Occupational and Environmental Health Nursing Commons^™

Building Shared Values In The Community: Culture Of Health, Donnelle D. Storrs

Doctor of Nursing Practice

The zip codes where patients live are stronger determinants of health outcomes than the frequency of visits with a primary care provider. Providers have a unique opportunity to extend health care beyond the clinic walls and engage in efforts to improve the communities where their patients grow, live, work, and age. In order to impact the health of patients, a culture of health needs to be developed. The Robert Wood Johnson Foundation culture of health action framework directed the build of a foundation of health as a shared value in a neighborhood with high morbidity and mortality rates in southwest …

Improving Communication To Reduce Patient Falls In A 48-Bed Medical-Surgical Unit, Christian Gella

Nursing and Health Professions Faculty Research and Publications

Abstract

Problem: Patient falls has been associated with increased morbidity, mortality and decreased quality of life. The increase in total patient falls for 2018 relative to 2017, and a spike of 10 patient falls for the month of June 2018 from a baseline of 5.3 falls per month has gained greater attention to reduce patient harm from falls while hospitalized. Prevention of falls minimizes patient exposure to the possibility of being injured. Despite efforts to curtail patient falls, improvement in communication is essential to address the safety issues surrounding improving quality of care practices, and consequentially reduce un-reimbursable hospital costs …

Measurement And Protection Of Lung Health In Poultry Farmers Of Southwestern Ontario, Rose-Marie Doyon Dolinar

Electronic Thesis and Dissertation Repository

Chronic obstructive lung disease (COPD), develops gradually, and tends to be noticed by farmers only after there has been a significant loss of lung function. People with symptoms of COPD often present for health care in later stages of disease, because they accept cough or breathlessness as “normal”.

Measurement of lung health for those at risk of developing COPD provides an opportunity for early detection of lung disease, and deter the progression toward irreversible damage to the lungs. COPD is, however, under-diagnosed.

The importance of bringing primary care providers and farmers together, and acknowledging the high-risk nature of occupational exposures, …

Blood Pressure And Job Domains Among Hotel Housekeepers, Marie-Anne Sanon Rosemberg Phd, Mn, Rn, Bidisha Ghosh Ms., John Shaver Bsn, Maria Militzer Ma, Julia Seng Phd, Cnm, Faan, Marjorie C. Mccullagh Phd, Rn, Aphn-Bc, Cohn-S, Faaohn, Faan

Journal of Health Disparities Research and Practice

Hotel housekeepers have challenging working conditions, putting them at risk for poor health such as hypertension. Despite their risks, few studies have measured their blood pressure (BP). The purpose of this study was to explore hotel housekeepers’ blood pressure and the associations between work and BP. Methods: A community engagement approach was used to recruit study participants. Data sources included questionnaires, and BP measurement. Results: Over 25% of the 39 hotel housekeepers reported hypertension diagnosis and/or antihypertensive medication used. Across the job domains, job satisfaction was correlated with diastolic BP, and workload was correlated with systolic BP. There were difference …

Antibiotic Stewardship Among Primary Care Providers In Mississippi, Foley D. Graham, Hayden S. Kilgore, Kali D. Rogers, Sierra G. Cain, Brittany D. Dickerson, Kayla L. Warner

MSN Research Projects

The World Health Organization states antimicrobial resistance is the ability of a microorganism to stop an antimicrobial from working which results in ineffective treatment and persistent infections. The Center for Disease Control and Prevention (CDC, 2017) reported that in the year 2015, 269.4 million antibiotic prescriptions were written in the outpatient setting, and approximately 30% of antibiotics written are unwarranted. Of those cases, most patients receive an antibiotic related to acute uncomplicated bronchitis, pharyngitis, or rhinosinusitis. The CDC reported that Americans spend nearly $11 billion yearly on antibiotics alone. However, up to 50% of all antibiotics prescribed are not indicated …

Employee Influenza Immunization: Education And A Directive To Increase Immunization Rates, Ashley Roman

Doctor of Nursing Practice

Purpose: The aim of this quality improvement project was to improve the influenza vaccination rate of health care workers at an ambulatory care center to meet the national benchmark of 90%.

