Medicine and Health Sciences Commons^™

Student Pharmacists’ Emotional Responses And Coping During The Covid-19 Pandemic, Hannah E. Johnson, Deaundre Bumpass, Aric Schadler, Jeffrey Cain

Journal of Wellness

Introduction: Health professions students, including student pharmacists, have been impacted by the coronavirus disease 19 (COVID-19 pandemic) as schools have transitioned to remote learning and cancelled milestone events. During times of crises, media consumption and hobby participation also impact well-being. The adverse emotional responses and coping strategies of student pharmacists amidst the COVID-19 pandemic have not been evaluated, nor have factors that may contribute to emotional responses. The purpose of this study is to determine Doctor of Pharmacy students’ emotional responses and coping precipitated by the COVID-19 pandemic, and the influence of media use, working status, and participation in hobbies. …

Consultation/Liaison Psychiatry During Covid-19, Robert Frierson, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

Consultation/liaison psychiatrists care for people with co-existing medical and psychologic difficulties. The coronavirus pandemic is stressful for patients and their psychiatric caregivers. Patients have lost support systems and harbor fears about exposing family to the virus. COVID-19 sometimes exacerbates previous psychiatric conditions, while diminishing intimacy with physicians. Everyone is oversaturated with COVID-19-related news focusing on rising concerns about the illness and about jobs, school, and housing insecurities.

The psychiatrist maintains a hospital presence despite fear of contracting the disease. Challenges include addressing staff morale, evidencing empathy despite telecommunication devices, and treating anxiety, depression, sleep phobias, post intubation flashbacks, COVID-19-induced cognitive …

Collaborative Human-Machine Interfaces For Mobile Manipulators., Shamsudeen Olawale Abubakar

Electronic Theses and Dissertations

The use of mobile manipulators in service industries as both agents in physical Human Robot Interaction (pHRI) and for social interactions has been on the increase in recent times due to necessities like compensating for workforce shortages and enabling safer and more efficient operations amongst other reasons. Collaborative robots, or co-bots, are robots that are developed for use with human interaction through direct contact or close proximity in a shared space with the human users. The work presented in this dissertation focuses on the design, implementation and analysis of components for the next-generation collaborative human machine interfaces (CHMI) needed for …

Perceived Social Support, Family Relationships, And Health-Related Quality Of Life Among Women With Breast Cancer In Jordan., Hedaya Rateb Hina

Electronic Theses and Dissertations

Introduction: Breast cancer is the most common cancer among Jordanian women. Perceived social support (PSS) and family relationships are strongly associated with positive psychosocial outcomes and health-related quality of life (HRQoL). This area was widely explored in Western countries, but little attention was devoted to investigate this area in Middle East region. Purpose: to investigate the interrelationships among PSS, family relationships, and HRQoL of women with breast cancer in Jordan using an exploratory cross-sectional design. Method: The contextual model of HRQoL designed by Ashing-Giwa (2005) provided the foundation for this study. A total of 140 women were …

Implementation Of A Risk Assessment Tool In The Cardiac Catheterization Laboratory To Identify High Bleeding Risk Patients On Dapt After Pci: A Quality Improvement Project., Ghulam Mughal

Doctor of Nursing Practice Papers

Bleeding is a risk among patients on dual antiplatelet therapy (DAPT) after the percutaneous intervention (PCI) in acute coronary syndrome (ACS). There is a need to accurately identify the patients with increased bleeding risk. Evidence shows that 1.7 cases bleed among 100 PCI patients, and 5% of patients are re-admitted for bleeding which increases subsequent death or MI within 60 days post-discharge bleeding. Evidence suggests that the internally and externally validated BLeeMACS bleeding risk instrument can be used to measure bleeding risk in this population. This quality improvement project aims to improve the awareness among healthcare providers of the bleeding …

A Research Framework For Evaluating Next Generation Sequencing In Community-Acquired Pneumonia, Ashley M. Wilde, Elena Swingler, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Matthew Song Pharmd, Bcidp, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

University Of Louisville International Travel Clinic: Pivoting During The Covid-19 Pandemic, Dawn Balcom, Subathra Marimuthu, Leslie A Wolf, Luanne Didelot, Sarah Tan, Daniel Hall, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Association Of Lung Cancer With Pneumonia And Chlamydia Pneumoniae Infection, Johnny Zakhour Md, Daniel Muller, Alex Glynn, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: The degree of association and type of causal versus non-causal relationship between pneumonia and lung cancer (LC) are evolving discussions. We reviewed English publications on the degree of association between pneumonia and subsequent LC.

