Digital Commons Network^™

Tobacco Screening Among Adults In Primary Care: Evaluation Of The Use Of The 5a’S Framework For Treating Tobacco Dependence, Alexis Owens

DNP Projects

Abstract

Background: Tobacco use in the United States is the chief cause of preventable disease and death. Preventing and identifying tobacco use through screening and education is essential to assist users to quit and to decrease overall tobacco associated health risks.

Purpose: The purpose of this study was to assess the integration of the 5A’s tobacco engagement framework into the workflow at one Primary Care Center. Study objectives included determining baseline tobacco screening data prior to 5A’s education, providing providers and support staff education on the 5A’s process, reviewing and interpreting pre/post data of the 5A’s process, and identification of …

An Assessment Of The Effectiveness Of A Safety Strategy Training Program On Knowledge Retention In New Nurses, Annette Mtangi

DNP Projects

Purpose: The purpose of this study was to assess the effectiveness of a lecture-based safety strategy training program on new nurses’ level of knowledge about how to reduce errors when providing patient care.

Conceptual Framework: Patricia Benner’s Novice to Expert model of knowledge and skill acquisition in nurses was the conceptual framework used for understanding how nurses acquire knowledge, skill and experience as well as their propensity for error at different stages of development.

Methods: This was a quasi-experimental pre-test, post-test assessment of the current lecture format. The instrument used was a survey that asked demographic, safety strategy knowledge, and …

Evaluation Of Adolescent Adherence Treatment Following An Emergency Department Visit, Marcus Seaton

DNP Projects

Mental Health disorders affect 1 of 5 youth in the United States and are chronic conditions that affect adolescents’ ability to function at home, school, work, and with interpersonal relationships. Follow up adherence is imperative to ensure treatment goals are met. The purpose of this Doctor of Nursing (DNP) project was to examine factors associated with adherence to outpatient mental health (MH) treatment following an emergency department (ED) visit among adolescents admitted to an ED of a large hospital in a multi-system healthcare organization located in a metropolitan area of the southeastern United States (U.S.). This DNP project aims were …

Parental Knowledge Of Car Seat Safety, Breanne P. Webb

DNP Projects

Background: Injuries sustained from motor vehicle accidents are one of the leading causes of death in children every year. In one year, more than 618,000 children 0-12 years of age rode in vehicles without the use of a proper restraint device at least some of the time. Of the children ages 12 years and younger who died in a motor vehicle accident in 2016 (for which safety restraint use was known), 35% were not buckled up (Centers for Disease Control and Prevention, 2017).

Purpose: The purpose of this project is to evaluate parental knowledge and understanding of car seat and …

Incidence And Treatment Of Acute Sinusitis In Two Outpatient Primary Care Settings And Provider Challenges In Treating Adult Sinusitis, Britney Nicole Perkins

DNP Projects

Abstract

BACKGROUND: Nationally, approximately one third of antibiotics are currently being prescribed unnecessarily. Antibiotic misuse can result in disability, longer hospital stays, increased costs to organizations, antibiotic resistance and death.

PURPOSE: The purpose of this project was two-fold: (1) explore current management of acute adult rhinosinusitis in an outpatient setting (2) assessing providers perceptions on the barriers to preventing antibiotic misuse.

METHODS: A retrospective chart review of 150 charts was performed to examine prescribing practices by providers treating rhinosinusitis at two primary care practices. An interview was conducted with the practice providers on barriers for compliance in antibiotic stewardship.

RESULTS: …

Advance Directives For Older Adults In Primary Care: An Intervention To Promote Screening And Documentation, Kathryn Bower

DNP Projects

Background: Advance care planning is the process of making decisions about the healthcare one wishes to receive should they become unable to make decisions for themselves, including the development of advance directives and designation of health care surrogates. Advance care planning is universally supported by governing bodies and professional organizations; however, less than one-third of Americans have an advance directive or designated health care surrogate.

