Examining Psychological And Knowledge Barriers To Colorectal Cancer Screening In Rural Appalachian Kentucky, Caroline Jenkins, Matthew Rutledge, Lauren Hudson, Nathan L. Vanderford, Nancy Schoenberg

Markey Cancer Center Faculty Publications

While recent rates of colorectal cancer (CRC) screening have improved in Appalachian Kentucky due to public health efforts, they remain lower compared to both KY as a whole, and the USA. Suboptimal screening rates represent a missed opportunity to engage in early detection and prevention. The purpose of this study is to determine the impact that lack of knowledge has on psychological barriers (e.g., fear and embarrassment) to CRC screening as well as the potential effect of a psychosocial intervention to reduce these barriers. Participants were recruited through faith-based organizations and other community sites. After randomizing participants to either an …

Caring For Ourselves Before We Care For Others: A Mindfulness-Based Intervention For Acute Care Nursing Staff, Kent Brouwer

DNP Projects

Background: Acute care nursing staff have recently faced increasing rates of anxiety, stress, emotional exhaustion, and burnout. Nursing burnout is directly linked to patient outcomes, nurse retention, and the resilience of our nurses. Therefore, it is in the best interest of hospital organizations to focus efforts on the well-being of the nursing workforce. A recent innovative technology to prevent burnout teaches mindfulness through the utilization of smartphone applications. There is limited evidence regarding the implementation and impact of brief mindfulness interventions on intra-professional acute care providers.

Methods: A pretest-posttest design with a midpoint evaluation was utilized in this pilot study. …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

The Effect Of An Educational Intervention On Attitudes Toward Behavioral Health Patients Among Medical Floor Nurses: A Pilot Study, Caroline C. Bowman

DNP Projects

Background: Stigma towards behavioral health patients by healthcare workers can create barriers to quality care for patients. Addressing these negative attitudes towards behavioral health patients can improve health outcomes and reduce healthcare costs. Current evidence-based practice for tackling stigmatizing attitudes include interventions to improve mental health education among healthcare providers to promote improved patient outcomes.

Purpose: The goal of this project was to enhance medical floor nurses' attitudes toward behavioral health patients by delivering a web-based educational intervention on recognition and management of behavioral health disorders. The aims of the project were to: 1.) Assess nurses' stigma toward behavioral health …

Exploring Palliative Care Education Needs And Desires Of Advanced Practice Providers In The Critical Care Setting, Jill Marie Clemmons

DNP Projects

Background: Critical care providers in the ICU setting are discovering that their patients are living longer with more comorbid conditions. They are confronted with palliative care situations almost daily. Recently palliative care has been thrust into the forefront of critical care and is a resource critical care nurse practitioners and physicians’ assistants need to be able to utilize. A gap in the literature has been found in the overall education of critical care providers regarding palliative care.

Purpose: The purpose of this study was to determine what palliative care training trauma/cardiac/neurological, and pulmonary critical care providers had previously received …

Effects Of Tailored Colorectal Cancer Patient Education On Colorectal Cancer Screening Rates In An Urban Kentucky Clinic, Brittany Pittman Hardcorn

DNP Projects

Background: Colorectal cancer (CRC) is one of the leading causes of death among Americans and Kentuckians. Most colorectal cancers are slow-growing, making regular colorectal cancer screening increasingly important to decrease morbidity and mortality. Although of this importance, there is low screening rates. Thus, the need to explore all colorectal screening options.

Purpose: The purpose of this project was to increase the number of patients screened for colorectal cancer by providing education on colorectal cancer and screening options in a primary care setting.

Methods: The design of the study was a 2 group quasi-experimental practice improvement project using a post-test educational …

Effectiveness Of A Web-Based Smoking Cessation Training Program For Health Care Professionals Within An Acute Psychiatric Facility, Allie Carmichael

DNP Projects

Background: Tobacco use is the leading preventable cause of death and disease in the United States, with the prevalence remaining especially high among people with mental illness. Mental health providers often lack training in smoking cessation and feel uncomfortable addressing the issue with this patient population. Studies show that educational training offered to providers can lead to increased knowledge that improves the provider’s confidence and attitude about delivering smoking cessation treatment to patients. Mental health professionals must receive training on smoking cessation treatment modalities so they can effectively provide holistic care needed for recovery for patients with mental illness.

Purpose …

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

Effectiveness Of Substance Use Disorder Education On Knowledge And Attitudes Among Entry-Level Obstetric Nurses, Kathryn Hughes

DNP Projects

Background: Substance use disorder (SUD) among pregnant women is a significant public health concern in the United States, particularly in Kentucky. Nursing curriculum has not kept pace with the escalating public health crisis regarding SUD. Graduating nurses joining the obstetric field are often not prepared to meet the unique care needs of this vulnerable population.

