Digital Commons Network^™

The Life Of International Law Is Not Logic But Experience, David Lefkowitz

Philosophy Faculty Publications

Justice Oliver Wendell Holmes Jr. famously maintained that ‘the life of the law has not been logic: it has been experience.’ Holmes’ statement suggests an antecedent question: what is the life of the law? This article construes this question ontologically. What gives law life? What animates it, and in so doing warrants the claim that law contributes to the production of social order in a particular community? The answer, I contend, is that law lives, or exists, only in those societies where law rules, and law rules only when the exercise of political power is conducted under the supervision of …

Addressing Implementation Gaps For Hope Channel Network Strategic Plans, Gideon Mutero

Doctor of Leadership Projects

The Hope Channel Network (HCN), in its endeavor to accomplish its mission, has developed a network strategic plan as a roadmap to success. In a complex and dynamic business environment, a strategic plan helps an organization to determine its direction and focus the efforts of the staff toward achieving its goals. However, developing a roadmap does not guarantee that HCN will reach its destination. It is crucial that the strategies formulated in the strategic planning process are implemented to achieve the desired goals. The HCN strategic plan had established goals that have not yet been fully accomplished due to ineffective …

Implementation Of An Evidence-Based Bundle To Educate Nurses In The Care Of Adult Post-Transplant Diabetes Mellitus Patients, Christine Slaughter

DNP Projects

Background: After solid organ transplantation, between 10-40% of patients develop post-transplant diabetes mellitus (PTDM) due to the immunosuppression regimen, infection, stress response and pain. Hyperglycemia events are common and managing glycemic targets is critical to decrease the likelihood of graft failure and mortality.

Purpose: To determine the impact of an evidenced-based bundle education strategy on the perceived confidence/knowledge of nurses and on their documentation compliance in the care of adult solid organ post-transplant diabetes mellitus patients.

Methods: A single group, pretest-posttest design was implemented to evaluate the effectiveness of the electronic educational program on the nurses perceived confidence/knowledge regarding glycemic …

The Effect Of An Intervention To Improve Screening For Opioid Use In Patients With Post Traumatic Stress Disorder, Tammy Swartz

DNP Projects

Background: Rates of post-traumatic stress disorder (PTSD) were reported to be higher during COVID-19 than during any other epidemic in history. Patients diagnosed with PTSD are at an increased risk of experiencing opioid use disorder (OUD). Early detection, prevention, and treatment are essential to prevent OUD.

Purpose: The purpose of this project was to determine if education aimed at increasing nurses’ knowledge increased patient screenings for OUD.

Methodology: A baseline chart audit was performed to determine the number of patients seen in the emergency department with PTSD who also were evaluated for OUD. Two hundred and forty emergency department registered …

The Impact Of An Educational Training To Front-Line Nurses And Providers To Reduce Seclusion And Restraint: Assessing Knowledge, Practices, And Attitudes, Kevin Bryant

DNP Projects

Background: The use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. Although it is typically agreed that such measures should be used as a last resort in patient care, the majority of nurses feel that seclusion and restraint are necessary interventions in managing adverse behaviors of mental illness. There is a lack of data examining front-line nurses’ and providers’ knowledge, practices, and attitudes toward the use of seclusion and restraint following the use of a targeted educational training.

Purpose: This project aimed to evaluate the impact of a web-based educational intervention on the knowledge, …

Utilizing The Stop-Bang Questionnaire To Assess Risk Of Obstructive Sleep Apnea In Hospitalized Patients With Heart Failure To Facilitate Sleep Medicine Referrals Upon Discharge, Chelsea Mitchell

DNP Projects

Background: Obstructive sleep apnea (OSA) is the most common sleep-breathing disorder. Undiagnosed OSA is highly prevalent in the population, especially in those with heart failure. OSA and heart failure combined create a negative feedback loop that can lead to poor clinical outcomes. Unfortunately, many cardiac patients are never screened for OSA.

