Medicine and Health Sciences Commons^™

Trust In The Nurse And Perceived Quality Nursing Care By Adult Oncology Patients With Implantable Vascular Access Port Devices: A Mixed Methods Study, Lois Rajcan

Electronic Theses and Dissertations

Objective: The purpose of this study was to obtain an understanding of nurse behaviors that promote trust and quality nursing care as perceived by oncology patients with totally implantable vascular access devices (TIVAD).

Methods: An explanatory sequential mixed-method design was used to answer the study questions. This design was comprised of two phases: 1) a quantitative online survey of oncology patients with TIVADs followed by; 2) qualitative interviews using purposively selected patients from the survey sample.

Results: Trust in the nurse and perceived quality of nursing care by patients with TIVADs were determined to be of average levels. Two qualitative …

Assessing Nurse Practitioners' Knowledge And Clinical Practice With Regard To The Oral-Systemic Link, Angela Haynes

Electronic Theses and Dissertations

Nurse Practitioners (NPs) comprise a significant portion of the U.S. primary care workforce and play an essential role in patients' health awareness, prevention strategies, disease management, and in providing appropriate provider referrals. Nurse Practitioners receive education on the oral-systemic connection, yet there have been limited studies on the clinical practice of NPs assessing the oral cavity to evaluate the condition of the teeth and the oral tissues. The purpose of this study was to explore the nurse practitioners’ knowledge and practice habits of assessing the oral cavity for diseases or abnormalities in the mouth that can, in turn, affect overall …

The Impact Of A Digital Intervention On Perceived Stress, Resiliency, Social Support, And Intention To Leave Among Newly Licensed Nurses: A Randomized Controlled Trial, Lisa Concilio

Electronic Theses and Dissertations

The nursing shortage has been deemed a public health crisis with the turnover rate of newly licensed nurses (NLNs) growing (Robert Wood Johnson Foundation, 2014). One out of five NLNs are leaving the profession due to work dissatisfaction and feelings of inadequacy (National Academy of Medicine, 2017). NLN attrition during the first year of hire has been associated with feelings of overwhelming stress and decreased sense of support which negatively impact patient safety (Spence Laschinger et al., 2016). As seasoned nurses are attempting to retire amidst a nursing shortage (American Association of Colleges of Nursing, 2018), NLNs require more support …

The Lived Experience Of Obesity, Spirituality, And Health Behaviors In African American Women, Andrea S. Poynter

Electronic Theses and Dissertations

Obesity is one of the fastest-growing health concerns impacting all racial, ethnic, gender, and socioeconomic groups in the United States of America. More than one-third of the U.S. adult population is classified as being obese (Obesity Society, 2014). Novak and Brownell (2012) identified that “obesity rates are consistently rising higher each year than in previous years” (p. 2345). Obesity has reached epidemic proportions in all races and genders within the US with African American women comprising a majority of those impacted by this chronic health condition. Obesity rates are well documented within the literature but what is lacking is the …

Supporting Postnatal Women With Opioid Use Disorder Treated With Medication Avoidance Therapy, Lea Ann Quave

Electronic Theses and Dissertations

Recent data in 28 U.S. states revealed that opioid use during pregnancy had increased by four times since 2014, going from 1.5 to 6.5 per 1,000 admissions. The use of opioids during pregnancy is dangerous to the mother and developing fetus, greatly increasing the risk for maternal death, miscarriage, and premature birth. The increase in the number of women with opioid abuse disorder (OUD) is reflected by a fivefold increase of infants born with neonatal abstinence syndrome (NAS), a withdrawal syndrome from opioids. Corresponding with U.S. trends, a community hospital in the Texas Gulf Coast region has seen an increase …

Use Of The Cameo Ii Acuity Tool To Decrease Burnout For Nurses Working In A Pediatric Intensive Care Unit, Frances Lynn Feria-Clement

