Digital Commons Network^™

Crescent City Nightingales: Gender, Race, Class And The Professionalization Of Nursing For Women In New Orleans, Louisiana, 1881-1950, Paula A. Fortier

University of New Orleans Theses and Dissertations

Through the examination of primary sources largely overlooked by historians, this dissertation traces the professionalization of nursing in New Orleans, Louisiana, from 1881 to 1950 while placing this localized history within the context of national trends. In the late nineteenth century, nursing developed into a middle class profession for women inspired by the careers of Florence Nightingale and Clara Barton. This dissertation investigates the process by which women became professional nurses while a complex intersection of issues related to gender, race, and class at times advanced, and at other times, hindered their progress towards professionalization. New Orleans serves as a …

A Transformational Leadership Program: A Necessity In Today’S Healthcare Environment, Kristin J. Pickerell

Graduate Theses, Dissertations, and Capstones

A Transformational Leadership Program: A Necessity in Today’s Healthcare Environment

Abstract

Objective

The purpose of this study was to enhance the transformational leadership capabilities of the nursing leaders in a small community hospital by implementing a leadership development course.

Background

Effective nurse leaders are critical in today’s fast-changing and uncertain healthcare environment. Competent leaders positively influence the nursing work environment, staff retention, patient safety, financial viability and quality outcomes. The development of a transformational skill set needed for a nurse leader to successfully lead a team to high-quality patient care.

Methods

Pre/post intervention design, using the Leadership Practices Inventory with …

Effect Of A Workplace Walking Initiative To Decrease Telehealth Nurses' Fatigue, Rae Ann Heissenbuttel

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

Background: Fatigue has been a common problem in the nursing profession. To date, most of the research regarding nurse fatigue has focused on nurses working in hospitals. Minimal research has been completed examining fatigue among nurses working in the telehealth environment and the effects of an evidence-based workplace initiative to decrease fatigue.

Aim: The aim of this translational project was to describe the overall self-reported health and fatigue for a group of telehealth nurses and to evaluate the effectiveness of the American Heart Association’s (AHA) walking program in improving overall health status and decreasing fatigue in telehealth …

The Creation And Implementation Of A Transgender Cultural Competence Nursing Education Toolkit, James Bl Donovan

Doctor of Nursing Practice (DNP) Projects

Healthcare disparities in the transgender populations have been linked to lack of healthcare provider cultural competence (IOM, 2011; Bradford et al., Harbin et al., 2012; Eliason, Dibble, & DeJoseph, 2010; Lim, Brown, & Jones, 2013). Prior research has identified that healthcare providers receive little, if any, transgender cultural competence training during their formal education. A survey of nursing educators at the University of San Francisco School (USF) of Nursing and Health Professions suggested that few educators are providing transgender content or understand the unique healthcare needs of that population. A literature review concluded that little is known about the best …

Emergency Preparedness On An Inpatient Hospital Unit, Hailee Marie Barnes

Master's Projects and Capstones

This paper will discuss the implementation of an emergency preparedness quality improvement project conducted by a University of San Francisco Clinical Nurse Leader (CNL) student on an inpatient cardiac unit, Unit H, at an urban teaching hospital in Northern California, Hospital B. An assessment of the current state of emergency preparedness, a diagnosis of Unit H’s area of greatest needs, the details of planning and implementing the quality improvement as well as the final evaluation will be discussed. The nursing process will be used for the structure of this paper as it was used as the structure of this project. …

Improving Interdisciplinary Communication To Improve Patient Satisfaction, Jennifer J. Barnes

Master's Projects and Capstones

The Clinical Nurse Leader project took place at a Magnet Hospital in Northern California. It involved the nursing staff on a 23-bed Post-Surgical Medical Surgical unit, as well as the therapists providing care to their diverse patient population. The goal was to improve interdisciplinary communication to decrease the frequency of missed or postponed therapy sessions. A review of literature revealed that this preventable issue could be the most significant factor resulting in an extended length of stay and affecting overall patient satisfaction. Project data was gathered from a variety of sources, including a unit assessment, shadowing therapists, interviews with key …