Purpose: The purpose of this project is to improve screening rates for OSA via the STOP-Bang questionnaire and establish an efficient and effective process for referrals to sleep medicine for heart failure patients screening high-risk.

Methods: The design was a quality improvement project with pre- and post-testing and a …

The Effect Of A Community Resiliency Model Education On Resilience, Psychological Empowerment, And Well-Being In Behavioral Health Nurses, Lorrie Smith-Esterle

DNP Projects

Background: Resilience, well-being, and psychological empowerment are associated with improvement in job satisfaction and nurse retention rates. The Community Resiliency Model (CRM) can promote emotional regulation, well-being, and create an internal state of balance in response to work-related stressors. Educating nurses on how to use CRM enables the recognition of changes in thoughts, emotions, sensations, and internal or external stimuli, which can promote resilience, well-being, and psychological empowerment.

Purpose: The purpose of this project was to evaluate evaluate the effect of a resiliency education using the Community Resiliency Model (CRM) on resilience, psychological empowerment, and well-being of behavioral health nurses. …

Improving Structural Empowerment Through The Co-Creation Of A Professional Governance Program Of Nurse Managers And Front-Line Nurses, Michelle Van Outer

DNP Projects

Abstract

Background: Professional governance is a model in healthcare systems where nurses are involved by participating in decisions that lead their practice. Participation in professional governance has been shown to improve nursing practice, employee satisfaction, nursing autonomy, and patient outcomes.

Purpose: The purpose of this study is to evaluate nurses’ perceptions of empowerment when front-line nurses are involved with their nurse managers in the design and structure of an inpatient state psychiatric hospital’s professional governance program.

Conceptual Framework: Kanter’s theory of empowerment will guide this project. As individuals feel more empowered, the success of the organization increases. Kanter suggests that …

The Impact A Nurse Recruiter Has On Nursing Staff Shortages And Nurse Manager Satisfaction In An Acute Psychiatric Facility, Johna Arnett

DNP Projects

Abstract

Background: Nursing staff shortages have persisted for the last few decades. Strategies to resolve this enduring challenge continue to drive the creative efforts to attract and retain new staff. These shortages not only affect patient care but can also impact the satisfaction of nurse managers. Little information is available on the effects of a nurse recruiter role on nursing staff shortages as well as nurse manager satisfaction.

Purpose: The purpose of this project is to assess how implementing a designated nurse recruiter impacts nursing staff shortages and nurse manager satisfaction in an acute psychiatric facility. This project examines two …

The Effect Of An Employee Recognition Program For Clinical Registered Nurse Retention At Eastern State Hospital, Kristi Richmond

DNP Projects

Abstract

Background: Nurse executives want to build and retain teams capable of delivering high quality care. However, registered nurse (RN) turnover continues to jeopardize this goal. RN satisfaction has been associated with reduced turnover in the nursing field. Adequate staffing levels are linked to better patient outcomes, and employee recognition is a key factor in RN retention.

Purpose: The purpose of this study was to evaluate the effectiveness of utilizing an existing recognition tool for RNs at an inpatient state psychiatric hospital in the southeastern United States to determine level of job satisfaction, level of job loyalty, level of engagement, …

Reducing Nursing Documentation Burden: Evaluation Of An Electronic Health Record Optimization Plan, Jessica Collins

DNP Projects

Background: UK HealthCare transitioned to a new enterprise electronic health record (EHR) system, offered by Epic Systems Corporation, in June 2021. Approximately 2,000 inpatient nurses use the EpicCare Inpatient Module in the 1,086 licensed bed facilities. Compared to other academic medical centers, UK HealthCare nurses take more time documenting in this EHR inpatient module’s Basic Assessment Flowsheet (documentation burden) and have a longer delay between assessment and documentation (timeliness) potentially contributing to nursing dissatisfaction with using this new EHR.

