Nursing Commons^™

Sector Rural Colombiano, Salud Y Plaguicidas, Sandra Patricia Carmona Urueña, Maria Nieves Avila Avila, Claudia Del Rocío Contreras Rodríguez, Sindy Alejandro Cifuentes Guerrero, José Ever Ramírez Calderón

Ciencias de la Salud

La región del Sumapaz de Colombia es conocida como la despensa agrícola de Cundinamarca tiene una importante actividad económica en la producción de frutas y hortalizas, por lo que se debe conocer el estado sociocultural, demográfico, ambiental, laboral y de salud de los productores. Otro aspecto es la composición del suelo y el agua que se enfrenta a la degradación debido al abuso de plaguicidas, la deforestación, los monocultivos, la falta de cultura ambiental y presencia institucional, y los proyectos comunitarios ecoamigables. Los campesinos de la región se caracterizan por bajos niveles de educación, lo que afecta su capacidad para …

Socioeconomic Deprivation And Cardiometabolic Risk Factors In Individuals With Type 1 Diabetes: T1d Exchange Clinic Registry, Stephanie Griggs, Sadeer Al-Kindi, Heather Hardin, Elliane Irani, Sanjay Rajagopalan, Ronald L. Hickman Jr.

Faculty Scholarship

Aims: Social determinants of health (SDOH) influence cardiovascular health in the general population; however, the degree to which this occurs in individuals with type 1 diabetes (T1D) is not well understood. We evaluated associations among socioeconomic deprivation and cardiometabolic risk factors (hemoglobin A1c, low-density lipoprotein, blood pressure, body mass index, physical activity) in individuals with T1D from the T1D Clinic Exchange Registry. Methods: We evaluated the association between the social deprivation index (SDI) and cardiometabolic risk factors using multivariable and logistic regression among 18,754 participants ages 13 – 90 years (mean 29.2 ± 17) in the T1D Exchange clinic registry …

Exploring Nurses' Confidence In Providing Support To Bereaved Families Following Stillbirth Fetal Loss, Silvia E. Salazar, Priscilla Kahn, Jill Costley, Roxana Linares, Natalie Bermudez

Nursing & Health Sciences Research Journal

Introduction: Stillbirth fetal loss (SFL) is a significant cause of infant death in the US, with 23,000 reported in 2017. Negative psychological and emotional repercussions of SFL, for parents and nurses, may be mitigated by nurses’ preparedness to provide bereavement support (BS). Several studies exploring BS for miscarriage-related fetal loss were found. However, studies exploring SFL BS and nurses’ preparedness for providing SFL BS are sparse. The purpose of this study was to assess nurses’ confidence and knowledge for providing BS to families experiencing stillbirth fetal loss.

Methods: This was a cross-sectional quantitative descriptive study. Postpartum registered nurses (RN) were …

Editorial Board

Nursing & Health Sciences Research Journal

No abstract provided.

Hdl Cholesterol: Too Much Of A Good Thing? Cardiovascular, Elizabeth A. Moxley

Faculty Articles, Papers, and Other Scholarship

It is considered a well-established fact that high-density lipoprotein cholesterol (HDL-C) is a robust, inverse predictor of the risk of experiencing an atherosclerotic cardiovascular (ASCVD) event.[i] Whereas, low HDL-C characterizes an atherogenic dyslipidemia that reflects adverse lifestyle choices, impaired metabolism, and increased cardiovascular risk.[ii]

Pharmacotherapy For Opioid Use Disorder In Mississippi, Amanda Michelle Whitacre

Doctoral Projects

The opioid epidemic is affecting Mississippi’s young to middle-aged adult population in a profound way. Pharmacotherapy for opioid use disorder (OUD) is the gold standard treatment. Despite the FDA-approved evidence-based treatment of pharmacotherapy for OUD, rural areas often lack providers available who will initiate and provide maintenance of this life-saving medication. For this doctoral project, a 36-question survey was developed based on a preliminary literature review. The survey was disseminated to advanced practice registered nurses (APRNs) in the family and psychiatric specialties across Mississippi to assess the barriers to APRNs filling the gap in pharmacotherapy prescribing for OUD. A continuing …

