Nursing Commons^™

Assessment Of Organizational Readiness: Parent Advisory Councils In A Children's Hospital Within A Hospital, Suzanne R. Springate

DNP Projects

Background: A children’s hospital within a hospital (CHWH) in the Midwest region of the United States established a strategic goal to become the preferred provider for children in the region. Outcomes in patient and family experience had fallen short of established organizational expectations. Recognizing that parent advisors are an essential component of patient and family centered care, the strategic plan called for integrating parents into formal, advisory roles.

Purpose: The purpose of this practice improvement project was to perform an assessment of organizational readiness to incorporate parents into formal advisory roles at this CHWH.

Methods: A cross-sectional survey design was …

Examining The Effectiveness Of An Intervention To Increase Provider Assessment Of Overweight And Obesity In The Primary Care Setting, Kristena R. Lea

DNP Projects

Obesity is an epidemic among adults in the United States, leading to a multitude of co-morbidities and billions of dollars in annual healthcare expenditures. Although primary care is the ideal setting for identification and treatment of overweight/obesity, it is often overlooked by providers. This capstone project was formed by three manuscripts, which were written to explore the lack of overweight/obesity identification and treatment in the primary care setting. Emphasis was made throughout the three manuscripts on the importance of providers using body mass index (BMI) as an objective means to discuss overweight/obesity with patients. The first manuscript is an integrative …

Implementing A Hospital-Acquired Pressure Ulcer Prevention Program, Maryann L. Lancaster

DNP Projects

Objective: To implement a Hospital-Acquired Pressure Ulcers (HAPU) prevention program utilizing an assessment tool to identify patients at risk, and intervene with a sacral Mepilex® dressing. Our aims are to determine if a change in nursing knowledge and change in nursing behavior after implementing our program.

Background: HAPUs are a significant problem in patient care and healthcare organizations must implement prevention protocols to reduce HAPU prevalence. Guidelines for implementing HAPU prevention programs suggest use of a validate risk assessment tool and initiating preventive interventions. One intervention found in the literature is the adjunctive use of prophylactic Mepilex® dressings to sacral …

Dnp Practice Inquiry Project Report: Depression Screening In Primary Care, Mary Kathleen Stafford

DNP Projects

Depression affects many people worldwide and is a leading cause of disability. National guidelines and recommendations have been created that support screening for depression in the primary care setting, however due to many barriers depression screening is often not performed or documented. This capstone project consists of three manuscripts, which evaluate the lack of depression screening in the primary care setting. The first manuscript is an integrative review of the literature to support depression screening in primary care and to address barriers to depression screening. The second manuscript is a guideline analysis of a national guideline published by the Institute …

Measuring Providers’ Adherence To The American Diabetes Association Screening Recommendation For Prevention Of Diabetic Nephropathy, Whitney R. Munroe

DNP Projects

Purpose: The purpose of this study was to evaluate provider adherence to the ADA’s recommendation for an annual screening urinary albumin excretion level to check for the presence of microalbuminuria. A secondary objective was to assess for adequate treatment (i.e. ACE inhibitor or ARB prescription) in those patients with microalbuminuria present.

Methods: A retrospective chart review was conducted on 60 randomly selected patients seen within a primary care practice in an urban university setting between January 1^st, 2014 and December 31^st, 2014. Inclusion criteria included age ≥ 18 years and an active diagnosis of type 2 …

Efforts To Improve Colorectal Cancer Screening Rates, Yong S. Girdler

DNP Projects

This project attempts to describe the efficacy of FOBT (guaiac-based FOBT & fecal immunochemical test), explore FluFOBT program, and examine the relationship between advanced practice registered nurse knowledge level about CRC screening recommendation guideline and self-reported referral rates in efforts to improve CRC screening rates.

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

Stress In Parents Of Children With Type 1 Diabetes, Megan B. Carter

DNP Projects

Pediatric healthcare providers across the country care for many children with complex chronic diseases. Many of these children are not developmentally mature enough to manage their disease process, leaving the parent of the chronically ill child to manage their disease. The parent of the chronically ill child may experience stress related to their child’s illness, termed pediatric parenting stress, and may have difficulty dealing with this stress (Streisand, Kazak, & Tercyak, 2003). The manuscripts in this Practice Inquiry Project further investigate the relationship between pediatric parenting stress and the health of the parent and the chronically ill child. The instruments …

Evaluation Of An Educational Intervention To Improve Nurse Managers' Understanding Of And Self-Assessed Competence With Personnel Budgeting, Sue J. Mcfarlan

DNP Projects

Purpose: The purpose of this paper is to report on the process and outcomes of a DNP practice inquiry project.

