Medicine and Health Sciences Commons^™

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

ETSU Faculty Works

Background:

Design and methods:

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

MSN Capstone Projects

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

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

Nursing Faculty Publications and Presentations

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

Role Of Hand Hygiene In The Prevention Of Central Line-Associated Bloodstream Infection In Intensive Care Unit Patients: A Benchmark Project, Meliana Amazan

MSN Capstone Projects

CLABSI (Central Line Associated Blood Stream Infection) is one of the most common hospital-acquired infections in the ICUs (Intensive Care Unit). Not only it is cost prohibitive, but it also prolongs hospitalization. However, it is avoidable. This condition needs to be reviewed to improve patients’ outcomes in the ICUs. This project aims to decrease or eliminate the incidence of CLABSI among ICU patients through proper and mindful hand hygiene. Healthcare providers should be aware of the different care bundles that contribute to decreasing CLABSI and be able to apply them correctly. Articles were searched on different databases such as Cochrane …

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

MSN Capstone Projects

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

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

MSN Capstone Projects

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

Implementation Of An Evidence-Base Hospital Acquired Pressure Injury Prevention Program, Brenda Miner

MSN Capstone Projects

Covid-19 hindered many quality improvement projects. As the stressors from the pandemic began to disappear the healthcare industry was struck with new struggles. These new struggles were ensuring quality care was being provided to all patients. The decline in quality care also led to a decline in reimbursement from payor sources, such as Medicare. During the pandemic the healthcare industry was at their most vulnerable state and now that the dust is settling the ramifications of just surviving are staring the industry right in the eyes. Change is difficult, but it is even more difficult following traumatic events such as …

Assessing The Impact Of Daily Chlorhexidine Baths In Prevention Of Central Line Associated Bloodstream Infections: An Evidence Based Project, Brooke Rea

MSN Capstone Projects

Background: The rates of central line associated bloodstream infections (CLABSI) is a major concern in the healthcare industry. It is imperative that healthcare professionals take every precaution to prevent these life-threatening infections to the already critically ill patient.

Objective: The reason for this paper is to assess the effectiveness of the use of daily chlorhexidine baths in patients with central lines in the prevention of CLABSIs.

Narrative Review: A narrative review of evidence was conducted to assess the effectiveness of daily chlorhexidine bathing in patients with central lines. Twelve studies were moved forward in the project. Each of the twelve …

Preventing Deep Vein Thrombosis In Surgical Patients, Ariel D. Roberson

MSN Capstone Projects

Deep vein thrombosis (DVT) is a significant medical issue that incurs thrombi formation in the venous system which can result in major medical problems. DVT’s often occur because of complications after orthopedic surgery. Common risks factors for DVT are vein injury, slow blood movement, increase estrogen, and chronic medical illness (Centers for Disease Control and Prevention [CDC], 2018). As many as 900,000 individuals are impacted by DVT each year (CDC, 2020). Consequently, recent estimates show that 60,000 to 100,000 Americans die each year because of DVT. Even more alarming, 10 to 30% of individuals will die of DVT within a …

Robot Revolution: Impacting Adoption Of The Technology, Cece Noland

MSN Capstone Projects

The author examined the value of robotic guidance platforms in spine surgery, and then implemented an improvement project to positively impact internal (Medtronic employee) adoption of the technology. By promoting adoption, robotics will continue to advance the standard of care for spine surgery patients. This paper is to meet fulfillment of requirements for NURS5382 Capstone.

Improving Safety In The Emergency Department: Utilizing Metal Detectors To Mitigate Weapon Possession, Jonathan Garcia

MSN Capstone Projects

Today’s high risk-healthcare environment has prioritized patient safety with great initiatives and, unfortunately, placed staff safety second. However, safety for both groups should be equal priorities. Evidence suggests that Emergency Departments (ED) often care for patients with a history of crime and mental health diagnoses, creating an environment where the threat of violence and weapons is increasingly prevalent compared to other clinical settings. (Erlyana, 2019) Risk mitigation is possible if we consider studies by Malka et al. (2015) and Laidlaw et al. (2017) that indicate the efficacy of metal detectors in accurately identifying concealed weapons. To improve clinician and patient …

