Medicine and Health Sciences Commons^™

Acceptability Of Telepsychiatry In A Rural Kentucky Community Mental Health Clinic, Leslie Brauner

Doctor of Nursing Practice Projects

While telepsychiatry has been championed as a method to improve access to care and health care delivery to remote regions, the willingness of rural patients to receive psychiatric treatment via telehealth technology remains uncertain (Rohland, Saleh, Rohrer, & Romitti, 2000). Published studies concerning general patient satisfaction with telemedicine are available; however, there is little focus on satisfaction of specialized telepsychiatric care to rural mentally ill adults. A capstone project was conducted to examine the acceptability and satisfaction of telepsychiatry in a rural Kentucky mental health clinic. Patient satisfaction with the modality was assessed using the Telemedicine Satisfaction and Usefulness Questionnaire …

The Nurse Manager's Leadership And Nurse Satisfaction, Deborah Bryant

Doctor of Nursing Practice Projects

Nurse managers face many challenges in today's healthcare environment including how to retain staff. The purpose of this capstone was to give tools to nurse managers on specific units to develop techniques for shaping a positive culture making a difference for the nursing staff, patients, families and others on the nursing units. Culture-shaping tools were taught to five nurse managers after completion of a pre-assessment survey by bedside nurses to determine if the behaviors of the nurse managers could impact the nurse satisfaction and improve retention. Nursing staff were queried for effectiveness in nurse satisfaction after the nurse managers had …

Implementation And Evaluation Of A Team Simulation Training Program, Yvonne Rice

Doctor of Nursing Practice Projects

Trauma care, characterized by complex, shifting priorities, presents many challenges to providers. Traditionally, immediate trauma care has been provided in emergency departments. It has recently been recognized that severely injured patients receive better care with improved outcomes when they bypass the emergency department and are admitted directly to the trauma surgical intensive care unit (TSICU). To assure that TSICU nurses and interprofessional staff are prepared to handle such patients, all new registered nurses in the TSICU of a Level I Trauma Center participate in a one-day Trauma Boot Camp. Originally, the focus of the Trauma Boot Camp was solely on …

Simulation In Assisting Nurses To Better Recognize Early Signs Of Clinical Deterioration Of Patients, Loretta Elder

Doctor of Nursing Practice Projects

The need to enhance the knowledge and skills of nurses caring for patients who exhibit signs of clinical deterioration has been validated in the literature. The literature has further supported the registered nurse as the key individual expected to recognize signs of clinical deterioration in the patient. The use of simulation as an effective teaching strategy has been well documented in the literature. The purpose of the project was to use simulation as an educational intervention to increase nurse knowledge, self-confidence, and competency when caring for patients exhibiting signs of clinical deterioration. The findings of this project are supported by …

Bordered Silver Foam Dressings For Colorectal Surgical Patients, Jessica Maynard

Doctor of Nursing Practice Projects

Although a surgical site infection (SSI) is a risk of an operative procedure, most are preventable (Health Protection Agency, 2009). The Joint Commission National Patient Safety Goal 7 stipulates the implementation of evidence-based practice for SSI prevention in acute care facilities. The purpose of this pilot project was to implement a bordered silver foam dressing protocol for post-operative colorectal surgical patients. Using a pre- and post-comparison design, the new dressing protocol was implemented for a two-month pilot for colorectal surgical patients meeting the specified criteria at Cabell Huntington Hospital. SSI rate following the protocol was compared to the SSI rate …

Improving A Fall Prevention And Management Program In An Acute Care Setting, Ashlee D. Gallion

Doctor of Nursing Practice Projects

In-patient falls are common but preventable adverse events. A patient fall has become a targeted event that hospitals across the country are trying to prevent by implementing new evidence-based strategies and techniques. The purpose of this capstone project was to implement a valid and reliable fall risk assessment tool and a post-fall huddle process. Following a 30-day pilot of the new fall prevention protocol on a medical-surgical unit at the Cabell Huntington Hospital, the documentation of fall risk and post-fall huddles was examined. Fall rates during the pilot were compared to pre-implementation rates. During this project, the new fall risk …

