Nursing Commons^™

Radon Potential, Geologic Formations, And Lung Cancer Risk, Ellen J. Hahn, Yevgeniya Gokun, William M. Andrews Jr., Bethany L. Overfield, Heather Robertson, Amanda T. Wiggins, Mary Kay Rayens

Nursing Faculty Publications

OBJECTIVE: Exposure to radon is associated with approximately 10% of U.S. lung cancer cases. Geologic rock units have varying concentrations of uranium, producing fluctuating amounts of radon. This exploratory study examined the spatial and statistical associations between radon values and geological formations to illustrate potential population-level lung cancer risk from radon exposure.

METHOD: This was a secondary data analysis of observed radon values collected in 1987 from homes (N = 309) in Kentucky and geologic rock formation data from the Kentucky Geological Survey. Radon value locations were plotted on digital geologic maps using ArcGIS and linked to specific geologic map …

The Effects Of An Evidence-Based Food Allergy Management Plan To Keep Children With Food Allergies Safe At School, Scarlet R. Spain

Evidence-Based Practice Project Reports

The prevalence of food allergies in children has increased 18% between 1997 and 2007 (CDC, 2013). Furthermore, 84% of food allergic children will experience a reaction at school (Powers, Bergren, & Finnegan, 2007). An exposure in a sensitive child may progress quickly into potentially life threatening symptoms and death if not treated. The purpose of this evidence based practice (EBP) project was to determine if implementation of a food allergy management policy in a school setting reduced overall incidence rates of food allergy reactions in school children and to examine compliance to policy guidelines. The project encompassed implementation of a …

The Pupillometer In Practice: Identifying And Overcoming Barriers, Audrey Lee Paulson

Doctoral Projects

Problem: The pupillometer is an assessment tool that provides an accurate assessment of pupil reactivity. It is appropriate for patients who are neurologically impaired due to injury or illness. This tool, available and in use at a local community hospital, has minimal perceived importance in the Neuroscience Intensive Care Unit (NSICU), due to a disconnect experienced by the staff. The hypothesis was that understanding the pupillometer information was insufficient and that improving the knowledge would increase the perception of usefulness. Method: Conduct a survey to determine the cause of the lack of interest and use of the pupillometer. Once the …

Perceptions Of Incivility In Nursing Education: A Survey Of Associate And Baccalaureate Program Nursing Students, Kim Elaine Young Vickous

Dissertations

This study explored differences of nursing students’ perceptions of student and faculty incivility, measured using the Incivility in Nursing Education survey, across semesters and between Associate and Baccalaureate of Science nursing students. A sample of 262 Associate and Baccalaureate of Science nursing program students enrolled in second, third, and fourth semesters from a state university located in the mid-south participated in the study. Descriptive statistics, Analysis of Variance, and Independent t-tests were conducted to examine the research questions. These questions explored what student and faculty behaviors were perceived as uncivil and most frequently occurring (disruptive and threatening) uncivil behavior in …

Chhs May 2015 E-Newsletter,, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Support For Breastfeeding Mothers: Are You Violating The Law?, Phillip Atherton, Christine Buttrick

Nursing Student Publications

On March 23, 2010, President Obama signed the “Break Time for Nursing Mothers” law in the Patient Protection and Affordable Care Act that requires employers to provide an opportunity for nursing mothers to breastfeed while at work. The law necessitates employers give a “reasonable” amount of time and a private space that is not a bathroom for the first year of a new infant’s life. In order to help mothers have access to breastfeeding, awareness of this law must be expanded, and the implementation of lactation programs in every workplace must be enforced so that mothers can continue to breastfeed …

Psychometric Instrumentation: Reliability And Validity Of Instruments Used For Clinical Practice, Evidence-Based Practice Projects And Research Studies, Ann Mayo Rn, Dnsc, Faan

School of Nursing and Health Science: Faculty Scholarship

Clinical Nurse Specialists and other advanced practice nurses (APNs) are relied upon for their expert data based decision-making to ensure excellent clinical practice, high quality evidence-based practice projects, and efficacious research studies. Using measurement instruments to collect data that lack reliability and validity can compromise decisionmaking leading to deleterious results for patients, nurses, and healthcare organizations. The ultimate goal is to choose reliable instruments that produce valid data so that clinical trends, project evaluations, and research findings are trustworthy. Determining the quality of a given instruments is most often done through a critique process. Critiquing potential instruments for use is …

