Nursing Commons^™

Increasing Pre-Procedure Communications To Decrease Colonoscopy Cancellations, Natalie Brooke Midkiff

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Colonoscopies play a vital role in early colorectal disease detection and prevention. Yet, the field of gastroenterology faces a persistent challenge - frequent procedure cancellations and incomplete examinations due to suboptimal bowel preparation. This not only compromises the effectiveness of colonoscopies but also poses potential health risks.

Purpose: This project aimed to reduce procedure cancellations and incomplete examinations by regularly communicating pre-procedure instructions and reminders through text messages and phone calls.

Inclusion Criteria: The criteria were clearly defined, targeting patients aged 18 and older who needed colonoscopies. This focus ensured the project's relevance to specialized gastrointestinal intervention. Establishing …

Identification Of Obstructive Sleep Apnea Symptoms Among Veterans In The Primary Care Setting, John Dominic Rosella Iv

Doctor of Nursing Practice Scholarly Projects

Untreated obstructive sleep apnea (OSA) has long-term cardiovascular and metabolic health implications, impacting quality of life and increasing health expenditures. Veterans have a higher prevalence rate of OSA attributed to an aging population and higher rates of comorbid conditions. The problem of under recognition of OSA symptoms partly relates to clinicians needing to elicit relevant symptoms routinely. At the same time, the lack of primary-care-based screening protocols contributes to the percentage of undiagnosed OSA. The purpose of this evidence-based project was to implement routine screening to identify OSA risk among veterans in primary care settings in South Carolina. The method …

Depression In Individuals With Chronic Liver Disease: Improving Screening In The Outpatient Setting, Kayla Corine Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Individuals with chronic conditions such as chronic liver disease experience higher rates of depression, often underdiagnosed and placing high risk demographics in jeopardy of adverse outcomes, including worsening prognosis, decreased quality of life, and increased symptomatology.

Purpose: Evidence advocates for routine depression screening within high-risk patient populations. This paper outlines the implementation of a quality improvement initiative aimed at enhancing depression screening at a selected outpatient liver clinic within an extensive hospital system by implementing the PHQ-9 questionnaire during patient clinic visits, where no standardized screening protocol was previously in place.

Methods: The Plan-Do-Study-Act cycle guided the implementation …

Shared Trauma: An Evolutionary Model Concept Analysis In Light Of Covid-19, April Hutto, Phyllis Raynor Phd, Aprn, Pmhnp-Bc, Beverly Baliko Phd, Rn, Pmhnp-Bc

Publications

Shared trauma (ST) is a term historically applied to social work experiences, but other healthcare professionals (HCP) also experience ST. With the occurrence of COVID-19, ST has impacted HCP globally and has led to new discoveries and more questions regarding its scope, impact and duration. This article aims to explore the concept of ST applied to nurses in light of COVID-19 using the Rogers and Knafl Evolutionary Model for Concept Analysis. Further examination and evolution of ‘shared trauma’, particularly during COVID-19, has led to the development of an adapted model to explore the implications of ST on health-related outcomes for …

Efficacy Of, And Barriers To, Treatment Options For Pans/Pandas, Kayla E. Pray

Senior Theses

Background: PANS/PANDAS are pediatric autoimmune disorders that cause an acute-onset of OCD-like symptoms and/or severe restricted eating, as well as anxiety, irritation, deterioration of fine motor skills, hyperactivity, and other psychiatric symptoms. An estimated 1-2% of the pediatric population is affected. Currently, there is little research published on the treatment options for PANS/PANDAS and there is no evidence-based consensus on the best treatment option.

Purpose: This study aimed to discover the efficacy of, and barriers to, available treatment options for PANS/PANDAS.

