Medicine and Health Sciences Commons^™

Improving Peripheral Intravenous Maintenance Compliance To Decrease Intravenous Infiltration In A Pediatric Icu., Miranda Jones

Doctor of Nursing Practice Papers

Purpose: Intravenous (IV) infiltration is recognized as the most frequent complication of IV therapy (Thigpen, 2007). Pediatric patients are at an increased risk due to small and weaker blood vessels, immature skin, lack of subdermal fat, and constant movement (Odom & Lowe, 2018). In 2018, the pediatric intensive care unit (PICU) in a Kentucky children’s hospital reported 229 IV infiltrations, that which included over 10% of the PICU population. As a result, a quality improvement (QI) project was developed to identify and correct barriers to compliance, knowledge gaps, and target specific behaviors that may contribute to IV infiltration in the …

Evaluation Of A Blood Pressure Education Program On Knowledge And Self-Efficacy In Patient Care Associates ., Casey Prestigiacomo

Doctor of Nursing Practice Papers

The American College of Cardiology (ACC) and American Heart Association (AHA) revealed common errors made by healthcare professionals when measuring blood pressure (BP) in adult inpatients. These errors include using incorrectly sized cuffs, improper cuff placement, and inappropriate patient positioning. Inconsistent cuff sizes and position lead to underestimated and overestimated results, directly impacting patient care and outcomes. Additionally, the ACC/AHA identified patient position and talking during assessments as factors that directly impact the accuracy of the results. At Norton Healthcare facilities, a majority of BPs are obtained by patient care associates (PCAs). The purpose of this quality improvement project was …

Implementation Of A Wellness Program For Emergency Department Medical Professionals., Madeleine Chesney

Doctor of Nursing Practice Papers

Background: Current data from the ANA HealthyNurse Survey 2018-2019 states that 70 percent of nurses that were surveyed report putting the health, safety, and wellness of their patients before their own. Additionally, in a study conducted between 2011 and 2017 of over 5,000 physicians less than 50 percent stated that they had enough time for their personal and family life. This data supports the urgent need to focus on the promotion of self-care and wellness for medical professionals. Objective: The purpose of this quality improvement project was to provide an opportunity for emergency department medical professionals to work toward improving …

Improving Palliative And Hospice Knowledge Among Nurses In A Long-Term Care Facility., Kelly Rae Smith

Doctor of Nursing Practice Papers

Background: Early referral and implementation of palliative best-practices in patients with chronic diseases and at the end-of-life (EOL) significantly decreases patient symptom burden, increases quality-of-life, contributes to patient and family satisfaction with care, and reduces healthcare costs. Nurses in long-term care (LTC) are poised to help identify patients appropriate for referral, to provide quality palliative and EOL care, but lack adequate knowledge. Objectives: To determine if a short one-on-one or two-on-one palliative and hospice educational offering can improve (a) knowledge of best-practice palliative and hospice care symptom management techniques (b) the ability of nurses to identify patients appropriate for hospice …

Improving Delirium Management And Compliance On A Trauma/Surgical Universal Unit., Ardis Roederer

Doctor of Nursing Practice Papers

Background: Delirium is an acute, reversible syndrome that may cause cognitive impairment, disorientation, perceptual disturbances, attention discrepancies, and fluctuating psychomotor activities. Health professionals may not recognize, treat, or prevent delirium. More than seven million hospitalized adults, with an estimated cost of $164 billion annually, suffer from delirium each year. Consequently, delirium commonly affects 15 to 37% of the older adult population, yet less than 5% of delirium cases are documented in the electronic medical records of older adult patients. Early detection, intervention, and compliance with best practices are critical for the reduction of hospitalized delirium incidence. Aim: This project aimed …

Expansion Of A Food Insecurity Scale In Primary Care., Andrea Gibson

Doctor of Nursing Practice Papers

As a household-level economic and social condition defined by limited or uncertain access to inadequate food, food insecurity serves as a health threat. Food security impacts health by increasing the risk of cardiovascular disease, type 2 diabetes, stroke, and several cancers (WHO, 2005). Expansion of the two-item food insecurity screening to a six-item short-form (USDA 6- SF) screening in primary care has the potential to identify and categorize households into three categories of food security, high/marginal, low, or very low. By differentiating food insecurity categories, clients received more appropriate referrals to services aimed at improving food security. During a recent …

Hepatitis A Educational Program In Food Service Workers., Katherine Barker

Doctor of Nursing Practice Papers

Louisville, KY was affected by a significant outbreak of Hepatitis A in 2017-2018. Kentucky consisted of one-third of the national deaths. The outbreak influenced not only human mortality but had an economic impact on the food service industry. Many restaurants were affected, and some were forced to close due to Hepatitis A outbreaks. To address this issues, a two-step educational process was designed for management to gain understanding of hepatitis A content. The first step was to survey staff (kitchen staff, waiters/waitress, busier, etc.) to determine the compliance rate and variables that influence the compliance rate for vaccination of Hepatitis …