Safe Staffing, Safe Patients Benchmark Project, Sarah Barton

MSN Capstone Projects

With the most recent pandemic, nurses have been overworked, overwhelmed, and understaffed at dangerous levels. Nurses are leaving full time employment at this facility in droves to seek better wages through traveling. In turn, our patient outcomes have taken a large hit, with an increase in falls, pressure ulcers, and catheter-acquired urinary tract infections, to name a few. This is costly for the hospital, not to mention the damper it puts on the hospital’s vision and goals. With the implementation of a nursing incentive program, the hospital could cut overall spending in half within 2 years with an investment of …

Early Mobilization For Adult Mechanically Ventilated Patients, Stephanie Miller

MSN Capstone Projects

Approximately 13 million people worldwide receive treatment in intensive care units (ICUs) annually. Many patients admitted to the intensive care unit require mechanical ventilation for their survival and attempts to mobilize these critically ill patients is frequently restricted for their own safety. It has been suggested that this lack of mobility may have a significant negative impact on the recovery process and lengthen the time of the patient’s overall hospital stay and recovery. Additionally, survivors report significant physical impairments and deconditioning that present obstacles towards their recovery and well-being after prolonged ventilation.

Pain In The Dying Patient, Shanna Selph

MSN Capstone Projects

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

Mindfulness Meditation To Reduce Nurse Burnout: An Ebp Implementation Project, Lester Denson Jr

MSN Capstone Projects

Hospitals across the United States are suffering from poor staffing (American Nurses Foundation, 2021). A common thread throughout those facilities is that nurses are leaving their jobs due to self-reported burnout, contributing to the staffing shortage and low morale (Shah et al., 2021).

Mindfulness training plays a part in decreasing emotional exhaustion for staff nurses. A reduction of emotional exhaustion has been discovered after the implementation of mindfulness-based intervention programs, with continued improvement after completion of the program (Sarazine et al., 2021; Bianchini & Copeland, 2021). The benefit of this implementation would be a reduction of nurse burnout which ultimately …

The Journey From Drug Addiction To Drug Withdrawal: A Christian Gospel Rehabilitation Program In Taiwan, Pi-Ming Yeh

ETSU Faculty Works

Background

World Drug Report estimates the number of opioid users at 53 million and identifies opioids as responsible for two thirds of the 585,000 people who died as a result of drug use in 2017.

Purpose

The purpose of this study was to analyze the testimonies of 30 people regarding their journeys from drug addiction to drug withdrawal in Taiwan.

Methods

This was a qualitative research design. The sample inclusion criteria were as follows: (a) being a drug abuser, (b) completed the Christian Gospel Drug Withdrawal Program or church-sponsored program, and (c) shared their related testimony on the Good TV …

Application Of Teaching Regarding Injury Appearance In Darker Pigmented Skin Patients: A Quality Improvement Project, Tiffany Akiba

DNP Projects

Significance and Background: The skin is the largest organ of our body, and skin injury prevention begins with accurately inspecting skin. Current practices stress on looking for any signs of redness which often signify that the skin is possibly injured or compromised. However, darker skin tones do not appear red when injured. Assessing for redness is a practice that is suited better for lighter skin tones.

Purpose: Provide education to providers on current skin assessment practices of darker skin tones.

Methods: The IHI Model of Improvement was used for this project, and the Plan-Do-Study-Act cycle was used to test for …

Exploring The Influence Of Postnatal Depression On Neonatal Care Practices Among Mothers In Western Kenya: A Qualitative Study, Florence Achieng, Alloys K’Oloo, Hellen Barsosio, Simon Kariuki, Helen Nabwera

Obstetrics and Gynaecology, East Africa

Background: Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality.

Objectives: To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya.

Design: A cross-sectional study.

Methods: Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale.

Results: Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to …

Alarm Fatigue Prevention Benchmark Project, Lauren James

MSN Capstone Projects

Healthcare technology is constantly evolving to find ways to help provide better outcomes for patients. Clinical monitoring is technology that helps healthcare staff recognize deterioration of the patient which allows them to intervene earlier, which increases the patient’s chance for survival. The monitors are connected to the patients to monitor vital signs such as heart rate, oxygen saturation, respirations, and blood pressures. They allow staff to get real time feedback of the patient’s condition and determine if the patient is getting better or any interventions need to be done due to clinical deterioration.

