The University of Texas at Tyler
Scholar Works at UT Tyler (University of Texas at Tyler)Not a member yet
5042 research outputs found
Sort by
A Mixed Methods Feasibility Study Comparing Rural and Nonrural Critical Illness Survivors
No full textThis dissertation is an exploration of mental health (MH) and behavioral concepts related to the experience of critical illness survivors (CISs). Physical issues of survivorship after critical illness have long been studied and treated; however, less is known about the mental health of CISs, what influences them to seek MH treatment, and if there are differences in these phenomena in rural and nonrural CISs. The first manuscript is a concept analysis of “powerlessness” as it relates to the intensive care unit (ICU) patient experience. The second manuscript explores the MH outcomes of sepsis patients, the most common diagnosis in ICUs, and how ICU nurses can support the MH of sepsis patients. The third manuscript represents the primary research study. Using an adapted Social Cognitive Theory model as a guide, a convergent mixed methods feasibility study examined Post-Traumatic Stress Disorder symptoms, self-efficacy, powerlessness, seeking MH treatment, health-related goals, and perceived barriers and facilitators to seeking MH treatment in rural and nonrural CISs. In completing this dissertation, the researcher was able to lay the foundation for future research involving rural and nonrural CISs. Implications for future research and practice are considered and discussed
The Use of Mindfulness-Based Stress Reduction to Reduce Stress and Burnout in Nurses
Get PDFThe Mindfulness-Based Stress Reduction Program (MBSR) has been used effectively in multiple clinical settings to reduce workplace stress and burnout in nurses. The MBSR’s cost-effective approach to stress management can be implemented into any healthcare facility’s policy. The topic of MBSR’s effect on stress and burnout has been identified as essential due to nurses working in fast-paced, stressful work environments. These work environments lead to increased stress and burnout. The International Council of Nurses surveyed nurses before and after the pandemic. There were 40% of nurses that reported symptoms of burnout before the pandemic compared to 70% of nurses after the pandemic (Bartholomew, 2021). According to Sarazine et al. (2020), workplace stress is the highest safety risk for nurses. The continuing consequences of stress and burnout if the evidence-based change is not implemented include health issues in nurses like high blood pressure, heart disease, and sleep disorders. The Health Risk Appraisal by the American Nurses Association (2016) reported that 82% of nurses blamed workplace stress for their increased risk for illness.
Other continuing consequences of stress and burnout include increased errors, increased turnover rates, nursing shortages, and poor patient outcomes, costing healthcare facilities money (Green & Kinchen, 2021). The national turnover rate is 8.8% to 37% due to nursing burnout (Haddad et al., 2022). The Registered Nurse (RN) vacancy rate in Texas increased from 5.9% in 2019 to 17.6% in 2022 (Texas Center for Nursing Workforce Studies, 2022). The PICOT question that will be used for the Mindfulness-Based Stress Reduction change project will be as follows: In nurses suffering from workplace stress and burnout (P), how does a Mindfulness-Based Stress Reduction Program (I) compared with no Mindfulness-Based Stress Reduction Program (C) affect workplace stress and burnout (O) within eight weeks (T)
Early Mobilization in Critical Care: A Benchmark Study
Get PDFCritically ill patients often have complex injuries to multiple organ systems creating barriers to mobilization and a decrease in functional status (Bergbower et al., 2020). Early mobilization (EM) in hospitalized patients has shown to improve patient outcomes and decrease length of stay (LOS) (Bergbower et al., 2020). The link between EM and LOS is one that warrants further investigation with the PICOT question: In critically ill patients (P), how does early mobilization (I), compared to standard mobility (C) improve patient outcomes (O) over a three-month period (T)? The purpose of this paper is to discuss the rationale for the benchmark project, present a review of literature that provides evidence for change, discuss key stakeholders that are directly and indirectly effected by the change project, discuss the plan for implementation and evaluation, and project recommendations
Preventing Deep Vein Thrombosis in Surgical Patients
Get PDFDeep vein thrombosis (DVT) is a significant medical issue that incurs thrombi formation in the venous system which can result in major medical problems. DVT’s often occur because of complications after orthopedic surgery. Common risks factors for DVT are vein injury, slow blood movement, increase estrogen, and chronic medical illness (Centers for Disease Control and Prevention [CDC], 2018). As many as 900,000 individuals are impacted by DVT each year (CDC, 2020). Consequently, recent estimates show that 60,000 to 100,000 Americans die each year because of DVT. Even more alarming, 10 to 30% of individuals will die of DVT within a month of being diagnosed (CDC, 2020). There is numerous research available about the causes of DVT, its impact, and successful interventions when used properly. However, awareness of DVT is limited, and frontline workers have limited knowledge of its causes and risk factors.
