Digital Commons Network^™

The Measurement Of The Impact Of Well-Being Resources On Moral Distress And Burnout Following The Covid-19 Pandemic In Front-Line Nurse Leaders, Benjamin Hughes

DNP Projects

Background: Due to the COVID-19 pandemic, there is significant burnout among front-line nursing staff. Little literature has been published about the measurement of burnout among front-line nursing leaders, such as nurse managers and directors, nor the interventions used to help with this ever-growing issue among this group. Since the pandemic began, there have been many resources identified to help front-line staff members with burnout, but none specifically looking at what has worked or been utilized by front-line nursing leaders.

Purpose: The purpose of this project was to describe what well-being resources were identified as being effective in decreasing moral distress …

Increasing Medicare Wellness Visit Participation In A Primary Care Clinic, Katherine Rodriguez-Guerrant

DNP Projects

Background: Medicare Wellness Visits (MWV) came into use in 2011 to provide Medicare patients and their providers a chance to create a 5 to 10 year plan to prevent illness, disease, and disability. These visits are often underutilized due to various barriers on both the provider and patient side.

Purpose: The purpose of this study is to assess provider barriers to conducting MWVs and provide an educational tool that will assist providers in increasing the number of MWVs conducted within this system.

Design: This is a descriptive, quasi-experimental study to assess provider barriers combined with a Quality improvement project that …

The Effect Of Relational Aggression Training On New Emergency Department Nurses, Mary Wethington

DNP Projects

BACKGROUND: Relational aggression (RA) in nursing is widespread. One group often at risk for exposure to RA is the newly licensed nurse. RA can lead to a negative work environment which can cause poor patient outcomes and high nurse turnover.

PURPOSE: The purpose of this study was to evaluate the effects of an educational program on RA in the emergency department with newly licensed registered nurses. This was conducted using one pre and two post surveys. The surveys evaluated the nurses’ knowledge of RA self-awareness before and six weeks after an educational session.

METHODS: This was a single-site, single-unit pretest …

Tobacco Use Screening And Cessation Counseling In Primary Care, Jacob A. Heil

DNP Projects

Abstract

BACKGROUND: Primary care providers (PCPs) are poised across healthcare settings to reduce the leading cause of preventable morbidity and mortality, cigarette smoking. However, their patients may not be screened for tobacco use and miss cessation counseling, thus increasing tobacco-related diseases, and incurring costs to healthcare payers.

PURPOSE: This project seeks to identify the documentation process in a new electronic health record (EHR), communicate efficacy barriers, administer an educational intervention regarding the new process for PCPs, and measure its impact on performance of tobacco use screening and cessation counseling.

METHODS: This project was a quasi-experimental, single center, pre- and post-interventional …

Activating The Patient: A Nurse Led Coaching Intervention To Engage Health Information Seeking Behaviors Using The Ideal Discharge Framework And Get Well Network, Korinne Callihan

DNP Projects

Background: Cardiovascular (CV) patients are often overwhelmed by the unexpected emergence of the health condition, volume of knowledge for self-care mastery and acceptance of the responsibility for self-care upon care transition to the home setting. Low health literacy levels have been linked to poor outcomes in CV patients, requiring investigation into appropriate methods for patient education. The Get Well Network (GWN), an interactive digital patient education care plan at UK HealthCare (UKHC), is underutilized in this patient population.

Purpose: the purpose of this study is to assess the effect of a nurse-to-patient coaching intervention using the IDEAL discharge framework from …

The Effects Of Cultural Competency Training On Providers Knowledge, Skills And Attitudes Towards The Latino Population, Jennifer L. Peppiatt

DNP Projects

Background: Providers in the United States (U.S.) healthcare system need to understand the cultural values, beliefs, and traditions of the growing Latino population. As a result, academic institutions are incorporating cultural competency training in their curricula. However, a noticeable knowledge gap exists for those currently practicing in the healthcare arena, impacting patient and provider satisfaction and healthcare outcomes.