The Effect Of A Facilitated Educational Program And Experiential Learning On Nursing Workplace Incivility, Nancy E. Armstrong

Doctor of Nursing Practice Projects

Workplace incivility is a well-documented issue in nursing. It has the potential to cause emotional and physical distress in victims, and potentially affect the quality of care provided. Research in acute care settings found that facilitated educational training sessions related to workplace incivility, in combination with experiential learning activities, assisted nurses in improving their understanding of workplace incivility and their communication skills. It has also been found to reduce workplace incivility. The purpose of this Capstone Project was to implement a civility training program that included education about incivility through facilitated discussions, as well as teambuilding exercises and experiential learning …

Evaluating The Effectiveness Of A Heart Improvement Toolkit Program: A Pilot Project, Cheryl L. Mitchell

Doctor of Nursing Practice Projects

Heart failure (HF) is a chronic, debilitating disease resulting in over one million hospitalizations with an estimated 30.7 million dollars in total health care cost per year (Go et al., 2014). Evidence shows that HF education programs that promote adherence to pharmacological and non-pharmacological provider recommendations are effective in reducing 30-day HF recidivism rates, increasing self-care behavior, and decreasing adverse clinical events. The purpose of this evidence-based project was to implement the Heart Improvement Toolkit (HIT) Program which is a one-on-one, comprehensive HF-specific education program, for patients with a HF diagnosis who have been admitted to non-cardiac specialty units. Program …

Breastfeeding Initiatives In Rural Kentucky: An Action Research Approach To Improving Public Health, Mallory D. Ratliff

Occupational Therapy Doctorate Capstone Projects

Breastfeeding offers numerous benefits for mother and baby and should be considered a priority for the health of communities as opposed to a parenting choice (American Academy of Pediatrics, 2012). Occupational therapists have a place in breastfeeding support, public health promotion, and guiding performance patterns (Pitonyak, 2014).

This study sought to identify what occupational therapists within the medical and community systems could offer stakeholders involved in breastfeeding support and neonatal care. Action research methods were utilized to allow stakeholders in a rural community in Kentucky to decide what objectives could benefit their area. A series of three focus groups were …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Dog Visitation In Long-Term Care And Its Effects On Depression, Leah Shea Simpkins

Occupational Therapy Doctorate Capstone Projects

The capstone project examined the effect of certified therapy dog interaction with residents of a long-term care facility. The primary researcher utilized the assistance of a certified therapy dog and certified therapy handler for five visits to the long-term care facility for a timeframe of once a week for five consecutive weeks. The visits were for a fifteen minute dog visitation in the participant’s room, which comprised the experimental group. The primary researcher monitored the participant’s interaction with the dog, verbalizations, and smile counts during this time. Control group was observed in the courtyard for five consecutive weeks for no …

Enriching Occupational Therapy In Early Intervention: Using And Documenting The Evidence, Shelli Dry, Christine Myers

Occupational Therapy Doctorate Capstone Projects

Occupational therapists working in Kentucky’s Early Intervention System (First Steps) are required to use evidence-based practice within their treatment sessions. Evidence-based practice incorporates information from scientific research, the clinician’s expertise and the family’s values in an all-encompassing treatment approach. Implementing evidence-based practice into treatment sessions promotes efficiency in treatment by improving clinical outcomes in a shorter period of time. This capstone project was developed as a first step in identifying methods to promote the implementation and documentation of evidence-based practice into early intervention services. This project included developing an online continuing education course and exploring changes in occupational therapists perceptions …

A Descriptive Study Of Menopausal Woman's Life Experiences, Stressors And Their Occupational Meanings, Melanie Ford Dr.