Improving The Timing Of Insulin Administration In Adult Acute Care Patients, Hollie Gow, Harold Girado, Venessa Rodriguez, Lourdes Talavera, Leyner Martinez, Pierce R. Buzzi Davidson, Esty Trimino, Dayana M. Aguilera, Catherina Chang Martinez, Annette Caravia, Joy Mitts, Shelli Anne Marie Chernesky, Diana Maria Lopez, Hector Gonzalez, Sandy Jones, Sara Perez, Nell Mayendia Blanco, Orlando Bodes Ramil, Christopher Scott, Andrea Calvo, Jan V. Roy, Yaribey Lopez, Margie Martin, Angelines Diaz, Yessenia Muniz, Joey Carralero

Nursing & Health Sciences Research Journal

Background: The correct timing of insulin administration in diabetic patients admitted to the hospital is important for the prevention of transient and serious glycemic deviations that could lead to negative patient outcomes. In November 2021, a South Florida Hospital identified an area of opportunity for quality improvement related to the process of subcutaneous insulin administration. In addition to bar code scanning, manual verification of the insulin dose by the primary nurse and another nurse was required prior to administration. Patients were experiencing delays in the timing of their insulin dose and nurses were reporting frustration with the process. Methods: The …

Achieving 6th Magnet Designation Via Virtual Visit During The Covid-19 Pandemic, Lourdes C. Castaneda, Suzanne S. Spoerl, Catherina Chang Martinez

Nursing & Health Sciences Research Journal

Despite the challenges encountered with the arrival of the COVID-19 pandemic, Baptist Hospital of Miami achieved the prestigious American Nursing Credentialing Center Magnet 6^th designation. We describe the journey including writing the documents, preparing for the virtual visit, and efforts from key stakeholders to support the virtual site visit with the use of technology, to hold videoconferencing and tours “on wheels.” Nurses showcased their professional practice and excellence in patient care through exemplars and narratives presented during the virtual visit. Last, we provide recommendations for success to organizations contemplating a virtual site visit.

Telehealth Acceptance Among Appalachian Respondents During Covid 19: A Secondary Data Analysis, Victoria Hood-Wells, Florence M. Weierbach, Amy Wahlquist, Janet M. Keener, Manik Ahuja, Hadii M. Mamudu

ETSU Faculty Works

Purpose: The purpose of this study is to examine the relationship between telehealth use, telehealth satisfaction, and chronic medical conditions among residents living in Appalachian and non-Appalachian communities.

Sample: A COVID-19 public health survey was distributed via social media and healthcare clinics in the tri-state region of central Appalachia. Survey responses were limited to adults aged ≥18 years who consented to participate in the survey that self-identified as an individual with one or more chronic medical conditions (n=195).

Method: Simple descriptive statistics including frequencies, percentages, means, and standard deviations (SDs) were calculated for variables of interest both overall and by …

The Effects Of Holistic Modalities On Stress Reduction In Nursing Students Attending School During The Pandemic, Rachel Kamp

Honors Theses

Nursing students tend to experience high levels of stress due to the pressures and demands of nursing school, including exams, clinical, and interactions with professors and preceptors (Labrague et al., 2017). Recently, the COVID-19 Pandemic has created additional stressors. Both mind and body modalities (yoga, meditation, deep breathing etc.) and exercise modalities (running, walking, etc.) are some of many health promoting, stress reducing activities that were proven to be effective in reducing stress in nursing students prior to the pandemic. This study aims to determine if these modalities are still effective now, and how nursing faculty supports stress reduction in …

Ways To Decrease Risk Of Postpartum Hemorrhage, Madison Holcomb

Honors Theses

Postpartum hemorrhage (PPH) is the leading preventable cause of maternal mortality (Jena et al., 2022). In fact, it accounts for 25% of maternal deaths globally (Cooper et al., 2022). There is a tremendous need for education to the pregnant population There are methods to decrease the risk that needs to be taught to patients. The education on risk factors should be provided in the in the preconception period and throughout pregnancy. There are several components of educational practice that may improve the knowledge of pregnant individuals. The educational components can be divided into implementations during the antenatal period and the …

Letter From The Editor: Coming Together As A Resilient Workforce, Nohemi Sadule Rios

Nursing & Health Sciences Research Journal

No abstract provided.

