Digital Commons Network^™

Evaluating Kentucky Advanced Practice Registered Nurses’ Confidence, Comfort, And Knowledge Levels Regarding Dermatology Care After A Web-Based Video Training, Victoria Hayden

DNP Projects

Background: It can take an average of 38.9 days to see dermatology from referral to initial appointment. As a result, delays in diagnosis and treatment of life-threatening conditions such as malignant melanoma could occur. Primary care providers frequently refer patients for benign conditions that can be appropriately managed in the primary care setting; often due to lack of knowledge or confidence in their clinical management skills. Educational resources equip providers with the knowledge and tools to feel confident in their management of various skin conditions in a primary care setting. Purpose: The purpose of this project was to …

The Effect Of Mentorship And Social Events On Job Embeddedness And Intent To Stay In Emergency Department Nurses, Kacie L. Albertsen

DNP Projects

Background and Purpose: The COVID-19 pandemic has drastically impacted nurse retention. According to the Kentucky Nurses Association, 57% of surveyed Kentucky nurses are considering leaving their jobs. Best retention strategies are unclear. Job embeddedness (JE) and Intent to stay (ITS) are factors that influence retention. The purpose of this project is to increase JE and ITS at a level one emergency department (ED) by implementing evidence-based mentorship and social event interventions.

Methods: This study utilized a mixed-methods, one group pretest-posttest design. Mentorship pairs were matched by personality type using the Big Five Personality Test. Four mentorship discussion meetings and two …

Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams

DNP Projects

Background: The American Diabetes Association recommends lifestyle modification to prevent and treat diabetes in their 2021 Standards of Medical Care in Diabetes. Evidence suggests that motivational interviewing (MI) is an effective intervention that clinicians can use to facilitate behavior change in patients with type two diabetes.

Purpose: The purpose of this project was to evaluate a brief motivational interviewing intervention that could be delivered by a PCP to provide individualized nutrition counseling for adult women with type two diabetes in a primary care clinic in Lexington, KY. This study was a continuation of a previous quality improvement project at this …

Depression Management Among Primary Care Providers: Evaluation Of An Educational Intervention, Whitney Hunt

DNP Projects

Background: Nearly one-third of patients diagnosed with depression and prescribed an antidepressant medication will stop taking their medication within the first month. Timely follow-up care can improve medication adherence and symptoms for depressed patients on antidepressants however, most patients do not receive timely follow-up. Common system and provider-based barriers to timely follow-up include limited provider time, lack of training, and mental health stigma.

Objective: The purpose of this project was to assess provider attitudes, knowledge level, perceived barriers, and current depression management strategies in a primary care setting.

Methods: In this quasi-experimental one group pre/post-test study a survey was used …

Staff Perceptions Of Workplace Violence In The Emergency Department; Increasing Safety Awareness And Education, Marissa Hibbs

DNP Projects

Purpose: The purpose of this project was to evaluate nursing staff perceptions of safety and workplace violence and increase safety awareness and knowledge in the emergency department of a level 1 trauma center.

Methods: This study was a single site project that used a descriptive non-experimental survey design to evaluate staff perceptions on workplace violence and safety before and after educational intervention. The study was broken down into three parts. After obtaining IRB approval, an invitation to participate in the pre-survey was distributed via email in a private electronic unit-based list server. Then an educational intervention on workplace safety and …

Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters

DNP Projects

BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.

PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.

METHODS: Electronic health records of telehealth patients were reviewed in an …

Impact Of Physical Activity Vital Sign Screening On Physical Activity Counseling And Referrals In Primary Care, Anna Selepina

DNP Projects

Background/Purpose: Physical Activity Guidelines for Americans recommend 150-300 minutes of moderate-intensity physical activity each week for adults; however, half of the adults do not meet this goal, which leads to increased chronic health conditions and poor health outcomes. The physical activity vital sign (PAVS) screening tool is an evidence-based assessment tool associated with increased physical activity counseling, which can lead to increased physical activity and improved patient outcomes.

Objective: The purpose of this study was to examine the impact of PAVS screening on physical activity counseling and referrals in primary care.