Occupational Therapy Doctorate Capstone Projects

This study describes some of the major physical and emotional occupational needs of menopausal women, and the direct impact this has on their relationships and overall well-being. The primary objective of this research project was to describe the life experiences of menopausal women and how various stressors affected their emotional, physical, and relational occupations. A descriptive grounded theory method was used to explore the stressors, their meanings, and the women’s unique perspectives of their menopausal experiences. Data were collected through semi-structured interviews and then coded and analyzed into key categories. From this information, specific themes were formulated, resulting in an …

Sleep Occupation Quality And Occupation-Based Hand Function In Carpal Tunnel Syndrome, Angela M. Goorman Ms, Otr/L

Occupational Therapy Doctorate Capstone Projects

Sleep disturbance is considered a health crisis by Centers for Disease Control and Prevention (2013). It is not uncommon for clients with carpal tunnel syndrome (CTS) to also have poor sleep (Patel et al., 2014). The purpose of this study was to investigate the impact of sleep quality on hand function, while controlling for pain level and CTS diagnostic electromyography severity in CTS clients at a Southern Arizona orthopedic practice. This study tested the following hypothesis: Sleep quality is positively associated with hand function above and beyond the association of pain and CTS severity to occupation-based hand function in CTS …

Community Based Programming Promoting Physical Activity, Jennifer Hight M.S. Otr/L

Occupational Therapy Doctorate Capstone Projects

Background: Childhood obesity is a growing health concern, negatively impacting a child’s quality of life, and ability to engage in daily occupations; while contributing to rising healthcare costs. This Capstone Project is a community based program encouraging the development of gross motor skills in the four year old population of a local childcare center to promote engagement in physical activity for less engagement in sedentary daily activities.

Purpose: Although many causal factors have been linked to childhood obesity, current review of the literature demonstrating effective interventions to decrease obesity in the pediatric population is limited, and there is a scarcity …

The Relationship Between Coaching Environment And Athlete Attributional Style, Una Britton

Online Theses and Dissertations

This study examined the relationship between attributional style and perceived coaching behaviors in collegiate cross-country/track and field athletes in the USA and Ireland. Participants included seventy-three collegiate athletes (Ireland: n = 24 male, n = 18 female, mean ± SD age: 20.39 ± 1.61 years. USA: n = 9 male, n = 22 female, mean ± SD age: 21.02 ± 2.18 years). Participants completed the Sport Attributional Style Scale (SASS; Hanrahan et al., 1989) and the Leadership Scale for Sport (LSS; Chelladurai & Selah, 1980) to assess attributional style and perceived coaching behaviors. Explanatory pessimism, total internality, stability, and globality …

Prehospital Emergency Medical Services Treatment Protocols: Aligning With National Best Practices, Zachary Ryan Charest

Online Theses and Dissertations

Many variances in prehospital Paramedic treatment protocols exist amongst Emergency Medical Service (EMS) Providers in the State of Kentucky. These differences lead to inconsistencies in quality of patient care delivered, reduce ease of mobility of providers and result in a decreased oversight from the Kentucky Board of EMS (KBEMS). To investigate the impact of protocol variances on patient care, a mixed methods study consisting of a convenience sample of Kentucky EMS prehospital Paramedic treatment protocols was collected and compared to the Kentucky state-wide treatment protocols. A literature review of best practices regarding EMS protocols was conducted. Of all protocols 81.9% …

Identifying Speech-Language Pathologists' Current Perceptions And Practice Patterns, Mary Margaret Griffith

Online Theses and Dissertations

A web-based survey was collected and analyzed from 39 speech-language pathologists (SLP) contacted through the American Speech-Language-Hearing Association's (ASHA) Special Interest Groups #2 and #4 as well as members of the American Board of Fluency and Fluency Disorders (ABFFD) via email regarding their current perceptions and clinical practice patterns with individuals with neurogenic and psychogenic stuttering. Participants reported using a battery of assessments and a variety of treatment approaches to diagnose neurogenic and psychogenic stuttering in addition to traditional fluency assessments and fluency enhancing techniques. Participants rated themselves as having more knowledge and experience with neurogenic stuttering than psychogenic stuttering. …

Educational Professionals' Current Knowledge Of Concussions And Return To Learn Implementation Practice, Michelle Kuzma

Online Theses and Dissertations

Purpose of Project: The purpose of this study was to determine the knowledge level and return-to-learn concussion management guidelines for secondary school educational professionals.