Purpose: The purpose of this project was to evaluate the effectiveness of a phase of the Epic Nurse Well-Being Project, a …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

An Educational Intervention On Provider Knowledge Of Hypertension Guidelines And Home Blood Pressure Monitoring, Alison Claire Oesterritter

DNP Projects

Background: While hypertension is the leading preventable risk factor for cardiovascular disease, disease control remains suboptimal. In the U.S., 47% of adults have hypertension, but only 25% are controlled. Despite having quality evidence-based guidelines, many recommendations are not implemented due to clinical inertia, or the tendency to not change therapy when targets aren’t met. Research has shown that this can be overcome with educational programs. Purpose: To provide training on hypertension guidelines and home blood pressure monitoring (HBPM) to overcome clinical inertia and improve patient outcomes related to hypertension. Methods: The project was a quasi-experimental, pre- and post- …

Improving Knowledge, Confidence, And Competency Among Icu Nurses Concerning The Benefits Of Using The Uk Ventilator Separation Protocol, Brittany Monroe

DNP Projects

Background: The trauma intensive care unit (ICU) at University of Kentucky (UK) Healthcare uses a ventilator separation protocol which provides specific guidelines on the successful weaning of patients from mechanical ventilation. However, many of the nurses are not aware of this protocol as formal education is not included in their orientation or training. This lack of knowledge can lead to risks such as increased patient morbidity, mortality, ICU length of stay, and healthcare-related costs. Research shows that using structured mechanical ventilator weaning tools in the ICU can shorten the duration of mechanical ventilation, which in turn, lowers these associated risks. …

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

The Effects Of An Educational Intervention On Nursing Knowledge Of Post-Operative Care Of Patients After Minimally Invasive Esophagectomy Surgery, Kelli Curry

DNP Projects

Abstract

Background: Minimally invasive esophagectomy surgery is commonly performed by thoracic surgeons on patients with esophageal cancer. The post-operative care of these patients is meticulous and follows a protocol developed by the thoracic surgeons at the University of Kentucky. At UK Chandler Medical Center, concerns have been raised regarding nurses’ lack of education of the protocol, and therefore decreased implementation. Increasing nursing knowledge pertaining to this protocol by performing educational in-services periodically and standardizing and implementing formal education as part of nursing orientation will decrease the knowledge gap and improve patient outcomes and increase utilization of the post-operative protocol.

Purpose: …

New Crew Nights: The Impact Of A Nurse Leader Led Mentorship Series On Perceived Competency In The Novice Nurse, Taylor C. Bergman

DNP Projects

Abstract

Background and Purpose: Nursing leaders across the United States are seeking to recruit and retain new graduate nurses as a national nursing shortage widens at an alarming pace. Healthcare systems are tasked to strengthen the skill set of novice nurses as they seek to meet the care needs of acutely ill patients and rebuild a skilled workforce for future years. This study evaluated the impact of a four-part mentorship series for novice nurses on perceived strengths in competency, communication, wellbeing, and teamwork.

Methods: In this quality improvement project with pre-intervention/post-intervention assessment, a sample (n=14) of medical surgical nurses with …

Implementation Of An Education Intervention Aimed At Intensive Care Unit Providers To Improve Knowledge Of And Screening For Cognitive Impairment Related To Post-Intensive Care Syndrome, Terry Harrod

DNP Projects

Abstract

Background: Post intensive care syndrome is a condition that can lead to a range of physical,

cognitive, and psychiatric issues and is frequently undiagnosed. Educating Nurse Practitioners,

Physician Assistants, and Physician Fellows who work in the ICU about post intensive care

syndrome and a cognitive screening tool like the MoCA can significantly enhance their

understanding and ability to diagnose a component of this syndrome.

Purpose: The purpose of this project was to evaluate the effect of an educational intervention

regarding post intensive care syndrome among ICU nurse practitioners, physician assistants, and

physician fellows treating patients within the ICU.