Methods: This prospective study took place in a small …

Evaluating The Effect Of Electronic Health Record Patient Portal Use On Medication Adherence In Adults With Chronic Conditions, Jennifer Averbeck

DNP Projects

Background Medication non-adherence is prevalent among fifty percent of the United States population. This behavior leads to increased morbidity and mortality as well as increased healthcare costs for both the patient and the healthcare system. More than two-thirds of nonadherence exists in those aged over 65 years old who are diagnosed with Multiple Chronic Conditions (MCC). Several studies have researched and trialed interventions to improve rates of adherence, limit poor health outcomes, and decrease overall cost of care. The patient portal is an interactive tool which encourages participation of the patient in their healthcare management. Implementation of this tool has …

Evaluating Providers’ Knowledge, Attitudes, And Intentions Toward Utilizing First Post-Discharge Visit Checklist In Primary Care To Reduce Readmissions In Heart Failure Patients, Binu Bashyal

DNP Projects

Background and Significance: Heart failure (HF) affects approximately 6.2 million adults in the United States and 40 million people globally. HF is one of the leading causes of emergency department (ED) visits and hospitalizations in adults. Twenty percent of patients admitted for HF are readmitted within thirty days, and up to fifty percent are readmitted by six months. A First Post-Discharge Visit checklist could help mitigate the problem of readmission.

Purpose: The purpose of this DNP project was to evaluate primary care providers’ knowledge, attitudes, and intentions towards utilizing the First Post-Discharge Visit checklist to reduce hospital readmissions among …

Evaluation Of Patient And Clinical Staff Perceptions Of Screening For Social Needs In An Underserved Population, Alysha Greenwell

DNP Projects

Abstract

Background. Despite ample strong evidence linking social determinants of health (SDOH) and unmet social needs to higher healthcare costs and worse health outcomes across the lifespan, only 16% of healthcare practices screen their patients for social needs. Various barriers contribute to low screening rates, including uncertainty about best methods for screening, the amount of time it takes to screen, and lack of confidence in knowing what to do once needs have been identified. As movements toward value-based models of care change the healthcare landscape, healthcare systems must find practical and effective methods to effectively screen for social needs utilizing …

Improving Nursing Comfort In Relation To Difficult Conversations, Sarah Clifton

DNP Projects

Abstract

Background/Purpose

Conversations between care providers and patients are integral to medicine and are the most performed “procedure” (Luff et al., 2016). In Pediatric Intensive Care Units (PICUs) and Pediatric Cardiac Intensive Care Units (PCICUs), children of all ages with diverse diagnoses and needs are treated for critical illnesses and traumatic events. Therefore, providers frequently have difficult conversations with patients and their families. Pediatric critical care nurses are often invited to participate in these discussions. However, their role during, and after, these conversations is not always clear. The goal of this project was to evaluate the impact of an educational …

Effectiveness Of A Multimodal Educational Program In Increasing Understanding And Utilization Of Tele-Icu Resources By Critical Care Nurses: A Pilot Study, Olga Vulakh

DNP Projects

Background. Integration of tele-intensive care units (tele-ICUs) into healthcare systems is associated with improved patient outcomes and organizational performance. Inadequate bedside nurses’ knowledge about tele-ICU is associated with poor communication and lack of trust between bedside and tele-ICU teams. These problems might diminish tele-ICU’s ability to maximally impact patient outcomes.

Purpose. The purpose of this project was to create a multimodal educational program with the goal of improving knowledge, attitudes, and skills related to tele-ICU among critical care nurses and to assess the effect of the educational intervention on tele-ICU utilization among bedside nurses as evidenced by the number of …

Relationship Between Number Of Mechanical Ventilation Days Prior To Ecmo Initiation And Outcomes In Covid-19 Patients, Brittany Bergman

DNP Projects

Background: Since the start of the pandemic, there has been over 16,000 COVID-19 positive patients placed on Extracorporeal Membrane Oxygenation (ECMO). Little is known about the effect of long mechanical ventilation prior to ECMO initiation. Purpose: The first purpose of this project is to evaluate whether a longer mechanical ventilator time (ten or more days) prior to ECMO initiation is associated with increased mortality and longer total lengths of time on ECMO in patients with COVID-19, as opposed to being on a ventilator for under ten days prior to being placed on ECMO. The second purpose is to increase provider …

Evaluation Of A Discharge Clinic Implemented For Patients Without A Primary Care Provider Or Access To Their Primary Care Provider, Jessica Sass

DNP Projects

Background: Patients transitioning from an inpatient hospital stay to self-care responsibilities post-discharge are at risk for readmission resulting in increased cost and resource utilization. Care transition programs can result in cost avoidance and decreased resource utilization.