Electronic Theses and Dissertations

The World Health Organization (WHO) reported registered nurse burnout is an occupational hazard resulting in serious consequences for patients, healthcare organizations, and individual registered nurses (Woo et al., 2020). The purpose of this project was to see if the Complexity Assessment and Monitoring to Ensure Optimal Outcomes II (CAMEO II) Acuity Tool, used as an intervention for staffing and scheduling, would have a positive effect against nurse burnout in a pediatric critical care setting in a pediatric medical center. Maslach’s Burnout Inventory- Human Services Survey for Medical Personnel (MBI-HSSMP) was used as a pre- and postsurvey to measure the emotional …

A Program Evaluation Of A Rural Nursing Academic Partnership, Meagan A. Spencer

Electronic Theses and Dissertations

As the American Association of Colleges of Nursing and Commission on Collegiate Nursing Education continue to promote the implementation and creation of literature on academic partnerships, a Christian university, sought to evaluate its academic partnership with a for-profit hospital for the first time in regard to student perspectives. The purpose of this mixed-methods program evaluation was to describe the student perceptions of the academic partnership in trusting, collaborating, and engaging nursing students and recruiting and retaining nursing graduates to rural hospitals and health care facilities. Measurable impacts included both qualitative and quantitative coding of the levels of trust, collaboration, and …

Undergraduate Nursing Students’ Learning Style Preferences And Preferred Faculty Teaching Methods Compared To The Actual Methods Used By Faculty, Linda Simpson

Electronic Theses and Dissertations

Aim. The aim of this study was to examine the generational differences of undergraduate nursing students’ learning style preferences and their preferred faculty teaching methods to the teaching methods used most often by nursing faculty in the classroom.

Background. Nursing educators are responsible for creating learning environments that are effective for students that are in different generations and nursing educational pathways. Each generational cohort brings a collective set of characteristics, expectations, and preferences to the classroom, challenging educators to balance the generational learning styles of all students with respectable, evidence-based, pedagogical approaches. This study was one of the …

Determining The Effectiveness Of A Peer Support Person In Individuals With Depression Symptoms, Donna K. Reeves

Electronic Theses and Dissertations

Abstract

This study’s aim was to evaluate the effectiveness of an existing peer support program as an adjunct treatment for patients with depression. This retrospective evaluation analyzed the total scores of 110 patients with depression on the PHQ-9 questionnaire at the initial assessment (Time 1), at 6-weeks (Time 2), and then at 12-weeks (Time 3). The participants were divided into two groups, those who enrolled in a peer support program (n = 55) and those without peer support (n = 55). PHQ-9 total scores for each time interval were compared for the two groups utilizing independent sample t-tests …

Lowering Perceived Stress Levels In Undergraduate Nursing Students, Caitlin Dodd

Electronic Theses and Dissertations

This project analyzed the effects of guided meditations and a stress management class on undergraduate, prelicensure nursing students’ perceived stress levels. College students and professional nurses are both susceptible to having high stress levels. Mindfulness activities have been shown to lower stress levels. Undergraduate, prelicensure nursing students participated in this project determining the effects of guided meditations and a stress management class on perceived stress levels in a quantitative, pre- and postinterventional study. Participants in the project completed a stress management class and 18 guided meditation sessions in an undergraduate classroom setting. The researcher used the Perceived Stress Scale-10 (PSS-10) …

Stroke Preventive In African American Women Ages 20-40 That Are Using Or Have Used Oral Contraceptives, Ashanti L. N. Coleman

Electronic Theses and Dissertations

This Doctor of Nursing Practice project will inform the audience of stroke awareness as it pertains to oral contraceptives. The study’s focus was to enhance the knowledge of African American women ages 20–40 that have used or are currently using an oral contraceptive. It has been identified that this patient population lacked the knowledge regarding stroke and oral contraceptives, and African American women continue to have the highest incidence of stroke. African American women also make up more than half of the consumers utilizing oral contraceptives. An oral contraceptive knowledge questionnaire was utilized from previous research to determine if any …

