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, …

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Improving Knowledge, Confidence, And Competency Among Icu Nurses Concerning The Benefits Of Using The Uk Ventilator Separation Protocol, Brittany Monroe

DNP Projects

Background: The trauma intensive care unit (ICU) at University of Kentucky (UK) Healthcare uses a ventilator separation protocol which provides specific guidelines on the successful weaning of patients from mechanical ventilation. However, many of the nurses are not aware of this protocol as formal education is not included in their orientation or training. This lack of knowledge can lead to risks such as increased patient morbidity, mortality, ICU length of stay, and healthcare-related costs. Research shows that using structured mechanical ventilator weaning tools in the ICU can shorten the duration of mechanical ventilation, which in turn, lowers these associated risks. …

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

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 …

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, …

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey

DNP Projects

Background. Delirium is an acute clinical syndrome that is characterized by features of disrupted arousal, attention, cognition, sleep, and perception. Delirium is a well-documented phenomenon in critical care settings in both adult and pediatric populations, particularly among patients with length of stay greater than or equal to 48 hours. Delirium has multiple adverse effects, including increased mortality rate, prolonged duration of mechanical ventilation, higher reintubation rates, prolonged intensive care unit (ICU) admission, prolonged hospital admission, short- and long-term cognitive impairment, and posttraumatic stress disorder. There are currently no accepted guidelines or FDA approved medications to treat ICU delirium in the …

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 …

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 …

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 …

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.

Program Evaluation Case Study, Grace Mullikin

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

Program evaluation case study utilizing Center for Disease Control and Prevention's Case Evaluation Framework.

Dental Outreach In Academic Dental Settings, Tisha Clayborn

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

Creating an effective outreach program in a dental academic setting involves a strategic approach combining educational objectives and community service. This Dental Outreach Program Guide aligns with organizational objectives, contributes to community well-being, and serves as a model for future outreach initiatives in academic dental settings. This program utilizes the PRECEDE-PROCEED planning model to design and evaluate an oral health strategy. This program aims to outline a strategic plan incorporating evidence-based decision-making, data-driven metrics, and a comprehensive roadmap for successful implementation.

Empirical Insights Into Survivorship Care: A Cross-Sectional Study Of Coc Accredited Hospitals In Kentucky, Amanda M. Beckett

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

ABSTRACT

Background:

Cancer survivorship care programs play a vital role in supporting cancer survivors and improving their quality of life. Understanding the landscape of survivorship and the potential barriers is key to optimizing care delivery.

Methods:

The primary purpose of this cross-sectional study was to explore existing cancer survivorship care programs offered by Commission on Cancer (CoC) accredited hospitals in Kentucky. Data from the Markey Cancer Affiliate Network (MCCAN) from 2022 through 2023 was analyzed. Variables included hospital characteristics such as rural code, types of survivorship services offered, and reported barriers to these services.

Results:

Analysis of n=19 CoC facilities …

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 …

Increasing Awareness Of Implicit Bias And Systemic Racism Among Clinical Staff Caring For Non-Hispanic Black Maternal Patients, Melissa Courtney

DNP Projects

Background: Kentucky is ranked 17^th in the nation for the highest maternal mortality rate in the U.S. with a rate of 22.9 per 100,000, and 78 percent of those maternal deaths were considered preventable. The Non-Hispanic Black maternal death rate in the U.S. and Kentucky is 2.9 times higher than that of the Non-Hispanic White maternal counterparts (Kentucky Department of Public Health Division of Maternal and Child Health (KDPHDMCH), 2022). The fundamental cause of maternal health inequities is structural racism, which leads to poor treatment and experiences in the healthcare system (Chinn et al., 2020). Structural racism and implicit …

Improving Education On Routine Echocardiograms In Reducing Right Sided Heart Failure When Managing Vv- Ecmo Patients, Ashley Williams

