Medicine and Health Sciences Commons^™

Electronic Medical Records And The Lost Art Of Nursing, Tonya Blackwell

Master of Science in Nursing Theses and Projects

Abstract not available

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 …

Finding Common Threads: How Patients, Physicians And Nurses Perceive The Patient Gown, Christy M. Lucas, Cheryl Dellasega

Patient Experience Journal

Evidence-based care is standard practice in medicine, but the patient gown has fallen outside the scope of scholarly research. The current gown renders a patient vulnerable, diminishing patients’ sense of identity, agency, and dignity with its one-size-fits-none design. The impact on providers is similarly neglected. Our objective was to explore how patients and providers derive meaning from patient gowns. A convenience sample at an academic medical center was interviewed utilizing a standardized framework developed by a medical student and two PhD-prepared researchers with experience in qualitative methods. The study was inductive in nature, seeking to understand perceptions of the patient …

Enhancing Patient Well-Being: Apply Positive Psychology In Nursing Practice, Farida Bibi Mughal

School of Nursing & Midwifery

Objective: Positive psychology is the emerging concept in the medical field and has shown the positive effects on one’s well-being. This paper highlights the application of PERMA model in nursing practice.
Method: The model applied in the clinical area to access improvement in patient’s well-being. The concept of positive psychology’s applicability is discussed with the real life examples.
Result: The PERMA model when applied yields a positive impact on patient’s health and overall well-being.
Conclusion: The learning outcomes of this research will help the people in health care to understand the relationship between positive psychology and nursing practices for the …

Therapeutic Communication And Relationships In Chronic And Complex Care, Sharon Brownie, Robin Scott, Rachel Rossiter

School of Nursing & Midwifery, East Africa

As the population ages and the incidence of chronic diseases and lifestyle-related conditions rises, nurses are increasingly required to provide care for people with a range of chronic (long-term) conditions. The healthcare needs of patients are often complicated by comorbid conditions. Nurses deliver healthcare in the context of the patient’s medical conditions, treatment regimens, the healthcare system, and the individual’s socioeconomic, personal and family factors, which may include the challenges of social isolation and geographic distance. In such complex circumstances, patients may be perceived as ‘difficult’ or ‘challenging’, however, the challenge is not the patient themselves, but the relationship between …

Madeleine Leininger And The Transcultural Theory Of Nursing, Daniel A. Busher Betancourt

The Downtown Review

This paper explores Madeleine Leininger’s Theory of Transcultural Nursing and the importance that her theory has in the realm of modern nursing care. The United States is a nation widely acclaimed for its advances in health care, and nurses hold a vital role in delivering such quality care to their patients, who offer differences in “values, beliefs, and lifeways." In light of the globalization of health care and the stress put on professionalism in nursing, Leininger’s theories and research on comparative human care hold a prominent place in health care that provide congruency in the beliefs and cultural values of …

Communication Skills Of Novice Psychiatric Nurses With Aggressive Psychiatric Patients, Rose Moss

Walden Dissertations and Doctoral Studies

Communication Skills of Novice Psychiatric Nurses with Aggressive Psychiatric Patients

by

Rose L. Moss

MS, University of Hartford, 1996

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

March 2015

The transition from novice nurse to a competent psychiatric staff nurse is often associated with major communication challenges, primarily when caring for aggressive patients. Guided by Peplau's theory, this quantitative study assessed the communication skills of novice psychiatric nurses (N = 25) who worked 24 months or less in the state psychiatric hospital with aggressive psychiatric patients. Additionally, certain demographic data …

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 …

Examining Nursing Presence In The Acute Care Setting As An Indicator Of Patient Satisfaction With Nursing Care, Wendy Hansbrough Phd, Msn, Rn

Dissertations

Nursing presence is conceptualized as occurring within the nurse-patient relationship when the nurse acknowledges the uniqueness of the patient, within his or her context of being and chooses to intervene on the patient's behalf with a patient who allows the nurse into a reciprocal relationship. Nursing presence is described as occurring in varying levels and nurse expertise is suggested as one antecedent. Quantification of nursing presence would be useful in examination of nursing care outcomes, quality management and research. The Presence of Nursing Scale, PONS (Kostovich, 2002) was used in this study to test its reliability and determine its validity …

Compassionate Care, The Patient Perspective, Lori Burnell Phd

Dissertations

Professional mandates call for nurses to respond with compassion (e.g., American Nurses Association [ANA] Code of Ethics, International Council of Nurses [ICN]) and countless hospital mission and vision statements prominently display compassion as their fundamental purpose. As a component of healthcare and nursing models, however, defining characteristics and standards are inconsistent. Compassion as a means of establishing a connection on a spiritual level abounds in the literature (Buck, 2006; Grant, 2004; O'Brien, 2008; Schultz et al., 2007) and is documented as a nursing requirement (e.g., ANA, ICN); however, it remains virtually uncharted from the lens of the patient. Through interpretive …

The Impact Of A Clinical Mentor Program On Patient Outcomes, Cynthia M. Steckel Phd

