Nursing Commons^™

Initiating A Peer Support Program For Parents Of Children With Autism Spectrum Disorder In Richland And Lexington Counties, Danielle P. Simmons

Theses and Dissertations

Objective: To initiate a parenting support program for parents of children with Autism Spectrum Disorder (ASD) in Richland and Lexington Counties. Background: Parents of children with ASD have increased stress and a poorer sense of well-being relative to parents of children with typical development. This parent population in Richland and Lexington Counties identified lack of support as a major stressor. The parenting support model initiated (e.g. Parent to Parent program) is an evidence-based intervention used to provide peer support to parents of children with ASD. The training of veteran parents is essential in the development and initiation of a Parent …

Implementing A Surgical Pathway To Reduce Operating Room Cancellation Rates, Demerise Ott Minor

Theses and Dissertations

Improving operating room efficiency is a high priority as health care cost become more challenging. In order to reduce surgical cancellation rates, a process improvement plan was implemented using a preoperative surgical pathway to optimize a patient’s health prior to scheduling the surgical procedure. The surgical risk assessment tool risk stratifies the patient based on the urgency of the procedure, the type of procedure, and the patients overall medical disease state. The Surgical Risk Tool determines patients with surgical risk scores of 9 or greater require medical and/or cardiac clearance in addition to hemoglobin A1C of 8 or less and …

Using Ultrasound Guided Peripheral Intravenous Catheters In Difficult Access Patients, Courtney Prince

Theses and Dissertations

The purpose of this quality improvement project is to compare the use of ultrasound to guide placement of peripheral intravenous (USGPIV) catheters versus standard techniques in difficult access patients, as measured by the number of attempts required to obtain venous access and total cost related to means of obtaining peripheral venous access between a nurse driven USGPIV and VAT team consults or physician assistance. The appraised evidence indicates USGPIV increases the number of successful PIV placements, prevents non-essential central lines and excessive needle sticks, and reduces patients and healthcare professionals frustrations (An et al., 2016, Au et al., 2012, Dargin, …

Slot Antenna Integrated Re-Entrant Resonator Based Wireless Pressure Sensor For High-Temperature Applications, Shujing Su, Fei Lu, Guozhu Wu, Dezhi Wu, Qiulin Tan, Helei Dong, Jijun Xiong

Publications

The highly sensitive pressure sensor presented in this paper aims at wireless passive sensing in a high temperature environment by using microwave backscattering technology. The structure of the re-entrant resonator was analyzed and optimized using theoretical calculation, software simulation, and its equivalent lump circuit model was first modified by us. Micro-machining and high-temperature co-fired ceramic (HTCC) process technologies were applied to fabricate the sensor, solving the common problem of cavity sealing during the air pressure loading test. In addition, to prevent the response signal from being immersed in the strong background clutter of the hermetic metal chamber, which makes its …

Patterns Of Communication Technology Utilization For Health Information Among Hispanics In South Carolina: Implications For Health Equity, Deanne K.Hilfinger Messias, Robin Dawson Phd, Rn, Cpnp-Pc

Publications

Background: Language, culture, geographic, social, and economic factors are associated with health disparities. Among more recent Hispanic immigrants, limited English proficiency and immigration status are barriers to health information and healthcare access. Improved access to culturally and linguistically tailored health information through technology could potentially enhance healthcare access and health outcomes. However, little is known about health information-seeking through technology among Hispanics in recent settlement areas. Purpose: The aim of this exploratory study was to describe patterns of self-reported utilization of technology for health information-seeking among the growing Hispanic population in South Carolina (SC) over a period of 5 years. …

Lysozyme Association With Circulating Rna, Extracellular Vesicles, And Chronic Stress, Sarah K. Abey, Yuana Yuana, Paule V. Joseph, Natnael D. Kenea, Nicolaas H. Fourie, Lee Anne B. Sherwin, Gregory E. Gonye, Paul A. Smyser, Erin S. Stempinski, Christina M. Boulineaux, Kristen R. Weaver-Toedtman Phd, Acnp, Anp, Christopher K.E. Bleck, Wendy A. Henderson

Publications

Background Stress has demonstrated effects on inflammation though underlying cell-cell communication mechanisms remain unclear. We hypothesize that circulating RNAs and extracellular vesicles (EVs) in patients with chronic stress contain signals with functional roles in cell repair. Methods Blood transcriptome from patients with Irritable Bowel Syndrome versus controls were compared to identify signaling pathways and effectors. Plasma EVs were isolated (size-exclusion chromatography) and characterized for effectors’ presence (immunogold labelling-electron microscopy). Based on transcriptome pathways and EV-labelling, lysozyme's effects on cell migration were tested in human colon epithelial CRL-1790 cells and compared to the effects of CXCL12, a migration inducer (wound assay). …

