Nursing Commons^™

Implementation Of A Screening, Brief Intervention, And Referral To Treatment Protocol For Treatment Of Opioid Use Disorder In Post-Carceral Populations, Adaora Ede, Mary Johnson

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

BACKGROUND: Opioid use disorder (OUD) is a pressing public health issue in the US affecting marginalized populations the most. Within the correctional setting, 65% of inmates are affected with OUD, worsening health outcomes when untreated.

LOCAL PROBLEM: This evidence-based practice (EBP) project targeted justice-involved individuals with co-occurring OUD at a behavioral health clinic in Johnson City, Tennessee. This project aimed to improve outcomes related to recidivism and relapse through clinician education and the implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol.

METHODS: Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was the guiding EBP model for the …

Pediatric Vaccine Pain Management & Perceptions Of Caregivers And Nursing Staff: An Evidence-Based Project, Madison K. Bears, Tami H. Wyatt

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

Background: In an age with many diseases controlled through immunization and herd immunity, the significance of immunization can wane in public memory. In children, injection pain is an obstacle to vaccination and can cause anxiety around medical visits, healthcare avoidance, delayed immunizations, and needle fear (McMurty et al., 2015; Shah & Sui, 2019; Taddio et al., 2022). Evidence-based vaccine pain relief techniques are described in the literature (Shah et al., 2009; Wu et al., 2022; Taddio et al., 2015), yet their use in practice is minimal (Taddio et al., 2022).

Local Problem: An evaluation of a pediatric clinic …

Improving Human Papillomavirus (Hpv) Vaccination Rates Through Age-Based Flagging, Savannah Jo Garcia, Karen Lasater

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

DNP SCHOLARLY PROJECT ABSTRACT

BACKGROUND: Over forty million Americans are currently infected with human papillomavirus (HPV). HPV can cause life threatening cancers of the cervix, vagina, vulva, penis, anus, and throat. Only half of U.S. adolescents have completed the HPV vaccine series.

LOCAL PROBLEM: The setting for this evidence-based improvement project is a rural family practice clinic in Texas. Texas has the largest group of teenagers not protected against HPV in the country. The project’s purpose is to investigate the effect of age-based flagging on adolescent vaccination rates in a rural community through evidence-based practice.

METHODS: Project …

Non-Opioid Pain Relief: Use Of Vitamin D In Central Appalachia, Christina Brown, Karen Lasater, Teresa Tyson

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

Background: Overdose deaths have exceeded US war fatalities since WWII. Central Appalachia faces high substance use rates and poor health determinants. The opioid epidemic costs $740 billion annually. Providing 100 million chronic pain sufferers alternative pain control is efficacious, equitable, and reduces opioids. The author collaborated with a nurse-led mobile clinic in Central Appalachia to identify evidence-based non-opioid pain relief options for practice translation. In patients with hypovitaminosis D, the body will increase parathyroid hormone production to absorb calcium resulting in skeletal or muscular pain. Vitamin D’s steroid properties reduce inflammation by dampening proinflammatory cytokines. Framework: The Johns Hopkins Nursing …

Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange

Doctoral Dissertations

As the U.S. older adult population increases and diversifies, healthcare providers need innovative, cost-effective, and culturally congruent approaches to gerontological nursing care. Decades of multidisciplinary evidence demonstrate that spirituality enhances older adult holistic health. However, although research about spirituality and nursing has become more culturally diverse, little is known about spirituality-health linkages of rural Appalachian older adults (RAOAs). This knowledge gap is significant because Appalachia leads the country in mortality related to chronic comorbidities such as heart disease, cancer, and depression. Given age, poverty, limited transportation, and health provider shortage areas, RAOAs experience severe health disparities. Moreover, spirituality is an …

Addressing Adolescent Sexual Health Through An Educational Toolkit For Providers In Rural Alaska, Anna M. Martin, Tracy L. Brewer, Hannah E. Warren

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

Introduction. Adequately addressing an adolescent’s sexual health is essential during the child’s development yet, 33% of adolescents have health visits with no mention of sexual health. On average, primary care providers spend approximately thirty-six seconds discussing sexual health topics with adolescents despite recommendations for comprehensive education. Alaska Native youth face significant disparities regarding sexual and reproductive health care. Implementation and evaluation of a comprehensive educational toolkit regarding various sexual health topics for rural healthcare providers in Alaska revealed positive outcomes in discussing sexual health with an adolescent.