Exploring Workplace Incivility And Bullying In Healthcare Workers In A South Florida Community Hospital, Nada Wakim, Natalie Bermudez, Claudia C. Sabogal-Rodriguez

Nursing & Health Sciences Research Journal

Introduction: Workplace incivility and bullying are concerning issues in healthcare with detrimental consequences for healthcare workers (HCW) and healthcare organizations. Organizational leaders’ recognition of incivility/bullying within healthcare organizations, and their sources, is imperative to prevent and/or address issues by creating “zero tolerance” work environments. The purpose of this cross-sectional, descriptive study was to explore HCWs’ experiences with incivility and bullying at a South Florida community hospital.

Methods: A convenience sample of HCWs at a South Florida community hospital were recruited to voluntarily complete the Nursing Incivility Scale.

Results: A sample of 325 HCWs responded to the survey. The results showed …

Evaluation Of Anti-Factor Xa Level Usage For Low Molecular Weight Heparin In A Healthcare System, Natalie Quesep, Lourdes R. Menendez, Erika Dittmar, Radhan B. Gopalani, Payal Patel, Srikanth Nagalla

Nursing & Health Sciences Research Journal

Background: Low-molecular-weight heparin (LMWH) is a commonly used anticoagulant for treatment of venous thromboembolism (VTE). Routine monitoring of therapeutic effects through anti-Xa levels is not recommended but may be beneficial in patients with altered pharmacokinetics.^1,2 Inappropriate monitoring leads to excessive testing and premature dose adjustments, compromising safety and efficacy. The purpose of this project was to assess appropriateness of monitoring LMWH anti-Xa levels and identify opportunities to optimize utilization within a community health system.

Methods: A random-sample, retrospective chart review at a multi-site hospital system was conducted over a 3-year period. Inclusion criteria were adults admitted with …

A Concept Analysis Of Moral Comfort In Nursing, Natalie Bermudez

Nursing & Health Sciences Research Journal

Introduction: Nurses are the most trusted professional group in the United States. As such, examination and exploration of concepts or phenomena, either positively or negatively affecting nurses’ ethical decision-making and moral actions, are needed. While nursing literature is abundant on moral distress and its negative impact, literature on moral comfort (a positive phenomenon) is sparsely available. The purpose of this concept analysis is to explore MC within nursing literature and other disciplines to identify moral comfort’s defining attributes, antecedents, consequences, and empirical referents.

Method: Walker and Avant’s eight-step concept analysis approach was used.

Results: Six articles were included in this …

Decreasing Sudden Unexpected Infant Death, Carey B. Acosta, Kristal Brown, Judy E. Bowling

Nursing & Health Sciences Research Journal

Background: Sleep-related sudden unexpected infant death (SUID) is an alarming, potentially preventable event with over 3,500 annual occurrences in the United States (US). In response to sleep-related SUIDs, the American Academy of Pediatrics and National Institutes of Health advocate for safe sleep practices to promote establishment of safe sleep environments for infants through the Safe to Sleep initiative. However, research evidence shows that lack of knowledge in hospital staff and community members (parents/caregivers) and cultural barriers/biases are factors associated with the inability or resistance to adopting safe sleep practices for infants.

Methods: In 2017, internal evidence within a local …

Lateral Decubitus And Prone Positioning: An Objective Structured Clinical Evaluation, David Hesley-Hernandez, James Bailey

Doctoral Projects

Improper positioning of patients in the lateral decubitus or prone positions can lead to significant complications, including but not limited to: airway and invasive line loss, physiologic derangements, soft tissue injury, and peripheral nerve injuries (PNI) (Barash et al., 2017; Butterworth et al., 2018). Chui et al.’s (2018) analysis found that PNIs accounted for 12% of anesthesia malpractice since 1990, making PNIs costly. PNIs effects are not limited to cost and result in increased lengths of stay, increased pain levels, and decreased quality of life (Wojtkiewicz et al., 2015). The massive effect poor positioning can have requires that the anesthesia …

Objective Structured Clinical Examination For Intraoperative Hypotension And Hypertension Management, Andrew Mcginity, James David Ingram

Doctoral Projects

Managing intraoperative hypotension and hypertension is a non-technical skill anesthesia providers need to maintain patient safety. Upon transitioning from didactic training to clinical training, SRNAs may find it difficult to manage a patient’s blood pressure intraoperatively. The ultimate consequence of the delayed or improper treatment of intraoperative blood pressure perturbations is end-organ damage at the patient’s expense. Unintentionally causing a patient harm will lead to an SRNA losing confidence in their abilities. This OSCE is intended to increase SRNA confidence and competence regarding intraoperative hypotension and hypertension management before entering the clinical arena.

