• Perceptions of Nurses Regarding a Nurse Residency Program

      Shaver, Chelsey; Department of Physiological and Technological Nursing (2016-03)
      Background: The turnover rate among newly licensed registered nurses (NLRNs) is a healthcare issue with reported rates as high as 61% within the first year of practicing. Job satisfaction and organizational factors impact retention rates per recent studies. Purpose: The purpose of this study was to evaluate the perceptions of a nurse residency program (NRP) among newly licensed registered nurses (NLRNs) related to job satisfaction and retention. Methods: The Casey-Fink Graduate Nurse Experience survey was used to evaluate satisfaction of a NRP among NLRNs. This survey was distributed to 72 of the 88 nurse residents after they completed the nurse residency program on the NRU. Forty-three surveys were returned and 38 were included in the study. Results: The turnover rate of the 88 NLRNs who started the NRP was 8% after 20 months. Respondents reported overall satisfaction with the NRP in areas of skill level, job stress, work relationships and the organization. Areas noted for improvement included increased preparation for workload management and increased skill practice in code responses, IV insertion, and tracheostomy management. Conclusion/Recommendations for Practice: By improving job satisfaction, this NRP assisted the facility in maintaining turnover rates lower than those reported by evidence-based research. Participants reported more time on their home units would improve acclamation to workload management, though a tiered, increased patient load with increased acuity.
    • Reducing Tobacco Dependence: Evaluation of Tobacco Cessation Education on a Stroke Unit

      Cook-McKnight, Crystal; Department of Physiological and Technological Nursing (2016-03)
      Background: Tobacco use is the number one preventable cause of morbidity and mortality in the United States.It is a leading cause of cerebrovascular disease, and tobacco users are three times more likely to have a stroke compared to non-tobacco users. Georgia is among the highest rates of tobacco use and stroke in the U.S. Evidence based tobacco cessation interventions are available; however, they are are underutilized by clinicians. Purpose: The purpose of this project was to evaluate if a brief educational intervention related to tobacco cesssation interventions compared to the current practice impacted the attitudes, beliefs, intentions and knowledge of tobacco cessation counseling of healthcare professionals on a stroke unit.Methods: A 45 minute presentation based on a guideline with the most current recommendations was provided to clinicians on a stroke unit. A pre-post survey evaluated the knowledge, attitudes, beliefs and intentions of 29 nurses and a respiratory therapist related to tobacco cessation interventions in a tertiary care hospital in Georgia.Results:Tobacco counseling and treatment knowledge increased significantly from pre- to post-training. Average correct answers post survey was 76% versus the pre survey of 24%. Attitudes, beliefs and intentions were moderately correlated to improved self confidence. Conclusion: Overall, healthcare professionals exhibited improved tobacco cessation knowledge. Attitudes, beliefs and intentions were moderately impacted.
    • Salubrinal Mediated Fetal Hemoglobin Induction Through The PERK-eIF2α-ATF4 Signaling Pathway

      Lopez, Nicole; Department of Cellular Biology and Anatomy (2016-03)
      Sickle cell disease (SCD) is an inherited disorder caused by a point mutation in the β-globin gene affecting ~100,000 people in the United States. These individuals suffer from hemolytic anemia, pain, and progressive organ damage. The best therapeutic intervention in SCD is fetal hemoglobin (HbF) induction by pharmacologic agents, however, Hydroxyurea is the only FDA-approved drug with proven efficacy. The goal of this project is to discover drugs that induce HbF by novel mechanisms for SCD treatment. Salubrinal (SAL), a selective inhibitor of eukaryotic initiation factor 2α (eIF2α), was shown to increase HbF levels by enhancing γ-globin mRNA translation. These findings lead us to test the hypothesis that SAL activates the PERK-eIF2α-ATF4 stress response, as a mechanism of HbF induction in erythroid progenitors. Studies were conducted in K562 and erythroid progenitor generated from CD34+ stem cells treated with SAL (5, 12, and 18µM) for 48hr. RT-qPCR and western blot were used to measure γ-globin mRNA and HbF protein levels respectively. Preliminary data revealed a dose-dependent increase for HbF levels in K562 and erythroid progenitors treated with SAL. Flow cytometry showed an increase in the number of cells producing HbF (%F-cells). Furthermore, eIF2α and ATF4 levels were increased by SAL in K562 cells. These findings suggest SAL mediates HbF induction through eIF2α/ATF-4 signaling; future studies using the preclinical sickle cell mouse model will be investigated.
    • Understanding and Promoting Breastfeeding among African American Woman of the Rural South

      Stewart, Jessica Lynn; Department of Clinical and Digital Health Sciences (2016-03)
      African American women (AAW) have lower rates of breastfeeding (BF) than whites and other U.S. minority groups. Along with its many maternal and child health benefits, research indicates BF can reduce the risk of developing triple-negative breast cancer (TNBC), an aggressive subtype of breast cancer with higher mortalities and incidence in AAW. Thus, increasing BF can be an important strategy for addressing breast cancer health disparities.This research seeks to ultimately determine whether increased awareness that BF reduces breast cancer and TNBC risk will positively alter AAW’s BF decision-making. A survey and an in-depth interview based on the Theory of Planned Behavior framework are used to examine AAW’s perceptions of breast cancer risk and prevention as well as their beliefs, attitudes and motivations that underlie BF decision-making. Preliminary analysis of 10 interviews to date showed that all of the participants had an intention and desire to BF, but many (n=6) lacked a realistic plan to manage BF and address expected barriers. When asked about breast cancer, most (n=8) demonstrated fear and avoidance of the topic. There was a general lack of knowledge, but excitement about the benefits of BF on TNBC prevention. Dissemination of this new evidence may be useful in guiding BF promotions among AAW. Also, there was a clear disconnect in BF intention versus action in this population. Further analysis will identify intervening factors that bridge the gap.