electronic survey of EHCWs at three hospitals in a major United States city was used to measure participants’ utilization and perceived benefit of wellness practices, burnout (2-item measure), overall stress (perceived stress scale), and stress …

Pediatric Fiberoptic Intubation Education Utilizing Simulation: A Quality Improvement Study, Aladin Bihorac, Jonathan Mangan

College of Science and Health Theses and Dissertations

Fiberoptic intubation has been used as a secondary option to intubate pediatric patients with difficult airways. Failure to understand how to properly use a fiberoptic scope could have severe consequences, such as increased trauma or mortality. This is a quality improvement research study that examines the effect of simulation training utilizing a pediatric flexible fiberoptic scope on the confidence and competence of Nurse Anesthesia Trainees (NATs). Competence was measured using time to successful intubation. The authors developed a survey tool to assess the confidence of the participants in intubating pediatric patients’ airways with a fiberoptic scope after educational training and …

A Systematic Review Examining The Efficacy Of Existing Child Abuse Screening Tools Used In The Emergency Department, Kaitlan Meyers, Alyssa Strapko

College of Science and Health Theses and Dissertations

Child abuse and neglect is a major health problem in the United States and has lasting and detrimental effects. This review examines the screening instruments that are in existence today to detect child maltreatment. The instruments are compared and evaluated for their feasibility of use in an emergency department setting.

Four electronic databases were searched to identify screening instruments that assessed for child physical, emotional, and sexual abuse and neglect. The following subject heading keywords were used: ‘child abuse or child maltreatment or child mistreatment or child neglect or child sexual abuse or non-accidental trauma or head trauma or battered …

Gender Affirming Anesthesia: It’S More Than Pronouns, Matthew Klimesh, Angela Kurth

College of Science and Health Theses and Dissertations

Transgender individuals experience healthcare-related discrimination, resulting in significant disparities and negative health outcomes in comparison to the general population. Many CRNAs do not receive formal or adequate education before being expected to care for transgender patients that contributes to these negative health outcomes. To correct this problem, an educational intervention was created to improve anesthesia providers' knowledge of genderaffirming therapies and to survey anesthesia provider attitudes towards transgender patients and knowledge, beliefs, and preferences towards treating transgender patients. A sample of anesthesia providers was collected (n=27) that included SRNAs and CRNAs at varying levels of professional experience from diverse sociodemographic …

Isolated & Impulsive: A Quality Improvement Pilot Survey Of The Perceived Icu Nurse Workload Implementing The A2f Care Bundle For Isolated Covid-19 Patients With Delirium., Ranier Calimlim

College of Science and Health Theses and Dissertations

Background: Existing research focused on A2F Care Bundle efficacy to optimize patient care and improve patient outcomes among ICU patients. Perceived workflow evaluation has been validated for healthcare task analysis endorsed by the Agency for Healthcare Research and Quality. A needs assessment was identified to evaluate nursing challenges with the A2F Care Bundle interventions, inform allocation where support and resources may be necessary when providing patient care for isolated patients with COVID-19 delirium.

Purpose: The purpose of this study was to evaluate the perceived workload of ICU nurses when implementing the A2F Care Bundle among isolated COVID-19 patients with delirium. …

The Importance Of Family Presence At The Bedside Of Critically Ill Patients, Brenda K. Ramsey

MSN Capstone Projects

The purpose of this paper is to discuss the visitor restrictions on patients and their families during the COVID-19 pandemic. At the beginning of the pandemic, visitation was highly restricted with only telecommunication as a means of “visiting” with your loved one who were hospitalized, especially in the ICU settings. During my research of keeper studies for my capstone project, the articles discussed different forms of communication. The articles discussed interventions such as electronic (e-visits) for physician offices and diaries kept in the ICU for communication between family and staff. Some discussed the effects of visitor restrictions and how it …