DNP Projects

Background: Patients who are placed on veno- venous extracorporeal membrane oxygenation (VV- ECMO) are at high risk for developing right sided heart failure. An echocardiogram is essential for diagnostics and recovery in ECMO patients and should be a standard of care when managing this patient population. More research is needed to understand the effect of reducing right sided heart failure using routine echocardiograms. Purpose: The purpose of this study is to evaluate if there is a significant difference in outcomes of VV- ECMO patients who received routine echocardiograms compared to those who did not, and appropriately manage once RV dysfunction …

Evaluating The Effect Of Sleep Hygiene Education On Sleep Quality Among First-Year College Students, Caroline Lowe Cunningham

DNP Projects

Abstract

Background: The American Academy of Sleep Medicine recommends college students should get seven to nine hours of sleep each night. Only one-third currently meet this recommendation. Poor sleep negatively affects academic performance, mood, and interpersonal relationships. Sleep hygiene is recommended to improve sleep quality and quantity.

Purpose: The purpose of this DNP project was to determine the effect of implementing a sleep hygiene educational intervention in classes intended for first-year college students at the University of Kentucky.

Methods: This quasi-experimental project utilized the Pittsburg Sleep Quality Index to assess participants’ sleep before an in-person sleep hygiene education and after …

A Case Study In Program Evaluation: A Prospective Program Evaluation Of Timely Reporting And Action Of An Infectious Disease Outbreak, Destiny Cozart

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

Methicillin-resistant Staphylococcus aureus also known as MRSA is an infection of a staph bacteria. High school athletes are at risk of contracting MRSA through skin to skin contact and/or MRSA contaminated equipment. This case study uses the CDC's six-step framework for program evaluation to measure the effectiveness of the online training modules designed to increase the knowledge of staff and stakeholders about MRSA and infectious disease outbreaks. The findings from this evaluation will advise the potential change(s) implemented in training modules, ultimately to enhance competency for decision makers and prevent MRSA and infectious disease outbreak amongst high school athletic programs.

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.

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.

Changes In Primary Care Availability In Appalachia, Whitney Beckett

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

The Affordable Care Act (ACA) was a groundbreaking moment in the United States healthcare system. It affected many different aspects of the system, including access to primary care professionals. Primary care professionals provide a key role in American’s health, especially when it comes to preventative care. With one-third of Americans experiencing barriers to such access, a solution is desperately needed to increase said access. These barriers are especially profound in low-income, underserved areas such as the Appalachian regions of Georgia, Kentucky, Tennessee, and West Virginia. The ACA attempted to increase access via Medicaid expansion; however, not all States expanded their …

Provider And Staff Education Surrounding Universal Hcv Screening And Linkage To Care In An Ambulatory Care Setting, Lauren Clifford

DNP Projects

Abstract

Background: In the United States, it is estimated that there are more than 2 million cases of Hepatitis C (HCV), with over 66,000 new cases since 2020 However, an estimated 75% of those with HCV go undiagnosed and less than 35% receive treatment within a year of diagnosis. In 2018, UK Healthcare (UKHC) implemented a universal HCV screening method using a Best Practice Advisory (BPA) for anyone 18 and older who presented to the Emergency Department and had labs ordered. Patients who screened positive were then referred to outpatient clinics for HCV treatment. Approximately ten percent of positive patients …

Implementation Of An Education Intervention Aimed At Intensive Care Unit Providers To Improve Knowledge Of And Screening For Cognitive Impairment Related To Post-Intensive Care Syndrome, Terry Harrod

DNP Projects

Abstract

Background: Post intensive care syndrome is a condition that can lead to a range of physical,

cognitive, and psychiatric issues and is frequently undiagnosed. Educating Nurse Practitioners,

Physician Assistants, and Physician Fellows who work in the ICU about post intensive care

syndrome and a cognitive screening tool like the MoCA can significantly enhance their

understanding and ability to diagnose a component of this syndrome.

Purpose: The purpose of this project was to evaluate the effect of an educational intervention

regarding post intensive care syndrome among ICU nurse practitioners, physician assistants, and

physician fellows treating patients within the ICU.

Methodology: …