Improving Staff Responsiveness To Patient-Initiated Call Lights, Doshia B. Williams

Master's Projects and Capstones

This Clinical Nurse Leader (CNL) project involves the nursing staff and patients of a 23-bed post-surgical medical-surgical nursing unit at a Bay Area community hospital. The goal of this project was to improve patient care, patient satisfaction and staff workflow. Assessment of the microsytem revealed that from July 2013 through July 2014, the nursing unit scored below the unit’s goal 10 out of the 12 months for the HCAHPS question related to patient’s receiving help as soon as they pressed their call button. The unit’s goal is 64%; however, the 12-month average was 50%, with one month as low as …

Onsite Integrative Clinics: Acupuncture, Positive Patient Outcomes, And Frequency Of Provider Office Visits, Sherry Shoemaker Phd

Dissertations

Purpose and Aims. There is limited information about outcomes of care, resource utilization, and associated costs for patients who receive acupuncture in integrative health settings. The purpose of this study was to address this gap through the following aims: To examine: (1) changes in patient pain levels pre/post acupuncture treatments; (2) relationships between receiving acupuncture treatments (number of treatments, length of time, select demographic factors, (age, gender), pain level pre and post acupuncture treatments; (3) relationships between number of treatments, length of time, age, gender, pain level (pre/post acupuncture treatments) and provider visits (pre/post acupuncture treatments); and (4) relationship between …

Exploring A Diabetic Registry For Cardiovascular Risk Factors, Mary C. Anziano Phd

Dissertations

Background: Cardiovascular disease is the leading cause of death in the United States. There were over 18 million people diagnosed with diabetes in 2002. These disease processes together combine for significant health burden on society (American Diabetes Association, 2008). The purpose of the study was to describe the relationship between select demographics, and clinical characteristics to determine risk factors for cardiovascular disease in a diabetic population. Methods: A retrospective descriptive study was conducted using a diabetic registry database containing patients diagnosed with diabetes from January 1, 2011 to December 31, 2012. Study variables included age, gender, socio-economic status, glycosylated hemoglobin …

The Case Of Reintegration Of Women Post Incarceration, Deana Raley Noble Phd

Dissertations

Women released from prison or jail face particular obstacles and challenges on reentry to the community, many of which are related to their childhood and to gender roles as women and mothers. This study relates the lived experience of one woman's successful transition to economic and mainstream societal reintegration and family reconnection after release from prison and the insights gained by the researcher. Case study methodology congruent with Miller's Relational-Cultural Theory philosophical framework was utilized in this in-depth, single case design and represents a unique case. The overall purpose of this descriptive and explanatory research was to explore precursors to …

Use Of Secure Messaging By United States Veterans And Significant Others, Claudia S. Derman

Theses and Dissertations

ABSTRACT

USE OF SECURE MESSAGING BY UNITED STATES VETERANS AND SIGNIFICANT OTHERS

By

Claudia S. Derman

The University of Wisconsin-Milwaukee, 2014

Under the Supervision of Professor Karen H. Morin, PhD, RN, ANEF, FAAN

The purpose of this study was to describe the topics discussed using secure messaging (SM), the pattern of use of SM, and whether the themes discussed and/or the pattern of use varied based on gender and age of the SM user. Secure messaging is an example of a technology that focuses on patient-centered communication. Secure messaging allows patients to communicate with their clinicians using the Internet and …

The Role Of Type A Behavior Pattern On The Stressor-Strain Relationship In Nurses, Jenny Anh Thu Le

Master's Theses

Three models (direct effects, moderated effects, and mediated effects) were used to test the role of Type A Behavior Pattern (TABP) in the stressor-strain relationship. The longitudinal study measured stressors (role ambiguity, role overload, and role conflict), strains (anxiety, tedium, affective commitment, intent to leave, and general well-being), and TABP in hospital nurses across two survey administrations. Stressors at Time 1 and strains at Time 2 were utilized for the analyses. TABP was found to have direct effects on anxiety and general well-being. In addition, TABP partially moderated the relationship between role conflict and anxiety and tedium, as well as …