Background: Influenza is a communicable disease that affects over 130,000 people causing 7,000 deaths (CDC, 2017b). Over the last 3 years the influenza immunization rates at the facility of interest have been on a downward trend despite multiple interventions, resulting in 43% last season. A directive was published at the beginning of the 2017-2018 influenza season mandating each employee to either get a vaccine or decline in writing. This …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Musculoskeletal Disorders In Healthcare Workers, Josephine Lauer

Master's Projects and Capstones

Musculoskeletal Disorders (MSD) are one of the leading causes of disability in hospital nurses and nursing aids and is a high cost problem in the healthcare industry. Working in a complex environment of an acute medical floor where repetitive nature of patient handling, can lead to musculoskeletal injuries for healthcare workers. This is evidenced by work-related injuries in hospitals nearly doubling compared to private industry and hospitals are one of the most hazardous work environments in the country. Musculoskeletal injuries of healthcare workers are an ongoing problem which requires investigation due to high risk of reoccurrence. This is especially true …

Decreasing Environmental Health Risks In The Philippines: Implementation Of A Culturally Appropriate Screening Tool, Alyssa Samson

Doctor of Nursing Practice (DNP) Projects

Objectives: The purpose of this DNP project was to increase the knowledge of environmental health risk factors in the Philippines among nurses and doctors located within that healthcare system. The overall goal was to educate providers on local environmental health risks, provide training for the use of a screening tool (Tagalog Environmental Health and Safety Assessment Tool [TEHSAT]), and provide resources aimed at increasing screening of at risk populations and provide opportunities for education and health promotion.

Methods: This project included a two-part educational training session. The first part included a preliminary presentation on environmental health and the use of …

Hazardous Drug Administration In The Home Setting: Reducing Exposure Risks, Cynthia D. Huff Msn, Rn, Ocn, Crni, Cnl

Master's Projects and Capstones

Hazardous drug (HD) administration used to be contained in controlled-healthcare settings, however, the introduction of HDs for home administration has become a growing area of concern for home health agencies. The objectives of the Clinical Nurse Leader (CNL) project aims to improve homecare nurses' knowledge of HDs and improve competency with personal protective equipment (PPE). The microsystem provides short-term homecare services for acute and chronically-ill patients. One team leader, two home infusion coordinators, and twelve registered infusion nurses participated in learning about exposure risks and PPE use with HD administration. Kotter's 8-step change theory was used to develop behavior change …

The Clinical Nurse Leader As Outcomes Manager: Optimizing Screening Mammography In An Outpatient Breast Center, Yao Luo

Master's Projects and Capstones

The Clinical Nurse Leader as Outcomes Manager: Optimizing Screening Mammography in an Outpatient Breast Center

Abstract

This clinical nurse leader (CNL) practice improvement project was conducted in an outpatient breast center that is part of a community safety-net hospital. The patient population consists of a large proportion of disadvantaged, low income, low English literacy, and high-risk women over 445 years of age. Recent observations and baseline data from the breast center and the mobile mammography van indicated that five to eight radiologic views were taken during a routine mammogram in a subset of screening patients which exceeds the standard set …

The Effect Of Algorithm Implementation In The Family Practice Setting On The Pain And Recovery Of Acute Low Back Pain Patients, Joan Caito

Evidence-Based Practice Project Reports

Nearly $86 billion is spent annually in healthcare costs for Americans with low back pain (Lee, McAuley, Hübscher, Allen, Kamper, Moseley, 2016). Additionally, the burden on the economy due to loss in productivity incurs approximately $114 billion dollars of lost revenue annually (Lee et. al., 2016). Patients with an acute low back injury inadequately treated may become a chronic issue. Only 50% of patients who experience back pain symptoms for 12 months will return to work (Petit, Fouquet, & Roquelaure, 2015). The purpose of this project will be to implement an evidence-based algorithm to standardize acute low back pain care …

Measuring Physiological Responses To Sensation In Typical Adults, Sarah Button, Kristen Christensen, Emily Minor

Dissertations, Masters Theses, Capstones, and Culminating Projects

Objective: Sensory processing issues can have a large negative impact on the ability to participate in daily occupations such as ADLs, access to work, school and leisure environments, and social interactions (Dunn, 2001). The evidence documenting sensory processing issues in adults is sparse. Physiological information can be used as objective evidence to support the claim that those with over-responsivity to sensations are experiencing their environment differently than the typical population. Understanding more about sensory processing in adults may lead to increased recognition of the problem and more opportunities for intervention to increase occupational participation. The purpose of this quantitative study …

Secondary Traumatic Stress Among Emergency Department Nurses, Melissa Machado

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Individuals employed in healthcare services are exposed daily to a variety of health and safety hazards which include psychosocial risks, such as those associated with work-related stress. Nursing is the largest group of health professionals in the healthcare system. Work-related stress has been associated with substandard quality and safety of care, poor health status, decreased quality of life and compromised safety among staff members (Christodoulou-Fella, Middleton, Papathanassoglou, & Karanikola, 2017).

