Medicine and Health Sciences Commons^™

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 …

Evaluating A High School Mrsa Prevention Program: A Case Study, Jamie Henning

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

MRSA poses a significant health risk to athletes nationwide. This case study examines the application of an online training module to address knowledge gaps regarding Methicillin-resistant Staphylococcus aureus (MRSA) among key decision-makers for high school athletes. It reviews the development and initial evaluation of a web-based training program designed to empower decision-makers with the knowledge to prevent MRSA infection and respond to suspected cases. Program evaluation recommended expanding the training module to wrestling staff with improved evaluation methods while continuing implementation and effectiveness assessment for the football staff. Despite initial data quality limitations, the online training module evaluation offered valuable …

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 …

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 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 …

Implementation Of Unit-Based Preceptor Orientation: The Effects On Perceived Orientee Competence And Self-Confidence Of The Precepting Cvicu Nurse, Laura K. Marcum

DNP Projects

Purpose: The purpose of this study was to assess how unit-specific preceptor training impacted the perceived readiness of new graduate nurses, self-confidence of preceptors, and the correlated job satisfaction.

Background: The nurse attrition rate is resulting in inexperience at the bedside. Nursing inexperience leads to lower quality patient care. If improving the efficiency of training and education can improve perceived readiness, then in turn we can increase the longevity of our new nurses. Improving the longevity of nurses has significant implications on the budget of each hospital, the patient outcomes, and the staff’s resulting job satisfaction.

Methods: New graduate nurse …

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 …

A Case Study In Program Evaluation, Kayla Shepherd

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

A program evaluation of a case study presented by the College of Public Health. This case study included a fictitious MRSA outbreak at a Kentucky high school football camp and the response of the Fayette County Public School System (FCPS) and the Lexington-Fayette County Health Department (LFCHD). Using the Centers for Disease Control and Prevention's Framework for Program Evaluation, I evaluated the Educational Infectious Disease Program designed by the FCPS and LFCHD. I provided recommendations to help improve the success of the program.

A Case Study In Program Evaluation: Evaluation Of A Mrsa Education Program, Kangai Miriti

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Program evaluations provide a deeper understanding of program components to promote effective program implementation. This evaluation follows the CDC’s 6-step Framework for Program Evaluation in Public Health to evaluate a MRSA education program. This evaluation has been prepared to be presented to the Lexington- Fayette County Health Department.

A Case Study In Evaluation, Laura Nagle

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Lexington – Fayette County Health Department is proposing a comprehensive evaluation of programming focused on preventing MRSA infections among high school athletes within Fayette County Public Schools. This document describes the recommended evaluation process.

Program Evaluation Case Study: Infectious Disease Reporting Training Program Evaluation, Emily Sekkath Veedu

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Lexington-Fayette County Health Department (LFCHD) has developed an educational program aimed at Fayette County Public Schools (FCPS) health and athletics staff members to ensure timely reporting and action in the event of an infectious disease outbreak (4). The program was implemented after a methicillin-resistant staphylococcus aureus (MRSA) outbreak occurred in a Kentucky community, with a high school football team presenting several of the cases (4). It was noted by a school nurse that many people attending an informational session lacked knowledge regarding infection control, suggesting a need for intervention in this community. I have evaluated this program in the …

A Case Study In Program Evaluation, Alyssa Osborne

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

As a result of a Methicillin-Resistant Staphylococcus Aureus (MRSA) outbreak at a local high school, the Lexington Fayette County Health Department (LFCHD) has been tasked with developing a program to ensure timely reporting of actions taken in the event of a MRSA outbreak or disease outbreak of similar nature (1). This program evaluation is guided by the CDC’s 6-step program evaluation framework (2), which was used to inform this assessment.

Adverse Outcomes Of Co-Occurring Methamphetamine And Opioid Use Among Pregnant And Postpartum Women, Hope Tevis

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

Overdose mortality rates increased significantly between 2018 and 2021 in the United States (NIH, 2023). Moreover, pregnant and postpartum women (PPW), who were aged 35 to 44 were observed to have the highest overdose mortality rates (NIH, 2023). Although there is existing research that examines the increase of co-occurring opioid and methamphetamine use, it still remains understudied when specifically focusing on PPW. This analysis intends to explore this gap in research by 1) exploring the history of co-occurring methamphetamine and opioid use among PPW who were seeking residential treatment, 2) highlighting the adverse health outcomes that follow co-use among …

A Case Study In Program Evaluation, Sierra L. Williams

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Lexington-Fayette County Health Department (LFCHD) developed an education program targeted toward infectious disease outbreaks. The program ensures timely reporting and action during an infectious disease outbreak within the Fayette County Public Schools (FCPS) system. I have been tasked with evaluating the program and its implementation of training modules through pre and post-surveys to determine if the program is significantly increasing the overall knowledge of program participants and make recommendations for how program aspects can be improved.