Purpose: The purpose of this project was to assess primary care provider attitudes and knowledge of advance care planning and to increase screening for and documentation of advance directives and/or health care surrogates …

The Effect Of Implementation Of A Nurse Manager Orientation Program On Nurse Manager Competency And Empowerment, Erin Coogan

DNP Projects

Background statement: Based on the role the nurse manager plays in improving quality outcomes, promoting staff and patient satisfaction, and creating the culture of the unit, it is vital that proper training is provided to new nurse managers to increase their competency and sense of empowerment.

Theoretical/Conceptual Framework: The theoretical/conceptual framework that provided the base for this study was Bandura’s theory of Self-Efficacy. A sense of accomplishment and overall well-being of a person is affected by a strong sense of efficacy.

Purpose Statement: The purpose of this project was to evaluate the effectiveness of a mandatory systemized nurse manager orientation …

Are Nurses High Risk For Experience With Behavioral Health Problems?, Farrah Alayne Thornsberry

DNP Projects

Abstract

Behavioral health problems impact approximately 19% of the United States population and nurses are not exempt from these experiences. In fact, nurses may be at higher risk for developing a behavioral health issue than the general public. The purpose of this study was to identify specific demographic, work-related, and behavioral variables associated with substance use and personal experience with any mental and or behavioral health problems among nurses in an academic healthcare system. Being female, younger in age, higher level of education and increased use of alcohol were risk factors associated with self-reported experience with behavioral health problems. Additionally, …

What Is The Prevalence Of Adhd In Children Who Were Diagnosed With Neonatal Abstinence Syndrome? A Retrospective Chart Review., Scott Graham

DNP Projects

Background: Neonatal abstinence syndrome (NAS) is the set of signs and symptoms present in a newborn whose mother was addicted to drugs while pregnant. NAS can occur due to sudden withdrawal from several drugs, including opioids, benzodiazepines, methamphetamines, and caffeine. It can cause many different issues in the newborn, including diarrhea, tremors, fever, and seizures. While these specific signs and symptoms are self-limited, research is showing that these children grow in to childhood and adolescence with increased risk of Attention-Deficit/Hyperactivity Disorder (ADHD), autism, motor dysregulation, and other cognitive and behavioral sequelae.

Purpose: The purpose of this project was to establish …

An Evaluation Of Preexisting Psychiatric Diagnosis: Patient Outcomes In An Intensive Care Setting, Nicole R. Ryan

DNP Projects

Abstract

BACKGROUND: Mental health is a state of well-being in which an individual is able to acknowledge ability levels, cope with the normal stresses of life, be a productive member of society and contribute to the community. An important consideration for DNP prepared nurses is implementing principles of the Collaborative Care Model as a guiding framework to improve access to evidence-based mental health care in a medical care setting.

PURPOSE: The purpose of this DNP project was to examine the demographic, clinical and treatment characteristics of patients with both medical and psychiatric diagnoses admitted to an Intensive Care Unit (ICU) …

Staff Perception Of Workplace Violence In The Ed: Implementing Egress Education And Cue Recognition, Kelsey Jobe

DNP Projects

Purpose: The purpose of this DNP project was to examine staff perception of workplace violence before and after an educational intervention provided to bedside staff members in the ED of a Level-1 trauma center. The project focused on assessing the impact of an educational intervention on staff perception of WPV related to safety and overall awareness.

Methods: This project was a single site project designed to examine the impact of an educational intervention using egress education and cue recognition in the ED setting using a pre- and post-survey. The survey examined staff perception of safety related to WPV before and …

Evaluation Of Depression Screening By Providers For Adult Patients With Type 2 Diabetes In Primary Care, Kristy M. Bryant

DNP Projects

BACKGROUND: Depression in adults with type 2 diabetes can lead to non-adherence to self-management behaviors and treatment recommendations, and ultimately worse health outcomes. Currently, only 50% of adult patients with type 2 diabetes treated in the primary care setting are screened for depression. Without screening for depression, a diagnosis of depression and subsequent treatment is likely to be missed and the patient is more likely to experience worse health outcomes and worse quality of life.