Purpose: The purpose of the study was to obtain a baseline assessment of the cultural competence of a select group of Advanced Practice Providers (APPs) caring for the Latino population at the University of Kentucky and provide a targeted educational intervention, followed …

Countering Moral Distress In Ecmo Nurses With Case-Review Debriefings, Sherry D. Griggs

DNP Projects

Abstract

Background: Moral Distress occurs when nurses know the ethically correct action to take, but they are restrained from taking it. It is especially prevalent in nurses caring for critically ill patients, such as those on extra-corporeal membrane oxygenation (ECMO). Effectively addressing moral distress is crucial to the growth and health of the nursing profession, which is the cornerstone of quality and safety in healthcare.

Purpose: The purpose of this project was to evaluate the effectiveness of case-review debriefings on moral distress of ECMO nurses.

Conceptual Framework: Analysis of Moral Distress Process was utilized. This framework addresses moral distress …

Increasing Adherence To Protocolized Diuresis For De-Resuscitation Of Icu Patients By Increasing Nursing Knowledge And Confidence, Jenna Haupert

DNP Projects

Background: Fluid overload in patients requiring intensive care leads to increased costs for hospitals and patients, increased length of intensive care unit (ICU) and total hospital stay, ventilator days, acute kidney injuries, and mortality rates. Multiple studies have indicated that aggressive de-resuscitation with diuretics can decrease length of stay, ventilator days, organ injury, and mortality rates. A nurse-driven diuresis protocol utilizing intravenous (IV) push furosemide was introduced to the University of Kentucky Medicine ICU, but patients are still commonly still over-resuscitated with no plan to diurese until organ damage has occurred. By educating bedside nurses, improving their knowledge and confidence …

Nurses' Knowledge Of Delirium In The Icu, Sara Hancock

DNP Projects

Abstract

Background: Delirium costs the healthcare system $38 to $152 billion dollars annually. Nurses have a unique opportunity as healthcare providers to assess for and identify delirium, but often fail to recognize delirium.

Purpose: The purpose of this DNP project was to determine the effect of implementing an educational intervention regarding delirium risk factors, symptoms, prevention strategies, and treatments, on the knowledge of nurses working in an intensive care unit.

Methods: This DNP project used a quasi-experimental pre-test post-test design. Participants completed a pre-test (Appendix A), an educational intervention (Appendix C & D), and a post-test (Appendix B). Pre-test …

Examining The Impact Of Patient De-Escalation Techniques Training On Nurses' Feeling Of Safety, Raymond O. Young

DNP Projects

Abstract

Purpose: To evaluate the effects of patient behavioral verbal de-escalation techniques training on bedside nurses’ feeling of safety in the presence of an aggressive patient, and nurses’ confidence level in their ability to successfully de-escalate aggressive patient behavior prior to the patient becoming violent. Objectives of this study were to demonstrate increased feelings of safety and security in the workplace among nurses receiving patient de-escalation training once the training was completed; to improve the overall perception of mental health status of nurses; to improve the job satisfaction and likelihood to stay in their current position; and to assess the …

Effect Of Anticipatory Guidance On Parental Knowledge And Anxiety Prior To Discharge Of Infant From The Neonatal Intensive Care Unit To Home, Stephanie Kelty

DNP Projects

Background: Lack of adequate parental education and discharge readiness from the Neonatal Intensive Care Unit (NICU) increases the risk for poor infant outcomes, hospital readmissions, postpartum depression, parental anxiety, and post-traumatic stress disorder. One component of parental readiness at discharge is receiving anticipatory guidance from a trusted healthcare provider prior to discharge.

Purpose/Objectives: This study aimed to evaluate the effectiveness of provider-led anticipatory guidance to enhance parents’ knowledge regarding high-risk infant behaviors and decrease anxiety related to caring for their high-risk infant after NICU discharge. Additionally, this study aimed to assess parental opinions about the value of anticipatory guidance sessions. …

Evaluation Of Middle School Teachers Knowledge, Attitudes, And Barriers Pertaining To Adapted Youth Mental Health First Aid For Middle School Students, Lauren Hurley

DNP Projects

Background: An estimated 17.1 million youth have experienced a mental health disorder, more than the number of children with cancer, diabetes, and AIDS combined (National Council for Behavioral Health, 2016). Unfortunately, of those children with a diagnosable condition, only a third receive mental health treatment (National Council for Behavioral Health, 2016). If a child or adolescent’s mental health disorder is left untreated, then unresolved issues may continue to affect them as adults, creating physical and mental health impairments, that could potentially have a negative impact on their futures. Youth Mental Health First Aid (YMHFA) is an evidenced-based training program that …

Promotion Of Early Recognition Of Depression To Improve Health Related Quality Of Life In Pediatric Oncology Patients, Jennifer Blankenship

DNP Projects

Background: Depression and anxiety are serious complications of cancer and deemed a challenging diagnosis due to the symptoms of depression mimicking common side effects of chemotherapy and radiation. Signs/symptoms frequently are underrecognized thus appropriate treatment is delayed, compromising the health-related quality of life (HRQOL) for pediatric oncology patients.