Dissertations

The increasing complexity of patient care requires an expert nurse to navigate the hospital stay, yet today's workforce brings a declining supply of seasoned nurses, creating a patient need/nurse expertise gap. The clinical mentor role was developed to bridge this gap and create a safety net, using expert nurses, relieved of a patient assignment, to provide oversight for quality patient care. Results reported elsewhere showed improvements in failure to rescue and pressure ulcers six months before and after implementation. The purpose of this study was to examine the long-term impact of this new care model over the subsequent three years …

A Proposed Teaching Module For Senior Undergraduate Nursing Students To Counteract Bullying Among Nurses, Sue M. Odegarden

Theses and Graduate Projects

Despite a plethora of literature on the potentially devastating effects of bullying, the behavior continues among professional nurses. Nurses who engage in the behavior jeopardize the nursing profession because of the negative impact bullying has on recruitment and retention. Bullying behavior is unprofessional, unethical and compromises patient safety. The purpose of this graduate field project was to design a learning module for senior undergraduate nursing students focused on bullying. New graduates are vulnerable to bullying behavior. The knowledge and skills acquired from the module enable undergraduate students to recognize and respond appropriately to bullying when it occurs and improves nurse …

"Take My Hand, Help Me Out:" Mental Health Recipients' Experience Of The Therapeutic Relationship, M.M. Shattell, S.S. Starr, Sandra Thomas

Faculty Publications and Other Works -- Nursing

The purpose of this study was to describe mental health service recipients' experience of the therapeutic relationship. The research question was ‘what is therapeutic about the therapeutic relationship?’ This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health-care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, …

"Take My Hand, Help Me Out:" Mental Health Recipients' Experience Of The Therapeutic Relationship, M.M. Shattell, S.S. Starr, Sandra Thomas

Sandra Thomas

The purpose of this study was to describe mental health service recipients' experience of the therapeutic relationship. The research question was ‘what is therapeutic about the therapeutic relationship?’ This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health-care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, …

Healthcare Encounters Of Formerly Incarcerated Women: A Grounded Theory Study, Karen Sue Hoyt Phd

Dissertations

The adult correctional population in the United States soared to nearly 7 million people (Bureau of Justice Statistics [BJS], 2005). Over 2 million individuals were housed in prisons or jails in the United States. Nearly 7 percent (6.9%) were women (BJS, 2005). Recent trends in the adult correctional population suggest that there has been a stark increase in the number of formerly incarcerated women in the United States. The purpose of this research was to explore how formerly incarcerated women perceived their healthcare encounters. The aims of this study were to answer the following questions. How did formerly incarcerated women …

Clients' Expectations Of Public Health Nurses' Home Visits, Eva G. Miller Dnsc, Ms, Rn, Phn

Dissertations

Although there is considerable research on the relationship between client expectations and outcomes of care in acute care settings, less is known about clients' expectations for public health nurses' home visits. The aim of this study was to understand clients' expectations of public health nurses' home visits as a first step in making explicit how expectations affect client responses to, and ultimately, outcomes of public health nurses' care. Interviews were conducted with a convenience sample of 19 primary caretakers of high-risk infants admitted to a Neonatal Intensive Care Unit (NICU) and voluntarily enrolled in a High-Risk Infant (HRI) Program in …

Reconciling Temporalities: A Substantive Explanation Of The Origins Of Difficulty In The Nurse Patient Encounter, Marilyn Theresa Macdonald Phd

Dissertations

Nurses describe patients as difficult on a regular basis. Nursing research to date has assumed the existence of this phenomenon. Most studies have listed descriptors of the difficult patient and offered interventions for nurses to use to alter patient behavior. Locating of difficulty within the individual and failure to consider the context of the nurse patient encounter is problematic. The practice of locating difficulty in the individual absolves organizations and society of responsibility to work to change factors that contribute to the construction of difficulty. The purpose of this research was to move beyond a focus on the patient as …

“It’S The People That Make The Environment Good Or Bad:” The Patient’S Experience Of The Acute Care Hospital Environment, Mona Shattell, Beverly Hogan, Sandra Thomas

Mona Shattell

A review of contemporary nursing research reveals a tendency to focus on select aspects of the hospital environment such as noise, light, and music. Although studies such as these shed light on discrete aspects of the hospital environment, this body of literature contributes little to an understanding of the entirety of that world as the patient in the sickbed experiences it. The purpose of the study detailed in this article was to describe the patient’s experience of the acute care hospital environment. Nondirective, in-depth phenomenological interviews were conducted, then transcribed verbatim, and analyzed for themes. Against the backdrop of “I …

Justifying Coercion: Nurses' Experiences Medicating Involuntary Psychiatric Patients, Paula K. Vuckovich Phd, Rn