Methods: A convenience sample of individuals diagnosed with PANS/PANDAS or their parent/caregiver was recruited anonymously through Facebook support groups. …

Factors Affecting The Transition From Pediatric To Adult Care Among Culturally Deaf Young Adults And Young Adults Who Are Deaf Or Hard Of Hearing, Anna Strickland Kell

Theses and Dissertations

Introduction: Adolescence to adulthood is marked by many transitions, including the transition from a pediatric to an adult medical home, also referred to as a health home. For young adults who are culturally Deaf, deaf, or hard of hearing, this transition may be complicated by population-specific needs related to language, literacy, and accessibility. Prior research with transition-age adolescents and young adults who are culturally Deaf, deaf, or hard of hearing has primarily focused on education or hearing health exclusively. The purpose of this research was to investigate the transition of health care from pediatric to adult services among culturally Deaf …

Uncovering The Complexity Of Perinatal Polysubstance Use Disclosure Patterns On X: Mixed Methods Study, Dezhi Wu, Hannah Shead, Yang Ren, Phyllis Raynor Phd, Aprn, Pmhnp-Bc, Youyou Tao, Harvey Villanueva, Peiyin Hung, Xiaoming Li, Robert G. Brookshire, Kacey Eichelberger, Constance Guille, Alain H. Litwin, Bankole Olatosi Ph.D.

Publications

BACKGROUND: According to the Morbidity and Mortality Weekly Report, polysubstance use among pregnant women is prevalent, with 38.2% of those who consume alcohol also engaging in the use of one or more additional substances. However, the underlying mechanisms, contexts, and experiences of polysubstance use are unclear. Organic information is abundant on social media such as X (formerly Twitter). Traditional quantitative and qualitative methods, as well as natural language processing techniques, can be jointly used to derive insights into public opinions, sentiments, and clinical and public health policy implications. OBJECTIVE: Based on perinatal polysubstance use (PPU) data that we extracted on …

I Don't Know How To Live Real Life Sober'-Identifying Needed Supports Through The Voices Of Pregnant And Parenting People Seeking Recovery, Phyllis Raynor, Cynthia F. Corbett, Delia West, Constance Guille, Kacey Eichelberger, Alain Litwin, Ron Prinz

Publications

Pregnant and parenting people (PPP) experience complex challenges when seeking recovery from substance use disorders (SUD). Using a community-based participatory research approach, researchers partnered with PPP seeking recovery from SUD to explore supports needed in their communities. Findings are reported in adherence with the consolidated criteria for reporting qualitative research. Thirty PPP were recruited from a residential drug recovery facility in the Southeastern United States. Participant interviews were conducted in-person or virtually. PPP were asked to identify existing and needed parenting and recovery supports in their communities. Interviews were transcribed, verified for accuracy and coded using NVIVO software. Thematic analysis …

Exploring Barriers To Effective Covid-19 Risk Mitigation, Recovery, And Chronic Disease Self-Management: A Qualitative Multilevel Perspective, Gayenell S. Magwood Phd, Rn, Faha, Faan, Charles Ellis, Chanita Hughes Halbert, Ebony Allen Toussaint, Jewel Scott Phd, Rn, Fnp-C, Lynne S. Nemeth

Publications

INTRODUCTION: Many research activities have focused on SARS-CoV-2 infection and subsequent COVID-19 respiratory illness during the pandemic. However, significant racial inequities emerged months after the COVID-19 pandemic began. The similarity between racial/ ethnic disparities in COVID-19 and those for other diseases raised awareness about the context for risk exposure and healthcare access. The purpose of this study is to examine social and structural determinants of health among COVID-19 survivors, carepartners, and the perspectives of healthcare stakeholders who experienced disruption during the early pandemic. MATERIAL AND METHODS: A purposive sample of interviews (n=9) and focus groups (n=10) were used to collect …

Exploring Barriers To Effective Covid-19 Risk Mitigation, Recovery, And Chronic Disease Self-Management: A Qualitative Multilevel Perspective, Gayenell S. Magwood Phd, Rn, Faha, Faan, Charles Ellis Jr, Chanita Hughes Halbert, Ebony Allen Toussaint, Jewel Scott Phd, Rn, Fnp-C, Lynne S. Nemeth