Moral Distress And Moral Residue Among Nurses Working In The Surgical Intensive Care Unit: A Descriptive Qualitative Approach., Adam Tyler Booth

Electronic Theses and Dissertations

Introduction: Approximately one in five Americans will die in the intensive care unit (ICU). Nurses spend more time with chronically ill and end-of-life patients than any other healthcare professional, and may perceive some actions in the ICU as immoral. Moral distress is defined as knowing the right course of action to take but being hindered by institutional constraints. Development of the Moral Distress Scale-Revised revealed that 31% of ICU nurses left a prior position or considered leaving their current nursing job because of moral distress. The purpose of this descriptive qualitative study is to explore surgical ICU (SICU) nurses’ perceptions …

Trust In Primary Care Providers: Perspectives From Deaf People., Greir Ander Huck Flynn

Electronic Theses and Dissertations

Trust is an integral part of the patient-provider relationship, responsible for influencing several key aspects of healthcare behaviors and patient perceptions of health outcomes. Though the topic has previously been discussed by scholars, little evidence exists to support the application of our understanding of trust in culturally Deaf populations. As such, this dissertation seeks to lay the necessary groundwork for further investigations on the topic by first understanding the nature of trust in patient-provider relationships from the perspectives of culturally Deaf people. The dissertation is comprised of five chapters. The first chapter provides an introduction to salient terms and concepts …

Qualifications Of Executive Nurses For Service On Hospital Boards, Michelle Lee Foxx

Electronic Theses and Dissertations

Abstract Healthcare governing boards have responsibility for the legal and financial stability of the organization. They are assuming more responsibility for quality care and outcomes. Nurse leaders have valuable insights into key shared governance issues such as quality of care, financial performance, legal requirements, and regulatory oversight. Yet, only 5% of the 3.2 million nurses in the U.S. health workforce hold a seat on hospital governing boards in the United States. The purpose of this study was to explore how nurses with executive experience perceive their own leadership qualities in the context of established requirements for executive hospital boards. Fifty …

A School-Based Sexual Health Education Program, Tracy L. Kendall

Electronic Theses and Dissertations

A small rural community has high incidence rates of chlamydia (4,751 per 100,000) and gonorrhea (970 per 100,000) in females 15–24 years old. Data obtained from Texas Health and Human Services showed that incidence rates of chlamydia and gonorrhea in females 15–24 years old were higher in Navarro County, Texas, than the state of Texas. Texas schools do not mandate sex health education. There is a gap in school-based sexual health education available to 18- and 19-year-old females residing in this rural community in Texas. The purpose of this research study was to evaluate the impact of school-based sexual health …

Medical Noncompliance In A Pediatric Patient Living In A Single-Parent Household, Lucy Obianuju Norrell

Electronic Theses and Dissertations

Abstract Noncompliance is a patient’s inability to comply with the recommended treatment for their complete recovery from an ailment, while compliance is the extent to which a patient adheres to the provider’s directive, such as medication and orders given. The purpose of this study was to determine if motivational interviewing when applied to noncompliant pediatric patients from single-parent households, would improve global medical compliance in this population as compared to the standard of care at the end of three months. Thirty-two participants were recruited using the homogeneous purposeful sampling. The project employed a mixed-method approach. Fred Kleinsinger’s noncompliant behavior tool …

Risk Factors Associated With Pressure Injury In Pediatric Congenital Heart Disease Patients, Ashlee Shields

Electronic Theses and Dissertations

Pediatric congenital heart disease (CHD) patients have unique risk factors associated with the pathophysiology of abnormal heart function. This vulnerable population is likely at an increased risk of acquiring a pressure injury during hospitalization. There are limited studies that include congenital heart disease patients and more specifically, factors unique to these patients. The purpose of this study was to identify risk factors associated with development of pressure injury in pediatric CHD patients. This retrospective study used a convenience sample from hospital-acquired data including subjects with congenital heart disease. The results demonstrated an association between pressure injury development and variables both …