Design: The design is a pretest posttest comparative evaluation.

Setting: The University of Kentucky Healthcare Chandler, Samaritan, and KY Children’s hospitals.

Subjects: A voluntary convenience sample of nurse managers was obtained (n=10)

Intervention: The intervention was a 2 hour didactic session and an individualized one-on-one educational session focused on general healthcare finance terms and more specifically on personnel budgeting and productivity metrics

Measures: The pretest and posttest consisted of 20 questions obtained from healthcare finance texts and preparatory materials for …

Adolescent Risk Behaviors, Screening, And Referral At An Adolescent Health Clinic: A Retrospective Review, Cheryl Marrs

DNP Projects

Aim: Investigate provider patterns of risk behavior screening at an adolescent health clinic and describe findings from a study that investigated patterns of risk behavior screening in an adolescent health clinic.

Background: Adolescents who engage in risky behaviors are vulnerable to problems with current and future mental health issues such as depression, substance use, or other psychiatric disorders. Identifying the risky behaviors in adolescents that are associated with the potential presence of depressive symptoms can be helpful to the provider when deciding to refer an adolescent for further mental health assessment. Provider fidelity in risk behavior screening is central to …

Pediatric Oncology Nurses’ Knowledge Of Safe Administration Of Chemotherapy/Biotherapy, Leslee A. Bertram

DNP Projects

The introduction of chemotherapy in pediatric oncology tremendously impacted the survival of children with cancer. In the past 60 years, the survival rates of children with cancer have drastically improved with 5-year survival rates of the most common types of childhood cancer nearing 90%. Use of chemotherapeutic agents is not without risk as they are administered in a variety of routes and doses. Disturbingly high error rate ranging from 4% to 18%, depending upon the administration setting (inpatient or outpatient) are reported in the literature (Watts & Parsons, 2013).

Chemotherapy errors have the potential to be lethal because of a …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

Evaluating The Effectiveness Of Crucial Conversations® Training On Nurses’ Self-Efficacy, Deeanna R. Mccallie

DNP Projects

Background: The history of nurse/physician communication is well documented. Although there is no universal definition of nurse-physician communication, an increasing body of evidence identifies this factor as an important component of organizing and delivering safe, quality care to patients. Communication has been identified as the root cause in 65% of sentinel events and noted as having significant effect on patient outcomes; contributing significantly to increasing care coordination, decreasing length of stay, and decreasing mortality rates. Purpose: To examine whether Crucial Conversations® training improves nurses’ self-efficacy scores and assess whether clinical nurse report improved ability to communicate with physicians. Methods: A …

Assessment Of Nurses’ Views And Current Practice Of Trauma-Informed Pediatric Nursing Care: Oncology, Alesandra S. Conley

DNP Projects

Purpose: The purpose of this project is to: (i) assess and evaluate the awareness, knowledge and current practice trends of pediatric oncology nurses as they relate to pediatric trauma-informed care. Methods: A prospective, cross-sectional sample of convenience was used to assess pediatric nursing staff at the Kentucky Children’s Hospital. The survey used in this study was replicated from a previous study, “Nurses’ Views and Current Practice of Trauma-Informed Pediatric Nursing Care,” authored by Kassam-Adams et al., nurses and doctors affiliated with Children's Hospital of Philadelphia, University of Pennsylvania, Penn State Hershey Children's Hospital, Nemours Child Health System, Children's Hospital of …

Childhood Nutrition And Lifestyle In Owensboro, Kentucky, Mckenzie J. Mattingly

DNP Projects

According to the CDC, childhood obesity is now one of the leading health problems in the United States. Thirty-five percent of adults in the United States are obese. Kentucky is the 12th most obese state for adults. and the 7th most obese state for children. The State of Obesity: Better Policies for a Healthier America, states that Kentucky’s adult obesity rate is currently 31.6 percent. This is up from 21.7 percent in 2000 and 12.7 percent in 1990. Primary care providers must work to help prevent these numbers from continuing to climb. Since our population of children who are overweight …

Improving Nutritional Status In The Hematologic Oncology Population, Mary A. Malone

DNP Projects

Background: Patients undergoing treatment for both solid tumor and hematologic malignancies experience numerous symptoms that greatly affect their nutritional status. Malnutrition can have a negative impact on oncology patient outcomes. There is a reduced response to treatment, reduced survival and quality of life. Early and consistent interventions have proven beneficial in the oncology population.