The Use Of Yoga For Chronic Pain Management In The Pediatric Population, Annabeth Huff

HIM 1990-2015

Chronic pain has an adverse impact on the quality of life in children and adolescents. It can impair a child’s physical, psychological, and social functioning, leading to lower satisfaction with life and poor self-image related to health status. Forty-five percent of children experience chronic pain related to either disease processes or idiopathic causes. Not all children who suffer from chronic pain respond to traditional therapies. The purpose of this literature review was evaluation of current research on the use of yoga as an integrative therapy for chronic pain management in the pediatric population. A database search of CINAHL, MEDLINE, and …

Non-Language Barriers To Effective Care Of The Hispanic Population, Elizabeth M. Dobbins

Undergraduate Honors Theses

This research study was designed to improve the quality of health care received by the Hispanic population in northeast Tennessee. After reviewing past research, it is evident that the Hispanic population reports a lower level of health care satisfaction and a greater number of health disparities. Although attempts to reconcile this problem have included implementing regulations and guidelines on the cultural competency of and the provision of language services by health care providers, no measurable improvement has been noted. To positively impact this pervasive problem, the focus must shift away from how health care agencies can affect health care for …

Nurse’S Perceptions Of Visitor’S Adherence To Transmission-Based Precautions, Jocelyn K. Spenillo

Undergraduate Honors Theses

Transmissions based precautions are measures implemented in various clinical health care settings as a means to prevent the transmission of infectious diseases and decrease instances of healthcare acquired infections (HAI). HAI’s result in increased cost to hospitals, longer hospitalization for patients, increased patient suffering, and fatal patient outcomes. While staff member adherence to transmissions based precautions are mandated through various organizations and hospital policies, a review of literature indicates little research has been conducted regarding visitor compliance with transmission-based precautions. The potential implications in healthcare from visitor non-adherence acquired infections are unknown; revealing a gap in literature and supporting the …

Blood Pressure Management In Patients With Spontaneous Intracerebral Hemorrhage, Paul Mammarello

Nursing Masters

The purpose of this study was to determine the efficacy of current American Stroke Association (ASA) blood pressure guidelines for non-traumatic intracerebral hemorrhage (ICH) in preventing neurological decline. In addition, it was intended to assist in determining if more strict blood pressure control correlates with better neurological outcomes.

Impact Of Implementing The Geriatric Resource Nurse Model On Fall And Hospital Acquired Pressure Ulcer Rates, And Length Of Stay In Older Adults In An Acute Care Hospital, Elzbieta Kmiecik, Cathie E. Guzzetta, Mary-Michael Brown, Qiuping Pearl Zhou, Desale Sameer

GW Research Days 2015

Background.Older adults are at high risk for adverse care outcomes, such as injuries from falls, hospital acquired pressure ulcers (HAPUs), and prolonged length of stay (LOS). Available evidence suggests outcomes may improve when older adults are cared for by healthcare providers with competence in geriatrics. To improve outcomes, an acute care not-for-profit teaching hospital in Washington DC area implemented a Geriatric Resource Nurse (GRN) model that prepares registered nurses (RNs) as clinical experts on core geriatric principles on four general care wards (three medical-surgical and one cardiac).

Objectives. Toexamine the effects of GRN model implementation on fall and …

The Cost Of Caring: Compassion Fatigue In Hospice Nursing, Stephanie O'Neil

Senior Honors Projects

Compassion fatigue is a concept that is often referred to as the “cost of caring.” Hospice nurses, who regularly care for patients at the end of life, are most susceptible to this sense of helplessness, isolation, and confusion, as each day they are faced with bearing witness to the tragic loss of their patients. Compassion fatigue has detrimental effects on the health and wellbeing of nurses, and impacts on the safety and dignity preservation of patients. The purpose of this project was to explore the concept of compassion fatigue in Hospice nursing practice. Kim and Schwartz-Barcott’s Hybrid Model is a …

Caregiving Factors Affecting Breastfeeding Duration Within A Neonatal Intensive Care Unit., Sharon G. Casavant, Georgine Burke, Carrie-Ellen Briere, Jacqueline Mcgrath

University Scholar Projects

Abstract

Background: Increasingly, evidence supports oral feeding of very-low-birth-weight (VLBW) preterm infants exclusively at breast or with breastmilk. Despite known breastmilk benefits, outcomes related to exclusive breastmilk provision are poor. Identifying factors that promote breastmilk provision is critical.