The hypotension and hypertension management tools and …

Dnp Final Report: Developing Competence And Improving Patient Safety With Documentation Training In The Simulated Environment, Laura Zebreski

DNP Final Reports

With the advent of electronic health records, nursing documentation has declined in quality. Poor documentation exposes patients to safety risks. Nursing documentation is subject to legal standards set by the Texas State Board of Nursing. A DNP scholarly project was designed to create a learning and safety intervention to train student nurses to provide correct documentation before entering clinical settings. The goal of this project was to prepare nursing students to provide quality documentation that fulfills the legal standard to attempt to correct the current deficiencies seen in practice and promote patient safety. For this project, the students took a …

Occupational Therapy Program Research Seminar, Kelly L. Taylor Otd, Ms, Otr/L, Cbis

Student Scholarship & Creative Works

Occupational Therapy Program Research Seminar

December 7, 2022 │ 8:30AM – 12:30PM

Murray State University, Paducah Regional Campus

Births In The Mountain West, 2016-2020, Corryn Richardson, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines state-level data on births and health indicators from the National Center for Health Statistics (NCHS), a government health statistics unit of the Center for Disease Control and Prevention (CDC). This fact sheet presents data related to births in the Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah.

The Creation Of A Critical Care Admission Pressure Injury Prevention Cart To Reduce Hospital-Acquired Pressure Injuries, Hollie Gow, Courtney Willard, Nelkys Casal, Lili Estevez, Laurie Green, Jose Arnaez, Carolina Granados, Diana Petraitis, Dayana Aguilera, Nushi Berahman, Ismaray Machin, Stephanie Colon, Rayma Yero, Shireen Knox, Gabriela Castillo, Catherina Chang Martinez, Seth Lopez

Nursing & Health Sciences Research Journal

The goal of this process improvement initiative is to reduce hospital-acquired pressure injuries related to Covid-19 with Critical Care patients. Critically ill and ventilated patients require prone position therapy and prolonged ventilator times place the patient at risk for hospital acquired conditions and pressure injuries. The Critical Care team created a Critical Care Admission Pressure Injury Prevention Cart that contains preventative dressings for all pressure areas at risk.

The Critical Care Admission Pressure Injury Prevention Cart has significantly reduced the pressure injury rate. With the emergence of the pandemic and additional surges, pressure injuries continued to be on the rise …

Evidence-Based Selection Of A Fall Risk Assessment Tool: A Program Evaluation Review, Lindsey Adams

Student Scholarly Projects

Fall prevention strategies are a consistent topic of discussion for healthcare regarding patient safety, as patient falls are costly to the patient and the organization. This project uses the CDC Framework for Program Evaluation to assess the fall prevention policy of a local hospital system, with particular emphasis on the fall risk assessment tool, Hester Davis. This project also explores the risks and benefits of adopting an alternative fall risk assessment tool, predictive analytics. Predictive analytics uses electronic health record (EHR) data analysis to provide a highly individualized patient fall risk score based on a large variety of patient and …

Increasing Equitable Access To Care: Implementation Of Universal Palliative Care Screening In The Intensive Care Unit, Sarah Weaver

Student Scholarly Projects

Practice Problem: At a small community hospital in Virginia, there is an absence of standardized screening processes for identifying intensive care unit (ICU) patients with unmet palliative care needs, contributing to delayed and unequitable access to palliative care consultations.

PICOT: The PICOT question that guided this project was “In adult ICU patients, how does implementing a palliative care screening tool upon ICU admission, as compared to standard ICU admission protocol, affect palliative care consultations within an 8-week time frame?"