Simplifying Qualitative Case Study Research Methodology: A Step-By-Step Guide Using A Palliative Care Example, Elizabeth M. Miller Mrs, Joanne E. Porter Professor, Michael S. Barbagallo Dr

The Qualitative Report

Qualitative case study research can be a helpful methodology when conducting health research. However, it can be overlooked or dismissed as a possible methodological choice due to different epistemological positionings by case study theorists and often confusing and contradictory definitions and terminology. Much has been written about case studies, but it takes time to wade through volumes of often philosophically and methodologically dense material to locate a theorist who presents case study research at a depth the novice researcher can understand. Case study research literature may offer a condensed summary of processes but often needs more theoretical detail. Therefore, discerning …

Enhancing Compliance Rates: The Impact Of Implementing A Bed Bath Bundle, Lizeth Rosales, Destinee Unabia, Dennisse Espinoza, Nicole Razi, Russell Hall

Master's Projects and Capstones

Abstract Problem: Bed baths are routine bedside procedures offered in hospitals to support patients'

cleanliness and promote comfort and overall well-being. This bedside procedure represents fundamental care provided by healthcare professionals. Ensuring proper bed bathing compliance in the healthcare setting of a medical-surgical observation and telemetry unit has been significantly challenging. After thorough monitoring of the unit, key factors contributing to low bed bath compliance include time constraints, staffing shortage, and barriers specific to patients and staff. The evidence-based interventions to improve bed bath compliance include a bed bath bundle emphasizing teamwork and effective communication, as identified through an extensive …

Improving Health Outcomes Among Patients With Chf Through Implementation Of Telehealth Depression Screening And Chf Symptom Management, Akudo Udodiri Unanwa

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Comorbid congestive heart failure (CHF) and depressive disorder is a leading cause of mortality globally. Despite effective detection and therapeutic options, 30-day hospital readmission rates for CHF patients remain high, with patients experiencing adverse clinical outcomes and poorer quality of life. Depression is identified as a common comorbidity among CHF patients that may negatively impact patient self-care and adherence to a CHF treatment plan.

Problem: Telehealth applications are an increasingly utilized approach to healthcare delivery that enhances timely access to healthcare services by reducing physical proximity and transportation barriers to care. Currently, telehealth screening for CHF in the …

Factors Affecting The Healthcare Of Adults With Communication Difficulties Due To Autism Spectrum Disorder And/Or Intellectual And Developmental Disability, Kathryn L. Shady

MUSC Theses and Dissertations

Purpose: This dissertation explores the healthcare barriers and facilitators experienced by autistic adults and adults with intellectual and developmental disabilities (IDD) who have communication difficulties (CD).

Problem: Approximately 5-10% of Americans have CD, including difficulties such as stuttering, aphasia, apraxia, and other forms of language impairment(1,2). Communication difficulties are present in about 25-30% of autistic individuals and 57.9% of those with IDD, which accounts for a large and poorly studied portion of those with CD(3,4). Individuals with CD report negative healthcare experiences and decreased levels of satisfaction with healthcare providers secondary to practices such as communication solely with a …

Fall Risk Identification And Reduction Among The Gerontological Population At A Long-Term Care Facility, Esther A. Lowe, Breanna Cates, Lisa James, Ashley Samson, Jowel Ochoa, Matthew Ng

Master's Projects and Capstones

Abstract

Problem: Data obtained from the facility from February 2022 to July 2023 showed that there were a total of 110 falls at the facility with 51% resulting in injury. The facility also lacked a standardized fall assessment tool with minimal follow up after fall incidents.

Context: A microsystem assessment of the geriatric population at the long-term care facility indicated the need for a standardized fall risk screening tool to accurately assess patients.

