Medicine and Health Sciences Commons^™

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 …

Cognitive Preference And Skill Acquisition: The Relationship Between Student Nurse Anesthetists And Certified Registered Nurse Anesthetists Thinking Styles, Thomas Diller

Electronic Theses and Dissertations

Decision-making in healthcare is a complex and, at times, uncertain process. In the United States Certified Registered Nurse Anesthetists (CRNA) administer the majority of anesthesia. Nurse Anesthetists must draw on their educational background, clinical experience, and cognitive processes to make sound clinical judgments. To avoid errors understanding the relationship between cognitive preference and skill acquisition is critical. This study was designed to describe the cognitive preferences of Student Nurse Anesthetists (SRNAs) and CRNAs in the United States. The 2 cognitive preferences explored are rational (analytical) and experiential (intuitive) decision-making.

The researcher used a quantitative, cross-sectional, descriptive correlational design. The researcher …

A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis

Undergraduate Honors Theses

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …

Nursing Students, Bullying, And Burnout: A Study On Bullying By Medical Staff Members Against Nursing Students In The Clinical Setting And Its Relation To Nursing Student Burnout, Kihley Bellamy

Undergraduate Honors Theses

The present study investigated the existence of bullying by medical staff members in the clinical setting as experienced by nursing students, the existence of burnout among these students, and if such students perceive feelings of burnout as directly related to experiences of bullying. Undergraduate main campus traditional Bachelor of Science in nursing students at East Tennessee State University in their second, third, fourth, or fifth semesters were invited to participate in the study. Participants (n=52) were required to complete an online survey that regarded bullying, burnout, and how participants perceive the relation between the two variables. The study shows that …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

Critical Appraisal Bibliography, Scientific Abstract, And Matrix/Evidence Table, Nicolas Fuller, Jerry Lunsford, Hayley Robinson

Epsilon Sigma at-Large Research Conference

Introduction and Background

As chronic and acute pain disorders continue to be diagnosed in the clinical setting, the number of patients searching for medical care in hopes of alleviating their symptoms is on the rise. Working in both medical and psychiatric facilities as a certified nursing assistant, I saw opioids frequently prescribed as a pharmacological treatment for individuals looking to lessen the pain associated with a multitude of pain related disorders. Working in long term care facilities, I watched individuals who had never struggled with substance use disorders develop clinical dependencies on narcotic medication due to the fact that they …

Non-Pharmacological Interventions For Fatigue In Lung Cancer Patients, Sydney Robey, Micah Stewart, Melody Trickett

Epsilon Sigma at-Large Research Conference

Abstract

Introduction & Background: One of the most common and debilitating side effects of cancer is fatigue. Fatigue is a general feeling of tiredness or weakness that can greatly impact a patient’s quality of life. It can have a profound impact on a patient’s ability to perform day to day activities and cause emotional distress leading to anxiety and depression. In recent years, there has been an increase in research to look at the effectiveness of non-pharmacological interventions on improving cancer patients’ fatigue.

Purpose Statement: The purpose of our research is to look at the effectiveness of different types of …

Sexual Health History Screening Implementation For Providing Quality Clinical Services In Primary Care: A Quality Improvement Project, Grace Unbehaun

Epsilon Sigma at-Large Research Conference

Abstract

Purpose: With the US reporting 20 million newly diagnosed STI/HIV cases annually, clinical guideline compliance and EBP recommendation implementation necessitate provider practice changes for high-quality routine sexual and reproductive health services. The project's purpose was to improve sexual health history-taking (SHH) and documentation in a private primary care practice (PPCP) serving high-risk populations. The DNP project aims to determine the effect of conducting a 30-minute educational session and implementing the CDC's 5Ps on a PCP's clinical guideline adherence to SHH recommendations and documentation with patients presenting for annual wellness exams, well-woman exams, family/contraceptive counseling, or acute urogenital complaints in …

Roles In Preoperative Planning, Joetta Combs

Epsilon Sigma at-Large Research Conference

This project represents the ever-changing methods surrounding Enhanced Recovery after Surgery and the protocols that compose it. The purpose of this study is to expand education of ERAS guidelines and improve patient outcomes through furthering staff education. Enhanced Recovery After Surgery has been a part of perioperative departments worldwide after being introduced in the 1990s by Northern European general surgeons and has been adapted and modified since its introduction (ERAS Society History, 2022). The preoperative and postoperative process is ever-changing and is difficult for staff to keep up with. Many staff members find it difficult to stay on top of …

Implementing Systematic Sexual Orientation And Gender Identity (Sogi Data) Collection At An Inpatient Hospital Located In The Southern Region Of The United States, Shawn Malugin

Epsilon Sigma at-Large Research Conference

Purpose

LGBTQ patients experience marginalization and discrimination when seeking healthcare in the Southern Region of the United States. As a result, they experience negative healthcare outcomes. Collecting sexual orientation/gender identity (SOGI data) is vital in decreasing health disparities and improving hospitalized LGBTQ patients’ quality of care. Providers cannot adequately assess health risk factors or deliver culturally competent care without SOGI data knowledge.