Methods: We searched the PubMed database using key words for pneumonia, LC, and chlamydia infection. We selected peer-reviewed studies of patients with pneumonia and LC. Case reports and other literature reviews were excluded from this review.

Results: Five studies examined the incidence and/or risk of LC for a total of 415,750 patients, and four studies examined cases with Chlamydia pneumoniae chronic infection at the time …

Pulmonary Inflammation And Injury Triggered By Spine Surgery In Recovered Covid-19 Patients Demand Consideration, Luciano Rodrigo Lopes, Silvana Kertzer Kasinski

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Why Should People Use Face Masks In The Time Of Covid? The Jri Position, Jose Bordon, Alex Glynn, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Testing The Effects Of Two Field-To-Fork Programs On The Nutritional Outcomes Of Elementary School Students From Diverse And Lower-Income Communities, Kimberly R. Hartson, Kristi M. King, Carol O'Neal, Aishia Brown, Toluwanimi Olajuyigbe, Shakeyrah Elmore, Angelique Perez

Faculty Scholarship

The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N  =  264) and the Field-to-Fork After-school Club (N  =  56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar’s and Wilcoxon signed rank tests. The …

Hair Toxicology Testing Among Children Evaluated For Physical Abuse: Evaluation Of A Practice Change., Ashley Dejarnette

Doctor of Nursing Practice Papers

Background: Despite a complete medical evaluation for child physical abuse, many suspected victims have indeterminant findings. The lack of a definitive diagnosis can impede child protection agencies’ ability to protect those children at high risk for abuse, leaving them vulnerable to subsequent injuries and potentially escalating violence by caregivers. Oftentimes, allegations of child physical abuse are accompanied by concerns for substance abuse by the caregiver as well. While we know that children living in homes where caregivers use illicit substances are at substantially higher risk for physical abuse, drug testing children for environmental exposure to illicit substances is not yet …

Using Simulation To Prepare Nursing Students To Care For Covid-19 Patients., Erika Keithley

Doctor of Nursing Practice Papers

Background: The COVID-19 pandemic has impacted the state, nation, and globe resulting in significant death and healthcare strain. To minimize risks associated with potential illness and educational interruptions, nursing students have often been prohibited from caring for COVID-19 patients during clinical experiences. Simulation-based education immerses students in a realistic clinical environment providing a safe learning environment for novice practitioners.

Purpose: The purpose of this project was to implement simulation-based education related to acute care of COVID-19 patients for pre-licensure nursing students. Project objectives included: (a) to educate nursing students on the care of COVID-19 patients; (b) to assess competency through …

Evaluation And Implementation Of A Video Intervention To Increase Adherence In A Rural Phase Ii Cardiac Rehabilitation Program., Holly Yahyawi

Doctor of Nursing Practice Papers

Background: In the U.S., heart disease affects over 30 million adults and is the leading cause of death. Cardiac rehabilitation (CR) decreases cardiac hospital readmissions, decreases the risk of additional cardiac events, and increases life expectancy. Environment: This project was implemented at a CR program which serves rural Indiana and Kentucky counties. Purpose: This QI project uses a Plan-Study-Do-Act framework to evaluate patient adherence to a rural CR program, implement a video intervention for patients, and measure patient’s perceptions. Procedures: CR patients watched four videos describing what CR is, what to expect at CR, CR benefits, and a patient CR …

Improving Pediatric Delirium Prevention To Decrease Pediatric Delirium Prevalence In The Pediatric Intensive Care Units., Kelsie Houchens