Team Up Against Overdose Deaths, Mary Elizabeth Pendergrass

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This grant proposal describes a community collaboration strategy for reducing overdose deaths. Utilizing a Community Advisory Board, the goal of the project is to increase awareness, knowledge, and usage of the Good Samaritan Law to obtain emergency medical care.

Machine Learning Framework For Real-World Electronic Health Records Regarding Missingness, Interpretability, And Fairness, Jing Lucas Liu

Theses and Dissertations--Computer Science

Machine learning (ML) and deep learning (DL) techniques have shown promising results in healthcare applications using Electronic Health Records (EHRs) data. However, their adoption in real-world healthcare settings is hindered by three major challenges. Firstly, real-world EHR data typically contains numerous missing values. Secondly, traditional ML/DL models are typically considered black-boxes, whereas interpretability is required for real-world healthcare applications. Finally, differences in data distributions may lead to unfairness and performance disparities, particularly in subpopulations.

This dissertation proposes methods to address missing data, interpretability, and fairness issues. The first work proposes an ensemble prediction framework for EHR data with large missing …

Sex Differences In Cardiometabolic Risk Factors In Youth With Obesity, Lucrecia Valdez

Theses and Dissertations--Nutrition and Food Systems

Background: The prevalence of hypertension in children and adolescents is rising, with 13% having elevated blood pressure and 5% having hypertension. Sex differences play a role in cardiovascular diseases in adults but are not well defined in youth. The objective of this study is to identify sex differences in obesity-mediated cardiometabolic risk factors in adolescents. Methods: This is a pilot study of n=82 youth with obesity recruited from a High BMI Clinic. Clinical data and blood samples were collected at a single time point. Serum sterols were quantified via LC-MS/MS. Number of cardiometabolic risk factors were evaluated. Data are mean …

Association Of Diabetes Prevalence With Labor Force Participation Rates In Kentucky Counties, Ryan Montgomery

MPA/MPP/MPFM Capstone Projects

Compared to other states in the USA, Kentucky has one of the highest rates of diagnosed diabetes and one of the lowest levels of labor force participation. This project employs a multivariable linear regression model to estimate the correlation between county-level diabetes prevalence and county-level labor force participation rates in Kentucky counties from 2015-2019, using publicly available data from the Centers for Disease Control’s Behavioral Risk Factor Surveillance System (BRFSS) and the U.S. Census Bureau’s American Community Survey (ACS). Labor force participation rates serve as the dependent variable and diabetes prevalence rates serve as the primary independent variable, alongside nine …

Improving Radiotherapy Workflow: Evaluation And Implementation Of Deep Learning Auto-Segmentation In A Multi-User Environment, And Development Of Automatic Contour Quality Assurance System, Jingwei Duan

Theses and Dissertations--Radiation Medicine

Radiotherapy is a frequently used therapeutic modality for cancer patients. Accurately contouring of tumors and organs at risk (OARs) is critical for developing optimal treatment plans in radiotherapy, especially after the implementation of Intensity-modulated radiation therapy (IMRT) and Stereotactic Body Radiation Therapy (SBRT). The manual contouring process is time-consuming and suffers from inter-observer variations. However, manual contouring is often hindered by laborious clinical duties, leading to reduced effectiveness, and increased segmentation errors due to fatigue. Additionally, online adaptive radiation therapy(ART), which has been shown to benefit patient outcomes, places higher demands on contouring and quality assurance (QA) speed.

Recently, deep …

Assessment Of The Interplay Between Regional Β-Amyloid Burden And White Matter Hyperintensities On Cognition And Default Mode Network In Clinically Normal Older Participants, Doaa G. Ali

Theses and Dissertations--Clinical and Translational Science

Objective: Alzheimer’s disease (AD) and subcortical vascular dementia are considered the most common pathologic contributors to dementia in the aging population. Both frequently coexist in over 80% of community dwelling adults with dementia. The neuropathological development of AD arguably begins with β-amyloid (Aβ) deposition in the brain. This series of studies aims to test the hypothesis that early focal regional amyloid deposition in the brain is associated with cognitive performance in specific cognitive domain scores in preclinical AD (pAD) (study1). Since mixed dementia is widely recognized as the norm rather than the exception, the second study aimed to explore the …

Examining A Blood Biomarker Approach To Blood-Brain Barrier Disruption, Samantha Ford