Aims

The aim is to collect SOGI data during intake to implement a standard of care to promote LGBTQ health outcomes and decrease marginalization.

Processes

To understand how to provide high-quality care to LGBTQ patients, providers receive instruction …

Incorporation Of National Safety Standards For Oral Chemotherapy Patient Education At An Ambulatory Cancer Center: A Quality Improvement Project, Danielle Giles

Epsilon Sigma at-Large Research Conference

Abstract

Purpose: An evaluation of the oral chemotherapy patient education process at one ambulatory cancer center identified a deficit in documentation in the electronic medical record (EMR) of many recommendations from the American Society of Clinical Oncology (ASCO) and Oncology Nursing Society (ONS) chemotherapy administration and safety standards. Aims: The aim of this quality improvement project is to evaluate the effectiveness of the implementation of two newly developed templates into the EMR at one ambulatory cancer center. Process: The project will evaluate effectiveness by comparing the frequency in documentation of 16 key elements pre and post implementation …

Caring For The Caregiver: Improving Screening For Caregiver Presence During The Inpatient Stay., Brittany Mendo, Florence Weierbach Phd

Epsilon Sigma at-Large Research Conference

Informal caregiver burden and burnout can cause worsened outcomes of care for both the recipient of care and the caregiver’s overall health. Experiencing increased levels of distress by the caregiver may be the deciding factor for the elder remaining in the home or being placed in a long-term facility for care. Thus, healthcare professionals must be diligent in assessment for presence of a caregiver on admission, as well as identifying needs and providing education of resources within the community upon discharge. The purpose of this project is to implement admission screening for caregiver presence during the inpatient stay, with the …

Opioid Use Disorder And Infant Health Outcomes: A Literature Review, Shayln Russell-Fritch

Epsilon Sigma at-Large Research Conference

Introduction and background

Opioid use disorder (OUD) is an epidemic in the U.S. OUD affects both the mother’s and infant’s health. Substance-exposed infants suffer from decreased health outcomes relative to non-exposed infants.

Purpose

The aim is to identify infant health outcomes when pregnant women are prescribed medication-assisted treatment (MAT) for OUD. Among pregnant women with OUD in the U.S., is medication-assisted therapy as compared to no therapy associated with decreased negative infant health outcomes?

Literature review

Five studies on OUD and infant outcomes in the U.S. were reviewed. CINAHL and PubMed were searched using terms opioid use disorder, pregnancy, and …

Nursing Staff Shortage And Patient Outcomes, Amber Scogin

Epsilon Sigma at-Large Research Conference

Introduction and Background: A widespread issue that is affecting patients and nurses alike is the ongoing prevalence of registered nurse shortages in the field of healthcare. This obstacle has jeopardized exceptional patient care for many years and research suggests there is a need for interventions to combat the growing shortage.

Purpose Statement: This research aimed to investigate how the lack of acceptable nursing staff levels affected patients’ quality of care, safety, and outcomes in various healthcare settings. It also emphasizes the need for interventions that would focus on the supply and retention of nursing staff in order to combat the …

Opioid Maintenance Therapy On Fetal Development, Baileigh Swearington

Epsilon Sigma at-Large Research Conference

Abstract

Introduction and Background: Methadone, Buprenorphine and other opioid management therapies are being put into effect to help pregnant women who have abused opioids in the months prior to getting pregnant and continued the abuse during pregnancy.

Purpose Statement: The purpose of this research was to determine if opioid maintenance therapies would have lasting effects on infants in their growth development. The population in the studies were derived from women who had or were currently abusing opioids during their pregnancy. The interventions taken were to prescribe women with a specific opioid maintenance treatment and measure the outcome on the infant …

Childbirth In Incarceration And Nursing Interventions, Breanna Mauk

Epsilon Sigma at-Large Research Conference

Introduction and Background

The number of incarcerated pregnant women is increasing every day. At the same time, their quality of care is decreasing. From being treated like animals by jail staff to having unqualified staff members instructing them during labor, this has to change. Not only is the safety of the woman at risk, but most importantly her unborn baby.