Purpose: The purposes of this project were to: (a) determine if implementation of a Discharge Clinic affected 30-day readmission rates in patients without a primary care provider, (b) ascertain if a visit by a paramedicine program paramedic impacted 30-day readmission rates in patients who missed their Discharge Clinic appointment, and (c) find out whether a second post-discharge phone call influenced 30-day readmission rates.

Method: …

Utilizing Podcast Education To Improve Nurse Knowledge, Confidence, And Behaviors Related To Palliative Care Conversations In The Intensive Care Unit, Brittany Estridge

DNP Projects

Background: The personal connection that Registered Nurses (RNs) build with patients and their families puts them at the forefront of many conversations during the patient’s stay in the intensive care unit (ICU). Some of the most difficult conversations are related to palliative care (PC). It can be challenging to know how to respond to the complex questions posed in palliative care conversations (PCC) when patients and their caregivers are making decisions that will alter the course of the patient’s treatment, as well as affect the quality and length of their life.

Purpose: Nurses receive inadequate training in PCC. The purpose …

Addressing The Inpatient Penicillin Allergy And Antibiotic Stewardship: The Effect Of Education On Compliance Rates Of The Nurse Driven Penicillin Allergy Assessment Tool, Alexandria Bassler

DNP Projects

Background: Penicillin allergies are the most frequently reported drug allergy but less than 1% of the total population has a true immune-mediated allergy. Patients who are labeled as having a penicillin allergy may receive drugs that are less effective, more costly, and more toxic. The nurse driven penicillin allergy assessment tool strives to increase penicillin allergy de-labeling rates by pharmacists and providers.

Objective: The purposes of this study were to (1) perform a retrospective and prospective chart review to determine compliance rates with the nurse driven penicillin allergy assessment tool, (2) provide an education module on antibiotic stewardship …

Modified Early Warning Scoring (Mews) Versus Epic Deterioration Index (Edi): Battle Royale For Which Has The Best Patient Outcomes In The Inpatient Setting, Dirk A. Church

DNP Projects

Abstract

Background: The increased workload bedside nurses face today requires new tools to assist with the identification of deteriorating patients during hospitalization. The Modified Early Warning Score (MEWS) tool has formed the background of early warning tools. Newer, more complex tools, like Epic’s Deterioration Index (EDI), have been developed to identify patient deterioration earlier. There is lack of evidence in the literature comparing different early warning tools, implementation, and patient outcomes.

Objective: The purpose of the study was to examine models for EWS notification for RRT and patient outcomes between the use of the MEWS and EDI in an adult, …

Lateral Spacing Of Subsurface Poultry Litter Bands: Effect On Gaseous Nitrogen Emissions, Nutrient Uptake, And Maize Yield, Jason R. Simmons

Theses and Dissertations--Plant and Soil Sciences

Poultry litter (PL) is traditionally applied to no-till maize (Zea mays L.) cropping systems by surface broadcast. Poultry litter is nutrient dense, and it has been repeatedly shown that surface applied PL nitrogen (N) is vulnerable to losses to the atmosphere and nearby water systems. An application method was developed by USDA-Agricultural Research Service scientists for banding poultry litter (PL) below the soil surface with minimal soil disturbance to reduce ammonia (NH₃) volatilization and surface run-off. It is well documented that subsurface applied poultry litter (PL) reduces N losses by ammonia (NH₃) volatilization; however, the …

Evaluation Of Chemical Control Options, Environmental Factors, And Management Practices Associated With Angular Leaf Spot (Pseudomonas Syringae Pv. Tabaci), Andrea Brooke Webb

Theses and Dissertations--Plant and Soil Sciences

Pseudomonas syringae pv. tabaci tox^- is the causal agent of angular leaf spot in dark tobacco. Since 2015, angular leaf spot has become the most significant foliar disease in dark tobacco production in Kentucky and Tennessee. Dark tobacco producers utilize one main tool, streptomycin sulfate, for the management of this bacterial disease. Resistance to streptomycin sulfate in P. syringae pv. tabaci isolates from dark tobacco fields in western Kentucky was first observed in 2015.