Racial Differences In Patient-Reported Post-Stroke Disability In Older Adults, Charles Ellis, Gayenell Magwood Phd, Rn, Faha, Faan, Brandi M. White

Publications

Longstanding disparities have been reported in stroke-related outcomes with blacks experiencing more post-stroke disabilities. Little is known about long-term disability outcomes among older stroke survivors. This study was a retrospective analysis of data from the 2015 National Health Interview Survey (NHIS). A group of 655 stroke survivors (541 white and 114 black) age 65 and older were asked to rate their ability to complete 10 functional tasks without special equipment. Univariate comparisons were completed using t-tests and chi-square statistics for racial comparisons of disability reports. Multinomial logistic regression was used to determine odds of reporting disability after controlling for relevant …

A Modified Ceramic-Coating Separator With High-Temperature Stability For Lithium-Ion Battery, Chuan Shi, Jianhui Dai, Chao Li, Xiu Shen, Longqing Peng, Peng Zhang, Dezhi Wu, Daoheng Sun, Jinbao Zhao

Publications

In this work, the ceramic coating separator (CCS-CS) prepared with polyethylene (PE) separator, Al₂O₃ inorganic particles, carboxymethyl cellulose sodium (CMC) and styrene-butadiene rubber (SBR) mix binders is further modified by coating with a thin polydopamine (PDA) layer through a simple chemical deposition method. Compared with the bare ceramic coating separator, the PDA-modified CCS-CS (CCS-CS-PDA) exhibits excellent thermal stability, which shows no thermal shrinkage after storing at 200 °C for 30 min. Compared with the PE separator, both the uptake and wettability with the electrolyte and water of CCS-CS-PDA are improved significantly. Meanwhile, when saturated with liquid electrolyte, the CCS-CS-PDA also …

Data Supporting The Effects Of Lysozyme On Mrna And Protein Expression In A Colonic Epithelial Scratch Wound Model, Sarah K. Abey, Paule V. Joseph, Natnael D. Kenea, Nicolaas H. Fourie, Lee Anne B. Sherwin, Christina M. Boulineaux, Kristen R. Weaver-Toedtman Phd, Acnp, Anp, Wendy A. Henderson

Publications

Colonic epithelial health is implicated in a host of gastrointestinal (GI) diseases and disorders. Lysozyme is suspected to play a role in the ability of the epithelium to recover from injury (Abey et al., in press; Gallo, 2012; Rubio, 2014) [1–3]. Disrupted repair mechanisms may lead to delayed or ineffective recovery and disruptions to epithelial biology resulting in GI symptoms and altered barrier function (Peterson and Artis, 2014) [4]. The effect of lysozyme on the transcriptomic and proteomic profile of healthy colonic epithelial cells was investigated. Epithelial cells in culture were scratch wounded and treated with lysozyme. mRNA and protein …

Patients Receiving Androgen Deprivation Therapy For Prostate Cancer Have An Increased Risk Of Depressive Disorder, Shiu-Dong Chung, Li-Ting Kao, Herng-Ching Lin, Sudha Xirasagar Mbbs., Ph.D., Chung-Chien Huang, Hsin-Chien Lee

Publications

Androgen deprivation therapy (ADT) results in testosterone suppression, a hypothesized mechanism linking ADT to depressive symptoms. This study investigated the relationship between ADT and the risk of subsequently being diagnosed with depressive disorder (DD) during a 3-year follow-up period. The patient sample for this population-based, retrospective cohort study was retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included all 1714 patients aged over 40 years with a first-time diagnosis of prostate cancer (PC) during 2001 to 2010 who did not have an orchiectomy. Among them, we defined 868 patients who received ADT during the 3-year follow-up period as …

Endoscopic Ultrasound (Eus)-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography Or Eus: Mid-Term Analysis Of An Emerging Procedure, Amy Tyberg, Jose Nieto, Sanjay Salgado, Kristen R. Weaver-Toedtman Phd, Acnp, Anp, Prashant Kedia, Reem Z. Sharaiha, Monica Gaidhane, Michel Kahaleh