Doctor of Nursing Practice Papers

Background: Pediatric delirium has emerged as a common complication of childhood illness in the intensive care setting, with estimated delirium prevalence ranging from 15.9% to 65.6%. Critically ill pediatric patients in the ICU are at risk for pediatric delirium due to modifiable risk factors including mechanical ventilation, sedating medications, physical restraints, and nutrition. In 2019, the pediatric intensive care unit (PICU) in a Kentucky children’s hospital reported only 18 % of chart audits revealed that physicians activated the physician-directed pediatric ICUs Delirium Prevention and Treatment Order Set (DPTOS) on pediatric patients. A quality improvement (QI) project was developed to identify …

Evaluating Quality Of Life And Participant Satisfaction In A Cancer Support Community Yoga Program., Lauren Topp

Doctor of Nursing Practice Papers

Purpose: The purpose of this EBP project was to evaluate program processes and outcomes of an established cancer support community yoga program for persons impacted by cancer and explore the impact of the program on quality of life (QoL) in persons with cancer.

Design: This project was a quality improvement project with a pre-test/post-test design. QoL was explored through the EROTC QLQ C30 questionnaire. Descriptive and explorative methods were conducted through a survey of participants’ satisfaction with the yoga program. Feedback for future improvements around QoL services were provided.

Methods: Members of Gilda’s Club (440 persons) received an …

The Black Church, Social Media, And Vaccine Hesitancy: A Program Evaluation Of A Virtual Town Hall Meeting Intended To Educate, Empower And Expedite Covid-19 Vaccine Uptake Intent Among Black Americans., Nina Johnson

Doctor of Nursing Practice Papers

Background: Vaccines are among the most important public health interventions of the 20th century saving millions of lives each year. Notwithstanding, the United States has seen a growing resistance to vaccinations since the late 1990s. Vaccine hesitancy (VH) is a delay or decline to accept vaccines, despite the available of safe and effective vaccines (WHO, 2019). Combatting VH in Black communities is especially challenging, complex, and multifaceted due to an elevated sense of medical mistrust from persistent racial discrimination, injustices and medical malfeasance. The current coronavirus-19 disease (COVID-19) pandemic has further magnified the intersection of this structural racism, the associated …

Why Targeted Testing Matters: Evaluation Of A Practice Change In Pediatric Ingestion Screening., Emily Neal

Doctor of Nursing Practice Papers

Background: The drug epidemic is plaguing the United States and more Americans than ever have been identified to use illicit substances regularly, including while caring for children. The practice of obtaining a standard urine or serum drug screen is outdated and ineffective in determining if children have been exposed to illicit substances. Often these immunoassay drug screens are negative despite pediatric patients having symptomatic responses to illicit drug exposures. Immunoassay drug screens are not designed for testing in children who are often passively and directly exposed as bystanders to adult drug use in their environment. This means that a “negative” …

Improving Patient Safety During The Emergency Department Discharge Process With The Use Of Two Patient Identifiers., Hannah English

Doctor of Nursing Practice Papers

Nurses are not always confirming two patient identifiers while conducting a patient discharge, resulting in patient identification errors. This problem has been shown to significantly affect patient safety and satisfaction, decreasing both when errors are made. These errors also have heavy financial and legal consequences on the affected facility and on the discharging nurses, warranting a need for improvement. The purpose of this quality improvement project was to decrease patient-identification errors at discharge by increasing nurse use of two patient-identifiers through the implementation of an education program. This ten-week program involved education sessions that presented evidence-based material specifically focused on …

Implementation And Evaluation Of A Quality Improvement Project To Increase Tdap Vaccination Rates For Primary Caregivers In The Neonatal Intensive Care Unit., Vickie Winner

Doctor of Nursing Practice Papers

Pertussis (whooping cough) is a highly contagious deadly disease for neonates. The Centers for Disease Control and Prevention (CDC) identifies primary caregivers (anyone caring for the infant in the home environment) as the most common source of neonatal pertussis. The CDC therefore recommends primary caregivers receive a booster tetanus, diphtheria, acellular pertussis (Tdap) vaccine to reduce the transmission of pertussis to neonates. The purpose of this quality improvement (QI) project is to implement and evaluate an intervention to increase Tdap vaccination rates among primary caregivers of NICU patients. The specific aims of this quality improvement project are to 1) implement …