Purpose: The purpose of this DNP project was to pilot an educational intervention embedded with content regarding SUD with entry-level obstetric nurses that were enrolled in the nurse residency program at UK HealthCare.

Methods: This project used a quasi-experimental pretest – posttest design. Participants completed …

Evaluation Of Dyad Effectiveness In A Psychiatric Healthcare Facility, Elizabeth Smith

DNP Projects

Background: Inadequate communication can lead to poor quality of care and patient outcomes. Physician-nurse dyad partnerships have been shown to increase effective communication but there is a lack of data to show the impact these dyads have on dyad members’ perceptions about patient safety, work engagement and quality patient outcome measures.

Purpose: This purpose of this project was to determine if a physician-nurse dyad structure in an inpatient psychiatric hospital would lead to improved participant perception about patient safety, work engagement, and patient quality outcomes.

Methods: A quasi-experimental pretest-posttest design was used. Participant perceptions related to patient safety, work engagement, …

The Effect Of An Educational Intervention On Clinical Rn Knowledge And Attitudes Toward Shared Governance Program At Eastern State Hospital, Tanna Mckinney

DNP Projects

Background: Shared governance programs are a popular way to improve Registered Nurse (RN) engagement and retention. These programs are notoriously difficult to garner and maintain participation. However, successful shared governance can improve patient outcomes, patient satisfaction and RN engagement.

Conceptual Framework: The theory of planned behavior was used as the conceptual framework for this study. This theory posits that attitudes, subjective norms, perceived behavioral control and intentions towards a behavior can predict behavioral achievement.

Methodology: Eighty clinical registered nurses were invited to voluntarily complete a survey to determine current attitudes about shared governance and intent to participate in shared governance …

Implementation Of Education And Use Of A Screening Tool To Assess Palliative Care Needs In The Critical Care Setting, Megan Stoeckinger

DNP Projects

Purpose: The purpose of this study was to measure palliative care knowledge, attitudes, perceived empowerment, and familiarity of the Supportive Palliative Care Indicators Tool (SPICT) among critical care nurses and advanced practice providers (APPs) before and after viewing a web-based educational video on an adult medicine intensive care unit (MICU).

Methods: This study was a one group pre- and post- implementation assessment using a web-based educational video and electronic surveys. The population included critical care nurses and advanced practice providers (APPs). This study spanned the timeframe between January 2022 and March 2022.

Results: Paired t-tests comparing pre-intervention …

Evaluation Of A Beverage Educational Intervention For Latino Parents Of Infants And Children Ages Nine Months To Five Years, Natalie Chelf

DNP Projects

Background: The Latino population has the highest rate of childhood obesity in the United States. Sugar-sweetened beverage (SSB) consumption has a positive correlation with increased rates of childhood obesity. Current research shows a deficit in culturally sensitive methods to reduce SSB consumption in the pediatric Latino population.

Purpose: The purpose of this project is to empower parents of Latino infants and young children with the knowledge to reduce or eliminate the consumption of SSBs in their child’s diet.

Methods: The project was a one group pre-test post-test quasi-experimental study design occurring in one pediatric outpatient clinic. The Information-Motivation-Behavioral Skills (IMB) …

Evaluation Of A Process Change On Mammography Screening Rates In A Family And Community Medicine Clinic, Christina Rademaker

DNP Projects

Abstract

Background and Significance: Breast cancer is the 2^nd leading cause of cancer death among women worldwide. Mammography is a screening approach used in the detection of breast cancer and proven to help reduce mortality. Only 72.8% of eligible American women have been screened for breast cancer within the past 2 years. One urban family and community medicine clinic (FCM) fell below the national average with a rate of 60.9%; as a result, they implemented an evidence-based strategy to improve mammography rates within the clinic.

Purpose: The purpose of this study was to evaluate the implementation of a telephone …

Improving Pediatric Providers’ Intent For Safe Sleep Anticipatory Guidance With An Electronic Educational Intervention, Lindsay Hamilton

DNP Projects

Background: Sudden Infant Death Syndrome or SIDS is the fourth leading cause of infant mortality in the United States. There is no definitive cause of death pertaining to SIDS, but certain risk factors have been identified that increase the risk of SIDS in an infant. While safe-sleep education during the prenatal time of parenthood is important, it is also essential to continue this education comprehensively in the primary care setting and in any other exposure the family has to healthcare.