Publications

Background/Aims: Performing endoscopic retrograde cholangiopancreatography (ERCP) in patients who have undergone Roux-en-Y gastric bypass (RYGB) is challenging. Standard ERCP and enteroscopy-assisted ERCP are associated with limited success rates. Laparoscopy- or laparotomy-assisted ERCP yields improved efficacy rates, but with higher complication rates and costs. We present the first multicenter experience regarding the efficacy and safety of endoscopic ultrasound (EUS)-directed transgastric ERCP (EDGE) or EUS. Methods: All patients who underwent EDGE at two academic centers were included. Clinical success was defined as successful ERCP and/or EUS through the use of lumen-apposing metal stents (LAMS). Adverse events related to EDGE were separated from …

Evaluation, Treatment, And Education In The Hospice Setting By Initiating A Formalized Pain Card, Alyssa M. Soprano

Theses and Dissertations

The purpose of this DNP quality improvement project was to evaluate the use of a formalized pain card that Nurse Practitioners could use to assist clients and caregivers in making the decisions necessary for safe and effective pain management with improving outcomes by using the Brief Pain Inventory Form for measuring: 1) decreased pain, 2) increased pain, 3) pain relief. The appraised evidence suggested that there was a need for a policy standard for patients to notify when pain is unrelieved despite exhausting all other efforts to control pain (Glowacki, 2015). Forty-one (n=41) hospice patients were surveyed pre and post …

Losing Weight With Five A’S (5 A’S): Assess, Advise, Agree, Assist, Arrange Framework And Motivational Interviewing (Mi) For Health Behavior Change Counseling, Jacqueline Baer

Theses and Dissertations

According to the Centers for Disease Control and Prevention (CDC), obesity has reached epidemic levels and has associated with increased risk of morbidity and mortality rates. The increasing prevalence of obesity is a major public health concern. Researchers calculate that health care costs are 44% higher among moderately and severely obese older persons than for persons at normal weights. Seventy-five percent of African American (AA) women are overweight and obese according to data from the CDC and The State of Obesity: Better Policies for a Healthier America. Compared to any other racial ethnic group, AA women are more likely to …

Barriers To The Use Of Guardrails On Iv Smart Pumps, Ivory Williams

Theses and Dissertations

Medication errors involving hospitalized patients have been an evolving challenge for decades. Moreover, errors related to intravenous (IV) medication administration continue to rise in hospitals despite implemented policies governing the use of Guardrails™ for safe IV medication infusion via smart pump technology. An organizational investigation was performed to identify barriers to the use of Guardrails™ among nursing staff. From 2015 through 2017, multiple interventions that aimed to identify barriers and increase nurses’ use of the safety features on IV smart pumps were implemented in the hopes of reaching a compliance goal of 90-100%. This quality improvement project assesses Guardrails™ compliance …

Improving Leadership Communication In Nurse-Physician Dyad Teams, Lisa James

Theses and Dissertations

Background: Changes in the delivery of healthcare services in the United States have been driven by cost containment over the last 20 years. To have a thriving organization within the current healthcare environment, nurses and physicians need to closely collaborate. As healthcare organizations prepare for the value-based era, new leadership models need to be implemented. This project addressed collaboration between nurse and physician leaders with a focused communication strategy to improve team performance, engagement, and quality outcomes in the acute care setting.

Method: A quality improvement project was designed to improve communication between front line team members and …

Simulation-Based Interprofessional Education In A Rural Setting, Ann D. Scott

Theses and Dissertations

The purpose of this project was to examine the feasibility and acceptability of a simulation-based IPE experience for pre-licensure nursing, pharmacy, and medical students on a rurally-located campus. Using a mixed-methods, explanatory sequential approach, this project: 1) examined the feasibility of implementing a simulation-based IPE experience using telehealth tools; and 2) evaluated student perceptions of inter-professional teamwork, roles and responsibilities, and patient outcomes for collaborative practice, both pre- and post-scenario.

Quantitative data were analyzed using SPSS. Results revealed 94% agreed/strongly agreed the IPE experience resembled a real-life situation. 100% of nursing/medical students and 80% of the pharmacy students indicated they …

An Evidence-Based Process Change To Improve Mammography Adherence, Tara E. Smalls

Theses and Dissertations

Breast cancer is a significant disease—affecting 12% of American women in a lifetime. Breast cancer costs $180 billion annually in healthcare expenditures and productivity. Mammography has been identified as the greatest tool to mitigate morbidity, yet in many organizations, mammography compliance rates are decreasing. This process improvement was conducted to address the barriers to patient follow through with mammography and to recommend strategies to improve the current breastscreening process.