Secondary traumatic stress (STS) is exacerbated in health professionals who are continuously confronted and care for patients suffering traumatic injuries and are critically ill, while experiencing emotional disruption themselves, thus …

Many People Are Afraid Of White Coats. They Should Be, Kathryn D. Tente

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The concept of “do no harm” is not a figure of speech. It is a pledge to our patients to insert ourselves between them and anything that can harm them physically or emotionally. “Do lab coats harbor microbes that are detrimental to our clients’ health?” was the question that drove this systematic review. Using a search to cover articles regarding the microbial integrity of the coat, several studies were found to include culture and sensitivity reports along with participants’ surveys that increase the data to include demographics, handling habits of the coat along with laundering habits of the owners of …

The Impact Of Rhode Island's Mandatory Health Care Worker Influenza Vaccination Regulation On Influenza Incidence In Long-Term Care Facility Residents, Wendy A. Chicoine

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Seasonal influenza is a serious public health problem that contributes to significant morbidity and mortality locally, nationally, and globally. The Centers for Disease Control and Prevention (CDC) estimates that influenza has caused between 9.2 million and 60.8 million illnesses, between 140,000 and 710,000 hospitalizations, and between 12,000 and 56,000 deaths annually since 2010, and approximately 80- 90 percent of influenza related deaths occurred in people 65 years and older. In 2012, prompted by the mounting\ evidence of the risk of nosocomial influenza infection for patients and low influenza vaccination rates of health care workers, the Rhode Island Department of Health …

Health-Related Fitness Differences Amongst Allied And Non-Allied Undergraduate Health Majors, Grant Ragan, Amy Shepherd, Narges Shirazi, Kaitlin Smith

Research Horizons Day Posters

No abstract provided.

Implementation Of The Banner Mobility Assessment Tool For Bariatric Patients, Nicole Benkert

Scholars Week

Abstract

The prevalence of morbidly obese patient within the United States is on a rapid incline. Evidence correlates an increase in patient falls, comorbidities, and hospital admission among this specific patient group. As a result, there is an increase in workload and injuries to staff as they tend to these patients. Healthcare facilities need to continuously update current patient handling programs and create specific policies for safely handling obese patients. Research suggests that Safe Patient Handling and Mobility Programs, as well as the Banner Mobility Assessment Tool (BMAT), have substantially decreased nurse injuries through a wide range of nursing specialties. …

Understanding Occupational Injuries, Hanbit (Joyce) Choi

Doctoral Projects

The purpose of this project is to better understand the potential negative impact of longer commute times on work-related health complaints and its relationship with frequency of work-related injuries among general assembly workers from various factories in the Bay Area. Companies in the United States seek to reduce the cost of work-related injuries by investigating the causes of and implementing necessary programs in their workplaces. According to the U.S. Census Bureau, there are about 115,000 employees who spend more than 90 minutes commuting to their jobs in the San Francisco Bay and San Jose Silicon Valley areas (2013). However, there …

Telemetry Nurses Knowledge Of Alarm Fatigue And Interventions For Change: An Education Program Development, Samantha Cruz

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Alarm fatigue is known to be one of the top safety concerns in the healthcare setting. The Joint Commission recognized Alarm safety as one of the 2017 National Patient Safety Goals. Alarm fatigue occurs when a healthcare worker becomes overwhelmed and often desensitized to patient monitor alarms. It has been established that interventions including ECG daily electrode and battery changes, skin prep for electrode placement, and adjusting alarm parameters to fit patient needs can lead to a reduction in false or nuisance alarms. In order for these interventions to be carried out successfully, education of nurses regarding alarm fatigue and …

Differences In Preventable Cardiovascular-Related Versus Unavoidable Occupational Causes Of Firefighter Fatalities On Duty, Amy Goad, Dnp, Ms, Np-C

Doctor of Nursing Practice Projects

Background: Firefighters across the United States face high fatality rates in the line of duty of which many are likely related to preventable cardiovascular risk factors.

Objectives: To assess differences in firefighter cardiovascular-related versus unavoidable occupational-related fatalities by career status, age, smoking, obesity, and hypertension.

Methods: We used an exploratory, comparative secondary data analysis design. We extracted data from a national database of deceased firefighters over 14 years. Variables extracted were career status, age, smoking, obesity, and hypertension as well as the reason for death while on duty (i.e., cardiovascular-related or unavoidable occupational-related death). Data were analyzed using Chi-Square to …

Impressions Of Participants In A Chemical Mass Casualty Exercise, Ethan J. Start, Joan M. Culley, Abbas Tavakoli

Senior Theses

A mass casualty exercise was performed to investigate triage and decontamination of patients exposed to an irritant gas. Nursing students participated in two groups: emergency department triage (ED) and decontamination (DECON). While participants felt overall that the experience was valuable, DECON participants had a greater interest in emergency response and were more likely to volunteer again.