Objective: The objective of this study is to evaluate the self-reported knowledge of University of Kentucky Children’s Hospital Pediatric Residents’, …

Improving Smoking History Screening And Documentation To Increase Lung Cancer Screenings In Primary Care Clinics, Destinee R. Rein

DNP Projects

BACKGROUND: In the United States, lung cancer has the highest mortality rate of all other cancers among men and women. Kentucky is ranked 50th among all states, leading the nation in new lung cancer cases each year. Lung cancer screening using Low dose Computed Tomography (LDCT) can reduce lung cancer-related morbidity and mortality. Lack of smoking history documentation to identify eligible patients is a major contributing factor to low national screening rates. Obtaining complete smoking history remains the most important technique in identifying candidates for lung cancer screening.

PURPOSE: The purpose of this quality improvement project was to evaluate …

The Impact Of Icu Telemedicine On Patient Outcomes In The Surgical Critical Care Setting: An Observational Study, Megan Steely

DNP Projects

Abstract

Background: In April 2020, the University of Kentucky (UK) implemented a division entitled the Enhanced Care through Advanced Technology Intensive Care Unit (eCAT ICU) to provide tele-critical care (TCC) services in all critical care areas at UK Healthcare. The eCAT ICU at UK HealthCare was the first TCC delivery system of its kind in the state of Kentucky. Use of TCC has been associated with improved patient outcomes and decreased costs.

Purpose: The purpose of this study was to analyze targeted outcomes in the surgical critical care population pre- and post-implementation of TCC at UK HealthCare. Specifically, the aims …

Effects Of An Educational Module On Perceived Knowledge, Perceived Barriers, And Attitudes Related To Sleep-Promoting Practices Among Bedside Nursing Staff Within A Medical Intensive Care Unit, Arden Gross

DNP Projects

Background: Adult patients in the critical care setting are at risk for experiencing sleep disruption due to critical illness and environmental factors. The effects of disruption to the sleep/wake cycle has been associated with dysregulation of biological processes such as healing and immune system functioning. Current literature includes the use of sleep-promoting protocols that aim to reduce environmental disruptors of sleep in the critical care setting. However, there is a disconnect between the perceived importance of sleep and clinical practice. Additionally, there is a gap in literature exploring the effects of educational-modalities on nursing staff knowledge, perceptions, and attitudes related …

The Effect Of A Web-Based Training On Suicide Knowledge, Attitudes, And Health Access Behaviors Of Behavioral Health Nurses Regarding Suicide Prevention, Marc Woods

DNP Projects

Background: Nurses, critical to the health care delivery system, experience a variety of psychological stressors that predispose them to suicide risk. Recent studies have verified elevated suicide risks in nurses when compared to the general population. There is limited understanding regarding the effectiveness of various strategies to reduce risk factors and increase protective factors for suicide among nurses.

Purpose: The purpose of this study was to evaluate if a web-based education module can improve the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in behavioral health nurses.

Conceptual Framework: Ajzen’s theory of …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

Addressing The Inpatient Penicillin Allergy: Implementing A Nurse-Driven Allergy Assessment Tool To Enhance Antimicrobial Stewardship., Shelby Ryan Bliss

DNP Projects

Background: In an acute care setting, more than half the inpatient population receives antibiotics. Approximately 10% of the general population reports an allergy to penicillin. It has been replicated in the literature with data that of those who report a penicillin allergy, up to 95% are incorrectly identified. When a patient is admitted to the hospital with a penicillin allergy on their electronic health record, they are at higher risk for adverse events such as a hospital acquired infection, the occurrence of an antibiotic resistant bacteria related to receiving broader therapy and increased healthcare utilization.

Purpose: The purpose of this …

Using The Samscore Questionnaire To Increase Skin Cancer Risk Screenings At Adult Patient Annual Exams, Taylor Abner

DNP Projects

Background: Malignant melanoma has become an increasingly prevalent problem in the United States. The earlier a skin cancer is identified, the better the outcome. There are conflicting recommendations about screening for skin cancer but in general identifying high risk patients is important and it is not being achieved in primary care.

Purpose: The purpose of this study is to evaluate use of the SAMScore Questionnaire to determine high risk patients at adult annual visits.

Methods: This was a multi-phased study with a quasi-experimental design that took take place at a family and community primary care clinic in central Kentucky. Baseline …

Screening For Severe Mental Illness In A Correctional Setting Using The Brief Jail Mental Health Screening Tool, Stephanie Kohl

DNP Projects

Abstract

BACKGROUND: Prisoners who are detained in jails and detention centers have higher rates of Severe Mental Illness (SMI) compared to the general population. However, SMI is often unidentified in this population, largely due to lack of assessment using effective SMI screening tools and lack of knowledge among prison staff about the prevalence of SMI and the importance of identification in the correctional setting. Prisoners with SMI often act out violently against others and themselves. Current standard practice for SMI screening varies significantly across jails. Many jails use standard medical questionnaires which help obtain a brief medical history but often …

The Effect Of Education On The Nida Modified Assist (Nmassist) Tool On Knowledge And Screening For Substance Use Disorder Among Clinicians, Victoria Page Arnold

DNP Projects

Background: Substance use disorder (SUD) is a disparity affecting nearly 24 million individuals in the U.S., nearly 10% of the total population. Oftentimes, the emergency department (ED) is the only medical care this population receives. There is often a lack of screening for SUD in ED’s, therefore referred care may be limited for these individuals. The National Institute on Drug Abuse Modified Assist (NMASSIST) is an evidence-based tool developed to educate and screen for SUD. This tool can be completed in a timely manner and aid in the recommended referral of care for this select population.