Faculty Publications

Introduction: Many research activities have focused on SARS-CoV-2 infection and subsequent COVID-19 respiratory illness during the pandemic. However, significant racial inequities emerged months after the COVID-19 pandemic began. The similarity between racial/ ethnic disparities in COVID-19 and those for other diseases raised awareness about the context for risk exposure and healthcare access. The purpose of this study is to examine social and structural determinants of health among COVID-19 survivors, carepartners, and the perspectives of healthcare stakeholders who experienced disruption during the early pandemic.
Material and methods: A purposive sample of interviews (n=9) and focus groups (n=10) were used to collect …

Addressing A Crisis In Nursing Practice: Exploring The Impact Of Multimedia Case-Based Learning On The Clinical Judgment Of Undergraduate Nursing Students, Macy Jenette Bennett

Theses and Dissertations

Clinical judgment is a priority nursing skill to ensure the delivery of safe and effective nursing care. New graduate nurses and nursing students lack the clinical judgment skills that are necessary for entry-level nursing practice. Nurse educators must therefore implement teaching strategies that facilitate clinical judgment. This study evaluated the clinical judgment of undergraduate nursing students after the implementation of multimedia case studies related to the concept of perfusion. Two research questions guided this study: (a) in what ways do undergraduate nursing students demonstrate clinical judgment after completing a series of perfusion-related multimedia case studies and (b) to what extent …

Equity-Informed Social Media Covid-19 Risk Communication Strategies: A Scoping Review, Nedra Peter, Lorie Donelle Phd, Rn, Fcan, Catherine George, Anita Kothari

Publications

OBJECTIVES: The COVID-19 pandemic has had devastating worldwide impact but most prominent was its effect on marginalised, underserved and equity-deserving populations. Social media arose as an important platform from which health organisations could rapidly disseminate information to equity-deserving populations about COVID-19 risks and events, provide instructions on how to mitigate those risks, motivate compliance with health directives, address false information, provide the opportunity for engagement and immediate feedback. The objective of this scoping review was to synthesise the academic and grey literature on equity-informed social media risk communication strategies developed during the pandemic. DESIGN: The review followed the Arksey and …

Patient-Reported Outcomes From The Phase Iii Himalaya Study Of Tremelimumab Plus Durvalumab In Unresectable Hepatocellular Carcinoma, Bruno Sangro, Peter R. Galle, Robin Kate Kelley, Chaiyut Charoentum, Enrico N. De Toni, Yurii Ostapenko, Jeong Heo, Ann-Lii Cheng, Andrea Wilson Woods, Charu Gupta, Jayne Abraham, Carrie L. Mccoy Phd, Rn, Anp-Bc, Nikunj Patel, Alejandra Negro, Arndt Vogel, Ghassan K. Abou-Alfa

Publications

PURPOSE:

In the phase III HIMALAYA study (ClinicalTrials.gov identifier: NCT03298451) in unresectable hepatocellular carcinoma (uHCC), the Single Tremelimumab Regular Interval Durvalumab (STRIDE) regimen significantly improved overall survival versus sorafenib, and durvalumab monotherapy was noninferior to sorafenib. Patient-reported outcomes (PROs), a secondary outcome from HIMALAYA, are reported here.

METHODS:

Participants were randomly assigned to receive STRIDE, durvalumab, or sorafenib. PROs were assessed (preplanned secondary outcome) using the European Organization for Research and Treatment of Cancer 30-item Quality of Life Questionnaire and the 18-item HCC module. Time to deterioration (TTD), change from baseline and improvement rate in global health status/quality of life …

Automatic Uncovering Of Patient Primary Concerns In Portal Messages Using A Fusion Framework Of Pretrained Language Models, Yang Ren, Yuqi Wu, Jungwei W. Fan, Aditya Khurana, Sunyang Fu, Dezhi Wu, Hongfang Liu, Ming Huang

Publications

Objectives: The surge in patient portal messages (PPMs) with increasing needs and workloads for efficient PPM triage in healthcare settings has spurred the exploration of AI-driven solutions to streamline the healthcare workflow processes, ensuring timely responses to patients to satisfy their healthcare needs. However, there has been less focus on isolating and understanding patient primary concerns in PPMs-a practice which holds the potential to yield more nuanced insights and enhances the quality of healthcare delivery and patient-centered care. Materials and Methods: We propose a fusion framework to leverage pretrained language models (LMs) with different language advantages via a Convolution Neural …