Caring For Victims Of Child Maltreatment: Pediatric Nurses’ Moral Distress And Burnout, Angela Karakachian

Electronic Theses and Dissertations

Background: Moral distress is a significant concern for nurses as it can lead to burnout and intentions to leaving the profession. Pediatric nurses encounter stressful and ethically challenging situations when they care for victims of suspected child maltreatment. Data on pediatric nurses’ moral distress in this situation are lacking, as most research in this field has been done in adult inpatient and intensive care units.

Aims: The purpose of this study was to describe pediatric nurses’ moral distress and determine the impact of caring for victims of suspected child maltreatment on nurses’ moral distress, burnout, and intention to leave.

Design …

Coping Behaviors Of African Americans With Inflammatory Bowel Disease: A Focused Ethnography, Patricia Scott

Electronic Theses and Dissertations

Background: Increasing numbers of African Americans are being diagnosed with inflammatory bowel disease (IBD) in the United States (Dahlhamer, Zammitti, Ward, Wheaton, & Croft, 2016). Little is known about the influence of culture on coping with the disease. Method: Twelve African American adults with IBD were interviewed and observed using a focused ethnography. Results: Data analysis resulted in four major themes: (1) spending time living in the bathroom; (2) time and food restricted eating practices and cultural food avoidance; (3) dealing with a life full of stress; and (4) the practice of seclusion to promote health. Discussion: Participants described coping …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

The Experiences And Well-Being Of Mexican Immigrant Women Living In Traditionally Non-Latinx Communities In Western North Carolina, Melinda Bogardus

Electronic Theses and Dissertations

North Carolina has, in recent decades, experienced significant growth in its Latinx, and more particularly Mexican immigrant population. As a traditionally non-Latinx state, or a state without a long-standing, large Latinx population, many communities and healthcare and service providers within North Carolina still lack knowledge, resources, and skills needed to serve and support Latinx immigrant populations well. Guided by interpretive description, this qualitative study on Mexican immigrant women in Western North Carolina sought to gain knowledge and understanding of what it is like for them to live in a traditionally non-Latinx region and how immigration has affected their well-being. Asking …

The Relationship Of Self-Efficacy And Clinical Reasoning Of Undergraduate Nursing Students, Amy G. Holder

Electronic Theses and Dissertations

Aim. This investigation aimed to discover if a there is a correlation between a student’s clinical reasoning self-efficacy and a student’s actual clinical reasoning ability. Also, this research sought to discover the connection between an undergraduate nurse’s self-efficacy of clinical reasoning and the locus of control of that student. Finally, this investigation sought to discover if perceived self-efficacy of clinical reasoning changed over time.

Background. The ability to successfully navigate the process of clinical reasoning is critical to providing safe, effective care for patients. For nurses, this process begins to develop in nursing school. Unfortunately, evidence suggests that newly graduated …

A Protocol Driven Stroke Code's Impact On Door-To-Needle Times, Jesse Osborne

Electronic Theses and Dissertations

Tissue plasminogen activator (tPA) is most effective the faster it is able to be administered to a patient that has been affected by stroke. A Stroke Code is a strategy that acute care facilities implement to reduce the time from diagnosing a stroke to administering tPA. The purpose of this study was to determine if the initiation of a Stroke Code in an acute care hospital reduces the door-to-needle time for patients affected by a stroke. In particular, does a Stroke Code reduce door-to-needle times. The research was conducted using data from April 1, 2014 to December 31, 2014 (pre-Stroke …

Effect Of Creatinine Point-Of-Care Testing On Turnaround Time For Computed Tomography Exams With Intravenous Contrast, Shannon Haltom