Methodology: …

The Effect Of An Educational Intervention On Early Mobility Compliance In Oncology Nurses, Jonathan A. Hacker

DNP Projects

Background: Geriatric adult patients admitted into acute care hospital settings are at risk of functional decline in their capacity for activities of daily living and independent ambulation. Many of these patients fail to achieve pre-hospitalization levels of function and continue to decline, requiring additional support and care after discharge. Current literature supports early mobilization and ambulation during hospitalization. However, ambulation and patient mobilization has been shown to be the most missed item of nursing care. There is a gap in literature and patient outcome data regarding the impact of early mobilization on medical-surgical patient populations.

Purpose: The purpose of this …

Provider And Staff Education Surrounding Universal Hcv Screening And Linkage To Care In An Ambulatory Care Setting, Lauren Clifford

DNP Projects

Abstract

Background: In the United States, it is estimated that there are more than 2 million cases of Hepatitis C (HCV), with over 66,000 new cases since 2020 However, an estimated 75% of those with HCV go undiagnosed and less than 35% receive treatment within a year of diagnosis. In 2018, UK Healthcare (UKHC) implemented a universal HCV screening method using a Best Practice Advisory (BPA) for anyone 18 and older who presented to the Emergency Department and had labs ordered. Patients who screened positive were then referred to outpatient clinics for HCV treatment. Approximately ten percent of positive patients …

Evaluation Of Nutritional Guidance From Providers For Patients With Type 2 Diabetes In A Primary Care Setting, Whitney Rice

DNP Projects

Background: Adherence to diet is a challenging part of managing type 2 diabetes mellitus (T2DM). Guidelines recommend including a registered dietician and/or a diabetes educator. While this is the gold standard, there are barriers to implementation in primary care. The Starting the Conversation (STC) diet recall tool can aid primary care providers (PCPs) in providing brief nutrition counseling for patients with T2DM. Purpose: To evaluate the perceptions and practices of PCPs regarding dietary education and documentation for patients with T2DM after provider education and initiation of the STC tool. Methods: This was a quality improvement project using a quasi-experimental pretest …

Improving Education On Routine Echocardiograms In Reducing Right Sided Heart Failure When Managing Vv- Ecmo Patients, Ashley Williams

DNP Projects

Background: Patients who are placed on veno- venous extracorporeal membrane oxygenation (VV- ECMO) are at high risk for developing right sided heart failure. An echocardiogram is essential for diagnostics and recovery in ECMO patients and should be a standard of care when managing this patient population. More research is needed to understand the effect of reducing right sided heart failure using routine echocardiograms. Purpose: The purpose of this study is to evaluate if there is a significant difference in outcomes of VV- ECMO patients who received routine echocardiograms compared to those who did not, and appropriately manage once RV dysfunction …

The Effects Of Yoga On Anxiety And Sleep Quality Levels Among College Students, Larisa Lucas Mullins

DNP Projects

Background: College students have poor sleep quality due to a newfound sense of freedom, exposure to new influences, or poor sleep hygiene (Dinis & Barganca, 2018). Specifically, evidence supports a correlation between sleep latency in onset or lack of nighttime sleep and increased anxiety (Dinis & Barganca, 2018). Yoga has been shown to decrease anxiety, stress symptoms, and depression (Mullen et al., 2021). Teaching yoga techniques and encouraging routine yoga practice to college students may improve sleep quality and decrease anxiety.

Purpose: This project's purpose was to evaluate the effect of yoga education and videos on sleep quality and …

Enhancing Communication Between Nurses And First Call Providers Using A Secure Chat Algorithm, Karen Hilt

DNP Projects

BACKGROUND: Healthcare requires quality multidisciplinary communication for patient care. Secure Chat is a feature within the Epic electronic health record to facilitate communication without violating Health Insurance Portability and Accountability Act (HIPPA). An algorithm to streamline communication utilizing this feature is needed to improve patient care.