DVTs can be prevented if hospital staff are trained and have the tools necessary to provide the necessary care to patients. Health care leadership must do their part to ensure this does not impact their organization. This plan will provide the training and support that could reduce DVTs from occurring. The costs for this project are minimal; however, costs associated with poor patient care or medical negligence can be enormous. These costs are not just financial, the costs for families who lose their loved ones can be significant and could have long-lasting effects on their quality of life. Hospitals that are not prepared for this preventable issue can sacrifice patient confidence and trust and lose credibility with stakeholders and communities
Improving Safety in the Emergency Department: Utilizing Metal Detectors to Mitigate Weapon Possession
Get PDFToday’s high risk-healthcare environment has prioritized patient safety with great initiatives and, unfortunately, placed staff safety second. However, safety for both groups should be equal priorities. Evidence suggests that Emergency Departments (ED) often care for patients with a history of crime and mental health diagnoses, creating an environment where the threat of violence and weapons is increasingly prevalent compared to other clinical settings. (Erlyana, 2019) Risk mitigation is possible if we consider studies by Malka et al. (2015) and Laidlaw et al. (2017) that indicate the efficacy of metal detectors in accurately identifying concealed weapons. To improve clinician and patient safety, the proposed change implements the utilization of metal detectors at all entry points into the ED. Concealed weapon screenings will incorporate static pole magnetic devices supplemented by hand-held metal detectors (HHMD). The initial investment would require ~$400,000 for the first year due to equipment and staffing costs. Subsequent years would decrease in cost based on staffing wages
The New Adolescent Epidemic: Vaping and the Electronic Cigarette
Get PDFIn this issue of the Hibbs Brief, we discuss some health issues regarding what is considered the new pandemic among adolescents – the electronic cigarette
Logistic Regression With Machine Learning Sheds Light on the Problematic Sexual Behavior Phenotype
Get PDFObjectives: There has been a longstanding debate about whether the mechanisms involved in problematic sexual behavior (PSB) are similar to those observed in addictive disorders, or related to impulse control or to compulsivity. The aim of this report was to contribute to this debate by investigating the association between PSB, addictive disorders (internet addiction, compulsive buying), measures associated with the construct known as reward deficiency (RDS), and obsessive-compulsive disorder (OCD). Methods: A Canadian university Office of the Registrar invited 68,846 eligible students and postdoctoral fellows. Of 4710 expressing interest in participating, 3359 completed online questionnaires, and 1801 completed the Mini-International Neuropsychiatric Interview. PSB was measured by combining those screening positive (score at least 6) on the Sexual Addiction Screening Test--Revised Core with those self-reporting PSB. Current mental health condition(s) and childhood trauma were measured by self-report. OCD was assessed by a combination of self-report and Mini-International Neuropsychiatric Interview data. Results: Of 3341 participants, 407 (12.18%) screened positive on the Sexual Addiction Screening Test--Revised Core. On logistic regression, OCD, attention deficit, internet addiction, a family history of PSB, childhood trauma, compulsive buying, and male gender were associated with PSB. On multiple correspondence analysis, OCD appeared to cluster separately from the other measures, and the pattern of data differed by gender. Conclusions: In our sample, factors that have previously been associated with RDS and OCD are both associated with increased odds of PSB. The factors associated with RDS appear to contribute to a separate data cluster from OCD and to lie closer to PSB
Occupational Health and Safety Policy Compliance among Community Health Workers in Western Kenya
Get PDFBackground: Compliance with occupational health and safety policies, monitoring, and evaluation are critical components of a safe workplace. Occupational hazards among community health workers have rarely been studied. This study aimed to assess compliance with occupational health and safety among community health workers in Western Kenya.
Methods: This cross-sectional study used a quantitative data-collection method. A sample of 309 community health workers and community health extension workers was selected using purposive and simple random sampling from 47 counties in Kenya and community health units, respectively. All community health workers in the sampled community units in the administrative locations were included as study participants. A structured questionnaire was used to collect data from the participants.