Principles of the Six Sigma DMAIC framework were utilized to analyze the breast-screening clinic process. Chart reviews and organization databases were applied to determine mammography adherence. The opportunities to improve current …

Developing And Implementing A Quality Assurance Strategy For Electroconvulsive Therapy, Jessa Hollingsworth

Theses and Dissertations

The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care, however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed …

Tuberculosis Screening In New Healthcare Employees: A Comparison Of Quantiferon®-Tb Gold In-Tube Test And Tuberculin Skin Test, Mary C. Giovannetti

Theses and Dissertations

Background: Streamlining onboarding processes for new hires to maximize efficiency and reduce costs while meeting regulatory requirements is a constant challenge for healthcare systems’ Employee Health staff. Health screening is a required step and includes obtaining a detailed health history, tuberculosis screening, drug screens, immunizations, fit for duty examinations, obtaining medical records, clarification of disability accommodations, pre-work screens, and other tests which are time consuming and result in delays in hire dates. Faced with a high volume of potential new employee hires a major southeast healthcare system was concerned about delays in new hire start dates. The two-step tuberculin skin …

Scribes Impact On Patient And Provider Experience In The Outpatient Setting, Kimberly A. Taylor

Theses and Dissertations

The purpose of this project was to evaluate the effectiveness of using scribes in the outpatient setting on patient and provider experience. A mixed methods approach with a convenience sample of voluntary patient participants scheduled for an outpatient appointment was utilized. Two primary care physicians volunteered to receive scribes. Four hospital corpsmen were selected and trained to serve in the scribe role.

This quality improvement project evaluated two aspects of experience during the implementation of the scribes. These included: 1) patient experience as indicated via a pre and post implementation questionnaire; and 2) provider experience as indicated via a pre …

Picturing Rest: A Photovoice Study Of African American Women’S Perceptions And Practices Of Rest, Eboni T. Herbert Harris

Theses and Dissertations

African American women are consistently identified as being less likely to participate in sustained leisure time physical activity (Tussing-Humphreys, Fitzgibbon, Kong, & Odoms-young, 2013), yet more likely to be overweight or obese (Levi, Segal, Laurent, & Rayburn, 2014). There has been a wide range of initiatives directed towards preventing and/or reducing obesity among African Americans, such as targeted physical activity and nutrition interventions involving goal setting, group and individualized counseling, and social support. Previous research focused on African American women’s perceptions toward physical activity, nutrition, and weight; emphasize the consideration of cultural attitudes like placing a high value on rest …

A Quality Improvement Project To Reduce The Incidence Of Clostridium Difficile Infection Through Implementation Of Evidence-Based Terminal Clean Procedures, Tamara Cook

Theses and Dissertations

Hospital-acquired infections (HAIs) are a huge economic burden and threat to patient health and outcomes. Clostridium difficile is the most common HAI. Effective hand hygiene and proper environmental cleaning procedures are significant to preventing the spread of C. difficile infections. The research question used to guide this project is: Does the use of a monitoring system for post C. difficile isolation terminal clean procedure reduce the rate of hospital-acquired C. difficile in the acute care population? A thorough organizational assessment was performed and directed this project to identify causes that may contribute to the recurrences of C. difficile infections. The …

Adherence Of Nurse Practitioners To Jnc 8 Guidelines, Stephanie E. Averette

Theses and Dissertations

The purposes of the evidence based project were to implement a best practice algorithm for treatment of hypertension (HTN) based on JNC 8 guidelines; compare nurse practitioners HTN pharmacotherapy prescribing practices before and after implementation of a HTN algorithm; and compare hypertensive adult patients’ systolic blood pressure (SBP) readings before and after the implementation of a HTN algorithm. A quasi-experimental pre-test and post-test design was used to collect and analyze data from 61 patient charts to compare nurse practitioner adherence to JNC 8 guidelines for NPs’ prescribing practices and subjects’ blood pressure (BP) outcome before and after the implementation of …

Best Practice For Screening Adult Patients With Psoriasis For Polyautoimmunity: Celiac Disease, Rheumatoid Arthritis And Crohn’S Disease, Susan Danielle Ashbaugh

Theses and Dissertations

The purpose of this quality improvement project was to determine if screening primary care patients with psoriasis will improve early detection of celiac disease (CD), rheumatoid arthritis, and Crohn’s disease (CrD). The aim of this project is to assess the utility of early screening in patients with psoriasis in order to facilitate earlier diagnosis of CD, RA and CrD, which would consequently initiate earlier treatment and improve long-term patient outcomes. Genetic and population-based studies suggest that individuals with psoriasis have a greater risk of also having CrD, CD or RA, than do individuals without psoriasis. The literature also suggests that …

Assessment Of Providers’ Perception And Knowledge Of Overactive Bladder In Women: A Quality Improvement Project, Helen Wambui Ngigi

