Medicine and Health Sciences Commons^™

Dedicated Vascular Access Team Benchmark Study, Rachel Davis

MSN Capstone Projects

Hospitals see a rise in the critically ill population. These patients present with multiple comorbidities resulting in frequent emergency department trips. Unfortunately, with each visit, these patients require a vascular access device. Over time their veins will no longer be easily accessible. Patients with veins that are no longer visible, palpable, or require special techniques to obtain access are considered to be difficult intravenous access (DIVA) patients. They will likely experience multiple attempts with each admission to the hospital, resulting in physical and emotional pain, not to mention being costly. The purpose of this paper is to compare the advantages …

Intraoperative Dexmedetomidine Administration Effects On Postoperative Pain Scores And Opioid Medication Requirements: Pain Management Expectations Among Crnas, Dorilynn Nicol, Melissa Gheen, Matthew Bodine

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

Abstract

Opioid pain medications are currently viewed as a standard part of pain control in the vast majority of surgical procedures. However, opioid pain medications can have harmful effects on patients leading to increased length of hospital stay, unplanned readmission, and contribution to relapse or development of opioid use disorder. An opportunity for improved practice of pain management lies within opioid alternative pain medications such as dexmedetomidine. Evidence-based literature reviews have shown that dexmedetomidine has promise as an analgesic medication within the perioperative period with fewer harmful side effects. Barriers to more widespread use of this medication include staff unfamiliarity …

A Qualitative Exploration Of The Use Of Service Dogs In Veterans With Post Traumatic Stress Disorder And Traumatic Brain Injury, Jennifer Shiroff, Kathy Gray, Gabrielle Santulli, Stephen Didonato, Jacqueline O'Rourke Fulford

College of Nursing Faculty Papers & Presentations

Objective

This qualitative research was conducted to add to the body of knowledge that supports the benefits of service dogs (SDs), as a tertiary treatment modality, to veterans with post‐traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI).

Methods

This grounded theory research design utilized open‐ended, semi‐structured interviews with veterans (n = 10) who were using SDs as a treatment modality for PTSD and/or TBI. Transcripts were analyzed using NVivo qualitative software until data saturation was achieved.

Results

Results from the data analysis identified 4 major themes with concurrent subthemes. The most prominent themes were functional status, impact of …

Women's Power In Hospital-Based Nursing: A Critical Qualitative Study, Kaitlyn C. George, Bret Lyman, Andy Pilarte Alcantara, Maya Stephenson

Faculty Publications

Aim: To understand the factors that affect power in hospital-based nursing and reveal how the female gender affects an individual's ability to feel empowered.

Design: Critical qualitative research design.

Method: Semi-structured interviews were conducted with nurses working in inpatient hospital settings in Utah and New Mexico. Data were collected from February to March 2022. Interviews were analysed using thematic analysis.

Results: Sixteen participants were interviewed. Six themes were identified from the data, four of which related to nurses' power at work, and two of which specifically related to how gender affects a nurse's ability to use power and feel empowered. …

Implementation Of The Generalized Anxiety Disorder 7-Item (Gad-7) Screening Tool In A Mental Health Outpatient Clinic, Ella Bosunglan Gang

Doctoral Dissertations and Projects

Purpose: The prevalent disorder known as generalized anxiety disorder (GAD) can have various negative consequences. GAD harms individuals, families, communities, and society as a whole. People with GAD frequently experience a crippling decrease in their physical and mental health. When generalized anxiety disorders are combined with the pressures of pre-existing medical conditions, the quality of life can be significantly impacted. GAD severely impairs social and functional functioning, resulting in frequent clinic appointments, doctor shopping, emergency room visits, high costs from family and employer treatment, and increased costs for global healthcare spending. Proper diagnosis is essential to effective treatment, and a …

Impacts Of Telemonitoring On Weight Obesity In African Americans, Miranda Bessem Mbutambe