Methods: Surveys were distributed to 1,334 middle and high school educational professionals. Surveys included questions regarding basic demographics, teaching and coaching experience, personal concussion experiences, general concussion knowledge, and knowledge of return-to-learn guidelines. Results: Survey response rate was 15.7% (N=210). The mean teaching experience was 13.9±8.6yr and 46.4% had previous or current coaching experience. Overall 25.8% of respondents had taken a class/clinic on concussion recognition. Of those that coached, only 49.0% took a class on concussion …

Effectiveness Of Visual-Based Safety Training Compared With Non-Visual Based Safety Training In The Meat Processing Industry For Non-English Speaking, Hispanic Employees, Erika K. Rinehart

Online Theses and Dissertations

The purpose of this research was to identify whether visual-based safety training for non-English, Spanish speaking employees in the meat industry is more effective than non-visual training. The literature review included in this thesis studies the known barriers to training Hispanic workers, the existing training methods out there for safety training, and the best forms of safety training for non-English, Spanish speaking workers.

The methodology in this research evaluated the effectiveness of visual-based training versus a non-visual training for non-English, Spanish speaking employees in the meat industry. Two training sessions with a total of 30 volunteers was organized in order …

The Role Of Speech-Language Pathologists In Swallowing Treatment Of Individuals With Hiv/Aids, Sarah Lynn Warner

Online Theses and Dissertations

The role of speech-language pathologists (SLPs) in the assessment and treatment of dysphagia in individuals living with HIV/AIDS is relatively absent from the literature. Dysphagia is described as difficulty swallowing that can be caused by oral indicators, structural dysfunction, and neurological disease (Bladon & Ross, 2007; Bobba et al., 2007; Nkuize et al., 2010). Dysphagia is a prevalent symptom secondary to the HIV/AIDS virus, yet dysphagia in the HIV/AIDS population often goes untreated (Bladon & Ross, 2007). One way to improve assessment and treatment of dysphagia is to ensure medical professionals are knowledgeable of the communication and swallowing disorders that …

The Effect Of Antibiotics On Pseudomonas Aeruginosa Biofilm Production, Courtney Paige Turpin

Online Theses and Dissertations

Antibiotic-resistant bacteria have become an increasing burden worldwide. A highly resistant species is Pseudomonas aeruginosa, a nosocomial pathogen that produces a biofilm that enhances its resistance. This project examined the possibility of using bacteriocin, an internal protective toxin produced by some species of bacteria, as a potential treatment for resistant bacteria. In this study, standard broad spectrum antibiotics were used to treat P. aeruginosa to prevent biofilm formation. The biofilm was then analyzed to determine if the biofilm is inhibited or facilitated by each treatment. Optimal concentrations of antibiotics were determined to be effective at a concentration of 0.07mg/mL for …

Effects Of A Six-Week Functional Training Program On Fitness And Body Composition Of Fire Science Majors, Kristen Anne Lebrun

Online Theses and Dissertations

Introduction: The leading cause of on duty death of firefighters is sudden cardiac events. Current research has shown the effects of fire physical training programs on firefighters, but has not researched fire specific physical training programs for the fire science major population. Purpose: The purpose of this study was to examine the effects of a six-week functional program on fitness and body composition of fire science majors. Methods: Fire science college students (N = 16) volunteered to take part in a six-week fire specific fitness program. The subjects that fully completed the study (N = 12) were randomly assigned to …

Behavior Based Safety And The Multi-Generational Workforce, Edward Paul Grzybowski

Online Theses and Dissertations

Generational differences of Baby Boomers, Generation X, and Millennials regarding their acceptance of feedback and observations were studied in order to determine if different approaches to each were needed in order to effectively implement a Behavior Based Safety program within a specific company. The study found that there was a greater difference between generations regarding observations than on other domains. The results suggest that additional research should be undertaken in order to extrapolate the findings to a larger population.