Interventions: A staff presentation was created highlighting the high rate of falls at the facility as well as to educate on the implementation of the Morse Fall …

Impact Of Strokes: The Burden Of Care, Post-Cva Fatigue & Caregiver Role Strain, Tanya G. Schlemmer

Nursing Faculty Publications and Presentations

Strokes and cerebral vascular accidents (CVAs) and related disease events are an unfortunate circumstance that inflicts individuals around the world and impacts people every day as individuals and their caregivers. The consequences of these strokes or CVA events are life-changing for all those involved. As a result of long-term disability related to strokes, the caregiver may undergo many emotional, psychological, and physical factors that impact their daily lives. There is a relatively short period of time to react to the necessary change and as a result there may be differences in coping associated with these unexpected health circumstances. Many stoke …

Atrial Fibrillation Management In Hispanic Adults, Tania Borja

Dissertations

Background: Research has found atrial fibrillation (AF) to be the primary or a contributing cause of death on 183,321 death certificates, and an underlying cause of death for 26,535 Americans in 2019. Findings indicate an increased AF diagnosis in White people compared to racial and ethnic minorities, contrasting widespread findings of increased prevalence of cardiovascular disease and ischemic strokes in minorities. Significant disparities—by race and socioeconomic status in disease distribution and access to testing and lifesaving treatments—have been documented, specifically associated with social determinants of health (SDOH); i.e., the conditions in which people are born, grow, live, work, and age. …

The Effectiveness Of Microcurrent Neurofeedback On Depression, Anxiety, Post-Traumatic Stress Disorder, And Quality Of Life, Gloria Duke, Courtney N. Yotter, Beverly Sharifian, Gary Duke, Sandra Petersen

Nursing Faculty Publications and Presentations

Background: The world faces a mental health crisis with elevated rates of depression, anxiety, and post-traumatic stress, leaving a profound impact on daily quality of life (QOL). Current treatments show varying degrees of efficacy and carry burdensome challenges. Evidence exists for use of an innovative neurotechnology to reduce symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD), but the science is lacking for use in the general population. Purposes: The purpose of this pilot study was to explore the effects of microcurrent neurofeedback on depression, anxiety, PTSD symptoms, and QOL in adults. Methodology: This was a one-group, exploratory pilot study …

Shift Change: Minimizing The Covid-19 Nursing Shortage And Decreasing Nursing Burnout, Suzanne R. Baker

MSN Capstone Projects

Burnout and the nursing shortage of the healthcare system is not a new issue for nurses, but the COVID-19 pandemic caused this problem to only get worse (Young, 2021). Most healthcare facilities are severely understaffed. The nursing shortage and symptoms of burnout among nurses working in the Intensive Care Units (ICU) and other high-demand COVID-19 nursing units have been magnified by the COVID-19 pandemic. Inferior working conditions such as increased work times, increased workload, and decreased training in the care of COVID-19 patients magnified nursing burnout and the ongoing nursing shortage (Galanis et al., 2021). Discovering ways to reduce the …

Pain In The Dying Patient, Shanna Selph

MSN Capstone Projects

This benchmark aims to educate nurses, doctors, and families on the importance of proper pain management in dying patients. The evidence in this benchmark will be appraised to improve practice, improve outcomes, and reduce healthcare costs (Melnyk, 2018). Feelings of being overwhelmed, fatigue, confusion, and guilt can occur in healthcare professionals without the proper knowledge of pain in the dying patient. Health professionals are responsible for ensuring proper care of patients is taken during the most difficult time of their lives to ensure they have the best quality of life through the end of their lives. The question to be …

Early Mobilization In Critical Care: A Benchmark Study, Monica Paige Voelkel

MSN Capstone Projects

Critically ill patients often have complex injuries to multiple organ systems creating barriers to mobilization and a decrease in functional status (Bergbower et al., 2020). Early mobilization (EM) in hospitalized patients has shown to improve patient outcomes and decrease length of stay (LOS) (Bergbower et al., 2020). The link between EM and LOS is one that warrants further investigation with the PICOT question: In critically ill patients (P), how does early mobilization (I), compared to standard mobility (C) improve patient outcomes (O) over a three-month period (T)? The purpose of this paper is to discuss the rationale for the benchmark …