Purpose Statement

Incarcerated pregnant women deserve the same healthcare as anyone else. The PICO question addressed in this paper is the following. In incarcerated pregnant women, how does ineffective health maintenance compared with effective health maintenance affect poor outcomes after …

Euthanasia: The Effects On Healthcare Professionals, Nana Bonsu

Epsilon Sigma at-Large Research Conference

Abstract

Introduction and Background: Euthanasia has expanded significantly around the world over the past years. The debate concerning euthanasia has focused on the legalization, complex issues faced by the medical team, and perspective on assisted dying. Euthanasia known as assisted suicide is a deliberate medical procedure of intentionally withholding treatment or withdrawing life-support measures to end the life of a suffering patient.

Purpose Statement: To define euthanasia and its background as well as discuss the psychological and moral effects that surround the subject.

Literature Review: Five articles were selected. Quantitative and exploratory qualitative studies were obtained from …

Advance Directives In Skilled Nursing Facilities, Jessica Altman, Alex Sargsyan

Epsilon Sigma at-Large Research Conference

Purpose: The purpose of this project is to decrease the likelihood of receiving unwanted treatment at the end of life. The project is conducted in a skilled nursing facility where only approximately 40% of the residents have an Advance Directive (AD) despite experiencing multiple comorbidities and nearing the end of life.

Aims: Implementing a quality improvement project, creating a system that addresses AD completion at admission with the outcome of increased recognition of residents’ end of life choices.

Process: Residents and their families are presented with a tool to help guide the conversation about AD at the admission care plan …

The Physical & Mental Effects Of Solitary Confinement, Dillon Leonard, Katelyn Martin, Sean Teague

Epsilon Sigma at-Large Research Conference

Introduction and Background: Solitary confinement has been a controversial topic in recent years among jail and prison systems. Solitary Confinement is the act of isolating a person in a prison or jail for up to 23 hours a day. These long periods of isolation can cause serious mental and physical damages to a human.

Purpose Statement: The purpose of this research is to understand the effects, both mental and physical, that solitary confinement has on a person. How does solitary confinement effect a person’s body and mind, and what interventions can be used to help prevent these changes?

Literature Review: …

Health Disparities In Minority Populations, Samuel Keirsey, Struti Patel, Madison Ray

Epsilon Sigma at-Large Research Conference

Abstract

Introduction and Background: Minority populations struggle to gain access to equitable healthcare due to cultural variations and language barriers. It is paramount for providers to accommodate to the differing needs of underserved minority groups.

Purpose Statement: We analyzed information on the effects of community-based interventions aimed at improving healthcare access for minorities.

Literature Review: We used PubMed as our main database. For our search, we looked up the keywords “Healthcare Access AND Minorities.” Next, we filtered articles that had been published since 2017 and sorted to include clinical trials, randomized control trials, and meta-analyses. After that, we came across …

Implementation Of An Adhd Electronic Portal In Pediatric Primary Care, Heather Cathey

Epsilon Sigma at-Large Research Conference

Clinical practice guidelines (CPGs) for Attention Deficit Hyperactivity Disorder (ADHD) recommend documentation of symptom scales and comorbidity screenings at the time of diagnosis and routinely throughout care. Rates of documentation for these tools in pediatric primary care are consistently low, creating a gap in care that impairs diagnosis, management, and patient outcomes. The purpose of this quality improvement project was to implement an online ADHD portal that emails, collects and scores these tools. The aims of the project are to improve utilization of CPGs by increasing documentation rates of symptom scales and comorbidity screenings for pediatric patients with ADHD. One …

Reducing Adverse Events: Medication Reconciliation In Primary Care, Jacklyn Halpin

Epsilon Sigma at-Large Research Conference

Abstract

Title

Reducing Adverse Events: Medication Reconciliation in Primary Care

Purpose

Primary care patients experience high levels of adverse drug reactions due to inaccurate medication reconciliation practices. Project Aims

The project aims to improve medication reconciliation in a primary care setting. Outcome Measures

Outcomes measures include identified medication discrepancies, staff satisfaction related to the use of the MATCH tool, and patient age ranges and gender.

Methods

Over a 4 week period, the clinic staff integrated the evidenced based instrument, Medication at Transitions and Clinical Handoff (MATCH) tool. Initially, the office manager provided a MATCH tool and a copy of the …

Lgbt Community And Mental Health, Danielle Schleeter

Epsilon Sigma at-Large Research Conference

Introduction and Background: Today, in 2022, there is a community that receives discrimination, lack of acceptance, and lack of equality. This is the LGBTQ community. They suffer from the indifferences of the way they express themselves resulting in a rise of mental health issues and overall health disparities.

Purpose Statement: The purpose of this review is to explore the disparities in mental health for the LGBT community including young adolescents and older adults. The question that drives this review is how does being a member of the LGBT community effect mental health.