Purpose: Breastfeeding practices of mothers of VLBW infants admitted to neonatal intensive care unit (NICU) were explored to identify factors associated with mode of feeding at discharge.

Method:

This retrospective study replicates previous work. Subjects were VLBW preterm infants consecutively admitted during a 24-month period. Primary outcomes included receiving any breastmilk at discharge. Infant variables included gestational age (GA), post-menstrual age (PMA) …

Tobacco Use And Attachment Style, Mary Heath Wise

Undergraduate Honors Theses

Tobacco has been recognized as the number one cause of preventable death in America and results in almost 5.2 million years of potential life lost each year. The use of tobacco products is highly correlated with pulmonary disease, cardiovascular disease, and other forms of chronic illness in America. Within the last ten years new tobacco products have been trending in the tobacco market such as the water pipe/hookah and e-cigarettes. With e-cigarettes and other newer forms of tobacco on the rise, it is important to look at the underlying factors for using all kinds of tobacco products as a means …

Family-Centered Pediatric Radiation Therapy: A Nurse-Led Quality Improvement Collaboration Model, Elizabeth A. Austin

Doctoral Projects

Problem: Parents of children diagnosed with cancer face a number of physical, emotional, and social hurdles in the race for a cure. Family schedules shift dramatically to accommodate daily radiation therapy treatment appointments. Ambulatory procedure unit nursing staff attempt to teach and interpret the process without the benefit of a family-centered intradepartmental structured communication process to promote safe care with these families.

Methods: Implementation of a structured family-centered interprofessional standard work model to promote interdepartmental collaboration. The project implemented a structured family-centered interview and standard work algorithms to improve the radiation therapy family experience.

Results: A structured, streamlined, interdepartmental interview, …

Choices Related To Maximizing Quality Of Life At End Of Life, Theresa Lynn

Dissertations

Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of quality or length of life. At least two opportunities exist for making choices regarding care at the end of life in the U.S.: completing advance directives and choosing hospice care. This dissertation consists of three studies related to this topic. The first is a quantitative study about advance directives and attitude toward death. The advance directive completion rate among adults in the …

Medical Crises In Older People: Cohort Study Of Older People Attending Acute Medical Units, Developmental Work And Randomised Controlled Trial Of A Specialist Geriatric Medical Intervention For High-Risk Older People; Cohort Study Of Older People With Mental Health Problems Admitted To Hospital, Developmental Work And Randomised Controlled Trial Of A Specialist Medical And Mental Health Unit For General Hospital Patients With Delirium And Dementia; And Cohort Study Of Residents Of Care Homes And Interview Study Of Health-Care Provision To Residents Of Care Homes, John Gladman, Rowan Harwood, Simon Conroy, Pip Logan, Rachel Elliot, Rob Jones, Sarah Lewis, Jane Dyas, Justine Schneider, Davina Porock, Kristian Pollock, Sarah Goldberg, Judi Edmans, Adam Gordon, Lucy Bradshaw, Matthew Franklin, Katherine Whittamore, Isabella Robbins, Aidan Dunphy, Karen Spencer, Janet Darby, Lukasz Tanajewski, Vladislav Berdunov, Georgios Gkountouras, Pippa Foster, Nadia Frowd

Publications and Research

Background: This programme of research addressed shortcomings in the care of three groups of older patients: patients discharged from acute medical units (AMUs), patients with dementia and delirium admitted to general hospitals, and care home residents.