Stressors And Resilience Are Associated With Well-Being In Young Adult College Students, Kimberly R. Hartson, Lynne A. Hall, Sara A. Choate

Faculty Scholarship

Objective: The purposes were to describe stressors and resilience behaviors of college students and examine the relationships among stressors, resilience, and well-being. Hypothesis: Resilience will modify the relationship between stressors and well-being. Participants: The sample included 1,010 college students, ages 18–26, from an urban Midwestern university. Methods: A secondary analysis of cross-sectional data from an anonymous survey was conducted using multiple regression and simple slopes analysis. Results: Resilience did not modify the relationship between stressors and well-being. Stressors (β = −.44, p < .0001) and resilience (β = .33, p < .0001) accounted for 42% of the variance in well-being (adjusted R2 = .42, F2,999 = 365.98, p < .0001). The most frequently endorsed stressors were sleep problems, anxiety, and relationships. Conclusions: Stressors and resilience …

Protection Against Infection In Epidural Stimulation Implantation: A Program Evaluation., Yukishia Austin

Doctor of Nursing Practice Papers

Background: Spinal surgical site infection (SSI) is the third most common complication after spinal surgery. Complications of surgical site infection can increase hospital length of stay, associated health care costs, mortality, and produce unfavorable surgical outcomes (Janssen et al., 2019). The need to decrease the incidence of surgical site infections (SSis) is a primary concern for the Kentucky Spinal Cord Injury Research Center (KSCIRC) organization. To decrease the risk of infection with epidural spinal cord implantation, a pre-operative quality improvement plan was implemented for KSCIRC to follow.

Setting: The project took place at the University of Louisville's Kentucky Spinal Cord …

Improving Communication And Teamwork Among Emergency Department Nursing Staff., Phoebe Girgis

Doctor of Nursing Practice Papers

Background: Emergency Department (ED) nurses are experiencing a rise in patient visits, staffing shortages, lower levels of job satisfaction, higher nurse to patient ratios, increased acuity for trauma patients, and increased psychiatric admissions. Tension, frustration, and breakdowns in communication are among reasons for lateral violence among emergency nursing staff.

Setting: This evidence-based practice project took place at a level one trauma academic medical center in the Southeastern region of the United States. Emergency Psychiatric Services (EPS) is a subunit within the ED which has a capacity of 24 patients for psychiatric services. The main ED, Medical ED (MED), or the …

Program Evaluation: Assessing The Effectiveness Of Diabetes Group Education Utilizing The Diabetes Knowledge Test., Aminata Gueye

Doctor of Nursing Practice Papers

Background: Diabetes Mellitus (DM) is the 7th leading cause of death in the United States (HHS ODPHP, 2019). It is also the leading cause of chronic disease complications such as adult-onset blindness, kidney failure, and lower-limb amputations (HHS ODPHP, 2019). It is recommended that all people with diabetes should participate in diabetes self-management education (ADA, 2018). Purpose: The purpose of this DNP project is to evaluate the effectiveness of diabetes group education by assessing participants’ knowledge utilizing the diabetes knowledge test (DKT) at an outpatient diabetes care center in Louisville KY. The evidence from the literature review supports the importance …

The Implementation Of A Standardized Car Safety Seat Discharge Teaching To Improve Self-Efficacy In Neonatal Intensive Care Unit Nurses., Madeline Sass

Doctor of Nursing Practice Papers

Background: There is a lack of standardization for car safety seat education to caregivers before hospital discharge. Nationally, 59% of motor vehicle accident deaths occur because the car seat is misused (Greenwall, 2015). The American Academy of Pediatrics (1999) states this is a gap in care because all caregivers need to receive proper car safety seat instruction before discharge. Purpose: This quality improvement project aimed to increase nursing self-efficacy and compliance of registered nurses (RNs) by implementing a standardized CSS discharge intervention. Methods: RNs on the unit were educated with a 7-minute presentation video titled “Car Seat Safety: Discharge Teaching” …