Evidence: This project was guided by consensus reports from the World Health Organization and the Centers to Advance …

Reducing Readmission (And Mortality) For Older Patients & Survivors Of Life-Threatening Conditions: A Study Using The Staarr Protocol, Akhenaten Amun

Symposium of Student Scholars

Readmission rates for patients admitted for heart failure, pneumonia, chronic obstructive pulmonary disorder, a myocardial infarction, a hip or knee arthroplasty, or coronary artery bypass surgery tend to have high readmission and mortality rates within 30 days of their discharge from a hospital. Starting in October 2012, the Healthcare Reimbursement Reduction Program enforced penalties on Medicare reimbursements for hospitals with readmission rates, for patients with the conditions above, were higher than averages based on facilities with similar characteristics and patient populations. Teach-back and verify (Klingbeil & Gibson, 2018), interdisciplinary teams that engage in patient care and support (Reiter-Palmon et al., …

Interventions To Decrease Readmission Rates In Lvad Patients, Karolina Jackson

Symposium of Student Scholars

Interventions to Decrease Readmission Rates in LVAD Patients

Karolina Jackson

WellStar School of Nursing, Kennesaw State University

NURS 4417: Advanced Clinical Practicum

Lynnda Campbell

October 21, 2022

Abstract

Background: Patients who have undergone implantation of a left ventricular assistive device are at a higher risk for readmission- whether that be due to driveline dressing infections, thrombosis, bleeding at the site of implantation, or electrolyte imbalances. These readmission rates in the LVAD population can be decreased through appropriate intervention methods. Literature Review: This study’s main purpose was to discover interventions healthcare facilities and core LVAD staff can implement in practice to …

The Evaluation Of Prevention Measures Against Hospital-Acquired C. Difficile, Lauryn Glover

Symposium of Student Scholars

Today, many hospitals struggle with the increase in hospital-acquired infections, but more specifically the spread of Clostridioides Difficile (C. Difficile) infections among patients. It has caused not only a burden on the patient’s health but has also created a financial burden on hospitals. Due to the spread of C. Diff infections in the hospital setting, many hospitals are implementing strategies to combat the spread of C.Diff. One essential prevention method starts with healthcare workers. Hospital staff is required to use hand sanitizer and frequent handwashing to prevent the spread of disease to their patients. The overall purpose of this research …

Impact Of Alarm Management Classes In Reducing Alarm Fatigue, Elizabeth Laegen

Symposium of Student Scholars

Alarm fatigue is becoming a more and more common problem for nurses working in inpatient hospital units, especially critical care units. Monitoring systems, ventilators, vital signs monitors, and other electronic devices designed to detect critical or pending critical values and alterations in patients have become more of a nuisance than the lifesaving systems they were designed to be. With alarms sounding frequently for what are typically nonactionable alerts, nurses to have developed a decrease in sensitivity to all alarms, regardless of importance. Research of alarm fatigue has shown that while the significance of the problem is clear and studies have …

In Adult Icu Patients With Central Lines, Does Improved Staff Adherence To The Clabsi Prevention Clinical Practice Guidelines Reduce The Incidence Of Clabsis?, Job Waihiga

Symposium of Student Scholars

A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when bacteria or viruses enter the bloodstream through the central line. Background: This project is important because central line-associated bloodstream infections increase hospital mortality rates, lengths of stay, and 30-day readmission rates. They also impose heavy financial burdens on hospital systems. Furthermore, out of all the nosocomial infections, central line-associated bloodstream infections have the highest and most recent incidence rates in this adult ICU unit. Purpose: This project aims to identify an intervention to improve staff adherence to the CLABSI prevention bundle and decrease the rate of …

Reducing Noise Levels In Intensive Care Units Using Noise Monitoring Technology, Kayla Kloes

Symposium of Student Scholars

Intensive care units require many medical procedures, activities, machines, and staff that contribute to high levels of noise. These high noise levels have been found to cause adverse psychological and/or physiological health effects related to sleep disturbances, increased anxiety, and increased stress. These health effects may lead to decreased patient satisfaction. The purpose of this proposal is to explore the effectiveness of the SoundEar 3-300 device in decreasing levels of noise and as a result, increasing patient satisfaction. The current research indicates that the SoundEar 3-300 device is successful at reducing hospital noise levels. This device allows for the measurement …