Doctoral Dissertations and Projects

Obesity has become a complex public health issue among African Americans over the last few decades, due to the health risks it poses to this population. Obesity exposes African Americans to a variety of chronic diseases, including, but not limited to, diabetes and cardiovascular diseases. Owing to the complexity inherent in obesity, healthcare practitioners have developed various strategies and interventions to manage weight among vulnerable populations. In this regard, telemonitoring, a continuous or non-continuous process that allows medical practitioners to remotely monitor, collect, and interpret data necessary for medical follow-up and, if necessary, make medical decisions regarding the health state …

Best Strategies To Address Burnout Among Healthcare Professionals: An Integrative Review, Kimberly Ann Delbo

Doctoral Dissertations and Projects

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy …

Implementation Of A Medical Emergency Chain Of Command Protocol In The School Setting, Vikki Shannon Brannon

Doctoral Dissertations and Projects

Medical emergencies occur every day in school settings across America. School nurses have a vital role in providing care for individuals experiencing a medical emergency and leading a multidisciplinary team during a medical emergency event. Since incidences of medical emergencies are commonplace, it is standard to have protocols and guidelines for these events. To address this concern, an evidence-based practice project was implemented in a rural school district in North Georgia. The pilot project was developed and implemented to assess the effectiveness of implementing a “Medical Emergency Chain of Command Protocol.” The protocol was developed to improve the effectiveness and …

How Does The Use Of Telemonitoring In Adult Patients With Uncontrolled Hypertension Improve Blood Pressure Control? An Integrative Review, Lucie Bakop

Doctoral Dissertations and Projects

Hypertension is an evolving problem worldwide and it constitutes a great risk for cardiovascular diseases. Despite the research and new drugs on the market to manage high blood pressure, hypertension remains the leading cause of disability-adjusted life and death worldwide. With many people suffering from hypertension around the world, and the burden of uncontrolled hypertension, it is imperative to find an intervention that can improve blood pressure control. To better target uncontrolled hypertension, the conventional method of management of high blood pressure based on in-person visits has shown some limitations and it must be combined with a contemporary approach that …

The Importance Of Pediatric Provider Awareness Of Social Determinants Of Health And The Impact On Health Outcomes: An Integrative Review, Whitney Lenelle Dowd

Doctoral Dissertations and Projects

Social determinants of health have become a global concern over the past several years. Efforts to reduce negative health outcomes related to social determinants of health are of high priority. Awareness of this issue by providers, especially pediatric providers, must be considered to help combat this major concern. A researcher seeks through an integrative review to determine provider perspective on social determinants of health, impact of social determinants of health on outcomes, and ways of integrating social determinants into prescriptive practice. The integrative review will inform stakeholders about the importance of pediatric provider assessment of social determinants of health and …

Educating School Nurses To Improve Bowel Continence In Children With Spina Bifida, Mckinley J. Waugh, Tracy L. Brewer, Lisa Wagoner

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

Children born with spina bifida, a neural tube defect, can have associated loss of bowel control resulting in bowel incontinence. The National Patient Spina Bifida Registry found that 87% of those living with spina bifida had bowel incontinence, and less than 30% were bowel continent (Sawin et al., 2015; Wiener et al., 2017). Unfortunately, providers may never start a child living with spina bifida on a bowel management program. Evidence suggests that children with spina bifida should begin a bowel management program early, using a stepwise approach. School nurses, who interact with children living with spinal bifida while attending school, …

Integrating A Biblical Worldview In Nursing Practice, Hannah Malafy

Honors Senior Colloquium

The Christian of today has the weighty task of discerning biblical truth in the midst of widely varying perspectives on every matter imaginable—especially in the healthcare setting. This essay aims to bring clarity to this mission by outlining the basic content of a biblical worldview, the defining characteristics of the nursing profession, and how the Christian with a biblical worldview approaches two specific areas of contention within the nursing profession.