Methods: In the AMU workstream we undertook literature reviews, performed a cohort study of older people discharged from AMU (Acute Medical Unit Outcome Study; AMOS), developed an intervention (interface geriatricians) and evaluated the intervention in a randomised controlled trial (Acute Medical Unit Comprehensive Geriatric Assessment Intervention Study; AMIGOS). In the second workstream we undertook a cohort study of older people with mental health problems …

Impact Of Prior Healthcare Experience On Self-Reported Confidence And Competency Among Third Year Clinical Nursing Students, Conrad N. Bukoski, Jennifer Fuvich

Senior Honors Projects

There is a long-running debate amongst nurse educators if prior healthcare experience facilitates or encumbers a nursing student’s clinical training and education. Nursing students with prior healthcare experience have often worked as home health aids (HHAs), certified nursing assistants (CNAs), patient care technicians (PCTs), emergency medical technicians (EMTs), electrocardiogram technicians (EKG tech), student nurse associates (SNAs), and paramedics. The psychomotor and cognitive nursing skills utilized in these healthcare positions vary and some overlap with nursing skills. All of these positions interact with other healthcare positions to deliver patient care.

Some educators feel that inadequate skills and training may be acquired …

Comparing Access To Medical Homes For Children Aged 6-17 Years With Add/Adhd And Autism In Arkansas, Marie Mackenzie Plum

The Eleanor Mann School of Nursing Undergraduate Honors Theses

A growing number of children are being diagnosed with attention deficit disorder and hyperactivity (ADD/ADHD) and autism in Arkansas. These developmental disorders necessitate comprehensive, holistic, effective and well-coordinated care, and require a complex treatment regimen. Lack of access to coordinated care creates a real impediment for these children as they are in constant need for medical services. Pediatric care provided within a medical home has been suggested to improve health outcomes of children with special health care needs. OBJECTIVE: The purpose of this study was to determine access to a medical home among children aged 6-17 years with ADD/ADHD, autism, …

Assessment Of Tracheostomy Care Practices In A Simulated Setting, Thomas Bolsega

HIM 1990-2015

Background: Although a tracheostomy is a common procedure for patients who require prolonged mechanical ventilation, little evidence exists as to the best practices for performing tracheostomy care to maintain the airway and promote skin integrity. Therefore, variability is likely, which may negatively impact patient outcomes. This study described tracheostomy care practices of registered nurses (RNs) and respiratory therapists (RTs) who regularly perform tracheostomy care in critical care settings. Methodology: The descriptive study was conducted following informed consent. RNs (n=15) and RTs (n=5) were asked to perform tracheostomy care on a simulated mannequin patient. An array of supplies (both required and …

Subcutaneous Injection Techniques Of Anticoagulant Therapies, Leah Morissette

HIM 1990-2015

Subcutaneous anticoagulant medications like Heparin and Low-Molecular Weight Heparin are injections that readily cause bruising, pain, induration, and hematoma formation at the injection site. It is known that these adverse reactions can be correlated to the technique used to administer these medications; however, there is no established technique that reduces bruising, pain, induration, and hematoma formation at the site. Currently, the only protocol for subcutaneous Heparin and Low-Molecular Weight Heparin is that it is to be administered subcutaneously in the abdomen and when using a prefilled syringe, the air bubble should not be removed. The purpose of this study was …

Acculturation Factors Associated With The Prevalence Of Obesity In Immigrant Children And Adolescents, Suzeline Desir

HIM 1990-2015

Childhood obesity (CO) is a significant public health issue in the United States, including the immigrant populations. Obese children and adolescents are at increased risk for multiple preventable comorbidities that affect their physical health and psychological well-being. The perception exists that the immigrant child population may possess protection against CO, but this group also experienced an increased prevalence of CO. Acculturation, or the adaptation to American culture and lifestyles, has been shown to be associated with the increased obesity rate among immigrant children and adolescents. Understanding the association between acculturation factors and CO is necessary to effectively combat obesity among …

A Retrospective Chart Review To Profile Appalachian Fall Risk, Hannah M. Warren

Undergraduate Honors Theses

This study was designed to create a high-risk fall profile for a specific Appalachian community. Data were obtained from 1,598 individuals with fall-related injuries who had been had been evaluated at a Level 1 Trauma center in Northeast Tennessee throughout 2011 and 2012, ages of individuals were 18 to 85 years. Data collected included: age, gender, county of fall, site of fall, type of fall, number of co-morbidities, season of fall, and time of day of fall. Results showed differences in criteria for categorizing individuals at high risk of falls, as well as data that had not appeared in the …

Assessing Quality Of Life, Psychological Well-Being And Depression In Hispanic American Women: Does Cultural Competence Matter?, Elizabeth T. Alvarez