However, all technology has setbacks and downfalls. …

Group B Streptococcus: A New Perspective, Susan Harris

MSN Capstone Projects

Group B streptococcus (GBS) is a major cause of illness and death in young infants across the nation. Current guidelines suggest pregnant women should be screened from thirty-five-to- thirty-seven-weeks gestation. Although screening may be negative at that time, the expectant mother could become colonized with GBS before delivery. GBS is a pathogen that lives in the gastrointestinal and genitourinary tract of fifteen to twenty percent of women of childbearing age (Moorhead et al., 2019). GBS does not become a problem until it is passed from colonized mothers to the neonate during delivery (Virranniemi et al., 2019). When GBS is passed …

The Use Of Mindfulness-Based Stress Reduction To Reduce Stress And Burnout In Nurses, Sherri Foreman

MSN Capstone Projects

The Mindfulness-Based Stress Reduction Program (MBSR) has been used effectively in multiple clinical settings to reduce workplace stress and burnout in nurses. The MBSR’s cost-effective approach to stress management can be implemented into any healthcare facility’s policy. The topic of MBSR’s effect on stress and burnout has been identified as essential due to nurses working in fast-paced, stressful work environments. These work environments lead to increased stress and burnout. The International Council of Nurses surveyed nurses before and after the pandemic. There were 40% of nurses that reported symptoms of burnout before the pandemic compared to 70% of nurses after …

Nurses’ Education, Knowledge And Perceptions Of Peripheral Intravenous Catheter Management: A Web-Based, Cross-Sectional Survey, Debbie Massey, Marie Cooke, Gillian Ray-Barruel, Nicole Marsh, Amanda J. Ullman, Alison Craswell, Marianne Wallis

Research outputs 2022 to 2026

Background: Peripheral intravenous catheters (PIVCs) are the most used invasive medical device. Unfortunately, PIVCs fail for a variety of reasons and failure often results in serious adverse events leading to patient discomfort, infection, delays in treatment, increased healthcare costs, and even death. In Australia, qualified nurses assess, manage, and remove a PIVC as part of their clinical role. To date, no study has described the current state of knowledge and confidence (self-efficacy) about PIVCs from the perspectives of qualified nurses working in Australian hospital settings. Aims: To describe the current state of knowledge and confidence (self-efficacy) about PIVC management from …

Exploring Assessment Policies For Clinical Practice: A Scoping Review Of The Literature, Lynda J. Hughes, Amy N. B. Johnston, Jacqueline H. Byrne, Debbie Massey

Research outputs 2022 to 2026

Background: Assessment of pre-registration nursing students in clinical practice is an essential process, ensuring students who graduate meet standards for practice and competently and safely care for patients under their care. However, such assessment remains challenging for individuals and organisations. Aim: We aimed to investigate what is known about the application of clinical placement assessment policies guiding pre-registration nursing programmes. Methods: Arskey and O'Malley’s five-stage method for scoping reviews was employed. Health and education databases were searched in July 2020 and December 2021. Identified papers were screened. The Joanna Briggs Institute's critical appraisal tools were used to appraise the quality …

The Incidence And Modifiable Risk Factors For Necrotizing Enterocolitis In Preterm Infants: A Retrospective Cohort Study, Kelvin Gitau, R. Ochieng, Mary Limbe, Caroline Kathomi, James Orwa

Paediatrics and Child Health, East Africa

Objectives: To evaluate the incidence and modifiable risk factors for Necrotizing enterocolitis (NEC) in preterm infants born at ≤32 weeks of gestation weighing <1500 >grams, at a private tertiary care hospital in Kenya.