Methods. Larrabee's Model for Evidence-based Practice Change guided the development, implementation, and …

Implementing A Structured Walking Program For Prek Through 8th Grade Teachers, Caitlin M. Kile, Robin Harris, Robin Bowden

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

Physical inactivity has become a significant health concern not only in the United States but worldwide. Adults are becoming sedentary due to sitting at work and school, computer use, and motorized transportation. During the COVID-19 pandemic, teachers experienced increased workloads, increased sedentary work time for virtual classes, and longer work hours. A PreK-8^th grade school system in the southeastern United States had health promotion and prevention programs for students but no health and wellness programs for teachers. Wellness programs can promote physical health and less worker absenteeism. At the completion of a 12-week walking program, the teacher's weekly time …

Reducing The Stigma Of Nurses In Recovery: Substance Use Disorder And Alternative-To-Discipline Program Education For Nurses, Daniel Paul Del Toro, Pamela Hardesty

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

Decades of previous studies suggest that approximately 10-15% of all actively licensed nurses in the United States may be impaired by or in recovery from alcohol or other drug addiction. As a result of the COVID-19 pandemic, medical professionals are experiencing unprecedented amounts of stress, fatigue and emotional distress that when coupled with poor coping mechanisms and easily accessible addictive substances may result in an increased risk for developing substance use disorder. By providing education to nurses regarding substance use disorder (SUD) and alternative to discipline programs (ADP), previous studies have shown that the risk of nurses developing SUD can …

Educating Healthcare Professionals To Identify And Care For Victims Of Human Trafficking, Kathleen L. Messman

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

Background: Health Care Professionals (HCPs) report a need for education, training, and appropriate healthcare guidelines to identify and treat those affected by human trafficking. Approximately 88% of survivors report having been in contact with an HCPs while being trafficked without the knowledge or intervention of an HCP. Population: 16 staff from a Federally Qualified Health Center in rural in East Tennessee, including medical and dental staff, mental health counselors and receptionists attending onsite training. Methods: A pretest-posttest-4 week follow up posttest design was utilized to determine whether an educational intervention increased knowledge and confidence in HCPs. A modified PROTECT Provider …

Educating School Nurses: Returning To School During The Covid-19 Pandemic, Kelle Flynn-Gulley

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

As schools began reopening, following government mandated school closure early on during the COVID-19 pandemic, new safety measures and protocols were put in place to keep students and staff safe. School nurses have become essential to ensuring schools reopen safely. However, as school nurses were forced to adapt to their increasing roles and responsibilities, a method for providing continuing education to school nurses within an East Tennessee school district did not exist. The goal of this evidence-based practice project was to provide continuing education to school nurses on COVID-19 return to school guidelines via an e-learning modality. Larrabee’s Model for …

Effect Of Infant Breastfeeding Versus Formula Feeding For A Minimum Of One Month On Cognitive Outcomes In Early Childhood, Mary K. Bosson, Sarah Michelle Hodges, Madison Victoria Cavalli, Kaitlyn Grace Carmichael

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

Cognitive development is an important part of infant growth since intellectual predilections in infancy set enduring patterns. Evidence supports that exclusive or mixed breastfeeding for at least one month may improve general child cognition scores. Breast milk contains nutrients such as docosahexaenoic acid (DHA), arachidonic acid (AA), zinc, choline, and vitamin B12 that enhance myelination in the brain to improve cognition. Even if formula is able to be fortified with these vitamins and minerals, formula-fed infants tend to experience slower digestion with less nutrient absorption. Despite the potential nutritional gains of breastfeeding, there is a knowledge gap regarding how long …

Improving Early Autism Diagnosis In Underserved Communities Through The Use Of “Learn The Signs. Act Early.” Developmental Milestone Tracking Tool, Tamara L. Ellington

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

Many children entering early childhood education programs have symptoms of autism spectrum disorder yet remain undiagnosed. Research suggests this is especially true for low-income and minority children who may not participate in regular pediatric check-ups, have parents with low health literacy, or who may experience provider bias. Thus, they are diagnosed at a later age compared to upper-class White children. Early autism-specific intervention services can have a profound and lasting impact on long-term developmental outcomes for children with autism. Identification of the symptoms of autism is key to triggering the autism evaluation process that leads to a formal autism diagnosis …

A School-Based Cognitive Behavioral Progrm To Improve Adolescent Mental Health, Amanda Harper

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

Problem. While anxiety and depression are prevalent in the adolescent population and can have significant long-term consequences, treatment rates remain low. The gold standard for treatment is cognitive behavioral therapy (CBT), but this is often unavailable.

Methods. This project aimed to increase access to CBT through a school-based program. Students from a local homeschool cooperative participated in the Creating Opportunities for Personal Empowerment (COPE). Measures of anxiety and depressive symptoms were collected at baseline, after the program, and one month after the program. A Friedman test was used to evaluate medians’ differences on the screening tools at all three time …

The Lived Resettlement Experience For Single Refugee Mothers From The Democratic Republic Of Congo, Lauren Michelle Mefford

Doctoral Dissertations

At least 72% of the 50,000 Congolese refugees resettled in the USA in the last 5 years are women and children. Many are single refugee mothers (SRM) disadvantaged by obstacles (i.e., childcare) that hinder them from becoming self-sufficient within the required timeframe post-resettlement. Published research on resettlement has focused general challenges, but an understanding of the unique needs and perspectives of SRMs is lacking. This phenomenological, qualitative study provides insight into the lived resettlement experience for SRMs from the Democratic of Congo (DRC). Participants (n=7) were recruited from a refugee resettlement agency in East Tennessee and partook in open-ended, unstructured …