“We Rely On Each Other”: A Qualitative Exploration Of Rural Eastern Region Native American Experiences During The Covid-19 Pandemic, Robin M. Dawson Phd, Rn, Cpnp-Pc, Hunter M. Boehme, Stephen Criswell Ph.D., Julia Dunham-Thornton, Melissa S. Nolan Ph.D., Mph

Publications

Background: Native American communities suffered disproportionately negative effects during the COVID-19 pandemic, yet no research has explored the experiences of rural Eastern Region Native Americans. Methods: Informed by the Native Reliance Model and Indigenous Standpoint Theory, we conducted a qualitative descriptive project in the Spring and Summer of 2022; data included semi-structured interviews and focus groups with 24 individuals representing five South Carolina tribal groups. Findings: Thematic analysis yielded four emergent themes: 1) “Let's just finish the Indians off”: Pandemic distrust rooted in historical and contemporary Native American experiences; 2) “We have been misled”: Making sense of conflicting public health …

Toward Concurrent Identification Of Human Activities With A Single Unifying Neural Network Classification: First Step, Andrew Smith, Musa Azeem, Chrisogonas O. Odhiambo, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Hanim E. Diktas, Spencer Upton, Corby K. Martin, Brett Froeliger, Cynthia F. Corbett, Homayoun Valafar

Publications

The characterization of human behavior in real-world contexts is critical for developing a comprehensive model of human health. Recent technological advancements have enabled wearables and sensors to passively and unobtrusively record and presumably quantify human behavior. Better understanding human activities in unobtrusive and passive ways is an indispensable tool in understanding the relationship between behavioral determinants of health and diseases. Adult individuals (N = 60) emulated the behaviors of smoking, exercising, eating, and medication (pill) taking in a laboratory setting while equipped with smartwatches that captured accelerometer data. The collected data underwent expert annotation and was used to train a …

Evaluation Of A Team-Based Model Of Nursing Care In The Acute Care Setting, Vanetta W. White

Doctor of Nursing Practice Scholarly Projects

Problem: The current nursing shortage is much different than the ones we have experienced in previous years. It is predicted that it will have long-lasting effects. With this shortage of nurses, especially in the acute care setting, alternative methods to deliver patient care beyond the current use of primary care models need to be explored. These alternative models of care which include team-based nursing must maintain quality and safety for patients cared for.

Purpose: This project will evaluate the outcomes of returning to a team-based nursing model of care on a medical-surgical unit while continuing to provide safe, quality care …

Implementation And Evaluation Of A Neonatal Resucitation Program Protocol In Stand-Alone Emergency Department, Hannah Collins Walden

Doctor of Nursing Practice Scholarly Projects

Problem statement: Within nursing there are some skills that hold a significant amount of risk. This includes neonatal resuscitation within stand-alone emergency departments. Due to the low frequency of opportunities to practice neonatal resuscitation, nurses must utilize alternative methods to maintain current evidence-based practice. Purpose: The purpose of this project was to evaluate the effectiveness of a protocol incorporating Neonatal Resuscitation Program (NRP) preparedness and simulation to increase stand-alone emergency department nurses’ perceived clinical competence to performing neonatal resuscitation. Methods: The development and implementation of a protocol that defines and incorporates NRP roles, provides a maintenance checklist for …

Measurement-Based Mental Health In Adolescents, Ayzia Lynn Taylor

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adolescent mental health is a growing concern. Children and adolescents are commonly diagnosed with Attention Deficit Hyperactive Disorder (ADHD), anxiety, and depression. Some youth may also experience co-occurring symptoms that their primary healthcare provider must distinguish to appropriately diagnose and treat.

Purpose: The project aimed to implement measurement-based care for adolescents between the ages of 12 to 18 in a pediatric outpatient facility that is not currently utilizing post-assessment screening tools. The project seeks justification for treatment options utilizing pre-assessment screening tools and therapeutic relief with medication intervention determined by post-assessment screening results.