Characterization Of Contaminants On Firefighter"S Protective Equipment A Firefighter's Potential Exposure To Heavy Metals During A Structure Fire, Donald F. Gagas

Online Theses and Dissertations

This research measured heavy metals, specifically cadmium, chromium, copper, and lead, on the surface of the firefighters bunker gear. Despite the fact that many studies have been conducted regarding the presence of organics in smoke emissions from structure fires, very few studies have investigated the extent of heavy metal emissions found during a structure fire. Using a wipe test procedure samples were collected from firefighters following a structure fire and analyzed for metals. Three locations on the bunker gear were used, the knee, elbow, and chest areas. The results showed that varying amounts of cadmium, chromium, copper and lead adhere …

The Experiences Of Occupational Therapists Working On Interprofessional Primary Health Care Teams: A Case Study., Emma Blake Mcclellan

Online Theses and Dissertations

The aim of this research was to provide evidence on the integration of occupational therapy (OT) intervention in primary care from the perspective of OTs. Typical services provided, experience with team members, and the identified value of OT in primary health care was explored. OT possesses the expertise and skill set to address the most common chronic conditions that primary care providers treat by entry level educational preparation. OT services are based upon a holistic view of individuals creating an affective skill set to participate in and coordinate health care delivery for the client. Currently limited evidence is available to …

A Qualitative Exploration Of Firefighter Participation In Wellness Programs Within A Career Fire Department In Northern Ohio, Conner O'Halloran

Online Theses and Dissertations

Firefighters respond to dangerous emergencies every day. The physical and mental wellness of firefighters is very important to their overall job performance. To support this, fire departments must have established, comprehensive wellness programs (International Association of Firefighters, 2008). Even with national standard recommendation of wellness programs, one does not exist in a fire department located in Northern Ohio.

The focus of this research is to explore reasons why these highly recommended wellness programs are not established. Successful establishment of a wellness program requires understanding why this fire department is hesitant or unsuccessful in implementing and maintaining a wellness program.

This …

Individuals Who Self Identify As Artists But Work In A Different Career: A Cross Case Analysis, Kelly Lee Price

Online Theses and Dissertations

The purpose of this study was to examine, from their individual perspective, the identity of individuals who self-identify as an artist but work in other careers. The research objectives of this study included: exploring the possible sense of occupational imbalance in an individual’s self-identity, exploring the personal identity of individuals who perceive themselves as artists but work at a different career, and explaining the relationships between art and self-identity including life balance, work ethic, and education. This research was based in an occupational science viewpoint, in that it looked at how occupations help to define life meaning, purpose, and identity. …

Elaborating Borderline And Psychopathic Personality With The Computerized Adaptive Test Of Personality Disorder In A Female Correctional Sample, Chelsea Sleep

Online Theses and Dissertations

Most of what we know about Psychopathic Personality Disorder (PPD) is based upon research with males. Considerably less research has examined female manifestations of the construct, however, some research suggests that Borderline Personality Disorder (BPD) may represent a female phenotypic expression of PPD, particularly among incarcerated offenders. The current study examined distinction and convergence between PPD and BPD. Utilizing a sample of 146 female correctional inmates as well as 109 female college students, the current study employed the Computerized Adaptive Test of Personality Disorder (CAT-PD) as well as other specific indices to explore the extent to which these two personality …

The Current Status Of Safety In High School Chemical Laboratories In Kentucky, Ahmed Rashed Alyammahi

Online Theses and Dissertations

This project is construed as a follow-up of the study conducted by Dr. Jack Gerlovich and his team to assess the status of science safety in Kentucky high schools in 2003-2004. The current study gathered online responses to an expanded survey from 57 high school chemistry teachers in Kentucky. The survey was developed to find answers to four main questions: What is the current status of safety in high school chemical laboratory in Kentucky? To what extent has this status improved or deteriorated since the creation and publication of the Total Science Safety-The Kentucky Edition CD in 2003? What are …