5th & 6th Grade School-Based Asthma Self-Management Program: Toolkit For Facilitators, Sarah Laroe, Jasmine Terrell, Tracy L. Brewer

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

This toolkit will aid school nurses in facilitating an asthma self-management program in their school. School-based asthma self-management programs have been shown to significantly improve school absences and improve health care outcomes in children living with asthma. Although there are many programs out there, this toolkit will utilize the Iggy and the Inhalers© program by Booster Shot Media. The program has several resources available online for free at their website, as well as resources that may be purchased. The program will be enlightening for the students and a fun way to learn about managing their asthma before they attend middle …

Relationship Between Social Media Use And Sleep Quality Of Undergraduate Nursing Students At A Southeastern University, Stephen B. Nowell, Kathleen Thompson

Chancellor’s Honors Program Projects

No abstract provided.

A Feasibility Study Of Just-In-Time Asthma Self-Management Intervention, Phillip Charles Scruggs

Masters Theses

Quality asthma care requires not only an initial diagnosis, but long term follow up care and education on long term control. Preventable symptoms continue to reduce the quality of life for chronic asthma sufferers and place an unnecessary burden on emergency services and the health care system at large. A mobile health (mHealth) solution is proposed to effectively improve outcomes for patients while ultimately reducing the overall burden of mismanagement on the healthcare system as a whole. The Just-in-Time Asthma Self- Management and Intervention (JASMIN) system provides a way for a patient or user to track, self-manage, and interact with …

Disaster Resilience In Rural Appalachia, Erin K. Conley

Chancellor’s Honors Program Projects

No abstract provided.

Parental Responses To Outcomes Of Developmental Screening Among Children: A Pilot Study, Ashley Elaine Manus

Chancellor’s Honors Program Projects

No abstract provided.

Living With Hypertension: Experiences Of Black Men Related To Their Perceptions Of The Clinical Encounter At Diagnosis, Glenda Mccartney Feild

Doctoral Dissertations

Introduction: In the U.S., hypertension (HTN) is the most common primary diagnosis and HTN related illnesses are the number one cause of death. Being a member of the Black population increases the risk for developing HTN. Black males are reported to develop HTN earlier in life and have a high incidence of undiagnosed, untreated, and uncontrolled HTN. Sociocultural and gender barriers influence this population’s perceptions of medical experiences, which affects their participation in health-promoting behaviors such as eating a healthy diet, engaging in regular physical activity, avoiding tobacco, limiting alcohol consumption, and decreasing stress.

Purpose: The purpose of this study …

Living With The Choice: A Grounded Theory Of Iraqi Refugee Resettlement To The U.S., Lisa Ann Davenport

Doctoral Dissertations

Though the United States has become a place of increasing resettlement for refugees, particularly Iraqi refugees who have been forced to flee their homeland due to violence, persecution and civil unrest, little is known about Iraqi refugee resettlement in the United States, or the way in which resettlement impacts health and adjustment. A grounded theory study was conducted to develop a substantive theory of Iraqi refugee resettlement. Participants in the qualitative study included 29 Iraqi refugees and 2 community partners who participated in face-to face interviews. Data analysis and interpretation revealed fundamental concepts related to Iraqi refugee resettlement. Results of …

The Lived Experience Of Transitioning From The Foster Care System To Adulthood, Carla Renee Parker

Doctoral Dissertations

Approximately 408,000 children were in foster care in the United States at the end of fiscal year 2010 (U.S. Department of Health and Human Services, 2012). Some children return to their families of origin; however, some children remain in the foster care system until they reach age 18 or 21 and must leave, which is called “emancipation” or “aging out” (U.S. Department of Health and Human Services, 2012). Transitioning foster youth are at risk for many negative consequences including poverty and homelessness. These negative consequences are associated with significant health implications, such as mental health problems and risky sexual behaviors. …

Cardiac Kids: Obesity Intervention Program In Elementary School Children, Christen Rose Waddell, Lisa Wagoner, Bonnie Callen, Carolyn Perry-Burst, Aneisa Mcdonald, Marcia Spence

Chancellor’s Honors Program Projects

No abstract provided.

Case Study: Community Perspectives Of A Service Learning Partnership Involving One School Of Nursing In The Southeastern United States, Polly Mcclanahan Mcarthur

Doctoral Dissertations

The purpose of this single case study was to describe community perspectives of a service learning (SL) partnership with a single university conferring a baccalaureate nursing degree. The longevity of the partnership extended the study purpose to explain why the partnership continued and worked well. A review of nursing literature revealed descriptive accounts of programs designed to meet needs of underserved populations and student learners. However, the review also revealed a knowledge gap in nursing education science regarding the community perspectives of successful SL partnerships. This study focused on relationships with the academe partner, interactions with students and faculty, and …