Purpose: Analyze existing physician and Advanced Practice Provider (APP) clinical practice regarding depression, via a pre- and post-survey and educational PowerPoint on the use of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to promote early recognition of depression.

Methods: A prospective, single-arm, study was completed in the Kentucky Children’s …

Increasing Confidence Of Nurses In Giving And Receiving Constructive Performance Feedback, Savanna Carroll

DNP Projects

Background: Nursing peer review is a process of reviewing standard nursing practice in an organization and comparing a nurse’s own practice to that standard. Nursing peer review contributes to the professional practice environment by assuring standard practice and competence, maintaining a culture of accountability, and maintaining psychological safety.

Purpose: The purpose of this project was to design and implement an educational intervention and simulation activity to prepare nurses to have constructive conversations with peers regarding work performance. Evaluation of the intervention would yield increased confidence and competence of nursing staff in giving constructive performance peer feedback.

Conceptual Framework: Bandura’s Social …

The Site Evaluation Of Quercus Alba Metabolites, Zachary Alexander Byrd

Theses and Dissertations--Plant and Soil Sciences

Quercus alba has been the prominent tree species utilized in the spirits industry for decades. Of its many qualities, the ability to impart desirable flavors on spirits combined with its natural abundance makes it the ideal choice for barrels. Creating barrels is a uniform process, but variability still exists in aged spirits even when all other parameters are controlled. In this thesis, I explore how the origin of Quercus alba influences metabolite variability.

Quercus alba is a resilient species that can grow in many climates. This is seen through Quercus alba’s vast growing range, of which barrel quality white oak …

Quantifying Crop Phenology For Food Sustainability Under Climate Change: Integration Of Remote Sensing, Machine Learning, And Ecosystem Modeling, Yanjun Yang

Theses and Dissertations--Plant and Soil Sciences

Climate change is projected to continue and accelerate significantly in the future if global greenhouse gas emissions are not curbed. Previous studies have shown that crop growth and production in agroecosystems are primarily determined by the weather conditions over the growing season. Crop phenology represents one of the most critical indicators in determining crop yield and adjusting the adaptation of crops to climate change. It provides essential information for monitoring and modeling crop growth dynamics and productivity. Therefore, understanding and quantifying the impacts of climate change on crop phenology and then agricultural production is crucial to formulate feasible climatic adaptation …

Regulatory Mechanisms In Arabidopsis Embryogenesis, Sanjay Joshi

Theses and Dissertations--Plant and Soil Sciences

Plants have amazing regeneration properties with single somatic cells, or groups of cells able to give rise to fully formed plants. One means of regeneration is Somatic Embryogenesis (SE), by which an embryonic structure is formed that “converts” into a plantlet. Somatic embryogenesis has been used as a model for zygotic processes that are buried within layers of maternal tissues. Understanding mechanisms of somatic embryo induction and development are important as a more accessible model for seed development. We rely on seed development not only for most of our caloric intake, but also as a delivery system for engineered crops …

The Impact Of Plant Secondary Metabolites On Auxin And Cytokinin Signaling, Timothy E. Shull

Theses and Dissertations--Plant and Soil Sciences

Secondary metabolites are a broad class of specialized compounds that mediate plant-environment interactions and mitigate stress. It is increasingly clear that many phenylalanine-derived secondary metabolites are nearly indispensable for plant survival and that plants adjust their growth according to their secondary metabolic outputs. Consequently, many phenylalanine-derived secondary metabolites have influence over hormone activity. For instance, multiple phenylpropanoid intermediates and catecholamines alter the sensitivity of plants to the central hormone auxin, which in concert with cytokinin directs most aspects of plant growth and development. This dissertation reviews previous research on the influence of phenylpropanoid intermediates and catecholamines on plants, with a …