Field spray trials were developed to evaluate the efficacy of alternative active ingredients compared to the grower’s standard, streptomycin sulfate. Two separate field trials were …

Building A Kentucky Baguette: Agronomic Traits, Bread Baking Quality Measurements, And Sensory Evaluation Of Modern And Landrace Wheat Cultivars Grown Under Conventional And Organic Nitrogen Management, Bryan Brady

Theses and Dissertations--Plant and Soil Sciences

The demand by artisan bread bakers across the United States for local wheat varieties has increased in recent years. The southeast is traditionally a soft winter wheat (SWW) region, producing low gluten flours more suitable for biscuits and cookies. Recently, hard winter wheat (HWW) varieties have been bred to produce acceptable yields in the high humidity environment of the southeastern United States. Artisan bread bakers in Kentucky would like to create a niche food value chain benefitting farmers, small-scale millers, bakers, consumers, and their local and regional food systems (LRFS). The increased demand and the availability of adapted hard wheat …

Application Of Multi-Scale Computational Techniques To Complex Materials Systems, Mujan N. Seif

Theses and Dissertations--Chemical and Materials Engineering

The applications of computational materials science are ever-increasing, connecting fields far beyond traditional subfields in materials science. This dissertation demonstrates the broad scope of multi-scale computational techniques by investigating multiple unrelated complex material systems, namely scandate thermionic cathodes and the metallic foam component of micrometeoroid and orbital debris (MMOD) shielding. Sc-containing "scandate" cathodes have been widely reported to exhibit superior properties compared to previous thermionic cathodes; however, knowledge of their precise operating mechanism remains elusive. Here, quantum mechanical calculations were utilized to map the phase space of stable, highly-faceted and chemically-complex W nanoparticles, accounting for both finite temperature and chemical …

Surface Properties, Work Function, And Thermionic Electron Emission Characterization Of Materials For Next-Generation Dispenser Cathodes, Antonio Mantica

Theses and Dissertations--Chemical and Materials Engineering

A dispenser cathode’s ability to thermionically emit electrons is highly dependent on its material properties, especially those of the surface. Understanding the relationship between surface properties and electron emission, therefore, is vital to reach the next generation of the many vacuum electron devices (VEDs) that rely on the physics of electron emission. In the past century, many techniques have been developed to characterize material surfaces and quantify thermionic emission. These techniques are based on a wide range of different physical phenomena, including measuring photoemission via the photoelectric effect, measuring the electrostatic potential between metals in electrical contact, and current collection …

Developing And Modeling Tunable Nanofiltration And Functionalized Membranes For The Separation Of Organics And Inorganics From Water: Per- And Polyfluoroalkyl Substances, Lanthanides, And More, Francisco Cecil Leniz-Pizarro

Theses and Dissertations--Chemical and Materials Engineering

In a world where clean water predictability is challenged by both global warming and the contamination of our natural resources, it is our responsibility to advance water separation technologies into more efficient processes and to lessen their environmental footprint. Pore and surface functionalization of membranes can enhance the separation of ions from water and even help overcome intrinsic challenges that some current separation technologies possess. If we begin with a complete fundamental understanding of the nanoscale interactions that occur in the process of separating ions from water, then we can engineer new functionalized composite membranes to provide alternative processes keeping …

Secondary Traumatic Stress Is An Occupational Hazard For Pet Hospice Support Staff: Psychoeducational Support Groups Provide The Cure, Kari Hayden

DSW Capstone Projects

There are three separate yet interrelated products presented in this final capstone product. The completed product is focused on pet hospice veterinary support staff and the need for an evidence-based social work intervention to combat secondary traumatic stress. This capstone uses the andragogical approach to adult learning theory as the foundation to construct a psychoeducational peer support group specific to this population. Implications for clinical social work in veterinary medicine are presented within this project.