Electronic Theses and Dissertations

Abstract

Emergency departments often have a stigma of long wait times. They face multiple challenges related to the flow of patient care due to the variety of factors that affect care and treatment. In order to support patient-centered care, the purpose of this project was to determine if point-of-care testing of creatinine decreases turnaround time for computed tomography exams with intravenous contrast in the emergency department. A mixed methodology of consecutive sampling and retrospective data collection was used. In all, 128 ratio data elements were reviewed, including a retrospective review of 64 charts from September 2018 and a consecutive sample …

Utilization Of A Concurrent Query Form To Improve Clinical Documentation In A Va Facility For Patients With Stroke Or Tia, Lisa A. Keefner

Electronic Theses and Dissertations

Caring for stroke patients diagnosed with acute ischemic stroke (AIS) and transient ischemic attack (TIA) at Veterans Health Administration (VHA) acute care hospitals is a very complex process that centers on accurate documentation. Inaccurate or missing documentation leads to patient safety issues, lower quality care, and inaccurate Veteran Equitable Resource Allocation (VERA) classification for reimbursement. This pilot project’s 3 problems of interest include improving provider response to clinical queries about documentation, capturing national metrics collected by the VHA, and accurately representing veterans in VERA classification. Based on a review of the literature available on patient treatment file (PTF) accuracy and …

Increasing Healthy Lifestyle Behaviors In Cargo Drivers, Ronda L. Bell

Electronic Theses and Dissertations

The purpose of this project was to examine the extent to which lifestyle behaviors of transportation drivers in North Texas can be improved with health education. This research study was conducted to examine the health behaviors of transportation drivers as a result of an educational partnership between nursing and the transportation industry. The goal was to improve healthy lifestyles through education to decrease chronic illness and comorbid conditions of a significantly at-risk occupational population. The impact of this education was immediate and verified with quantitative measurement and statistical analysis. Results demonstrated that after nurse-led health education, transportation drivers reported significant …

The Impact Of Education On The Attitudes Of Staff Of A Rehabilitation Hospital, Kathryn Voreis, Kathryn G. Voreis

Electronic Theses and Dissertations

Stroke, also known as CVA or cerebrovascular accident, is a major chronic disease worldwide. In the United States, it is the leading cause of disability, costing a billion dollars each year (CDC, 2017). Typically, Western medicine is used for the treatment of stroke in the United States. An approach that has potential to improve general health outcomes, movement, mobility, aphasia, and quality of life includes acupuncture along with the standard therapies. The purpose of this quantitative research was to determine if the staff of a rehabilitation hospital would have a change in attitude after an educational program on acupuncture. The …

How Do Nurse-To-Patient Ratios In The Emergency Department Impact Patient Experience?, Jessica L. Marcoux

Electronic Theses and Dissertations

There is a lack of consensus about the staffing matrix across nursing and especially in emergency

nursing, where variations in arrival patterns, acuity, social determinants of health, and length of stay all impact the workload of emergency nurses. The objective of this paper was to determine if government-mandated staffing ratios had a greater impact on patient experience at hospitals in California than staffing based on hours per patient visit at hospitals in Massachusetts. Seven hospitals from the state of California with government-mandated nurse-to-patient ratios were compared to 7 hospitals from Massachusetts that did not have mandated staffing ratios to determine …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

Follow-Up Nurse Telephone Calls For Heart Failure Patients: A Case Study, Danielle M. Schievelbein

Electronic Theses and Dissertations

Follow-up care is essential when trying to avoid readmissions for patients who have recently been discharged from a healthcare facility. As evidenced by the literature, multiple strategies have been implemented to help manage the care of heart failure patients; however, readmissions continue to be higher than desired, which implies the current strategies utilized should be reviewed and revised. It is important to evaluate the effectiveness of methods when providing follow-up care that prevents readmissions and is also beneficial and convenient for the patient. The qualitative case study explored a heart failure follow-up protocol completed by a registered nurse using the …