Increasing Extubation Awareness During Interdisciplinary Rounds With A Rounding Tool In The Pediatric Intensive Care Unit (Picu)., Lilly Giang

Doctor of Nursing Practice Papers

Purpose: Prolonged duration of mechanical ventilation and endotracheal tube intubation are associated with longer length of stay and increases risk for infection by about 3% per day when mechanically ventilated (Mirzarahimi et al., 2020). Evidence suggests that the use of a rounding tool during interdisciplinary rounds improves clinical outcomes, reduce duration of mechanical ventilation, and decrease length of stay in the PICU. The aim of the project was to measure registered nurses and PICU providers perception of the extubation prompts and determine if the extubation prompts decrease duration of mechanical ventilation and length of stay. Methods: After extensive review of …

Improving Pneumonia Immunization Rates Among Adult Residents Of A Long-Term Care Facility., Salma Hegazi

Doctor of Nursing Practice Papers

Background: Pneumonia is a significant cause of morbidity and mortality in long-term care facility (LTCF) residents (Stamm et al., 2020). Vaccination of LTCF residents is a reasonable prevention strategy, (Andre et al., 2018; Centers for Medicare & Medicaid Services, 2020; Kaiser Family Foundation, 2019). Improving immunization rates among LTCF residents remains to be a challenge (Rehm et al., 2012; Stamm et al., 2020).

Purpose: The purpose of this quality improvement (Q.I.) project is to improve the pneumococcal pneumonia immunization rates at an LTCF in Louisville, KY.

Methods: A review of each residents' medical record to obtain immunization status, evaluating the …

Implementation Of A Newborn Skin Care Routine To Decrease Diaper Dermatitis., Shelia Kingsley

Doctor of Nursing Practice Papers

Background: Diaper dermatitis (DD) is an acute, inflammatory reaction of the skin, and is one of the most common skin problems in infancy. Diaper care procedures should aim at supporting skin barrier function to reduce the incidence of diaper dermatitis. Evidence indicates that providing appropriate skin care practices can be effective in preventing skin redness and breakdown. Purpose: To create an evidence-based skin care guideline that would improve consistency in care, decrease skin breakdown and standardize workflow. Methods: A Neonatal Skin Assessment Report was created and used to review pre- and postintervention Neonatal Skin Condition Score (NCSC) © assessment scores. …

Incorporating A Caregiver Support Group For Parents Of Children Diagnosed With Type 1 Diabetes Mellitus (T1dm)., Molly Recktenwald

Doctor of Nursing Practice Papers

Background: Learning to live with a chronic illness can be one of the most stressful times for a child and family. A new diagnosis of Type 1 Diabetes Mellitus (T1DM) consists of overwhelming amounts of education, and at the time of a new diagnosis, caregivers can experience extreme emotions, including depression and anxiety. Parent support groups have been shown to validate and alleviate parents’ emotions surrounding the diagnosis. Purpose: The purpose of this project was to initiate a support group for parents and caregivers of children diagnosed with new-onset T1DM that can be maintained and expanded in the future to …

Integrating Mhealth In A Virtual Prenatal Class To Promote Behavior Modification In Pregnant Women., Brittney Corniel

Doctor of Nursing Practice Papers

Background: Occurrences of pre-term births are disparagingly higher among women from vulnerable populations. Prenatal classes provide healthcare professionals an opportunity to educate pregnant women about mitigating their risk factors for perinatal complications.

Purpose: To introduce the use of pregnancy mobile applications in a prenatal class to assist women in obtaining optimal maternal health for fetal development.

Methods: A pre/post-test design was used to explore the relationship between increased mobile health (mHealth) use and achievement of health behavior goals. The project intervention included a 15-minute PowerPoint presentation about optimal use and effectiveness of mobile apps in pregnancy, pregnancy health behaviors, and …