The first scholarly product presented is the Systematic Literature Review (SLR). The SLR utilizes a scoping review process in an attempt to locate prior research …

International Social Work Field Education, Shelli Gregory

DSW Capstone Projects

International Social Work Field Education (ISWFE) involves a set of unique challenges. For the literature review of this capstone project 20 peer-reviewed journal articles written between the years 2009 and 2018 were reviewed to answer the following research question: What are the unique challenges associated with ISWFE and the best practices for combatting these challenges? The challenges most frequently mentioned in the literature are the perpetuation of colonial mindset; students experiencing emotional vulnerabilities, stress, & distress (guilt, shame, loneliness, fear, helplessness, isolation, and homesickness); supervisory issues; language barriers; funding; culture shock, disequilibrium, or clash; safety concerns; administrative problems such as …

Developing And Deploying Data-Driven Tools For Accelerated Design Of Organic Semiconductors, Vinayak Bhat

Theses and Dissertations--Chemistry

Organic semiconductors have gained widespread attention due to their potential applications in flexible, low-cost, lightweight electronics, energy storage and generation technologies, and sensing applications. However, developing new organic semiconductors with improved performance remains a significant challenge due to the vast chemical space of possible molecular and materials structures. Furthermore, the high cost and time-consuming nature of experimental synthesis and characterization hinder the rapid discovery of new materials. To overcome these challenges, this dissertation presents a data-driven approach to organic semiconductor discovery. The primary focus of this work is the development of data-driven tools, namely machine learning models, to predict critical …

Surface Modification Of Carbon-Based Electrodes For Electrochemical Conversion Processes: Oxygen Reduction Reaction And Bicarbonate Conversion, Udari Shyamika Kodithuwakku Arachchige

Theses and Dissertations--Chemistry

Oxygen reduction reaction (ORR) and conversion of bicarbonate into value-added chemicals are two significant electrochemical processes for energy storage and conversion. ORR is an important electrochemical reaction in fuel cells and metal-air batteries that provide power conversion and storage capacity, respectively, for portable electronics, and electric vehicles. However, the performance of catalysts (e.g., platinum-based) is critically limited by slow kinetics, inefficient four-electron pathway, and surface deactivation. This limited performance of platinum-based catalysts, the scarcity of platinum, and vulnerable supply chains for critical minerals require the development of alternative electrocatalysts now more than ever. Carbon-based materials possess several key properties that …

Exploring The Role Of Ring Annulation In Polycyclic Aromatic Hydrocarbons For Organic Electronic Applications, Tanner Smith

Theses and Dissertations--Chemistry

Organic materials offer promising potential for the next generation of electronic devices, as their tunability, processability, and low-temperature manufacturing make them a cheap and versatile alternative to traditional silicon-based electronics. The ability to systematically alter the electronic properties of organic materials is vital for their incorporation into device applications. Polycyclic aromatic hydrocarbons (PAHs) are of significant interest for organic electronic applications, as relevant properties are highly dependent on their size, structure, and functionalities, and thus can be tuned to fit a wide variety of applications. Due to the enormous number of structural isomers available in larger PAHs, the development of …

Engaging Predominantly White Churches In Racial Justice Work, Christopher B. Rakestraw

DSW Capstone Projects

Over the past three years, the tragic deaths of many people of color have renewed nationwide discourse on racial injustices and racism. White churches seeking to become anti-racist are confronted with a number of obstacles. This capstone project addresses the topic of Engaging Predominantly White Churches in Racial Justice Work through three interconnected scholarly products. Each product draws from the research of sociology, psychology, social work, education, and religion to investigate a different aspect of the overarching subject.

The Systematic Literature Review examines the impact of white racial identity on the racial attitudes of Predominantly White Church (PWC) congregants. Evidence …

Treatment Of Borderline Personality Disorder: Re-Envisioned To Mitigate Stigma And Enhance Treatment Effectiveness, Abigail Lorraine Steinkamp

DSW Capstone Projects

Borderline personality disorder (BPD) and the characteristics that define it are often viewed negatively by therapists and other mental health providers. Terms to describe these clients commonly include “manipulative”, “attention-seeking”, and “always in crisis.” Because of this jargon, there is a deep-set stigma that surrounds the disorder. Therapists and treating clinicians base their decisions and treatment protocol on hearsay of the disorder and already have an image of their prospective BPD client before the client enters their office. This capstone project seeks to inform clinicians about the present stigma and provides tools that are proposed to reduce stigmatizing beliefs within …