PURPOSE: The purpose of this study was to determine, develop, implement, and evaluate a communication protocol between nurses and first call providers. The overall goal was to improve the knowledge, attitudes, efficacy, and address barriers with communication of nursing staff and providers through efficient messaging embedded within Epic, electronic health record

CONCEPTUAL MODEL: …

Electroconvulsive Therapy: Improving Psychiatric Rn Knowledge And Attitudes Using An Educational Module, Garrett Payne

DNP Projects

Abstract

Background: Electroconvulsive Therapy (ECT) is a robust, versatile treatment option for many psychiatric disorders and diseases, but systemic low levels of knowledge and negative attitudes exist towards the procedure among healthcare workers, specifically among psychiatric RNs. The negative attitudes surrounding ECT are most attributable to a misunderstanding of its uses, efficacy, procedures, and safety. Psychiatric RNs hold more negative beliefs and misconceptions about ECT than any other group of healthcare workers who directly care for patients receiving the treatment. Psychiatric RNs also demonstrate poor understanding of ECT treatment procedures and outcomes. Current evidence-based practice shows that providing psychiatric RNs …

Nurse Management Competency Training For Frontline Nurse Leaders, Travis Drake

DNP Projects

Background: Growing evidence shows that front line nurse leaders take on their role with minimal education and training. Healthcare facilities are pressed for resources and time to allow for proper development of these leaders.

Purpose: The purpose of this project was to provide novice nurse leaders with a condensed management development program utilizing key American Organization of Nurse Leaders (AONL) nurse manager competencies. This abbreviated program was developed focusing on three key competencies of finance, innovation, and human resources. The impact of the program was measured by comparing self-assessment prior to any of the education and after the entire program …

An Educational Intervention To Improve Neonatal Icu Nurses’ Breastfeeding Support Knowledge, Self-Efficacy, And Breastfeeding Rates At Discharge, Sarah Money

DNP Projects

Background: The benefits of breastfeeding for both mother and baby are known. It is recommended that all infants be exclusively breastfed until six months (Meek & Noble, 2022; North et al., 2021). Despite this, breastfeeding rates remain low, especially in medically fragile infants requiring care in the neonatal intensive care unit (NICU) (Rollins et al., 2016). Receipt of evidence-based breastfeeding support by healthcare providers has been shown to improve breastfeeding success; however, many healthcare providers report not being comfortable or knowledgeable enough to offer support consistently (Mulcahy et al., 2022; Rollins et al., 2016).

Purpose: This study aims …

Advancing Household Robotics: Deep Interactive Reinforcement Learning For Efficient Training And Enhanced Performance, Arpita Soni, Sujatha Alla, Suresh Dodda, Hemanth Volikatla

Engineering Management & Systems Engineering Faculty Publications

The market for domestic robots—made to perform household chore, is growing as these robots relieve people of everyday responsibilities. Domestic robots are generally welcomed for their role in easing human labour, in contrast to industrial robots, which are frequently criticised for displacing human workers. But before these robots can carry out domestic chores, they need to become proficient in a number of minor activities, such as recognizing their surroundings, making decisions, and picking up on human behaviours. Reinforcement learning, or RL, has emerged as a key robotics technology that enables robots to interact with their environment and learn how to …

Improving Neuropathological Analysis With Aβgan: Addressing Morphology Imbalance For Efficient Alzheimer's Disease Diagnosis, Sujatha Alla, Prasanthi Chidipudi, Nagesh Bheesetty, Vedvikash Reddy Velur, Joshit Mohanty, Puneeth Bheesetty, Marisha Jmukhadze, Narendra Lakshmana Gowda, Sai Gireesh Komaragiri

Engineering Management & Systems Engineering Faculty Publications

Histopathologists are experiencing a digital revolution in their field thanks to the digitization of Whole Slide Images (WSIs), which are microscope slides of tissue that can measure gigapixels in size. With so much high resolution data at their disposal, computer vision techniques can now be used to automate laboratory processes, create visual standards, and increase analysis throughput, all of which reduce the workload of pathologists [1]. The "gold" standard in neuropathology, particularly for Alzheimer's Disease- is pathological diagnosis made by looking at White Matter Inclusions (WSIs) in brain tissue. Semi-quantitative scoring in accordance with the standards established by the Consortium …