Adverse Childhood Experiences Screening Among Adults In An Inpatient Behavioral Health Unit, Erika Y. Bales, Allyson Neal, Brittany Mcgill

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

Adverse childhood experiences (ACEs) are common amongst people of all ages, races, and socio-economic statuses. The consequence of ACEs impact ones mental and physical health and life span. High ACE scores lead to increased risk of suicide, depression, anxiety, and substance abuse. The purpose of this project was to screen adults admitted to an inpatient psychiatric hospital for ACEs. This project sought to determine if there is a relationship between overall ACEs score and impact on health versus length of stay. Ultimately, the aim is to reduce negative health outcome for patients as measured by length of stay. The results …

Mental Health Benefits Of Physical Activity In Older Adults, Adrian Kurt Zitzmann

Master of Science in Nursing Family Nurse Practitioner

Physical activity is the fountain of youth, strengthening both the physical body as well as the mind, leading to better emotional stability and a general sense of well-being. The population over age 65 is nearing retirement age and are transitioning from a high paced work and family life to a slower and less active “empty nest” lifestyle. Among adults over age 65, will implementing an exercise program for 30 minutes per day increase mental well-being? The benefits of physical activity will be supported by gathering a group of older adults ages 65 and up from a local retirement community to …

Health Status And Preventive Health Services Among Reproductive-Aged Women In Treatment For Opioid Use Disorder, Vanessa Short, Dennis J. Hand, Lauren Pyfer, Hanna Steiger, Meghan Gannon, Gregory A. Jaffe, Diane J. Abatemarco

College of Nursing Faculty Papers & Presentations

OBJECTIVE: To assess the utilization of preventive health services and the prevalence of chronic health conditions among a cohort of women in treatment for opioid use disorder (OUD).

METHODS: Ninety-seven women who were receiving treatment for OUD from a single urban treatment program completed a self-administered anonymous online questionnaire that asked about demographics, health, receipt of preventive health services, and utilization of health care. Descriptive statistics were used to describe data.

RESULTS: More than one-third of respondents reported that their health was fair or poor, whereas one-quarter were very concerned with their health. Most participants (59%) reported at least one …

Feasibility Of A Mindfulness Education Module For Nurses: An Evidence-Based Practice Project, Executive Summary, Emily Looper, Palmer Gleason, Dr. Katherine Newnam

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

Nurse burnout is a well-defined problem that has been exacerbated by the COVID-19 pandemic and negatively affects nurses’ mental health, nursing shortages, patient safety, and quality of care. Evidence shows that mindfulness is an effective strategy for managing stress and decreasing burnout in nurses. This article describes an evidence-based practice project that translated this evidence into practice via a vetted mindfulness educational intervention for nurses in intensive care and acute care settings. The purpose of this project was to assess the feasibility of this educational intervention, processes, and outcomes with the goal to extend the project hospital-wide. Pre-intervention levels of …

The Mediating Effect Of Caregiving Relationship Quality On The Association Between Caregiving Stressors And Mental Health Problems Among Older Spousal Caregivers, Fei Wang, Elliane Irani

Faculty Scholarship

Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect =.14, p =.016). Moreover, role overload was positively associated with caregiver mental health problems, …

Socioeconomic Deprivation And Cardiometabolic Risk Factors In Individuals With Type 1 Diabetes: T1d Exchange Clinic Registry, Stephanie Griggs, Sadeer Al-Kindi, Heather Hardin, Elliane Irani, Sanjay Rajagopalan, Ronald L. Hickman Jr.

Faculty Scholarship

Aims: Social determinants of health (SDOH) influence cardiovascular health in the general population; however, the degree to which this occurs in individuals with type 1 diabetes (T1D) is not well understood. We evaluated associations among socioeconomic deprivation and cardiometabolic risk factors (hemoglobin A1c, low-density lipoprotein, blood pressure, body mass index, physical activity) in individuals with T1D from the T1D Clinic Exchange Registry. Methods: We evaluated the association between the social deprivation index (SDI) and cardiometabolic risk factors using multivariable and logistic regression among 18,754 participants ages 13 – 90 years (mean 29.2 ± 17) in the T1D Exchange clinic registry …

Telehealth Acceptance Among Appalachian Respondents During Covid 19: A Secondary Data Analysis, Victoria Hood-Wells, Florence M. Weierbach, Amy Wahlquist, Janet M. Keener, Manik Ahuja, Hadii M. Mamudu

ETSU Faculty Works

Purpose: The purpose of this study is to examine the relationship between telehealth use, telehealth satisfaction, and chronic medical conditions among residents living in Appalachian and non-Appalachian communities.