PURPOSE: The purpose of this study was to evaluate impact of provider education on improving screening rates for depression in adult patients with type 2 …

The Effects Of Screening Tool Of Older Persons’ Prescriptions On Potentially Inappropriate Prescribing In Elderly Inpatients, Jamie Leigh Edmiston Franks

DNP Projects

Objective: The purpose of this project is to educate providers and implement the use of the Screening Tool of Older Persons’ Prescriptions (STOPP) on patients 65 and older admitted as inpatients at Owensboro Health and reduce potentially inappropriate medications (PIMs).

Background: Polypharmacy, the use of multiple medications or medications that are not medically necessary, is a persistent and growing problem for elderly patients in the United States. Polypharmacy has become synonymous with medications that are considered potentially inappropriate in individuals 65 or older. PIMs may be medications that, in the elderly, have deleterious effects, no indication, are used for treatment …

The Effects Of Compassion Fatigue On Burnout Among Inpatient Psychiatric And Intensive Care Unit Nurses, Amita Madan Neidlinger

DNP Projects

PURPOSE: This DNP project is relevant to nurses of the psychiatric and Intensive Care Unit (ICU) setting, as high stress environments may produce higher rates of compassion fatigue and burnout. Investigation of these areas may help illuminate unnecessary healthcare costs that are associated with these phenomena. This DNP project is important to the University of Kentucky’s healthcare system, its patients, and nurses. Increased absenteeism and increased medication errors are positively associated with the prevalence of compassion fatigue and burnout in nurses. Outcomes from this project will allow identification of unnecessary healthcare costs and encourage administrators to focus on reducing nurse …

Increasing Smoking History Documentation And Lung Cancer Screening Orders In A Primary Care Clinic, Tabitha M. Caudill

DNP Projects

BACKGROUND: In 2018, there were approximately 234,030 new lung cancer diagnoses and 154,500 lung cancer deaths in the United States. Kentucky leads the nation in new lung cancer cases each year. The USPSTF estimates that 10% to 12% of lung cancers detected by routine screening would not have been detected until the cancer advanced; therefore, the USPSTF recommends yearly lung cancer screenings using low dose CT (LDCT) scans of the chest for patients 55 to 80 years old who have a 30 pack-year smoking history and are currently smoking or have quit within the last 15 years.

PURPOSE: …

Nurse-Led Positive Psychology Intervention Is Feasible In Patients With Heart Failure, Erin Taylor

DNP Projects

Introduction:  Prevalence of heart failure (HF) in the US is projected to rise 46% by 2030, resulting in more than 8 million people with HF.  Negative psychologic states including depression and pessimism (negative future expectations) have been linked with poor cardiovascular outcomes, including HF.  Despite the fact that optimism (positive future expectations) and other positive affective states have been associated with superior outcomes, there has been little focus on interventions designed to increase positive psychological states in patients with HF.

Objective: To test the acceptability and feasibility of a nurse-led positive psychology intervention, Best Possible Self (BPS).

Methods: A convenience …

Evaluating The Feasibility Of Outpatient Iv Diuretic Therapy For Patients With Decompensated Heart Failure, Christina Thompson

DNP Projects

Heart failure is a prevalent chronic disease that contributes to many hospitalizations that may not always be necessary. Evidence supports that patients who present to the Emergency Department in fluid overload can be treated in the outpatient setting when only IV diuretic is warranted. Both decreases in costs and improved outcomes have been reported, yet there has been little movement toward providing outpatient diuresis versus hospitalization. The purpose of this DNP project was to evaluate the feasibility of an outpatient option for IV diuretic therapy for patients with acute decompensated heart failure experiencing symptoms of fluid overload. This descriptive study …

Screen Time And The Effects On Attention Deficit Hyperactivity Disorder, Cassandra Starks

DNP Projects

PURPOSE: The purpose of this project is to determine if an educational intervention with families decreased overall screen time use in school-aged children with attention-deficit/hyperactivity disorder (ADHD).