Methods: Adolescents between the ages …

Implementation Of Shared Decision Making To Impact Decisional Conflict In Advancing Chronic Kidney Disease, Margaret Mcannar Sorkin

Doctor of Nursing Practice Scholarly Projects

Problem Statement: A notable phenomenon in nephrology is indecision regarding treatment for End Stage Renal Disease (ESRD). Indecision regarding treatment for ESRD can lead to suboptimal dialysis starts, creating poorer health outcomes, decreased quality of life, and higher healthcare costs. Purpose: This project aimed to determine if participation in a shared decision-making (SDM) program decreases decisional conflict in patients with advancing renal disease deciding between ESRD treatment options. Methods: A pretest-posttest design was used. Participants were recruited from a private nephrology practice. Inclusion Criteria: English-speaking patients, over the age of 20, with Chronic Kidney Disease Stages 4 or 5 (estimated …

Implementing The 5a’S Of Obesity Management In Primary Care, Holly H. Rowell

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The prevalence of obesity continues to increase globally, with greater prevalence in the southern United States, resulting in higher costs to the healthcare system and greater risks for the development of other chronic diseases. Purpose: Determine if implementing the 5A’s of Obesity Management among primary care providers in a rural, low-income healthcare setting will increase the diagnosis of obesity and result in a subsequent decrease in weight among patients who are obese. Methods: An educational session was held to familiarize providers with the 5A’s of Obesity Management and the importance of obtaining and documenting proper height …

Impact Of Hydrogen Peroxide Wipes Disinfecting Clostridioides Difficle On High-Touch Surfaces, Tyler Wolf Ramirez

Doctor of Nursing Practice Scholarly Projects

Clostridioides difficile is the leading cause of nosocomial diarrheas worldwide (Centers for Disease Prevention and Control [CDC], 2022). 15% of all hospitalized patients in the United States develop antibiotic-associated diarrhea (AAD), with 15-25% of cases caused by C. difficile (CDC, 2022). C. difficile costs the United States Healthcare system $5.4-6.3 billion annually (Balsells et al., 2019). The project’s purpose was to see if implementing hydrogen peroxide (H2O2) wipes using an interprofessional team leads to the following expected outcome(s): reduction in hospital-acquired C. difficile infections and comparable disinfection rates to sodium hypochlorite. An interprofessional team consisting of the primary lead, Clinical …

Human Papillomavirus Vaccination Rates Among Adolescents In South Carolina, Rebecca Jane Morrison

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Among adolescents 11-17 years of age in South Carolina, low rates of human papillomavirus (HPV) vaccination can negatively impact health outcomes through increased risk of acquiring HPV-associated cancers.

Purpose: To determine if the 4 Pillars™ Immunization Toolkit increased HPV vaccination rates among adolescent patients.

Methods: The 4 Pillars™ Immunization Toolkit was the framework for this bundled intervention. Pillar 1, convenience and easy access, included after-school HPV express clinics. Pillar 2, communication, utilized staff motivational interviewing skills, campaign promotion materials, documentation of declination, and second-dose callback appointments. Pillar 3, enhanced vaccination systems, was designed to use …

Impact Of The Blaylock Risk Assessment Screening Score On Inpatient Length Of Stay On Inpatient Psychiatric Units Within An Acute Care Hospital, Princess P. Minter

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Insufficient discharge planning at the time of patient admission can result in increased hospitalization length of stay and poor clinical outcomes, including a rapid deterioration of stabilized patients’ mental status while unnecessarily waiting for discharge arrangements to be put in place at the time of discharge. Purpose: To determine if completing the Blaylock Risk Assessment Screening Score (BRASS) index tool to identify barriers to discharge at the time of patient admission impacts the length of stay for patients admitted to general psychiatric inpatient units. Methods: Patient admission and discharge data collected using the BRASS index within 48 hours …

Assessing Readiness To Quit As An Intervention For Tobacco Cessation In Oncology Patients, Victoria Gabriela Maddox

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Smoking and tobacco use is the leading cause of preventable death in the United States. Twenty percent of all cancer diagnoses are directly linked to smoking, and tobacco-related diseases and cancers contribute to one in every five deaths annually in the United States. Less than one in ten smokers are successful at quitting. Smokers attempting to quit are more successful in cessation programs after evaluation of self-efficacy, such as the readiness to quit.

