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Effectiveness of a Multi-departmental Nursing Tiered Orientation Model on Service Line Culture, Self-Efficacy of Nurses, Positive Patient Outcomes and Nurse Satisfaction
Get PDFAbstract Background: Nurses who transition into specialty practice areas in healthcare settings may demonstrate a lack of confidence and a high level of stress. Decreased levels of nursing engagement, self-efficacy, and interdepartmental team collaboration may also be seen. Multi-departmental tiered orientation models can help facilitate the development of increased confidence and competence and ultimately lead to improved patient outcomes. Purpose: The purpose of this doctoral project was to evaluate the effectiveness of a multi-departmental tiered orientation model for nurses hired into a specialty area. The specific objectives included were to a) determine the effectiveness of the model on service line culture b) determine if there was a correlation with use of the model and increased nurse engagement, self-efficacy, and nurse satisfaction c) determine if the model had a positive impact on turnover rates within the Neonatal Intensive Care Unit and d) assess if there were improved patient outcomes associated with reported Central Line Associated Bloodstream Infections (CLABSI’s) and Hospitals Acquired Pressure Injuries ( HAPI’s) while utilizing the model. Method: A retrospective cohort design was used for this study. The department of interest for the study was a 28-bed level III neonatal ICU (NICU). Participants included Neonatal Intensive Care Unit RNs who completed the multi-departmental nursing tiered orientation model. Results: A total of 31 RN’s between both the NICU and the Mother Baby units completed the survey, and 17 of those survey participants completed the multi-departmental tiered orientation model. Statistically significant associations were observed between staff engagement and unit culture (p = .001). Nurse satisfaction with use of the model had a potential range of 1 to 5, with a mean of 4.03, indicating high satisfaction. Conclusion: A multi-departmental tiered orientation models has an overall positive impact for nursing staff when transitioning into practice. Future research should focus on continued development of tiered models and address key barriers for successful improvement
HEARING BETWEEN THE LINES: ANALYZING OCCUPATIONAL HEARING LOSS FIRST REPORTS OF INJURY FROM 2005-2019 IN KENTUCKY
No full textDespite safety measures that have been implemented to protect workers from Occupational Hearing Loss (OHL), the all-industry prevalence of OHL has yet to decline. A cross-sectional analysis was conducted on OHL workers’ compensation First Report of Injury/Illness (FROI) data between 2005-2019 in Kentucky to uncover demographic, situational, and temporal trends of OHL FROI (n=1125). Most reports were found to be from older (45+) individuals, men, and included lost time. In line with previous literature, the rates of OHL FROI in KY were highest in the Mining, Quarrying, and Oil and Gas Extraction industry (96.8 per 100,000 FTE, 95% CI: 86.6, 107.7) and the Transportation and Warehousing industry (13.5 per 100,000 FTE, 95% CI: 11.7, 15.5). Construction and Extraction Occupations had the most OHL FROI (n=328). Between the study period, a reporting peak was identified in 2014 with 143 FROI. This study provides a description of the OHL reporting population in Kentucky and identifies where further study is necessary but is subject to misclassification and reporting bias. Additionally, there is a need to assess OHL in high-risk industries and occupations that may not be a part of state workers’ compensation, like Agriculture and temporary/contractual workers. However, workers’ compensation has been found to underrepresent OHL incidence in all industries, meaning that better hearing safety practices need to be implemented
Increasing HPV Vaccination Adherence in Floyd County, KY: Give Teens Vaccines
Get PDFCervical cancer remains a pressing public health issue, particularly in underserved and rural areas where access to preventive care is limited. This capstone addresses the urgent need to increase human papillomavirus (HPV) vaccination adherence in Floyd County, Kentucky—part of the central Appalachian region that experiences disproportionately high cervical cancer incidence and mortality. Despite the proven effectiveness of HPV vaccines in preventing the virus strains most responsible for cervical cancer, uptake in this region remains below national targets due to socioeconomic barriers, limited healthcare access, and lack of awareness. Give Teens Vaccines is a two component intervention leveraging existing healthcare systems to educate both providers and parents on the necessity, efficacy, and safety of the HPV vaccine. By focusing on early prevention through improved vaccination adherence, this initiative seeks to reduce cervical cancer disparities and promote long-term health in eastern Kentucky
Heartache in the Heartland: Unraveling the Social Roots of Deaths of Despair in Kentucky
Get PDFIntroduction: Deaths of despair (DoD), encompassing suicides, drug overdoses, and alcohol-related liver diseases, have emerged as a critical public health crisis in the United States, with their rise particularly pronounced from 1995 to 2013 and exacerbated by the COVID-19 pandemic. Kentucky, grappling with high rates of substance use disorder, poor mental health, and economic hardship, is at the forefront of this issue, particularly in its rural and Appalachian regions.
Purpose: This study explores the social determinants contributing to DoD in Kentucky, focusing on economic and social factors that influence rising rates of suicide, drug overdose, and alcohol-related liver disease. The goal is to provide evidence to guide policy and intervention strategies.
Methods: An ecological study was conducted across 120 Kentucky counties from 2011 – 2020. DoD mortality data were sourced from the CDC WONDER database, and socioeconomic variables from the American Community Survey. Principal Component Analysis (PCA) reduced 10 county-level socioeconomic variables. Poisson regression estimated associations between socioeconomic principal component scores and DoD mortality, adjusting for confounders like age, and racial demographics.
Results: The median DoD mortality rate was 59.7 per 100,000 people, with geographic variation. Three principal components explained 78.4% of the variance in socioeconomic factors. Counties with extreme socioeconomic disadvantages (low education, high poverty, high disability, high unemployment) were strongly associated with higher DoD rates (RR=1.07; 95% CI=1.02-1.12).