METHODS: This study was a single group pre-test, post-test interventional study design. The sample population consisted of the parents/guardians of 30 school-aged children diagnosed with ADHD (5-12 years) recruited from the University of Kentucky Developmental and Behavioral Pediatrics Clinic between November 2019 and February 2020. Parents completed a survey about their child’s daily screen time exposure (tablets/cell phones, laptops/computers, video games, and television) and were educated how screen time can exacerbate ADHD symptoms, …

Vade Mecum: Mediators And Disputes Involving Insurance, Robert H. Jerry Ii

Journal of Dispute Resolution

No abstract provided.

Reducing The Impact Of Racial Discrimination In Policing, Brittain Mcclurg

Journal of Dispute Resolution

No abstract provided.

Burnout And Self-Stigma Of Seeking Psychological Help In Military Healthcare Providers, Odelia N. Mcfadden

PCOM Psychology Dissertations

Military healthcare providers (HCPs) are tasked with maintaining the military’s mission readiness while balancing the roles of being providers and military members themselves. As such, military HCPs serve in various settings, including hospitals, clinics, ships, and austere environments. Military HCPs may experience a host of occupational stressors, such as long deployments, being in the line of fire, seeing dead or injured comrades, responding to mass casualty events, having excessive caseloads, and working prolonged hours. These factors make military HCPs susceptible to burnout. Unfortunately, stigma of seeking psychological help is prevalent in the military and may deter individuals from seeking the …

Forage Quality Of Cool Season Perennial Grass Horse Pastures In The Transition Zone, Annmarie Christine Riley

Theses and Dissertations--Plant and Soil Sciences

Cool season perennial grasses are the foundation of equine nutrition in the transition zone. The objective of this study was to evaluate forage quality using ADF, NDF, IVTDMD, CP, WSC, and ESC and changes in vegetative swards seasonally, diurnally, across species (Kentucky bluegrass, tall fescue, orchardgrass, and perennial ryegrass) and cultivar. This study was conducted in 2015 and 2017 and plots were maintained vegetatively with two to four week mowing. Morning and afternoon sample collection occurred monthly during the growing season. Samples were flash frozen; freeze dried, ground, and scanned using Near Infrared Reflectance Spectroscopy (NIRS) to predict forage quality. …

Breeding For Tomato Resistance To Spider Mite Tetranychus Urticae Koch (Acari: Tetranychidae), Ammar Sami Al-Bayati

Theses and Dissertations--Plant and Soil Sciences

Cultivated tomato plants are extremely susceptible to the two-spotted spider mite Tetranychus urticae Koch. Selection for pest resistance is usually a crucial step required to achieve successful genetic resistance transfer from wild into cultivated tomato genotypes. S. habrochaites LA2329, a wild relative of tomato, is highly resistant to arthropods. Its resistance has been attributed to the presence of a high density of type IV and type VI trichomes and abundant production of 7-epi-zingiberene, a sesquiterpene hydrocarbon. The interspecific backcross hybrids used in this research were derived from the cross between the wild relative tomato, S. habrochaites LA2329, and the cultivated …

Stress, Cognitive Distortions, Engagement In Self-Care, And Burnout In Psychology Graduate Students, Lauren Matturro

PCOM Psychology Dissertations

Psychology graduate students are tasked with finding a balance between academic responsibilities, clinical training, home life, time constraints, and financial concerns. These competing demands lead to stress, which is well documented in medical students with similar workloads, but understudied in psychology graduate students. Previous studies indicate that perceived stress can be linked to prevalence of an individual’s cognitive distortions. Additionally, stress within the human service fields often leads to burnout. Self-care is widely recognized as a preventative effort against developing burnout. However, as students have limited time, they may find engaging in self-care activities to be difficult. The purpose of …

Endodontic Residents: Factors Influencing The Decision To Become A Dental Educator, Lauren E. Kuhn