Covid-19 Peak Immunity Values Seem To Follow Lognormal Distribution, Julio Urenda, Olga Kosheleva, Vladik Kreinovich, Tonghui Wang

Departmental Technical Reports (CS)

For the current pandemic, an important open problem is immunity: do people who had this disease become immune against further infections? In the immunity study, it is important to know how frequent are different levels of immunity, i.e., what is the probability distribution of the immunity levels. Different people have different rates of immunity dynamics: for some, immunity gets to the level faster, for others the immunity effect is slower. Similarly, in some patients, immunity stays longer, it others, it decreases faster. In view of this, an important characteristic is peak immunity. A recent study provides some statistics on the …

Effects Of Bariatric Surgery On Metabolic Insulin Resistance, Tricia Brown

Nursing Student Class Projects (Formerly MSN)

Diabetes and Obesity are major diseases that affect Americans today. This project looks at insulin resistance independent of weight loss in diabetic patients who have had undergone bariatric surgery. Bariatric surgery changes the structure of the stomach and the digestive process. A metabolic change has been noted in patients immediately after surgery. Studies have shown that bariatric surgery can cause a remission of diabetes. A change in insulin resistance is noted immediately after surgery. A specific pathologic process is still unclear, and more research is needed. This project explores different theories of metabolic changes in the human body after bariatric …

Neuroblastoma, Cydney Keene

Nursing Student Class Projects (Formerly MSN)

In the pediatric population, Neuroblastoma is the most common solid malignant tumor, beginning in utero along the sympathetic nervous system. The maturation of neural crest cells determines if an immature cell does not mature, a solid malignant mass can form. Various articles and journals conduct studies and compare statistics in supporting the development and pathophysiology of Neuroblastoma in children. Dependent upon the tumor site and presence of metastasis, with interventions and early detection, the cancer cells will be targeted for removal.

Trauma Informed Care (Tic): Caring For Victims Of Trauma, Deanna Smith

Nursing Student Class Projects (Formerly MSN)

This poster discusses the use of trauma-informed care (TIC) in care settings to address health needs of patients who have experienced traumatic events. Complex trauma, childhood trauma, and post-traumatic stress disorder (PTSD) can cause long term impacts on health of patients including physical, behavioral, and cognitive manifestations. This poster explores health implications of trauma, how they can present in healthcare settings, and how the use of trauma-informed care can alleviate the burden on healthcare settings and improve patient outcomes by preventing further re-traumatization. The use of the TIC approach is applicable to all care modalities and settings, including primary and …

Wound Healing, Emily Schmitter

Nursing Student Class Projects (Formerly MSN)

The topic being presented is wound healing. Wound healing is a pathological process that occurs in three phases: inflammation, proliferation and new tissue formation, and remodeling and maturation. Several factors can affect wound healing such as nutrition status, increased age and health status. Wound healing is relevant to advanced practiced nursing because APNs participate in prevention, assessment, and treatment of wounds. The APN is responsible for teaching diabetic patients about the importance of proper nutrition. The APN must also be able to identify a hard-to-heal wound. And the APN must know how to prevent infection and induce healing in hard-to-heal …

Acute Respiratory Distress Syndrome, Caroline Bedinghaus

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a complex disease discussed in the following poster. ARDS is an inflammatory disease with a high mortality rate, making it a topic of high interest. Numerous different diseases can initiate ARDS, but not everyone who develops one of those diseases goes into ARDS. The inflammatory response within the lungs causes refractory hypoxemia and shunting. Treatments available for ARDS is mechanical ventilation with smaller tidal volumes, prone positioning, and neuromuscular blocking agents. Nurses caring for these critically ill patients must have an understanding of the overall picture of ARDS, while continuously assessing for possible complications …

Diabetes Mellitus, Cara Young

Nursing Student Class Projects (Formerly MSN)

There are two types of diabetes mellitus, Type 1 which involves a decrease in insulin production and Type 2 which is related to an impaired sensitivity to insulin due to peripheral insulin resistance (Chesworth, 2019). Type 1 diabetes is a dysfunction of the pancreas that an individual is usually born with and affects about 10 percent of the diabetic population. Type 2 diabetes is a product of obesity and age that affect the body’s sensitivity to insulin, not a problem with its production, and affects the remaining 90 percent of the diabetic population (Chesworth, 2019). The hyperglycemia that comes with …

Coarctation Of The Aorta, Megan Berens

Nursing Student Class Projects (Formerly MSN)

