Medicine and Health Sciences Commons^™

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 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 …

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 …

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 …

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 …

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 …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

Effects Of An Apn-Led Amiodarone Clinic On Adherence To Recommended Monitoring Guidelines, Melissa Bartoszewicz

Evidence-Based Practice Project Reports

Evidence shows that patients receiving amiodarone therapy have not adhered to monitoring guidelines set forth by the Heart Rhythm Society. Uncertainty with responsibility for monitoring has led to the development of pharmacist-managed or multidisciplinary-managed outpatient amiodarone clinics. Some limitations have been identified in the pharmacist-managed outpatient clinics that may be overcome by advanced practice nurse (APN)-managed clinics. The purpose of this EBP project was to determine what effects an APN-led amiodarone clinic would have on adherence to amiodarone monitoring guidelines. Using the PICOT format, the clinical question was developed: Does enrollment in an amiodarone clinic compared with “usual care” change …

The Effect Of Shared Medical Appointments And Education On Hemoglobin A1c Levels, Gina L. Moore

Evidence-Based Practice Project Reports

Type II diabetes affects millions of people worldwide. Approximately 25.8 million or 8.3 percent of the United States (U.S.) population has type II diabetes. The number of adults in the United States developing diabetes has been projected to double by the year 2030 (World Health Organization, 2013). Diabetes is the leading cause of kidney failure and blindness, as well as the major cause of heart disease and stroke which is the 7th leading cause of death in the U.S. The purpose of this evidence-based project was to determine the effects of education during shared medical appointments with type II diabetic …

The Effect Of Telephone Follow-Up On Pain Experienced By Patients After Knee Replacement Surgery, Laurie J. Jones

Evidence-Based Practice Project Reports

Hospital length of stays are decreasing throughout the U.S. in an effort to contain healthcare costs, but these measures can be detrimental to patients. Those who get knee replacement surgery are finding their length of stay reduced from an average of 3 to 4 days to 24 to 48 hours, which can affect pain control and interfere with rehabilitation and recovery. This affects many people, as more than 632,000 knee replacements occur each year (American Academy of Orthopedic Surgeons, 2008). The purpose of this evidence-based project was to evaluate the effect of telephone follow-up on pain experienced by knee replacement …

Influence Of A Palliative Care Protocol On Nurses' Perceived Barriers To Palliative Care And Moral Distress, Christina Cavinder

Evidence-Based Practice Project Reports

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported …

The Effect Of Patient Education On Anxiety Levels In Patients Receiving Chemotherapy For The First Time, Sarah Garcia

Evidence-Based Practice Project Reports

Cancer affects approximately 1.5 million people every year throughout the United States.Comprehensive care that includes psychosocial aspects is important to help patients effectively adapt to their diagnosis and treatment plan. Improper prevention and management of anxiety can lead to poor psychosocial outcomes, dissatisfaction with care, and decreased adherence to treatment. Current evidence suggests that education is effective at helping reduce anxiety in patients receiving chemotherapy for the first time. The purpose of this evidenced based practice project was to determine if nurse-led patient education regarding chemotherapy side effects, side-effect management, and orientation to the infusion center was effective at decreasing …

The Use Of Stress Reduction Techniques In Nursing Education, Jennifer S. Bauer

Evidence-Based Practice Project Reports

Stress is a complex phenomenon that has significant effects on students which may disturb their physiological, psychological, and spiritual health and well-being. Nursing students have been identified to be at high risk for stress during their education. Stress can arise from new clinical experiences, academic load, and personal stressors (Jones & Johnston, 2006). This increase in stress can lead to the student’s inability to assimilate and learn within the classroom and clinical settings. A review of the literature provided evidence that reported a positive relationship between guided imagery and a decrease in stress and anxiety. This evidence-based practice (EBP) project …

Effects Of A Parish Based Heart Healthy Education Program, Kristin A. Kilinski

Evidence-Based Practice Project Reports

Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Some risk factors for cardiovascular disease can be modified which include: diet; physical activity; smoking; hypertension; diabetes; and weight. Various national programs, such as “Go Red for Women” and “Let’s Move,” have been implemented to address this growing epidemic. Community programs are needed as an adjunct to these national initiatives. Thus, a parish based cardiovascular disease educational program would provide for a unique socially and spiritually supportive environment for education at the community level. Research findings indicate that parish based educational programs are effective in increasing …