Relationship Between Age And Pre-End Stage Renal Disease Care In Elderly Hemodialysis Patients, Rubette Harford Phd, Msn, Rn

Dissertations

Purpose: The primary purpose of this dissertation was to examine the relationship between age and receipt of three components of pre-end stage renal disease care prior to first initiation of hemodialysis, and to explore the implications of differences in interpretation of funding policies for dialysis services in Puerto Rico and the U.S. mainland. Background: The growing burden of chronic kidney disease (CKD) is a national public health concern, particularly within the aged population. It is estimated that more than 25 million Americans are living with some level of kidney disease, with an increasing prevalence noted with increasing age (Coresh et …

Undergraduate Nursing Student Situation Awareness During Simulation, Lynn Phillips

Dissertations

Graduate nurses encounter complex and rapidly changing patient care situations that require attentiveness, careful surveillance, and the recognition of subtle changes and patterns that will lead to appropriate decisions. Many researchers concur that new graduates are ill-equipped to meet these challenges, resulting in significant risk to patient safety. Situation Awareness (SA) is a skill that has been taught in the field of aviation to facilitate decision-making in complex, dynamic situations; however, there is little known about how nursing students develop SA. This mixed methods explorative study contrasted sophomore and senior nursing students’ (n=33) measured levels of SA during simulations of …

Establishing The Validity And Reliability Of The Fairness Of Items Tool, Nikole Anderson Hicks

Dissertations

No abstract provided.

Experience Of Registered Nurses During Their First Year As Neonatal Nurse Practitioner Students, Catherine Lewis Witt

Dissertations

Many neonatal intensive care nurseries require neonatal nurse practitioners (NNPs) to manage care of premature and sick neonates. The supply of NNPs has consistently lagged behind the demand for their services and the current number of projected graduates from NNP programs is unlikely to meet the demand. Neonatal nurse practitioner students are required to have two years of experience as a registered nurse in a neonatal intensive care unit prior to beginning a NNP program. The purpose of this qualitative study was to describe the experiences of registered nurses during their first year as neonatal nurse practitioner (NNP) students. This …

I Get By With A Little Help From My Friends: A Qualitative Study Of Nurse Close Work Friendship And Social Support, Jennifer Ptacek

Masters Theses

The nursing profession is laden with numerous job, emotional labor, and communication stressors, which come from both patients and healthcare organizations. These frequent and simultaneous pressures can result in nurse burnout and turnover (Tracy, 2009). Socially supportive workplace communication has been identified as a solution to reducing nurse stress, burnout, and turnover (Apker & Ray, 2003), but has not specifically considered social support in nurse work friendships. A mixed qualitative method study was conducted with five nurse best friend pairs, using job observations of participants’ work friendship communication and individual and joint interviews. Two major communication themes emerged from the …

Needs Of Patient’S Families In The Hospital Tele-Intensive Care Unit, Mary L. Jahrsdoerfer

Doctoral Dissertations

Purpose: To explore, identify and describe the perceptions of family members of a patient admitted to a telemedicine intensive care unit (tele-ICU); and to determine if these needs differ from those established by the Critical Care Family Needs Inventory (CCFNI) in the traditional ICU setting. Background: The tele-ICU is a new care modality in which offsite nurses provide consultation to bedside clinical staff at geographically-dispersed ICUs. The last decade demonstrates a growing existence of tele-ICU’s in our healthcare culture. ’Information’, ‘close proximity’, ‘assurance’, ‘support’ and ‘comfort’ have been identified as the top five needs of family members in the traditional …

Symptom Burden And Healthcare Utilization In Pulmonary Arterial Hypertension, Catherina Anne Madani Phd