Most hematologic cancer patients have good nutritional health. However, as their treatments intensify, side effects compared to their solid tumor counterparts can adversely affect nutrition. Interventions, consisting of total parenteral or enteral nutrition are initiated but only after oral intake has been impeded for 2-3 days. …

Examining The Relationship Between Type And Extent Of After-School Care Use And High Bmi In Children Ages 5-17, Morgan E.B. Chojnacki

DNP Projects

Objectives: The purpose of this study was to examine the relationship between body mass index (BMI) and after-school care use in school age children and adolescents in Kentucky. The specific aims of this study were to examine differences in BMI groups (high versus normal/low) by: a) type and b) extent of after-school care use.

Methods: Parents of children age 5-17 years were administered a 21-item survey which assessed the amount of time their children spent in specific types of after-school care. BMI of the child/adolescent participants were obtained at the time of the survey. High BMI was defined …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

Delirium Screening Instrument Knowledge And Perception Among Cardiovascular Intensive Care Nurses, Brittany Lynn Dahl

DNP Projects

Background: Delirium is a serious condition that affects critically ill adult patients in the intensive care unit. Bedside nursing delirium measurements are considered a dependable source of information that can be used for clinical decision-making. Nurse education and assessment of perceptions is important when building a framework for successful delirium assessment. However, few data exist about nursing perceptions and practices associated with delirium screening instruments. The overall purpose of this project is to examine nurse perceptions and knowledge about delirium and delirium screening instruments at the University of Kentucky (UK) Hospital’s Cardiovascular Intensive Care Unit (CVICU).

Objectives: The aims of …

The Road Was Paved With Good Intentions, Kristina Dreifuerst, Suzie Kardong-Edgren

College of Nursing Faculty Research and Publications

No abstract provided.

Tumor Growth Increases Neuroinflammation, Fatigue And Depressive-Like Behavior Prior To Alterations In Muscle Function, Diana M. Norden, Sabahattin Bicer, Yvonne Clark, Runfeng Jing, Christopher J. Henry, Loren E. Wold, Peter J. Reiser, Jonathan P. Godbout, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Cancer patients frequently suffer from fatigue, a complex syndrome associated with loss of muscle mass, weakness, and depressed mood. Cancer-related fatigue (CRF) can be present at the time of diagnosis, during treatment, and persists for years after treatment. CRF negatively influences quality of life, limits functional independence, and is associated with decreased survival in patients with incurable disease. Currently there are no effective treatments to reduce CRF. The aim of this study was to use a mouse model of tumor growth and discriminate between two main components of fatigue: loss of muscle mass/function and altered mood/motivation. Here we show that …

Differences In Inflammatory Markers Between Nulliparous Women Admitted To Hospitals In Preactive Vs Active Labor, Jeremy L. Neal, Jane M. Lamp, Nancy Lowe, Shannon L. Gillespie, Loraine T. Sinnott, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Objective

To determine whether labor-associated inflammatory markers differ between low-risk, nulliparous women in preactive vs active labor at hospital admission and over time.

Study Design

Prospective comparative study of low-risk, nulliparous women with spontaneous labor onset at term (n = 118) sampled from 2 large Midwestern hospitals. Circulating concentrations of inflammatory markers were measured at admission and again 2 and 4 hours later: namely, neutrophil, and monocyte counts; and serum inflammatory cytokines (interleukin -1β, interleukin-6, tumor necrosis factor-α, interleukin-10) and chemokines (interleukin-8). Biomarker concentrations and their patterns of change over time were compared between preactive (n = 63) and active …

Factors Influencing Self-Care Behaviors Of African Americans With Heart Failure: A Photovoice Project, Aimee Woda, Ruth Ann Belknap, Kristin Haglund, Margaret Sebern, Ashley Lawrence

College of Nursing Faculty Research and Publications

Objectives

The purpose of this study was to understand the influences of heart failure (HF) self-care among low income, African Americans.

Background

Compared to all other racial groups, African Americans have the highest risk of developing HF, coupled with high mortality and morbidity rates.