Theses and Dissertations

Background: OAB is defined by subjective symptoms, rather than objective measure, the patient’s perspective is important in managing OAB (Hung et al., 2013). As such providers need to capture the patient’s perspective of their OAB symptoms and their impact on the quality of life. A patient work up helps providers determine the cause of the symptoms as well as the degree of bother to the patient (Barkin, 2016). The diagnosis of OAB is essentially clinical and can be performed through structured questionnaires (Juliato et al., 2016). When conducting a patient history, it is important to determine the onset and severity …

Utility Of The Modified Early Warning System Score In Early Sepsis Identification, Lisa E. Hart

Theses and Dissertations

The purpose of this quality improvement project is to improve outcomes for patients presenting to the emergency department with sepsis, realizing that time is a key factor. The appraised evidence indicates that early recognition and prompt treatment improve outcomes and decrease mortality. The evidence further highlights that use of an early warning system, like the Modified Early Warning Score, can assist nurses and providers with recognizing deterioration more quickly and lead to a reduction in time to interventions. Between January 2016 and March 2017, the author conducted a retrospective chart review to compare time to antibiotic administration and lactate measurement …

Dielectrically-Loaded Cylindrical Resonator-Based Wireless Passive High-Temperature Sensor, Jijun Xiong, Guozhu Wu, Qiulin Tan, Tanyong Wei, Dezhi Wu, Sanmin Shen, Helei Dong, Wendong Zhang

Publications

The temperature sensor presented in this paper is based on a microwave dielectric resonator, which uses alumina ceramic as a substrate to survive in harsh environments. The resonant frequency of the resonator is determined by the relative permittivity of the alumina ceramic, which monotonically changes with temperature. A rectangular aperture etched on the surface of the resonator works as both an incentive and a coupling device. A broadband slot antenna fed by a coplanar waveguide is utilized as an interrogation antenna to wirelessly detect the sensor signal using a radio-frequency backscattering technique. Theoretical analysis, software simulation, and experiments verified the …

Multi-Omics Analysis Reveals Molecular Mechanisms Of Shoot Adaption To Salt Stress In Tibetan Wild Barley, Qiufang Shen, Liangbo Fu, Fei Dai, Lixi Jiang, Guoping Zhang, Dezhi Wu

Publications

BACKGROUND: Tibetan wild barley (Hordeum spontaneum L.) has been confirmed to contain elite accessions in tolerance to abiotic stresses, including salinity. However, molecular mechanisms underlying genotypic difference of salt tolerance in wild barley are unknown. RESULTS: In this study, two Tibetan wild barley accessions (XZ26 and XZ169), differing greatly in salt tolerance, were used to determine changes of ionomic, metabolomic and proteomic profiles in the shoots exposed to salt stress at seedling stage. Compared with XZ169, XZ26 showed better shoot growth and less Na accumulation after 7 days treatments. Salt stress caused significant reduction in concentrations of sucrose and metabolites …

Variation In Type And Frequency Of Diagnostic Imaging During Trauma Care Across Multiple Time Points By Patient Insurance Type, Nathaniel Bell, Laura Repáraz, William R. Fry, R Stephen Smith, Alejandro Luis

Faculty Publications

BACKGROUND:

Research has shown that uninsured patients receive fewer radiographic studies during trauma care, but less is known as to whether differences in care are present among other insurance groups or across different time points during hospitalization. Our objective was to examine the number of radiographic studies administered to a cohort of trauma patients over the entire hospital stay as well as during the first 24-hours of care.

METHODS:

Patient data were obtained from an American College of Surgeons (ACS) verified Level I Trauma Center between January 1, 2011 and December 31, 2012. We used negative binomial regression to construct …

The Hvnramp5 Transporter Mediates Uptake Of Cadmium And Manganese, But Not Iron, Dezhi Wu, Naoki Yamaji, Miki Yamane, Miho Kashino-Fujii, Kazuhiro Sato, Jian Feng Ma

Publications

The Natural Resistance Associated Macrophage Protein (Nramp) represents a transporter family for metal ions in all organisms. Here, we functionally characterized a member of Nramp family in barley (Hordeum vulgare), HvNramp5. This member showed different expression patterns, transport substrate specificity, and cellular localization from its close homolog in rice (Oryza sativa), OsNramp5, although HvNramp5 was also localized to the plasma membrane. HvNramp5 was mainly expressed in the roots and its expression was not affected by Cd and deficiency of Zn, Cu, and Mn, but slightly up-regulated by Fe deficiency. Spatial expression analysis showed that the expression of HvNramp5 was higher …