Dissertations

Background: Pulmonary arterial hypertension (PAH) is a rapidly progressive disease. There is currently no cure; thus treatment is aimed at prolonging survival, improving functional status (FS), and symptom mitigation. Symptom burden (SB) can impact quality of life (QOL), and lead to increased healthcare utilization. Palliative care (PC) has been associated with higher QOL, decreased depression, aggressive care, and mortality. The Institute of Medicine's (IOM) recent report supports earlier integration of PC for people living with serious illness. Detection of patients at high risk for heavy SB may help to identify patients who could benefit from earlier integration of PC into …

Patient Care Technology And The Nurse-Patient Relationship, Belinda M. Toole Phd, Msn, Rn

Dissertations

Background: Technological devices are increasingly used in healthcare and their proliferation has providers questioning the impact on the patient-provider relationship. Technological device integration has been studied in the primary care setting, less extensively in the acute care setting. The impact of device use on the nurse-patient relationship in acute care setting required further study, particularly with nursing's history of holistic practice incorporating caring and presence. Objectives: The study purpose was to explore the patient's perceptions of nurse caring and presence when technological devices were used in care delivery in the acute care setting. Specific aims were: 1) to describe the …

The Effects Of Enhanced Discharge Education On Knowledge Retention In First Time Stroke/Tia Patients, Edward M. Stiner Jr.

Theses and Dissertations - UTB/UTPA

The purpose of this study is to determine whether patients aged 40-65 years, who are admitted for stroke or a transient ischemic attack (TIA) for the first time and who receive enhanced stroke discharge education have higher levels of education retention than patients aged 40-65 years who are admitted for stroke/TIA for the first time who receive standard stroke discharge education without the enhancement. Forty male and female participants were randomly placed into either a standard discharge education N=20 or enhanced discharge education group: N=20. The standard discharge education group received the usual stroke/TIA discharge education administered by the staff …

Depressive Symptomatology And Perceived Social Support In Adolescents With Type 2 Diabetes, Kristiana Gay Huffman Cullum Phd, Cpnp

Dissertations

Type 2 diabetes has increased dramatically in the pediatric population in the last decade. One of the comorbidities of diabetes is depression. In the presence of depression, diabetes may be mismanaged by patients and lead to a decline in health. Diabetes with comorbid depression may have better disease management outcomes in the presence of higher levels of social support. Defining childhood depression, which encompasses adolescence, and the subtleties of this disorder compared to the adult counterpart, was needed to better delineate important variables for this research study. There are several instruments that evaluate adolescents' perceived social support, but a fairly …

Patients With Advanced Lung Cancer: Quality Of Life And Perception Of Dyspnea, Barbara A. Roces Phd, Msn, Np, Rn

Dissertations

Background: Dyspnea perception can be defined as a multidimensional experience of breathing discomfort, influenced by physiological, psychological, social, and environmental factors, that includes secondary psychological and behavioral responses and cannot be defined only by physical objective abnormalities (Mularski et al., 2010). Dyspnea is the most common and distressing symptom in patients with advanced lung cancer and decreases one's quality of life (QOL) (Smith et al., 2001). Furthermore, dyspnea has been found to interfere with physical activities such as walking, work, and psychological activities such as disposition, taking pleasure in life, relationship with others, and sleep (Tanaka, Akechi, Okuyama, Nishiwaki, & …

Protein Losing Enteropathy Following Fontan Palliation In The Single Ventricle Population, Alaina Dunkleberger

Nursing Student Class Projects (Formerly MSN)

Congenital heart defects requiring single ventricle palliation are a rare but life-threatening occurrence. There are multiple defects resulting in single ventricle physiology including defects in which the right or left ventricle within the heart is either undeveloped (hypoplastic left heart syndrome, hypoplastic right heart syndrome), or the valve to the main pulmonary artery did not form (pulmonary atresia). These defects prevent the heart from supplying adequate blood flow to the lungs or body. Single ventricle congenital heart defects are not easily treated surgically due to their complexity in nature. Single ventricle surgical palliation typically involves three open-heart surgeries including the …

Relationships Among Uncertainty, Coping, And Psychological Distress In Older Adults With Mild Cognitive Impairment, Jennifer Sjostedt Avery

Dissertations (1934 -)