Methods

Using the photovoice method, participants related important lifestyle factors through photography. The participants and researcher met for reflection and discussion 2 h per week for six weeks.

Results

Four themes emerged: family support gives me the push I need, social interaction lifts me up, improving my mind to lift depression can improve my heart, and …

Storage Conditions And Passages Alter Il-6 Secretion In C26 Adenocarcinoma Cell Lines, Diana M. Norden, Raymond Devine, Donna O. Mccarthy, Loren E. Wold

College of Nursing Faculty Research and Publications

The C26 adenocarcinoma tumor line is frequently used to establish peripheral tumors in mice for the study of cancer cachexia and cancer-related fatigue. Recently, we have noticed a progressive decline in the effects of tumor growth on our biological and behavioral measures in the tumor-bearing mice. Therefore, we compared effects of three aliquots of the C26 tumor cell line that differed in storage condition and number of passages on cytokine secretion, tumor growth, weight loss and fatigue behavior. Three aliquots of the C26 tumor line were selected as alpha (α), beta (β), and gamma (γ). Aliquot α was an original …

Baker Act Project, Lucy Arcila, Evelyn Quinones Lassalle, Carla Green, Melinda Patton, Melinda Collins

All Publications

No abstract provided.

Dogs, Physical Activity, And Walking (Dogs Paw): Acceptability And Feasibility Of A Pilot Physical Activity Intervention, Elizabeth Richards

School of Nursing Faculty Publications

Background. The aims of this study were to describe the development of and investigate the feasibility and acceptability of a pilot randomized controlled physical activity intervention based on social cognitive theory which used a dog walking strategy.

Methods. Participants (n=49) were randomized into an intervention or control group. Overall, participants were middle-aged (mean=45.7±13.4 years), Caucasian, and on average considered obese with an average BMI of 30.0±5.5. Descriptive statistics were used to summarize participant characteristics and analyze the feasibility and acceptability data. Regression models were used to: 1) examine significant differences between intervention and control groups across time (baseline to post-intervention) …

A Survey On Practices Of Koraga Tribes During Diarrhoea In Children, Shrisha, Binu E. Margaret Mrs, Sheela Shetty Mrs

Manipal Journal of Nursing and Health Sciences

Introduction: Every society follows different practices to treat various childhood illnesses. Tribal populations are isolated from the general population by their own lifestyle and practices. The objective of the study was to assess the treatment practices of the Koraga tribes during diarrhoea in children. Materials and Methods: A descriptive survey using face-to-face interview technique was undertaken among 200 caretakers of Koraga tribe using a semi-structured questionnaire. Data analysis was done using SPSS v16.0. Results: 110 (55%) respondents were using arrowroot mixture; curd and salt were used by 34 (17%) to treat diarrhoea. Other practices include use of wheat sooji porridge …

Pre And Post Implementation Evaluation Of An Emergency Department Severe Sepsis Alert And Practice Protocol, Darleen Williams

Electronic Theses and Dissertations

Severe sepsis kills an estimated 1,400 people worldwide every day. This often fatal infectious process accounts for an estimated 215,000 deaths in the United States (US) annually. The main goal of this project was to evaluate the impact of the Emergency Department Severe Sepsis Alert and Practice Protocol (EDSSAPP) post implementation, on time to first antibiotic administration, length of stay, and mortality in patients admitted via the ORMC ED with severe sepsis. This study evaluated the time to first antibiotic administration, total ED and hospital length of stay (LOS) and mortality of severe sepsis patients either with a severe sepsis …

Barriers To Health Care Among Laotian Americans In Middle Tennessee, Xaiyavong Saenphansiri

DNP Projects

Background. Laotian Americans have unique heath beliefs and practices. The cultural differences between Laotian American patients and American health care providers can create challenges in achieving not only evidence-based, but also culturally sensitive care. Although the current literature addresses barriers to health care for Asian Americans, there are few studies related to the Laotian-American minority.

Aim. Describing the particular barriers to preventive and curative care in the Laotian-American population in Middle Tennessee would inform strategies for successful prevention and early treatment programs for this population. The purpose of the study is to describe the health beliefs and barriers to …

Mennonite College Of Nursing Annual Report, 2014-2015, Mennonite College Of Nursing

Annual Reports - Mennonite College of Nursing

Annual report of the Mennonite College of Nursing at Illinois State University