Purpose: This evidence-based practice project aimed to evaluate the impact of motivational interviewing with the 5A’s model on smoking cessation efforts in patients at an …

Use Of An Audit And Feedback Tool And Sglt-2 Inhibitors To Delay Progression Of Chronic Kidney Disease, Megan Elaine Lanpher

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adults with Type 2 diabetes mellitus and chronic kidney disease experience a higher risk for progression to end-stage kidney disease, which negatively impacts health, increases medical costs, and decreases quality of life. Purpose: Determine if an audit and feedback intervention in a local nephrology clinic can increase provider adherence to a clinical practice guideline that supports the prescription of sodium glucose cotransporter-2 (SGLT-2) inhibitors. Methods: A pretest-posttest design was used to determine if an audit and feedback tool delivered to providers at three-week intervals would increase prescription of SGLT-2 inhibitors in adults with Type 2 diabetes and chronic …

Appropriate Policies For Patients Utilizing Insulin Pumps With Continuous Glucose Monitoring During Hospital Admission, Mary Elizabeth Holiday

Doctor of Nursing Practice Scholarly Projects

Problem Statement: A growing number of patients with diabetes are using advanced diabetes management technology with an integrated insulin pump and continuous glucose monitor (CGM); however, multiple concerns surround their use during hospitalization, ranging from patient safety risks to nursing comfort in overseeing these devices.

Purpose: This project aimed to determine if an accurate, reformed inpatient policy supporting specific automated insulin pump use during admission maintained patient glucose control, improved patient satisfaction, and increased nursing comfort levels.

Methods: Pre- and post-policy nursing knowledge surveys, retrospective admission glucose metrics, and patient experience narratives were evaluated.

Inclusion Criteria: Patients and nurses were …

Reducing Wait Times For Psychiatric Intakes, Ryan Brad Carsten

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Early intervention for mental illness is vital to a swift recovery and extended wait times for mental health treatment have proven to be a barrier to early intervention. Purpose: The purpose of this quality improvement project was to determine if wait times for psychiatry intakes at the University of South Carolina (USC) Student Health Center Psychiatry Services can be reduced and kept under 1 week by utilizing the Specific Timely Appointments for Triage (STAT) model. This model consists of clinicians scheduling a specified number of intake appointments based on the typical demand for service. Students were booked in …

Using Visual Thinking Strategies To Increase Empathy Levels In Inpatient Psychiatric Nurses: A Quality Improvement Project, Katharine E. Harding

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Research indicates that empathy is declining in today’s behavioral health nursing workforce. Purpose: The aim of this quality improvement project was to apply an evidence-based Visual Thinking Strategies intervention to the clinical problem and increase empathy levels from pre-survey measurement among psychiatric nurses. Method: VTS methodology was employed through in-person interviews where participants viewed art-based images pertaining to mental health. Feedback from semi-structured questions was shared among participants. Pre and post-test interventional quantitative data via The Jefferson Scale of Empathy-Health Provider version (JSE-HP) and The Interpersonal Reactivity Index (IRI) instruments were collected. Inclusion Criteria: Participants were voluntarily recruited …

Examining Risk Factors For Early-Onset Breast Cancer, Jennifer Grace Taylor

Theses and Dissertations

Introduction: There have been great advancements in screening and in the identifying of risk factors associated with breast cancer, however, there is a lack of information of these factors in women with breast cancer occurring under the age of 45, known as early-onset breast cancer (EOBC). EOBC is often found at later stages, negatively impacting young women’s careers, family planning, and mental health. Additionally, because of the health disparities that exist within the U.S. health care system, women belonging to racial and ethnic groups, specifically young Black women, tend to have poorer outcomes and higher mortality rates of EOBC …