An Evaluation Of Eragrostis Tef For Future Cultivar Development, Eric Wayne Luteyn

Theses and Dissertations--Plant and Soil Sciences

The many benefits of utilizing teff (Eragrostis tef) as small grain is well documented in journal publications. Over time the domestication of this species has become essential to the diets of the local population and the livestock living in the African highlands. Current research points to a high diversity of trait characteristics found in many teff populations and the potential utilization of these traits to increase desirable characteristics in both grain and forage varieties. With the overarching goal of adding to what is already known about teff, this study evaluates the different traits that are of interest to …

Understanding The Cellular And Physiological Mechanisms Of Fertilization And Early-Stage Seed Development, Mohammad Foteh Ali

Theses and Dissertations--Plant and Soil Sciences

Flowering plants have evolved a unique double-fertilization process. Two sperm cells fuse with two female gametophytic cells, the egg and central cells within the ovule, giving rise to the embryo and endosperm, respectively. Sperm cells in flowering plants are nonmotile and delivered in close proximity to the egg and central cells by the pollen tube. Flowering plants have established filamentous actin (F-actin) based sperm nuclear migration system for successful fertilization. Prior to fertilization, the female gamete forms a mesh-like structure of F-actin that shows constant inward movement from the plasma membrane periphery to the center of the cell where the …

Building Capacity For Cool Season Vegetable Production In Kentucky: Strengthening Supply Chains Through Crop Model Development And Analysis Of A Farm-To-Institution Market, Chelsea Jo Maupin

Theses and Dissertations--Plant and Soil Sciences

Cool season vegetable crops are suitable for both direct-to-consumer (DTC) and farm-to-institution (FTI) markets in central Kentucky. However, crop planning for predictable harvest is challenging. Seasonality issues can be detrimental to FTI markets wherein institutions require consistent, large volumes of product. This research investigates both production and market aspects of salad crops in central Kentucky, through development of growing degree day (GDD) crop models for loose-leaf lettuce (Latuca sativa), carrots (Daucus carota subsp. sativus), and spinach (Spinacia oleracea), and through a case study analysis for a FTI initiative called the Salad Bar Program. Simple …

An Electrochemical-Mechanical Investigation Of Next Generation Lithium Metal Electrode And Solid Electrolyte, Andrew Meyer

Theses and Dissertations--Chemical and Materials Engineering

Lithium-ion batteries (LIBs) are a staple in today’s society. From our cellphones, laptops, power tools, the ever-growing electric vehicle, and many more application, LIBs are more important to us than most realize. They provide the best combination of both high-energy and high-power density compared to other battery types such as Ni-Cd, Ni-MH, or the lead acid batteries used in our cars. Plus, LIBs are much safer. However, as new technologies grow and are developed, the demand for higher energy and power density, better safety, lower costs, and longer life increases. One way to achieve the ever-increasing demands is to replace …

Improving Manufacturing Processes For Making Lithium Ion Battery Electrodes, Ming Wang

Theses and Dissertations--Chemical and Materials Engineering

Rechargeable lithium-ion batteries (LIBs) are widely used to provide energy and power in portable electronics, electric vehicles, and energy storage systems. The LIB market has grown dramatically as they have a combination of high energy density, high power density, proven reliability, and long cycle life. The manufacturing process is one of the key factors as it strongly affects the cost and performance of LIBs.

This dissertation is focused firstly on the development of a conventional slurry-based electrode manufacturing process. Slurry making is a critical step that affects the subsequent steps in battery manufacturing. In this work, we have investigated the …

Microscale Contact And Friction Of Low Modulus, Lightly Crosslinked Polydimethylsiloxane, Justin Glover

Theses and Dissertations--Chemical and Materials Engineering

Friction and adhesion of soft materials are important for pressure sensitive adhesives, biomaterials, and soft robotics; however, the behavior on the microscale is not fully understood. When two objects come into contact, their interactions are usually mediated by small contact points due to surface roughness. At the microscale size, surface forces can deform soft materials to minimize energy by increasing the contact area, which is balanced by the elastic deformation of the polymer network. However, for soft, crosslinked materials with a modulus below ~100 kPa, it is challenging to predict the behavior with prior contact and friction models. Additionally, lightly …