MUSC Theses and Dissertations

Significance and Introduction: Dental schools in the United States are faced with a shortage of faculty. Endodontic residencies and pre-doctoral clinics are not immune to the faculty scarcity. The purpose of this study was to assess factors that influence endodontic residents’ decisions on whether to pursue a career as a dental educator. This information may be used to inform future recruitment and retention efforts for endodontic faculty. Materials and Methods: All United States American Association of Endodontists (AAE) members designated as “resident members” (525) were sent an electronic survey. The survey included demographic data, and factors impacting their career decisions. …

Histological Examination Of Periodontal Pathogens: An Observational Study Of Human Biopsy Specimens, Ralee Spooner

MUSC Theses and Dissertations

The Objective: The present study aimed to evaluate the presence of periodontal pathogens P. gingivalis, F. nucleatum, and F. alocis in gingival biopsies of patients with health, periodontitis, or peri-implantitis. Background: P. gingivalis, F. nucleatum, and F. alocis are periodontal pathogens implicated in diseases of the periodontium and peri-implant tissue. Purinergic signaling is a complex network of small molecular messengers and receptors that elicit agonistic/antagonistic actions on the immune response during infection. P. gingivalis secretes an effector molecule, nucleoside-diphosphate-kinase (Ndk), which has been shown to impact the host purinergic signaling cascade to facilitate chronic infection. Materials and Methods: An observational …

Agency: Married Women Traders Of Nantucket, 1765-1865, Mary L. Heen

Law Faculty Publications

Before the enactment of separate property and contract rights for married women, generations of married women in seaport cities and towns conducted business as merchants, traders and shopkeepers. The first part of this article shows how private law facilitated their business activities through traditional agency law, the use of powers of attorney, trade accounts and family business networks. These arrangements, largely hidden from public view in family papers, letters, and diaries, permitted married women to enter into contracts, to buy and sell property, and to appear in court. Private law, like equity, thus provided a more flexible alternative to the …

Booming Business And The Resulting Trade Secrets: How The Increase In United States And European Union Trade Led To Resulting Trade Secrets Directives And The Domination Of The Intellectual Property Field, Jordana Balsam

Cardozo International & Comparative Law Review

The note argues that the surge in trade between the United States and the European Union has led to the implementation of new trade secrets directives in both regions, establishing trade secrets as the dominant form of intellectual property over patents. The Defend Trade Secrets Act (DTSA) in the U.S. and the Trade Secrets Directive (TSD) in the E.U. were enacted to address the growing need for robust protection of trade secrets in an increasingly globalized economy.

Alternative Infrastructure Finance: Should The United States Adopt Federal Guidelines To P3 Concessions, Dih-Lin Wong

Cardozo International & Comparative Law Review

The article argues that the U.S. struggles with modernizing its infrastructure due to insufficient investment and a lack of standardized legal frameworks for public-private partnerships (P3s). While P3s offer a promising alternative to traditional financing by allocating risks and generating efficiencies, the U.S. faces challenges due to a patchwork of state-level laws and procurement practices. The article suggests that adopting federal guidelines for P3s, drawing lessons from successful models in the UK and Australia, could streamline infrastructure financing, attract private investment, and enhance project efficiency.

A Case For United States Overhaul Of Its Current Biotechnology Regulation Scheme Through The Implementation Of Biotechnology-Specific Legislation To Clarify Existing Uncertainties Seen In The Collective Framework, Jordan Emmert

Cardozo International & Comparative Law Review

The U.S. biotechnology regulatory framework, established by the 1986 Coordinated Framework and its 1992 Update, is outdated and insufficient to address modern biotechnology products, particularly genetically modified organisms (GMOs). While efforts such as the Obama Administration’s 2015 Memorandum and the 2016 Update aimed to modernize the system, they failed to resolve jurisdictional ambiguities and regulatory gaps, leading to inconsistent agency enforcement and public distrust. The note argues that updating the statutory framework is essential to align U.S. regulations with international norms, ensure public safety, and maintain global competitiveness.