Results: Approximately one-third of the participants were females, 211(75.9%). Participants’ ages ranged from 18 to 68 years, with a mean of 36.8 years and a peak of 41-50 years, 113 (40.6%). The mean compliance to occupational level was 15.5, with a standard deviation of 6.7. Nearly three-quarters (76.6%) of the participants had low compliance with occupational health policy. A relatively high compliance score was in the 20-30 age group, with a mean score of 2.86±1.07 SD. Conclusion: This study provides evidence for the implementation of an occupational health policy to improve the care and safety of community health workers in Kenya
DESIGN AND IMPLEMENTATION OF AN OPTIMIZATION PLATFORM FOR COMMON FIXED PHOTOVOLTAIC SYSTEMS
Get PDFMost household photovoltaic (PV) panels are installed in a fixed arrangement (fixed-type) based on a rule of thumb that comes from experience. The azimuth angle is usually set facing south with a tilt angle equivalent to the location\u27s latitude. However, research shows that this is not the best for all geographical locations and during all hours of the day. Consequently, this brings up the hypothesis that optimizing the PV system\u27s azimuth and tilt angles would ensure that the PV panel produces the most possible output as it is adjusted to face the sun most effectively during peak sunlight hours. This work provides two optimization platforms to maximize the harvested energy from fixed-type solar photovoltaic (PV) systems. The first platform is based on a combination of factors such as climate data, geographical location, and seasonal variations to maximize the solar energy harvested. Results from the implementation of the proposed platform indicate that reasonable adjustments to the tilt and azimuth angles based on the combined information enhanced the power generation by the PV system over one year. The proposed platform was verified experimentally, and the results show a 4.5% increase in power generation over one year, considering the Tyler, TX, location. In certain months, the increase in power generation reached almost 13.37%. Moreover, the second optimization system is developed as an extension of the initial platform, taking into account the electricity requirements to minimize the cost of energy (COE). This platform aligns the number of solar panels and the angles of solar modules in a way that ensures a substantial portion of the household\u27s electricity needs are met by solar power, all while keeping costs at their lowest. The second optimization underwent testing to attain the most favorable cost-saving ratio. It was developed using various scenarios that align with user requirements and behavior. For instance, it was determined that selling excess solar panel electricity to the grid could significantly contribute to overall system cost savings. The platform can accommodate additional scenarios, adapting to user habits and delivering optimal outcomes in terms of cost reduction. The system has successfully demonstrated a significant cost reduction of 7–11% for Tyler, TX, for different scenarios and 13–18% for Corpus Christi, TX, in the results, along with additional energy savings that can either be sold to the grid or stored for future use
PROGRAM EVALUATION OF IMPROVING READING OUTCOMES USING EVIDENCE-BASED INSTRUCTION THROUGH RESPONSE TO INTERVENTION
Get PDFThis research leverages improvement science principles and rigorous scholarly design-based implementation research to delve into the efficacy of reading interventions for secondary students, a previously underexplored domain. The first iteration of this study critically assessed the present state of RtI practices within a rural East Texas school, while the subsequent iteration was an evaluative exploration of implementing a phonics-based reading intervention. The second iteration investigates the impact of the Reading Horizons Elevate (RHE) intervention program on reading outcomes of sixth-, seventh-, and eighth-grade students within a turnaround middle school in East Texas. This study focuses on the relevance of design-based implementation research in determining the potential of such interventions. This mixed-method approach, comprised of qualitative and quantitative data collection strategies, seeks to understand the alignment between teacher perceptions of using evidence-based strategies and programs in reading intervention for struggling readers. A key performance indicator for this exploration was STAAR (State of Texas Assessment of Academic Readiness). Preliminary findings suggest empirical gains through the intervention, yet its scalability remains a subject for future investigation. This study faced several limitations, including constraints related to participant sampling, with students selected based on prior year data and a small sample size from a convenience sample, as well as challenges associated with the intervention\u27s design and delivery, like the rigid intervention schedule, exclusive use of Orton Gillingham-based dyslexia program symbols, and reported low student engagement during specific lesson phases. Additionally, the absence of a control group and potential researcher bias might have influenced the study\u27s reliability, validity, and generalizability of findings