Sample: A COVID-19 public health survey was distributed via social media and healthcare clinics in the tri-state region of central Appalachia. Survey responses were limited to adults aged ≥18 years who consented to participate in the survey that self-identified as an individual with one or more chronic medical conditions (n=195).

Method: Simple descriptive statistics including frequencies, percentages, means, and standard deviations (SDs) were calculated for variables of interest both overall and by …

Hdl Cholesterol: Too Much Of A Good Thing? Cardiovascular, Elizabeth Moxley

Faculty Peer-Reviewed Publications

It is considered a well-established fact that high-density lipoprotein cholesterol (HDL-C) is a robust, inverse predictor of the risk of experiencing an atherosclerotic cardiovascular (ASCVD) event.[i] Whereas, low HDL-C characterizes an atherogenic dyslipidemia that reflects adverse lifestyle choices, impaired metabolism, and increased cardiovascular risk.[ii]

Developing Competence And Improving Patient Safety With Documentation Training In The Simulated Environment, Laura Zebreski

DNP Final Reports

With the advent of electronic health records, nursing documentation has declined in quality. Poor documentation exposes patients to safety risks. Nursing documentation is subject to legal standards set by the Texas State Board of Nursing. A DNP scholarly project was designed to create a learning and safety intervention to train student nurses to provide correct documentation before entering clinical settings. The goal of this project was to prepare nursing students to provide quality documentation that fulfills the legal standard to attempt to correct the current deficiencies seen in practice and promote patient safety. For this project, the students took a …

Innovating Cultural Competence Education For Nurses, Darian A. Frieson, Jennifer Patrick, Walker Ray Corless, Abigail Taylor Coulthard, Rebecca R. Fogerty

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

Objective

To improve cultural competency levels of registered nurses on the Mother/Baby unit by educating nurses.

Background

Demographics are shifting in the U.S. with an increase in minority populations. Research has revealed insufficient education or a complete absence of education, resulting in nurses that are not equipped to adequately care for culturally diverse patients.

Methods

The Evidence-Based Practice Improvement (EBPI) Model guided the development and implementation of the project. A cultural competence education module was developed utilizing resources from the U.S. Department of Health and Human Services. Outcomes were measured using a pretest/posttest design tool, the Inventory for Assessing the …

Births In The Mountain West, 2016-2020, Corryn Richardson, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines state-level data on births and health indicators from the National Center for Health Statistics (NCHS), a government health statistics unit of the Center for Disease Control and Prevention (CDC). This fact sheet presents data related to births in the Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah.

Education Of Staff Nurses On The Implementation Of A Standardized Clinical Care Pathway For Patients Who Undergo Correction Of Pectus Excavatum, Amber Jones, Tracy Brewer, Sally Mcquilkin

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

Objective: Educate staff nurses on a new standardized clinical care pathway (SCCP) for Nuss Procedure patients to decrease the length of stay, decrease hospital costs, decrease postoperative complications, and improve pain control. Design: Evidence-based practice improvement initiative. Setting/Local Problem: An inpatient surgery unit at a local pediatric medical center with no previous standardized care plan for Nuss Procedure patients. Participants: All staff nurses working on the inpatient surgery unit of a pediatric medical center. Intervention/Measurements: An SCCP was created by a multidisciplinary care team. All staff nurses on the inpatient surgery unit at a local pediatric medical center were assigned …

Coping With Congenital Heart Disease: Implementation Of An Evidence-Based Intervention In A Pediatric Cardiac Intensive Care Unit, Victoria M. Raphael, Tracy L. Brewer, Sherry Pye