Theses and Dissertations--Medical Sciences

Blood-brain barrier disruption has been identified to associate with the pathogenesis several neurological diseases such as dementia [1, 2], multiple sclerosis[3, 4], acute or chronic cerebral ischemia[5], brain trauma[5], meningitis[5], encephalitis[5], stroke[6], and seizures[7]. Being able to effectively identify blood-brain barrier disruption is limited in methodology. The current standard is using a cerebrospinal fluid (CSF) albumin to serum albumin index, which requires the use of a lumbar puncture. A novel method of identifying blood-brain barrier disruption utilizing blood biomarkers is proposed in this study. Participants in this study had previously collected blood and CSF samples, which were analyzed to compare …

The Development And Characterization Of Nanobodies Specific To Protein Tyrosine Phosphatase 4a3 (Ptp4a3/Prl-3) To Dissect And Target Its Role In Cancer., Caroline Smith

Theses and Dissertations--Molecular and Cellular Biochemistry

Protein Tyrosine Phosphatase 4A3 (PTP4A3 or PRL-3) is an oncogenic dual-specificity phosphatase that drives tumor metastasis, promotes cancer cell survival, and is correlated with poor patient prognosis in a variety of solid tumors and leukemias. The mechanisms that drive PRL-3’s oncogenic functions are not well understood, in part due to a lack of research tools available to study this protein. The development of such tools has proven difficult, as the PRL family is ~80% homologous and the PRL catalytic binding pocket is shallow and hydrophobic. Currently available small molecules do not exhibit binding specificity for PRL-3 over PRL family members, …

Examining The Effects Of Hyperglycemia On Retinal Regeneration, Emmanuella Ec Kyllians

Theses and Dissertations--Biology

Diabetes is a disease that affects how the body processes glucose, leading to a cascade of other complications, one of which is diabetic retinopathy (DR). DR is a neurovascular disease that affects the retina and research has revealed the role of retinal neurodegeneration in its development. Animal models like zebrafish have emerged as important tools for studying the molecular and cellular mechanisms underlying DR. On the other hand, retinitis pigmentosa (RP) is a degenerative disease that involves the progressive degeneration of rods and cones, and hyperglycemia has been found to impair regeneration. Therefore, this study aims to examine the effects …

Enhancing Dna-Damaging Therapy Through The Inhibition Of Dntp Synthesis Using A Synergistic Drug Combination To Treat Pancreatic Neuroendocrine Neoplasms, Jennifer Castle Md

Theses and Dissertations--Clinical and Translational Science

Despite clinical advances, pancreatic neuroendocrine neoplasms (pNEN) remain a difficult clinical entity to treat and can carry a poor prognosis. Systemic therapy is used to treat pNENs which are not amenable to surgical resection. Peptide receptor radionuclide therapy, a form of radiation therapy (RT) and cisplatin are two different forms of DNA-damaging therapy in current use to treat pNENs. However, their efficacy remains poor as single agents. This study aimed to increase the sensitivity of pNENs to the DNA-damaging agents, RT and cisplatin, by inhibiting deoxynucleotide triphosphate (dNTP) synthesis. Triapine, a ribonucleotide reductase inhibitor (RNRi), and ataxia telangiectasia and Rad3-related …

Ideal Body Weight And Body Fat Percentage Predict Relative Energy Deficiency In Sport (Red-S) Scores In Collegiate Athletes, Emily Norman

Theses and Dissertations--Nutrition and Food Systems

Background: Low energy availability (LEA) is the underlying cause of Relative Energy Deficiency in Sport (RED-S) which negatively affects athletes' physiological function, health, and performance. RED-S results from inadequate dietary intake to support energy expenditure for daily living, growth, and optimal performance. It occurs in both male and female athletes, with or without disordered eating. However, screening and diagnosis in athletes can be difficult. Objective: This study aims to identify strong predictors of RED-S and assess its prevalence in collegiate male and female athletes. Methods: A total of 270 NCAA athlete test points from mixed sports were evaluated for RED-S …

The Influence Of Apoe Genotype On Lipid Droplet Dynamics, Cassi Friday

Theses and Dissertations--Physiology

Excess lipid droplet (LD) accumulation is associated with several pathological states, including neurodegenerative disorders such as Alzheimer’s disease (AD). However, the mechanism(s) by which changes in LD composition and dynamics may contribute to the pathophysiology of AD remains unclear. Apolipoprotein E (ApoE) is a droplet-related protein with a common variant (ApoE4) that confers the largest increase in genetic risk for late-onset AD. Interestingly, ApoE4 is associated with both increased neuroinflammation and excess LD accumulation. This dissertation work seeks to quantitatively profile the lipid and protein composition of LDs between the ‘neutral’ ApoE3 and ‘risk’ ApoE4 isoforms, in order to gain …