Materials and methods: This retrospective cohort study was conducted at the Aga Khan University Hospital Neonatal Intensive Care Unit (NICU). Preterm infants born at ≤ 32 weeks’ gestation and weighing2019, were recruited into the study. The primary outcome was NEC Bell Stage IIa-IIIb based on Modified Bell’s criteria. Maternal and neonatal characteristics were evaluated. The association between variables of interest and NEC was determined using logistic regression analysis …

High Fructose Corn Syrup And Sugar Substitutes: Hemoglobin A1c Implications In Diabetes?, Rachelle S. Glover

Doctoral Dissertations and Projects

Diabetes mellitus type 2 (DMt2) is an increasing health concern of epidemic proportion in the United States. High fructose corn syrup (HFCS) and artificial sweeteners (AS) have been implicated as contributory factors to DMt2. This project seeks to demonstrate elimination of daily consumption of HFCS and AS in DMt2 patients can contribute to lower hemoglobin A1C (HgbA1C) levels by comparing two groups of patients receiving two differing diabetes education programs. A reduction of HgbA1C levels by 0.2-0.5% is expected in DMt2 patients instructed to eliminate HFCS and AS, and no change is expected in HgbA1C levels in DMt2 patients receiving …

Whether Covid-19 Infection Affects Human Cognitive Function, June Li Alsgaard

Doctoral Dissertations and Projects

The COVID-19 pandemic, resulting from the SARS-CoV-2 virus, continues to impact the daily lives of individuals worldwide. Although research has been conducted on long-COVID symptoms, the underlying causes remain unclear. Notably, instances of neurological decline have been observed following SARS-CoV-2 infections. 125,573 articles regarding neurological damage and cognitive disfunction were published and can be found from major research databases. For this scholarly project, 25 peer-reviewed journal articles pertaining to long-COVID and neurologic function changes, as well as potential underlying reasons for these changes, were curated. The proposed hypotheses include the virus' ability to pass through and harm the blood-brain barrier …

Evaluating The Need For Return-To-Learn Concussion Protocols In High School Student-Athletes: An Integrative Review, William David Midgette

Doctoral Dissertations and Projects

Over a million high school students are estimated to sustain at least one sports-related concussion annually. Unfortunately, over a third of these student-athletes suffer from post-concussion syndrome, which leads to the question of whether student-athletes are allowed proper time to heal after a concussion or if more can be done to optimize concussion recovery. Proper and optimal recovery post-concussion encompasses both physical and cognitive rest. While concussion management has traditionally focused on the physical aspects of recovery, emphasis has shifted to the cognitive impacts of concussions. There is literature to support that cognitive rest is vitally important, if not equally …

Application Of Classic Grounded Theory In Nursing Studies: A Qualitative Systematic Review Protocol, Justine Connor, Tracy Flenady, Trudy Dwyer, Debbie Massey

Research outputs 2022 to 2026

Introduction Classic grounded theory (CGT) is a valuable method for nursing research, but the application of CGT methodology in nursing studies has not been specifically investigated. With the increasing use of CGT in nursing research, attention is now focusing on the quality of studies using this methodology. In this systematic review, we aim to develop an understanding of the application of CGT methodology, specifically appraising the quality of the methodology's application in the field of nursing research. Methods and analysis The reporting of this review will be guided by the Preferred Reporting Items for Systematic and Meta-Analysis guidelines statement and …

Effectiveness Of An Evidenced-Based Cognitive Behavioral Therapy Intervention For Adolescents In A School Setting, Sarah Ellen Gray, Kimberly Michaela Carter, Amanda Harper

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

The adolescent years are a formative time when rapid hormonal and physical changes stimulate the developing mind. Exposure to poverty, abuse, violence, and lack of peer and social support causes an increase in vulnerability to the development of mental health problems. The COVID-19 pandemic has also exacerbated symptoms of depression and anxiety. Regardless of the risk factors, anxiety and depression continue to be significant health problems, affecting thousands of adolescents yearly in the United States. The first-line treatment recommendation for managing anxiety and depression symptoms is cognitive behavioral therapy (CBT). However, access to a provider for CBT treatment is …

Implementation Of A Home-Based Walking Program To Address Cancer-Related Fatigue, Mary Catherine Hyatt, Karen Lasater, Michelle Payne

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Background: The non-treatment of cancer-related fatigue (CRF) in adult oncology patients on treatment is a clinical practice issue identified globally and at the local Hematology and Oncology Clinic. Despite the growing evidence supporting physical activity to address CRF, this problem remains prominent. Objective: An 8-week home-based walking program was implemented at the local clinic to address this problem. This project aimed to increase the prevalence of managing CRF and reduce the severity of CRF. Methods: With the provider's recommendation, adult oncology patients on active treatment at the Hematology and Oncology Clinic registered for the program in …