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

Caregivers are exposed to many stressors in the pediatric cardiac intensive care unit (CICU) setting. In caregivers of children diagnosed with congenital heart defects admitted to the CICU, symptoms of psychological distress are prevalent (Doherty et al., 2009). These symptoms include, but are not limited to, feelings of acute and chronic stress, worry, anxiety, and depression. Without intervention, these symptoms can negatively influence the health and behavioral outcomes of the admitted child (Commodari, 2010). Providing support for these caregivers during their child’s admission can reduce the significance of these adverse psychological symptoms and promote both patient and caregiver well-being (Melnyk …

An Education Intervention Project In Community Clinics To Improve The Identification Of Patients With Pulmonary Alveolar Proteinosis And To Correctly Identify The Type Utilizing The Differential Diagnostic Algorithm, Catherine J. Poisson

Doctoral Dissertations and Projects

With over 7000 types, rare diseases affect 25-30 million Americans and contribute to over one trillion dollars in healthcare-related costs. Prescribers lack the knowledge to improve awareness, identification, and treatment of rare diseases. Pulmonary alveolar proteinosis is a rare disease in which patients present with symptoms such as dyspnea, fatigue, and respiratory infections. Diagnosis can take four to 92 months. A differential diagnostic algorithm published in the literature can guide clinicians in identifying the type of pulmonary alveolar proteinosis the patient has. In addition, if the clinicians perform a laboratory test called the granulocyte-macrophage autoantibody test, this test provides 100% …

Focused Group Meetings To Promote Job Satisfaction For Emergency Department Advanced Providers, Kendra Osei-Wusu

Doctoral Dissertations and Projects

Objective: Over the last few years, the pattern of increased burnout, operating under adverse environments, and being under- appreciated as led to a decrease in job satisfaction among emergency room providers(physicians, advanced practicing nurses, and physician assistants). Therefore, this scholarly project examined if small focused group discussions among emergency room providers will help combat poor job satisfaction scores and increase the well-being of the practitioners that keep the emergency room functioning. Methods: Using a quasi-experimental design, 10 providers that work in the emergency department at Lifebridge Health were randomly selected. Baseline well-being and job satisfaction rates were measured prior to …

Constant Observation The Benchmark Study, Kalana Sanders

MSN Capstone Projects

Constant observation is defined as “an increased level of observation and supervision which continuous one-to-one monitoring techniques are utilized to assure the safety and wellbeing of an individual patient in the patient care environment. In the hospital setting constant observation has become the most used resource for mental health patients. The use of constant observation has significantly improved patient safety outcomes reducing falls and suicide rates drastically. With one study in Pennsylvania showing a vast improvement in patient safety in simply one-month times. As fall rates decreased from 53,966 falls occurring without the implementation of constant observation to only 323 …

Decreasing Pain In Pediatric Patients During Intravenous Catheter Insertions On The Pediatric Inpatient Surgery Unit, Breonna Scott, Robert Cornette, Tammy Childers

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

Abstract

As healthcare in the United States transforms, the voice of advocacy for pediatric patients is also evolving. The act of inserting a peripheral intravenous (IV) catheter for medical care of a pediatric patient is one of the most common invasive procedures in the healthcare industry. However, the preventable pain accompanying such a common procedure is often overlooked. Pediatric patients are different than adults due to the lack of physiological and psychological development. When a peripheral intravenous catheter is inserted without pain prevention interventions, there are long-term and short-term consequences for the patient and family. In turn, there are many …

Implementation Of Provider Education Regarding Exercise As Adjunctive Treatment For Common Mental Health Diagnoses, Lauren Grace Martin

Doctoral Dissertations and Projects

Mental and physical health are inextricably linked. The advent of the Covid-19 pandemic reduced physical activity levels while worsening mental health symptoms. Pharmacological treatments are frequently used to treat mental health conditions; however, side effects can worsen metabolic issues. There is significant evidence that exercise can improve mental health conditions. The purpose of this project was to utilize provider education as an intervention to increase the use of exercise as an adjunctive treatment in the psychiatric treatment plan. This project was implemented at Nevada Mental Health, an outpatient behavioral health clinic in Las Vegas, Nevada. The investigator conducted a chart …