Mild cognitive impairment (MCI) has an average prevalence of 18.9% and most often affects people 60 years of age or older. It is a cognitive stage between normal functioning and dementia (Petersen, 2003; Petersen, 2011; Petersen et al., 2014). MCI can be broken into two subtypes classified by the presence of memory impairment (amnestic MCI) or the lack thereof (nonamnestic MCI). Medical diagnostic criteria are commonly used to guide research with older adults with MCI. A theoretical framework that addresses the antecedents and consequences of MCI, specifically one examining the relationships among MCI, uncertainty, coping and psychological distress, is essential …

Skin Cancer Risk Perception And Sunscreen Use In Adolescent Female Soccer Athletes, Cheryl L. Butera Phd, Msn, Aprn, Fnp-Bc, Np-C, Phn

Dissertations

Over 3.5 million cases of skin cancer are diagnosed annually in the United States. In adolescent females ages 15-19, melanoma is the second most common form of cancer. The greatest risk factor for skin cancer is ultraviolet rays from the sun. Research has shown that sunscreen use is protective of all skin cancers, especially melanoma. The purpose of this study was to obtain perceptions about risk of skin cancer and sunscreen use among 13- to 18-year-old adolescent female club soccer athletes as a basis for effective interventions to improve sunscreen use in this population. The Health Belief Model was employed …

Exploring Perceptions Of Staff Registered Nurse Preceptors For Undergraduate, Pre-Licensure Nursing Students, Katherine C. Hall

Doctoral Dissertations

Staff nurses are increasingly called upon to accept more responsibilities and roles in addition to provider of patient care, including that of preceptor. Aside from dealing with demands of high acuity patients, working long hours with inadequate staffing, and carrying heavy workloads, nurses may view teaching and supervising students as an additional burden, time-consuming, and not part of their role. The purpose of this dissertation was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students. Emphasis was placed on exploring RN’s perceptions of the role, specifically the preparation for, support in, and understanding of what the role …

An Evidence-Based Educational Intervention For Staff Nurses And The Rapid Response Team, Grace Katherine Gembrowski

Doctoral Dissertations

Rapid response systems (RRSs) have been proven to decease mortality, cardiac arrests, and ICU admissions. The three major health care system issues lead to failure to rescue: failure to communicate, failure to plan, and failure to recognize deteriorating conditions. It is crucial in a hospital setting that nurses have a basic knowledge base of why, when, and how the RRS should be activated as they are the first line of defense to recognizing signs of deterioration in patients. Previous research has shown that, although signs of patient deterioration are seen by staff, they are not always acted upon (Pusateri et …

Nurse Practice Environment And Peripheral Intravenous Infiltrations In A Pediatric Hospital On The Magnet Journey, Jannise Topacio Baclig Phd

Dissertations

Background: Characteristics such as quality patient care, excellence in nursing, and innovations in professional nursing practice shape a health care organization into a "magnet" organization. Magnet designation is a key aspect of nursing, which places pressure on healthcare organizations to commit to nursing excellence and patient care should they take the challenge of attaining this prestige. With growing focus on quality and safety, nursing needs to remain diligent in ensuring a healthy work environment that not only supports the profession, but also sustains exceptional patient outcomes. The purpose of this research study was to describe the relationship of the nurse …

The Relationship Of Nursing Career Perception Congruence And Perceived Social Support On Hispanic Middle School Female Nursing Career Choice, Karen Vicino Bourgeois

Dissertations, Theses, and Capstone Projects

The purpose of this study was to examine the relationship of nursing career perception congruence and perceived social support on Hispanic middle school females' nursing career choice. A non-experimental descriptive, cross sectional design examined the relationship in a convenience sample of 200 Hispanic middle school females from the New York tri-state area. Instruments used to measure nursing career choice, nursing career perception congruence, and perceived social support, were: (1) the Nursing Career Choice Questionnaire (NCC); (2) Attitudes, Values, and Beliefs Scale (AVBS); and (3) the Child and Adolescent Social Support Scale (CASSS) .Multinomial logistic regression analyses indicated support for the …