Respiratory Tract Diseases Commons^™

Reducing Copd Readmissions Through The Implementation Of A Guideline-Based Clinical Pathway: An Evidence-Based Practice Improvement Project, Hannah F. Hall, Allyson Neal, Samantha Bauer

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

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is characterized by airway inflammation and damage that inhibits appropriate airflow. Exacerbations of COPD (ECOPD) hasten disease progression and have profound impacts on the patients.

Local Problem: East Tennesseans experience higher rates of COPD than the rest of the state. Community members at the project site identified that the inpatient management of ECOPD is inconsistent and discordant with the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The purpose of this project was to reduce readmissions and increase guideline concordance by developing an algorithm …

Education Of Ventilator-Associated Pneumonia Prevention In Adult Intensive Care Patients, Carlin Morgan

Scholars Week

The purpose of this project was to improve knowledge related to evidence-based ventilator-associated pneumonia (VAP) preventative measures that decrease the prevalence of VAP in adult patients in the intensive care unit (ICU). An educational presentation was provided to twelve critical care nurses at a 349-bed hospital in western Kentucky. A pretest was obtained to measure the nurse’s knowledge prior to the presentation. A PowerPoint and pamphlet containing VAP prevention techniques were presented to the twelve critical care nurses during each meeting. A posttest was then administered after the presentation to measure the efficacy of the educational presentation. The mean of …

Exploring The Unmet Care Needs Of Women With Chronic Obstructive Pulmonary Disease (Copd), Jessica Madiraca

MUSC Theses and Dissertations

The primary objective of this study was to examine the feasibility of study procedures to and explore the unmet needs and potential barriers of women with advanced COPD who may need palliative care (PC). This multi-method study was guided by the adapted Hierarchy of Needs Model and explored unmet care needs, assessed knowledge of PC services, and identified barriers that women experience when receiving or during the implementation of PC. Further exploration of PC needs by sex provided information on unmet care needs of women with advanced COPD. Participants were recruited through convenience sampling by using COPD Patient-Powered Research Network …

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Identification Of Molecular Markers Associated With Copd In Non-Smokers And Smokers: A Bioinformatics Analysis, Agede O. Ayodele, Isa M. Wasagu, Ademola E. Fawibe, Alakija K. Salami

The University of Louisville Journal of Respiratory Infections

Background

Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential.

Methods

Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively.

Results

In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Implementation Of A Smoking Cessation Program In A Multidisciplinary Clinic, Lori Prewitt Moore, Shannon Harris

DNP Manuscripts

Tobacco use remains the solitary, most preventable cause of death and secondary disease among patients in the United States (US). Health-related smoking costs are in an excess of $300 billion yearly (CDC, 2018). Addressing this global, public health concern is vital in order to attempt to reduce unnecessary smoking-related comorbid conditions and death. This project is important to scholarly nursing practice in order to reduce smoking-related Chronic Obstructive Pulmonary Disease (COPD) exacerbations, reduce carbon monoxide (CO) levels, and reduce dyspnea on exertion (DOE) among current primary care smokers. The expectations of this project are for the doctoral of nursing practice …

Improving Glycemic Control During The Covid-19 Pandemic: A Quality Improvement Project, Megan Henderson

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Diabetes is a costly, chronic health condition. The COVID-19 pandemic has significantly impacted the delivery of health care and exacerbated chronic health conditions, such as diabetes. Diabetes is one of the most significant comorbid conditions associated with poor COVID-19 outcomes (Cariou et al., 2020). Control of blood glucose levels during the COVID-19 pandemic has proved challenging to maintain. The purpose of this quality improvement project is to identify gaps in diabetic self-care and then implement a diabetic toolkit to improve self-efficacy of diabetes self-management. According to the American Diabetes Association (2022), self-management of diabetes, education, and support from providers is …

What? Is Epstein–Barr Virus Infection Linked To Multiple Sclerosis?, Asha Mahajan, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Do You Know The Pathophysiology Of Cytokine Storm During Covid-19?, Shameera Shaik Masthan, Deekshitha Turaka, Ahmed Abdelhaleem, Mounica Vorla, Steven B. Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Quality Improvement For Timely Extubation In An Urban Community Icu., Connor Epperson

Doctor of Nursing Practice Papers

Background: Prolonged duration of mechanical ventilation (MV) is associated with higher morbidity, mortality, and increased resource utilization. Research has shown that the coordination of spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) through standardized protocols increases frequency of readiness to extubate assessments, thus reducing time on MV.

Purpose: The purpose of this project was to improve weaning protocol adherence by re-educating RN staff about the current weaning protocol and the importance of interdepartmental communication to perform coordinated SATs/SBTs, thus reducing MV duration.

Intervention: Education was provided to nursing staff on the current weaning protocol and the …

What About Anosmia From Covid-19 ?, Sharanya S E Santhi, Sara Elnour, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Treating Cytokine Storm In Patients With Covid-19, Ahmed Abdelhaleem, Deekshitha Turaka, Shameera Shaik Masthan, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: Correspondence, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Covid-19, Vaccination, And Heart Transplantation, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.