Implications: Extreme socioeconomic disadvantage is a key predictor of DoD rates in Kentucky. These findings can inform public health interventions and policy changes targeting high-risk areas, especially rural and Appalachian regions
Effect of Fertilizers on Cutting on Time on Chemical Composition of Sward from Permanent Meadow
Get PDFEcological problems and surpluses of milk and meat have given rise to less intensive systems of grassland utilisation. One of such system is utilisation of air nitrogen via legume symbiosis with nitrogen fixing bacteria. In Slovenia, where conditions for legume growth are more favourable than in NW Europe, natural meadows fertilized with P and K only give reasonable yields - on average around 7 t DM per ha (Leskosek, 1981). Most legumes suffer after frequent defoliation so such meadows should be defoliated only 2- 3 times during the growing season. Under less frequent cutting regime nutritive value of forage is often too low to meet the requirements of the animals. In the following experiment the influence of long term fertilization treatments (unfertilized, PK and NPK) on the changes of nutritive value of meadow during growth was examined
Mineral Composition of Grasses Grown on Peat Soils in Northwestern Hungary and Fertilization Experiments. Manganese
Get PDFThe main goal of these experiments which were carried out for four years was to study the mineral composition of grasses grown on peat soil, where preliminary studies indicated manganese, copper and zinc deficiency. We tried to eliminate these deficiences by agrochemical methods, because in our opinion, intervening in the first part of the foodchain - in the soil - we can contribute to solving of the deficiency problems more fundamentaly (Ti:ilgyesi et al., 1983)
The Effect of Supplementation of Setaria Grass with Cassava or Gliricidia Leaves on Growing Sheep
Get PDFIn tropical areas, grasses are the main forage offered to ruminant, eventhough they have low quality such as native grass crude protein of about 7-12 %, and napier grass about 9-14 %. Recently in Indonesia, plantation of setaria grass was introduced especially in transmigration and watershed areas, regardless its nutritive value, and its influence on animal performances. Similar with other grasses, setaria grass has a low nutritive value and when fed alone can not meet the production requirements. More over, Jones et al. (1970) reported that cattle with setaria in a grazing system can lead to the death due to oxalate poison. To prevent this and to increase growth rate a supplementation with high protein feedstuffs is necessary. For most farmers in the tropics, such concentrates can not be used economically, rather gliricidia of cassava leaves can be provided by farmers. Gliricidia leaves contain sufficient crude protein and are harmless when given continuously during a long period of time (Chanlokar, 1982). This species grows well in small plot, along fence lines and roads-sides. Cassava leaves are one of the five major crop by-products in Java, Indonesia. It contains approximately 25 % crude protein. This is assumed to be a potentially important low cost source of protein for ruminants (de Boer and Forno, 1975). This experiment was carried out to evaluate the nutritive value, voluntary intake and digestibility of setaria grass with or without cassava and gliricidia leaves and their effect on performance of sheep
Chemical Regulation of Growth and Quality of Orchardgrass/Alfalfa Mixtures
Get PDFAlthough mixtures tend to provide a better balance of nutrients and can produce higher forage yields, they are more difficult to manage than either grasses or legumes alone (Baylor, 1974). Furthermore; quality can be variable, due to species differences in rates of maturation, and this commonly ��results�� in wastage because one of the mixture components typically 1s harvested at a later than ideal stage of maturity. If the growth and chemical composition of one component could be manipulated by the producer, improvements in efficiency could result. This may be possible with plant growth regulators. Recent developments in herbicide chemistry have produced materials that have broad-spectrum phytotoxicity in non-leguminous plants, but tend to have selective growth regulating ability in grasses at lower rates of application. One such compound is \u27imazethapyr\u27, [5-ethyl-2-( 4-isopropyl-4-methyl-5-oxo-2-irnidazolin-2-yl)nicotinic acid], a member of the Irnidazolinone family and currently under development by the American Cyanamid Co. (Princeton, NJ) for weed control in alfalfa (Medicago sativa L.). The objective of this study was to ��evaluate the potential of both mefluidide (MF) and 1mazethapyr (IM) for inhibiting the initial spring growth and improving the quality of first cutting orchardgrass in an orchardgrass (Dactylis glomerata L.)/alfalfa mixture managed for hay production
The Effect of Plant Population Density and Fertilizer Nitrogen on the Performance and Quality of Maize for Silage
Get PDFGhanaian soils are inherently low in Nitrogen (N) content especially in grassland areas and where the forest has been cleared for cultivation. The diet of Ghanaians is very low in protein, and more meat protein is needed. Livestock production is empeded when during the long dry season livestock lose weight, get diseased or die because of insufficient forage. This limits animal protein available for Ghanaians. Forage conservation in the rainy season for use during the drought period is suggested, and for this, silage preparation has been found most practicable .. Means of improving the yield and quality of forages in the tropics include the adoption of high plant densities and fertilizer N application. The present study therefore aims at investigating the effects of plant population density and fertilizer N application on the performance and quality of maize grown as forage for ensilage
Near Infrared Reflectance Spectroscopy for Estimation of Digestible Organic Matter Intake and Body Weight Gain
Get PDFHigh correlations have been reported between data from near infrared reflectance spectroscopy (NIRS) and the protein and fiber contents, as well as the intake and digestibility, of forages (Norris et al., 1976). The finding in some studies that sample sets for calibration and unknown samples should be restricted to relatively narrow populations (Marten et al., 1983) has limited the usefulness of NIRS. However, in experiments with legumes, correlations with NIRS data were almost as good across species as among species (Marten et al., 1984). The experiment reported here was conducted to discover quantitative relationships between NIRS spectra and chemical composition, digestibility, intake and body weight from 20 forages representing 5 plant cultivars/species grown at 4 locations