Coarctation of the aorta (CoA) is a ductal dependent congenital heart defect that causes decreased blood flow to areas of the body distal to the site of constriction. CoA is one of the most common congenital heart defects, though is often missed in neonatal assessments. Neonatal patients with CoA often present to the hospital in a state of cardiopulmonary collapse. CoA is occasionally diagnosed in older children and adults who have upper extremity hypertension and decreased femoral pulses. CoA repair is performed through surgery or percutaneous catheter interventions. Patients with CoA have an increased likelihood of developing other vascular lesions. …

Venous Thromboembolism, Ngwangong Mitti

Nursing Student Class Projects (Formerly MSN)

Venous thromboembolism (VTE) is a serious pathophysiological condition that is a major cause of morbidity and mortality, especially perioperatively (Elisha at al., 2015).

The Pathophysiology Of Acute Respiratory Distress Syndrome (Ards), Alyscia Defrancisco

Nursing Student Class Projects (Formerly MSN)

Acute Respiratory Distress Syndrome (ARDS) is fatal when not recognized early, nursing care can have a positive impact on patient outcomes. ARDS is a disease of the lung caused by an acute lung injury. ARDS accounts for 10-15% of ICU admission and is underrecognized. Key nursing consideration are essential to help identify and treat ARDS.

Healthcare Inequities Of The Hiv Population, Michael Silvka

Nursing Student Class Projects (Formerly MSN)

AbstractThe social attitude in the United States toward people living with HIV (PLWH,) has changed verylittle since the diagnosis became prevalent in the 1980’s. Healthcare inequities experienced by(PLWH) affect their well-being in many ways every day. The ability of society to decrease theseinequities is within our grasp. (PLWH) are depending on social determinants being addressedto allow equitable access to preventative measures, testing, and treatment of their illness. Theneed for appropriate and sustainable change to social perception of the HIV epidemic must beaddressed to ensure fair and equitable treatment is available to all persons affected by thisdisease

Pathophysiology Of Schizophrenia, Chimezie Onuchukwu

Nursing Student Class Projects (Formerly MSN)

This poster presents the pathophysiology of schizophrenia. This topic was selected because it helps to understand the pathophysiology of the condition as well as the clinical significance of the condition. Schizophrenia is a condition that is not well known and there are misconceptions in the community about the condition. I believe by understanding its etiology, pathophysiology, and presenting signs and symptoms; I will be able to give the best nursing care to my patients. Patients with the condition exhibit five major symptoms including delusions, hallucinations, disorganized, disorganised speech or thinking, and inability to function normally. Under DSM V diagnosis criteria, …

Sars-Cov-2 Or Covid-19, Amy Phillips

Nursing Student Class Projects (Formerly MSN)

The emergence of COVID-19 has stunned the world and challenged the medical field in ways not seen in almost a century. COVID-19 has proven to be unpredictable and can have effects ranging from mild to life threatening, including pneumonia, Acute Respiratory Distress Syndrome, multi-system organ failure and death. This presentation discusses the presentation, pathophysiology, current treatments and implications on nursing for COVID-19. Research is ongoing to determine just how and why this virus attacks the way it does, how to best treat the virus and how to develop a vaccine to prevent future outbreaks.

Pulmonary Arterial Hypertension, Gifty Menka

Nursing Student Class Projects (Formerly MSN)

Pulmonary arterial hypertension (PAH), is diagnosed as persistently elevated pressures in the pulmonary arteries. It is a severe disease that requires early diagnosis and treatment as it can be life-threatening if not treated promptly and adequately. The initial presenting signs and symptoms such as lethargy, malaise, and exercise intolerance can be vague, making it difficult to diagnose. Also, doctors at centers that specialize in treating PAH are the only ones who can properly diagnose the condition and initiate disease-targeted therapy. There are different types of PAH; the World Health Organization (WHO) recognizes 5 groups of pulmonary hypertension (PH), and they …

Depression: The Cause, The Signs, The Stigma, Elisabeth Sanderson

Nursing Student Class Projects (Formerly MSN)

Depression is a common phenomenon. According to World Health Organization (2020) there are over 264 million people suffering from depression globally. Takahashi (2019) states that major depressive disorder is the most common mood disorder and additionally notes that it is the leading cause of disability not just in the United States but in the world. From a pathophysiological perspective depression has multiple possible causes. This paper seeks to look at depression as a relevant health care concern and to describe accepted theories on the pathophysiology of depression as well as discussing key signs and symptoms of the disorder. It seeks …