Sotrovimab: Neutralizing Antibody To Combat Covid-19, Aya Allam, Steven Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Are Antipyretic Medications Compatible With Sars-Cov-2 Vaccines?, Sharanya S E Santhi, Niguma Rayamajhi, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Mucormycosis: Covid-19 And Corticosteroids, Mittal Savaliya, Nivedita Jha, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Impact Of Spontaneous Breathing Trials On Reducing Ventilator-Associated Pneumonia In Adult Intubated Patients: A Scoping Review, Jireh R. Johnson Bsn, Rn, Hamzha Aysheh Bsn, Rn, Keianna Luckett Bsn, Rn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background For ventilated patients in the intensive care unit, ventilator-associated pneumonia (VAP) is a major source of morbidity. It is difficult to diagnose due to many of the diagnostic criteria being subjective, its clinical signs that are broad, and its association with various respiratory disorders. Hospitals have developed varying ventilator bundles in expectation to prevent the incidence of Ventilator-associate pneumonia. We performed scoping review to determine the impact of spontaneous breathing trials (SBT) on reducing VAP.

Methods From August to November of 2021, using the MEDLINE, ScienceDirect, and Scopus databases and MeSH search terms, we identified over 20,000 articles containing …

Discharge Care Bundle To Reduce Copd 30-Day Readmission Rates In A Hospital Acute Care Unit, Dao Vang

Student Scholarly Projects

Practice Problem: Chronic obstructive pulmonary disease (COPD) readmissions severely impact patients’ health, mortality, and quality of life and increase unnecessary healthcare use and spending. Utilization of a protocol and discharge care bundle to reduce the readmission rate for COPD patients is critical to combat the problem.

PICOT: The PICOT question that guided this project was in adult patients 65 years or older admitted to a hospital acute care unit for acute exacerbation of COPD (P), does a protocol and discharge care bundle (I) compared to no protocol and no discharge care bundle (C) reduce the 30-day hospital COPD readmission rate …

Pulmonary Post-Acute Sequelae Of Covid-19, Usman Akbar, Shivam Gulati, Johnny Zakhour Md, Alex Glynn, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: Persistent symptoms have been observed in a substantial proportion of survivors of COVID-19 since relatively early in the pandemic. Among these post-acute sequelae of COVID-19 (PASC), respiratory symptoms appear to be the most prevalent.

Methods: We conducted a literature review of peer-reviewed publications in English on the clinical and epidemiological features of respiratory PASC in cohorts of 100 or more patients with a follow-up of four weeks or more after acute infection. Included studies reported the prevalence of persistent respiratory symptoms and/or the results of follow-up pulmonary function tests.

Results: On our review included 14 studies across eight countries …

Implementation Of A Drive-Through Covid-19 Mass Vaccination Site: Experiences From Louvax–Broadbent In Louisville, Kentucky, Ruth Carrico, Sarah Beth Hartlage, Valenchia Brown Msn, Aprn, Fnp-C, Sarah M. Bishop, Luanne Didelot, William Hayden, Beverly Williams Coleman, Sarah Tan, Delanor Manson, Kellie Kane, Dawn Balcom, Paul Kern

The University of Louisville Journal of Respiratory Infections

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination.

Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked …

Risk Factors For Acute Respiratory Infections In Children Between 0 And 23 Months Of Age In A Peri-Urban District In Pakistan: A Matched Case–Control Study, Fatima Mir, Shabina Ariff, Maria Asif Bhura, Suhail Chanar, Aspara Ali, Muhammad Jawwad, A Hussain, Arjumand Rizvi, Muhammad Umer, Zahid Memon, Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Acute respiratory infection (ARI) accounts for nearly 15% of all childhood mortality in South Asia, with children from rural areas at higher risk due to inaccessibility to healthcare facilities. We therefore aimed to identify risk factors associated with ARI in children under 2 years of age in rural Pakistan.
Methods: A retrospective 1:2 matched case-control study was conducted between October and December 2018 in Taluka Kotri, Jamshoro District of Pakistan. Cases were identified as children between 0 and 23 months of age with a history of fever, cough, sore throat, fast breathing, difficulty breathing, or chest indrawing in the …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

Consultation/Liaison Psychiatry During Covid-19, Robert Frierson, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

Consultation/liaison psychiatrists care for people with co-existing medical and psychologic difficulties. The coronavirus pandemic is stressful for patients and their psychiatric caregivers. Patients have lost support systems and harbor fears about exposing family to the virus. COVID-19 sometimes exacerbates previous psychiatric conditions, while diminishing intimacy with physicians. Everyone is oversaturated with COVID-19-related news focusing on rising concerns about the illness and about jobs, school, and housing insecurities.

The psychiatrist maintains a hospital presence despite fear of contracting the disease. Challenges include addressing staff morale, evidencing empathy despite telecommunication devices, and treating anxiety, depression, sleep phobias, post intubation flashbacks, COVID-19-induced cognitive …

Implementation Of An Oral Hygiene Protocol For Adults Patients On Acute Care Units, Sharon J. Boler

Student Scholarly Projects

Practice Problem: Patients diagnosed with non-mechanically ventilated aspiration pneumonia can result in increased levels of care, longer lengths of stay, and are 8.4 more likely to die while hospitalized. Oral hygiene protocols have led to promising outcomes, evidenced by fewer cases of aspiration pneumonia in adult patients on medical surgical units.

PICOT: The PICOT question that guided this project was in adult non-mechanically ventilated hospital patients, does an Oral Hygiene Protocol (OHP) compared to current practice affect hospital acquired aspiration pneumonia during hospitalization.

Evidence: Fourteen studies met inclusion criteria that support the implementation of an evidence – based oral hygiene …

A Research Framework For Evaluating Next Generation Sequencing In Community-Acquired Pneumonia, Ashley M. Wilde, Elena Swingler, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Matthew Song Pharmd, Bcidp, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

University Of Louisville International Travel Clinic: Pivoting During The Covid-19 Pandemic, Dawn Balcom, Subathra Marimuthu, Leslie A Wolf, Luanne Didelot, Sarah Tan, Daniel Hall, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.