Literature Review: This literature review utilized search engines …

Implementing A Flipped Classroom Approach In An Online Medical-Surgical Nursing Course, Ellen Schoen

Epsilon Sigma at-Large Research Conference

Background: According to Park, et. al. (2021) a flipped classroom consists of pre-class activities that expose students to the subject matter, in-class activities that promote interaction between classmates, learners and instructors and post-class activities that help solidify information. This method of education is thought to be more effective at promoting clinical judgement than traditional lecture-based classrooms. Delivery of course content through virtual meetings can also allow for additional flexibility in students’ schedules, while still allowing for engagement with classmates and promoting students’ engagement in their learning and motivations to learn (Philips & O’Flaherty, 2019).

The nation-wide restrictions on 2020-2021 academic …

Interventions Of Childhood Obesity, Scott Mattox

Epsilon Sigma at-Large Research Conference

Introduction and Background

Childhood obesity affects 17% of children in the United States (Whooten et al., 2018). It is well understood that many social determinants contribute to the manifestation and improvement of this disease.

Purpose Statement

I aim to compare the impact of increased health education through medical professional to families and obese/overweight children compared to implemented physical activity in social and personal settings on BMI improvement among the obese/overweight children.

Literature Review

Searches performed through the Sherrod Library data base at East Tennessee State University included the following key words: social determinants, long-term study, physical activity, clinical, community and …

The Benefits Of Different Birthing Positions, Sydney Miller, Maci Cloninger

Epsilon Sigma at-Large Research Conference

Many babies are delivered by using the standard lithotomy birthing position. However, evidence shows several benefits to an upright birthing position. The purpose of this study is to discover birthing positions that lead to more positive outcomes in laboring women delivering in hospitals. This research was conducted by examining previous studies conducted on a similar topic. However, the studies found mainly focused on the benefits of squatting positions and the implementation of devices that helps achieve an upright position. All findings support an upright birthing position provides a more optimal position for birthing a child due to the force of …

The Effects Of Exercise And Nursing Care On Postpartum Depression, Greyson Whaley

Epsilon Sigma at-Large Research Conference

Abstract

Introduction and Background: According to the Centers for Disease Control and Prevention (2020), “postpartum depression is depression that occurs after having a baby which is more intense and lasts longer than those of “baby blues,” a term used to describe the worry, sadness, and tiredness many women experience after having a baby.” It also states, “1 in 8 women report symptoms of depression after giving birth, about 1 in 5 (20%) women were not asked about depression during a prenatal visit, and over half (50%) of pregnant women with depression were not treated.”

Purpose Statement: The purpose of this …

Domestic Violence And Abuse In The Healthcare Setting, Madison Garrett, Michaela Franklin, Tiffany Gragg, Nicholas Stuckwish

Epsilon Sigma at-Large Research Conference

Introduction and Background: Domestic violence and abuse (DVA) is a growing global concern that affects patients encountered by nurses. DVA is defined as anything that is used to establish and maintain control over another person. The occurrence of DVA has ongoing negative consequences for patients related to their safety, especially if nurses are not properly trained to detect and control the situation.

Purpose Statement: For all registered nurses, does ongoing training opportunities and implemented universal screening processes on DVA, as compared to inadequate training and generalized screening processes, lead to effectively detecting DVA and providing better emotional, physical, and safety …

The Effects On Pregnancy In Homeless Women, Kristin F. Rucker, Carlie R. Lyons

Epsilon Sigma at-Large Research Conference

Abstract

BACKGROUND: The number of homeless pregnant women is continuing to increase around the world. Homeless women are experiencing difficulties with their pregnancy that others may not face, including birth abnormalities and not seeking appropriate care due to cost and stigmatization. Nurses need to educate homeless pregnant women on what is needed for a healthy pregnancy and childbirth. OBJECTIVE: This exploratory research describes the needs for advocacy in women who are experiencing homelessness while pregnant and how homelessness affects pregnancy, childbirth, and postpartum care. LITERATURE REVIEW: The search methods used was CINAHL and ETSU Library. Keywords: homelessness, …

Applying Scaffolding Methodology To Structure Dnp Intensive Skills Education, Candice Short, Jean Hemphill, Victoria Pope

Epsilon Sigma at-Large Research Conference

The Doctor of Nursing Practice (DNP) Family Nurse Practitioner (FNP) curriculum was developed to incorporate learning outcomes and experiential opportunities for students to attain the core FNP knowledge for doctoral education. Historically, challenges related to developing clinical skills in blended/online programs has been problematic. The appeal of online FNP education has challenged educators to develop new ways to provide students opportunities to experience hands-on clinical skills within the subspecialties of the DNP, FNP role. With limited clinical sites, and now with more clinical access constraints imposed by the COVID-19 pandemic, it is imperative that new models of instruction provide students …