Dissertations

This grounded theory study delineates the process inpatient psychiatric nurses use to respond to the challenging nursing problem of medicating resistant involuntary patients. Since approximately one third of all admissions to psychiatric units in the United States are involuntary (Durham, 1996), caring for involuntary patients is a significant part of psychiatric nursing. Medication administration is a major treatment modality that is expected in caring effectively for psychiatric patients (American Psychiatric Association (APA), 1994; APA, 1997; Patel & Hardy, 2001). The process of getting the involuntary patient to accept medication is a major nursing function in a psychiatric unit that treats …

Conceptual Metaphor In The Health Care Culture, Cheryl D. Glennon Dnsc, Ms, Rn

Dissertations

The conceptual metaphor has meaning only when understood within the cultural framework which gives rise to the conceptualization. The purpose of this study was to investigate the interaction of cognition (conceptual metaphor) and culture as manifest during intercultural communication in teaching-learning sessions between health care providers and patients. An ethnography of communication (Hymes, 1974; Saville-Troike, 1989) was the method employed to investigate the use of metaphor by patients, nurses and other health care professionals. Patients were viewed as a sojourner group in the health care culture; nurses and their health care partners were seen as a host group. Data were …

Cultural Discovery In Nursing Practice: The Experience Of Nurses' Who Work With Vietnamese, Evelyn Labun Dnsc, Mscn, Rn

Dissertations

The purpose of this investigation was to generate a substantive theory of cultural discovery among nurses who work with Vietnamese. A grounded theory approach involving dimensional analysis was employed. A purposive sample of 27 registered nurses with experiences working with Vietnamese in acute care, community, and clinic settings was interviewed using a semi-structured format. Data were analyzed for dimensions as well as conditions, context, action strategies, and consequences. The theory of cultural discovery described how nurses learn to see their Vietnamese clients, how they saw a common humanity with others, and how they learn to see health. Nurses who made …

The Effect Of Written Information And Reassurance On Patient Satisfaction, Anxiety, And Intent To Return For Emergency Care, June Andrea Dnsc

Dissertations

Patients' satisfaction is one of the primary goals of emergency department (ED) providers today. As emergency departments are overcrowded, stressful environments, anxious patients want to be kept informed. Nurses have the opportunity to meet these needs and possibly influence the patients' perception of the experience and intent to return for future care. This study examined the effects of providing written information and reassurance on patient satisfaction, anxiety, and intent to return for emergency care. The design was a posttest design involving a comparison between the control and three experimental groups. Two hundred and forty patients participated in the study, approximately …

A Model Of Patient Satisfaction And Behavioral Intention In Managed Care, Diane Sturdy Greeneich Dnsc, Ms, Rn

Dissertations

Determination of patient outcomes associated with new and return business is a primary objective of the managed care marketplace. Identification of variables which contribute to both positive and negative patient experience in managed care systems is crucial to their effectiveness. The purpose of this study was to test the functional relationships between the variables of nurse practitioner attributes and behaviors, patient perceptions of the managed care system, and outcomes of patient satisfaction and intention to return to and recommend the managed care system. Functional relationships were measured with the Patient Satisfaction Semantic Differential (Greeneich and Long, 1992), and the Service …

The Lived Experiences Of Nurses' Interactions With Ethnically Diverse Clients: A Phenomenological Perspective, Colette R. York Dnsc, Msn, Rn

Dissertations

This study explored the phenomenon of nurses' lived experiences while interacting with clients who were ethnically dissimilar to themselves in a variety of nursing care settings including acute care, ambulatory care and public health. This study is timely, especially in the county in which the study was conducted because of the ongoing influx of legal and illegal immigrants from diverse foreign geographic locales. Van Kaam's method for conducting phenomenological studies was employed for data gathering, categorizing and analyzing. Categories were stated in terms of perceptions and feelings. The most frequently stated perceptual moments included perceiving client ethnicities based on physical …

Sociolinguistic Dimensions Of Nurse Practitioner Practice: A Question Of Power, Merrily J. Allen Dnsc, Mn, Rn

Dissertations

Ethnographic methods were used to examine the sociolinguistic dimensions of female nurse practitioner interactions with female patients. The purpose was to provide a contextual account of the discursive practices used by the nurse practitioners during routine office visits with female patients. Direction for this research was provided by my concern about power inherent in professional-client dyadic relationships. Data collection methods included formal and informal interviews, participant observation and audio taping nurse-patient encounters. Nine nurse practitioners and 26 patients participated in the study in both private and public ambulatory care settings. Data analysis yielded two concurrent story lines which I labeled …

Nursing Care Through The Eyes Of The Patient, Donna May Fosbinder Dnsc, Msn, Rn

Dissertations

Ethnographic methods were used to examine the nurse-patient interaction for the purpose of developing descriptive and explanatory theory of patient satisfaction based on patients' perceptions regarding their nurses' interpersonal skills. A private acute care hospital was the setting for 40 patients and 12 nurses who were study participants. Four processes provided the framework for the themes that emerged: "translating," "getting to know you," "establishing trust," and "going the extra mile." I labeled the action of nurses informing, explaining, instructing, and teaching patients the translation process. Informing and explaining were described by both patients and nurses as very important to the …