Malignant Hyperthermia, Nicholas Colangelo

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia is a rare manifestation of a genetic mutation involving the ryanodine receptors. This mutation causes a sustained intracellular calcium release that is triggered by certain anesthetics such as depolarizing neuromuscular blockers and volatile gases. The extended release of calcium functions as a dangerous catalyst for hyper-metabolism that will lead to rapid death if unrecognized and untreated. Current treatment involves the drug dantrolene in tandem with symptomatic management in the intensive care setting. Symptomatic treatment may likely involve rapid cooling, fluid resuscitation, electrolyte management, and mechanical ventilation until symptoms resolve. A literature review of malignant hyperthermia is of vital …

Malignant Hyperthermia, Alec Smith

Nursing Student Class Projects (Formerly MSN)

Abstract: There are many issues that healthcare professionals face in the evolving world of medicine. One of these is the development of a disease process known as Malignant Hyperthermia (MH). This condition is precipitated by frequently used anesthetic agents such as volatile gases and depolarizing muscle relaxants. The onset of MH is sudden and can be life-threatening, therefore, diligent monitoring of patients is essential in early recognition and treatment of MH. The purpose of this poster is to provide in -depth knowledge about MH. This includes the pathophysiology of the disease, signs and symptoms, treatment options, and implications MH has …

Schizophrenia And Genomics, Tiffini Lasch

Nursing Student Class Projects (Formerly MSN)

There are several advancements in genomics under specific categories, such as cancer and autism. Mental health is one of the leading diseases to cause a significant debt burden in today's society. However, genomics has not translated well into mental health treatment. One area of focus is schizophrenia. Those with schizophrenia suffer from severe and devastating symptoms. The symptoms can lead to harsh complications. Which can make it impossible to function in everyday life. Many believe it is not just genetics alone, but also environmental factors that contribute to schizophrenia. Through large genome-wide associated studies, discoveries are being made. There have …

Pediatric Asthma, Monica Stricklin

Nursing Student Class Projects (Formerly MSN)

Effective management of asthma will improve pediatric patient quality of life. This may be achieved through the prevention of asthma exacerbations by continuous pediatric and guardian/parent education to proper inhaler technique, appropriate medication management and the avoidance of environmental triggers. These modalities may prevent trips to the emergency department, hospital admissions and the pediatric patient can avoid missing days from school.

Bronchiectasis: Pathophysiology And Management, Olivia Fleetwood

Nursing Student Class Projects (Formerly MSN)

Bronchiectasis is a chronic respiratory condition that can decrease the quality of life of patients with this disease. A persistent cough, increased sputum production, and recurrent chest infections that lead to damaged dilated and thickened bronchi characterizes this condition. Bronchiectasis can result from several conditions such as abnormalities of airway anatomy, immune deficiency, and infections; however, the cause may not always be identifiable. The damage done to the airways is irreversible and can cause complications in daily life and especially during surgical procedures. This poster evaluates the pathophysiology of bronchiectasis and discusses the surgical implications of having a patient with …

Hyperosmolar Hyperglycemic State, Justin Momeyer

Nursing Student Class Projects (Formerly MSN)

Hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA) are dangerous complications of diabetes. HHS is examined in this poster and compared to DKA. Even though both have some similarities, they have very different laboratory profiles, patient presentations, treatments, complications, and can require different levels of care. With diabetes becoming more common amongst patients in the hospital, it is imperative that healthcare providers are aware of both of these complications. Nurses who understand both of these complications are able to act pro-actively for their patients, ask questions regarding correct treatments and orders, include the right providers in the care team, and …

Heart Failure With Reduced Ejection Fraction, Jennifer Klubnik

Nursing Student Class Projects (Formerly MSN)

Heart failure with reduced ejection fraction (HFrEF) is a chronic disease that contributes to high morbidity and mortality. This poster will display and discuss HFrEF and effects of this chronic disease on the population. Pathophysiology, treatment modalities, and implications for the advanced practice nurse (APN) will be discussed. Different categories of heart failure will be discussed to compare and contrast the specific indications for HFrEF. The specifics of cardiac remodeling and molecular changes that occur with HFrEF are considered when deciding which treatment modalities to implement. HFrEF treatment focuses on quality of life and mitigation of symptoms. The APN is …

Infective Endocarditis, Tessa Friend

Nursing Student Class Projects (Formerly MSN)

The proposed poster is an overview of the pathophysiology and nursing considerations for infective endocarditis. Infective endocarditis (IE) is an infection that affects the endothelium of the heart. While not a highly prevalent disease in the United States, it does have a significant mortality rate of up to 30% at 30 days after diagnosis despite many medical advancements to attempt to prevent and treat it. IE can cause multisystem organ dysfunction through complication of the disease or embolization of the vegetation.

The poster goes over several complications associated with IE and the evidence-based treatment of those complications. Several articles on …