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Thesis Title: Assessing Quality of Life, Psychological Well-Being and Depression in Hispanic American Women: Does Cultural Competence Matter? ABSTRACT BACKGROUND: Hispanic people are at an elevated risk of developing depression as compared to any other racial and ethnic groups in the United States. Hispanic women, in particular, experience depression at roughly twice the rate of Hispanic men. The projected growth of the Hispanic population coupled with the high prevalence of depression among Hispanic women will exacerbate this already serious public health conundrum if targeted and culturally competent interventions are not tailored to better tackle this illness. OBJECTIVE: The purpose of …

Parent Perceptions Of Patient Safety Culture In The Neonatal Intensive Care Unit, Madelene J. Ottosen

Dissertations and Theses (Open Access)

Background: Understanding and promoting a positive culture of patient safety within neonatal intensive care units (NICU) has been to shown to decrease threats to patient safety. Parents are an integral part of the NICU culture, yet little is known about how they perceive patient safety and what role they would find meaningful and appropriate for engaging in safety promotion activities in the NICU. Therefore the purpose of this study was to determine how neonatal parents conceptualize patient safety and their role within the Neonatal Intensive Care Unit (NICU).

Methods: Using an ethnographic qualitative approach, semi-structured interviews and field observations of …

Work-Related Musculoskeletal Disorders: Psychological Factors In Licensed Nurses, Cynthia Pipkins

Dissertations and Theses (Open Access)

Background: Physical risk factors for work-related musculoskeletal disorders (WMSD) among licensed nurses have been well established. Rehabilitation following WMSD traditionally focuses on physical dimensions, but both physical and psychological factors may be useful during rehabilitation, as suggested by the Fear Avoidance Model of Chronic Pain (FAMCP) and the Pain Experience Psychological View model (PE).

Purpose: The purpose was to describe demographic characteristics of nurses with and without WMSD and relationships among related psychological factors of pain (intensity, severity, and interference), personality traits (extraversion and neuroticism), and coping strategies (catastrophizing, diversion, reinterpreting, cognitive coping, fear avoidance, and depression) as postulated in …

Activity-Rest And Skin Temperature Circadian Rhythms And Sleep Patterns In Community-Dwelling Women, Kristina L. Leyden

Dissertations and Theses (Open Access)

Purpose: The purpose of the study was to explore activity-rest and temperature circadian rhythms and sleep patterns in ambulatory women of reproductive, perimenopausal, and postmenopausal stages. Study aims were to (1) correlate the patterns of activity-rest with skin temperature and determine (2) lead-lag relation between activity-rest and circadian temperature rhythm, (3) stability of activity-rest patterns during work and non-work days, (4) duration of actigraphy sampling sufficient to reliably capture activity-rest patterns, and (5) sleep parameters in participating women across reproductive stages.

Design: Analysis of extant data sets.

Sample and Setting: Seven community-dwelling women, 27-to-54-years old

Methods: Participants wore an actigraph …

A Study Designed To Explore Trends In 30-Day Readmission Rates Of Patients With Congestive Heart Failure After Implementation Of New Patient Education Tools, Kelly Williams

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Congestive heart failure (CHF) is a major problem in the United States today. So many aspects to the disease process exist that creating and implementing interventions to manage symptoms during the progression of the disease presents a challenge. Providing effective patient education to patients with this chronic disease process is a challenge due to the high frequency of readmissions to the hospital for these patients. Recently a CHF discharge class and visual educational tool were implemented at a hospital in Northwest Arkansas in an attempt to improve knowledge retention of patient education material. The purpose of this study was to …

Patients' Perception Of Feeling Known By Their Nurses And The Nurse Practice Environment, Deene' L. Mollon

Dissertations

Healthcare leaders have a responsibility to understand the connection between healthy practice environments and patients’ perceptions of care. The purpose of this research was to explore the relationship between the nurses’ perception of the practice environment and the patients’ perception of feeling known by their nurses.

This descriptive, correlational study used quantitative and qualitative methodology. A convenience sample of 123 patients, on six patient care units, completed the Patients’ Perception of Feeling Known by their Nurses Scale and a supplemental survey designed to determine the content validity of the Patients’ Perception of Feeling Known by their Nurses Scale. To …