The Effectiveness Of Yoga In Preventing And Managing Back Pain, Sonja M. Brockman

Theses and Graduate Projects

In this Doctorate of Nursing Practice-Family Nurse Practitioner (DNP-FNP) scholarly

project, a yoga program was developed and implemented to educate how the practice of yoga can be utilized to manage or prevent back pain in nurses. Back pain in nurses is a common condition that can cause nurses to become unable to work and ultimately affect the nursing work unit. The practice of yoga has gained popularity in Western culture for improving health and back pain. A review of the recent research literature from 2000- 2015 that investigated back pain in nurses, back pain management, treatment, and yoga, is provided …

The Effect Of Training And Recognition On Nursing Assistant Retention In Acute Care Settings, Rachael Austin Swann

Nursing Theses and Capstone Projects

Nursing assistants are being hired in acute care settings to alleviate staffing issues associated with the nursing shortage. This has been a great economical solution to ensure adequate staff because of the large number of trained individuals in this vocation. Turnover and retention with nursing assistants in all settings including acute care is an expensive and reoccurring problem. Although several strategies have been implemented to prevent this, few provide a sustainable positive outcome. This situation requires an approach to look at the causes of turnover and provide interventions to reverse the negative impact. The intent of this research looked at …

Emergency Registered Nurses’ Perceptions Of Workplace Violence, Margarite Elsey

Nursing Theses and Capstone Projects

Workplace violence (WPV) is a significant issue in today’s healthcare field, especially for nurses in the emergency department. WPV is defined by action of verbal abuse, threats, disruptive behavior, harassment, intimidation and/or physical abuse, or assault (Stene, Larson, Levy, & Dohlman, 2015). Emergency Department (ED) registered nurses (RNs) are in a prime position to experience WPV due to the nature and purpose of the emergency room. To address effectively the problem of WPV against RNs in the ED, it is crucial first to understand how nurses in this setting perceive WPV from patients and/or visitors. In a Level I Trauma …

Exploring Nurse Stress, Andrea Butler

Nursing Theses and Capstone Projects

Aims: To explore levels of stress among nurses working in medical-surgical, telemetry and medical-telemetry nursing departments. Background: Bedside nurses are continuously confronted with stressful situations. These stressors can be very unpredictable and varying in intensity. As the nurse will face many different stressors, it is important for leadership to recognize the origin of the stress in order do everything possible to promote positive outcomes. Conquering stress within nursing departments provides a benefit for the greater good. Methods: This study used a descriptive, correlational study design. The association of occupational job stress for a nurse working within medical-surgical, telemetry, and medical-telemetry …

The Impact A Nurse's Work Environment Has On Breastfeeding, Ashley Dawn Hull

Nursing Theses and Capstone Projects

Breastfeeding is a global health initiative, as defined by the World Health Organization (WHO), because of its numerous health benefits to mothers and infants. Despite breast milk’s documented benefits to mothers and babies, many women are not choosing to breastfeed their infants. A lack of paid maternity leave policy within the United States influences postpartum responsibilities, physically, and psychologically. This paper presents nurses’ responses to the Workplace Breastfeeding Support Scale survey regarding their workplace environment support of breastfeeding. Nurses providing direct patient care for more than 50% of their shifts revealed 45.5% disagreed in some variance with their comfort in …

Academic Incivility In Modern Generation Of Nursing Students, Laila Akber Cassum

School of Nursing & Midwifery

Incivility in nursing academia and workplace is one of the emerging and complex issues in recent years, and can have substantial consequences on the organizational benchmark as well as on the teaching and learning milieu of the institution. Growth of academic incivility among the modern and diversified generation of students can have a profound destructive impact on their academic life and professional career. Impolite and discourteous attitude and behavior in a classroom atmosphere can originate from the learners as well the teachers, which can significantly impact the critical thinking and learning outcomes of the learner. This matter needs to be …

The Potential Role Of Weightlifting Training On The Biomechanics Of Patient Movements In The Prevention Of Back Injury, Michael Lee Callihan

Theses and Dissertations--Nursing

Back injury in nursing is a significant concern for the health of the worker, the costs to the healthcare system, and the safety of the patients. Current injury prevention measures include ergonomic adjustments to the work environment, the use of mechanical lifting equipment, policies to limit manual handling of patients, and the teaching of lifting techniques. These measures have been met with limited success in reducing injury rates. Little is known about whether changing the lifting biomechanics used in the healthcare setting can lower high injury rates across the profession.

The purposes of this dissertation were to: 1) identify the …

Increasing Annual Influenza Vaccination Rates Through Primary Prevention Strategies Among Health Care Workers In A Psychiatric Long-Term Care Facility: An Evidence-Based Approach, Kathleen Miller

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Influenza is a highly infectious, serious respiratory virus that causes almost 226,000 hospitalizations and averages 36,000 deaths annually in the United States (U.S.). Those at the highest risk for influenza-related complications and death include the elderly, the very young, those with chronic disease, and people with weakened immune systems. Since 1981, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee for Immunization Practices (ACIP) have recommended that all medically eligible healthcare workers (HCWs) receive an influenza vaccination annually. Despite recommendations, many HCWs decline the seasonal influenza vaccination putting themselves and their patients at risk. The CDC …