Versatile Functionalization Strategy For The Capture Of Antibodies Using Silica Nanoparticles, Sayma Afrin

Theses and Dissertations--Chemical and Materials Engineering

In this work, the synthesis of protein-functionalized nonporous silica nanoparticles and their application to capture antibodies was demonstrated. Silica nanoparticles were chosen as they offered particle and pore size tunability, low toxicity, thermal stability, ease of synthesis and ease of surface functionalization. A biotin-streptavidin-biotin bridge was constructed on the surface of the particles and used to attach biotinylated Protein A/G (PAG), which has high affinity for antibodies. The biotin-streptavidin-biotin bridge is hypothesized to orient the PAG in a favorable manner for efficient antibody capture. Nonporous silica nanoparticles (approximately 270 nm in diameter) were synthesized via the Stöber method. Following amine …

Development Of Soluble Bioactive Poly(Beta Amino Esters) (Pβaes) For Post-Synthesis Processing, Kelley Wiegman

Theses and Dissertations--Chemical and Materials Engineering

Polymers have proven to be a viable platform to facilitate the controlled and targeted release for a variety of therapeutic agents. Polymeric prodrugs are a growing area of drug delivery in which active pharmaceutical ingredients are covalently linked to a polymeric form in an effort to enhance stability, delivery, and pharmacology. One naturally occurring class of active ingredients, known as polyphenols, can potentially offer a vast array of beneficial therapeutic properties. However, the therapeutic efficacy of these compounds is severely limited due to poor solubility and bioavailability as well as an oxidative and thermal instability. To improve the efficacy of …

Photocatalytic Degradation Of Lignin By Supported Silver Nanoparticles, Ning Wei

Theses and Dissertations--Chemical and Materials Engineering

Lignin is the second most abundant form of biomass on earth. The phenolic structure and high carbon to oxygen ratio make lignin an attractive renewable source of fuel and chemicals. However, its recalcitrance and heterogeneous nature prove difficult for decomposing lignin’s polymer structure and separation of the products. This work has focused on the use of low-energy catalytic approaches to overcome these barriers. A mimic of the lignin degrading enzyme laccase, consisting of a copper cluster Cu4Py4I4 modified with AgNO3, was developed to function similarly to the laccase active site. The prepared copper complex solution was found to be active …

Derivation, Exploration And Evaluation Of Non-Equiatomic High Entropy Alloys, Artashes Ter-Isahakyan

Theses and Dissertations--Chemical and Materials Engineering

High-entropy alloys (HEAs) are a class of multicomponent alloys based on an innovative alloying strategy that employs multi-principle elements in relatively high concentrations. Commonly defined as alloys that contain at least five principal elements, each with a concentration between 5 and 35 at %. The term entropy refers to the excess configurational entropy associated with HEAs, which is thought to facilitate the formation of solid solutions. The design strategy results in vast compositional space for exploration and innovative potential triggering a renaissance in physical metallurgy. These alloys may have favorable properties compared to conventional dilute solid solutions, but their preeminent …

A Seat At The Table: Visioning Social Work’S Leadership Future, Lucas Hall

DSW Capstone Projects

This capstone focuses on the history of social work leadership, current trends in social work leadership, what is lacking and where we can go in the future. The systematic literature review was focuses on what is in the literature as it relates to social work leadership preparation. The conceptual paper proposes the creation of social work leadership fellowships and certification programs. Finally, the practice application paper is the full realization of the first two papers. A solution to the crisis of a lack of social work leadership preparation is proposed and fully fleshed out. The solution being the full-scale implementation …

Back To Basics: Re-Envisioning Job Satisfaction Through Social Work-Strengths-Based Leadership, Mary Mcdaniel

DSW Capstone Projects

Social work job satisfaction is a pressing concern, becoming even more dire, in times of depleted social work workforces like experienced in Kentucky in 2021 or during an overall depleted workforce like experienced nationally due to The Great Resignation labor trend of 2022. Over recent years, it has become evident social workers and social service workers are less willing to settle for employment experiences and work environments of high stress, exhaustion, and frustration. Instead, social workers’ work expectations are changing, with social workers looking for positive work experiences such as workplaces which promote wellness, self-care, work-life balance, flexibility, and professional …