Purpose: The purpose of …

A Multifaceted Approach To Improving Sedation Practices In The Cardiovascular Intensive Care Unit, Casey Mingua

DNP Projects

Purpose: Sedation protocols have been positively correlated with improved patient outcomes in the intensive care unit (ICU). Therefore, healthcare leaders should direct efforts to improving protocol compliance through evidence-based strategies. The purpose of this study was to evaluate the impact of a multifaceted intervention, consisting of educational outreach, point of care (POC) reminders, and audit and feedback (A&F), on nurse compliance with an ICU sedation protocol. A secondary data analysis was performed to evaluate the impact of the intervention on patient outcomes.

Methods: This was a before/after comparative analysis. A Research Electronic Data Capture (REDCap) pre-survey (n=58) was distributed to …

The Measurement Of The Impact Of Well-Being Resources On Moral Distress And Burnout Following The Covid-19 Pandemic In Front-Line Nurse Leaders, Benjamin Hughes

DNP Projects

Background: Due to the COVID-19 pandemic, there is significant burnout among front-line nursing staff. Little literature has been published about the measurement of burnout among front-line nursing leaders, such as nurse managers and directors, nor the interventions used to help with this ever-growing issue among this group. Since the pandemic began, there have been many resources identified to help front-line staff members with burnout, but none specifically looking at what has worked or been utilized by front-line nursing leaders.

Purpose: The purpose of this project was to describe what well-being resources were identified as being effective in decreasing moral distress …

Increasing Medicare Wellness Visit Participation In A Primary Care Clinic, Katherine Rodriguez-Guerrant

DNP Projects

Background: Medicare Wellness Visits (MWV) came into use in 2011 to provide Medicare patients and their providers a chance to create a 5 to 10 year plan to prevent illness, disease, and disability. These visits are often underutilized due to various barriers on both the provider and patient side.

Purpose: The purpose of this study is to assess provider barriers to conducting MWVs and provide an educational tool that will assist providers in increasing the number of MWVs conducted within this system.

Design: This is a descriptive, quasi-experimental study to assess provider barriers combined with a Quality improvement project that …

The Effect Of Relational Aggression Training On New Emergency Department Nurses, Mary Wethington

DNP Projects

BACKGROUND: Relational aggression (RA) in nursing is widespread. One group often at risk for exposure to RA is the newly licensed nurse. RA can lead to a negative work environment which can cause poor patient outcomes and high nurse turnover.

PURPOSE: The purpose of this study was to evaluate the effects of an educational program on RA in the emergency department with newly licensed registered nurses. This was conducted using one pre and two post surveys. The surveys evaluated the nurses’ knowledge of RA self-awareness before and six weeks after an educational session.

METHODS: This was a single-site, single-unit pretest …

Tobacco Use Screening And Cessation Counseling In Primary Care, Jacob A. Heil

DNP Projects

Abstract

BACKGROUND: Primary care providers (PCPs) are poised across healthcare settings to reduce the leading cause of preventable morbidity and mortality, cigarette smoking. However, their patients may not be screened for tobacco use and miss cessation counseling, thus increasing tobacco-related diseases, and incurring costs to healthcare payers.

PURPOSE: This project seeks to identify the documentation process in a new electronic health record (EHR), communicate efficacy barriers, administer an educational intervention regarding the new process for PCPs, and measure its impact on performance of tobacco use screening and cessation counseling.

METHODS: This project was a quasi-experimental, single center, pre- and post-interventional …

Activating The Patient: A Nurse Led Coaching Intervention To Engage Health Information Seeking Behaviors Using The Ideal Discharge Framework And Get Well Network, Korinne Callihan

DNP Projects

Background: Cardiovascular (CV) patients are often overwhelmed by the unexpected emergence of the health condition, volume of knowledge for self-care mastery and acceptance of the responsibility for self-care upon care transition to the home setting. Low health literacy levels have been linked to poor outcomes in CV patients, requiring investigation into appropriate methods for patient education. The Get Well Network (GWN), an interactive digital patient education care plan at UK HealthCare (UKHC), is underutilized in this patient population.

Purpose: the purpose of this study is to assess the effect of a nurse-to-patient coaching intervention using the IDEAL discharge framework from …