Medicine and Health Sciences Commons^™

Nursing Students' Lived Experiences Surrounding Medication Administration, Sally Nan Morgan Phd

Dissertations

Medication errors are abounding and the complexity of medication administration creates an environment where health care providers are at risk for making errors. This environment includes nursing students learning medication administration. Coupled with a rigid, protocol-driven pedagogy, nursing students may be placed in a learning experience counterproductive to accuracy. Previous studies have focused on causes and perceptions of medication errors looking for the delineation between safe and unsafe practice. In doing so, past research may have narrowed the path of discovery needed to diminish medication errors. In addition, research regarding the lived experience of nursing students while they are learning …

Call-Shift Fatigue And Use Of Countermeasures And Strategies By Certified Registered Nurse Anesthetists, Ramona M. Domen Phd, Crna

Dissertations

Purpose: The purpose of this study was to examine whether Certified Registered Nurse Anesthetists (CRNAs) experience fatigue during call and to assess their use of fatigue avoidance strategies (practices that prevent fatigue) and fatigue countermeasures (practices that decrease fatigue) to mitigate its effects. Method: Using a cross sectional descriptive survey design, data were collected from a randomly selected sample of 323 practicing CRNAs who worked call shifts. Data analysis: Data were analyzed using descriptive and multivariate statistics. Results: The sample was fairly evenly distributed with slightly more female respondents, 55% (n = 179). Fifty four percent worked a weekday call …

Analysis Of Texas Nurses' Preparedness And Perceived Competence In Managing Disasters, Sylvia Theresa Baack

Nursing Theses and Dissertations

Awareness of disaster preparedness has penetrated every level of the government and has captured the attention of citizens around the world. The increased prevalence of natural disasters cannot be denied, and the growing turbulence of world affairs is the focus of intense media attention. Nurses make up the largest sector of the healthcare workforce and are integral responders to major natural and human-induced disasters. It is essential that nurses have the knowledge and preparation needed to respond effectively, not only for the benefit of health care organizations, but for the safety of the community at large. This article explores the …

Health Literacy And Health Promotion Behaviors Among Samoans, Katherine Tong Phd, Msn, Cfnp, Phn

Dissertations

Limited health literacy is associated with failure to engage in health promotion behaviors. Few studies examine this relationship among Samoans. This study used a cross-sectional correlational design to determine health literacy levels and their relationship to health promoting behaviors in a southern California Samoan population. Health literacy (Short form Test of Functional Health Literacy in Adults) and health promotion behaviors (Health Promotion Lifestyle Profile II) were measured in a convenience sample of 87 Samoans in southern California. Data analysis employed chi-square, t-test, and one- way ANOVA. Significant associations were found for health literacy and demographic characteristics of employment and marital …

Associations Among Perceived Benefits, Barriers, Cues, And Physical Activity In Thai Primary Students, Sireewat Ar-Yuwat Phd, Mph, Rn

Dissertations

The purpose of this study is to examine the relationships between perceived benefits, perceived barriers, and cues to action and levels of physical activity in Thai fourth grade students. The Health Belief Model was used as the theoretical framework of the study to investigate students' beliefs related to physical activity. The participants in this cross-sectional study were fourth grade students selected by a simple random sampling method. A sample of 123 students was recruited from primary schools in Muang district, Phitsanulok province. The sample schools were selected by stratified random sampling. For data collection, the study utilized two instruments: the …

Lived Experience: East African Somali Speaking Women Accessing The U.S. Healthcare System, Shukri Adam Phd

Dissertations

Access to prenatal healthcare for East African Somali Speaking Women (EASSW) who are immigrants to the U.S. has been dependent on the availability of a systematic healthcare treatment model. The purpose of this study was to explore EASSW's lived experiences in accessing prenatal healthcare services in the U.S. A descriptive, qualitative phenomenological approach informed by the work of Husserl was used to explore EASSW's experiences, views, and problems encountered while attempting to access prenatal healthcare services in the U.S. Fifteen EASSW of childbearing age (ages 18–45) were recruited for this study. All participants interviewed privately, beginning with a semi-structured, open-ended …

A Retrospective Analysis Of Maternal And Child Outcomes Following An Obesity Intervention Program, Melinda S. Bender Phd

Dissertations

Background: One of the highest risk groups for childhood obesity and associated co-morbidities in the United States are low-income Hispanic preschool children. To reduce obesity, effective interventions are being sought to improve health behaviors among high risks groups. Objectives: To evaluate a subset of data from a larger 9-month promotora facilitated obesity intervention study. The aims were to determine: 1) pre- to post-program differences in health behaviors including: (a) children's consumption of high carbohydrate beverages (HCB); and (b) maternal walking, beliefs, knowledge, self-efficacy, and relationship building regarding nutrition and physical activity; and 2) which covariates were significant for change in …

The Experience Of Forgiving In The Marital Relationship, Kathleen M. Leo

Seton Hall University Dissertations and Theses (ETDs)

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Interventions To Improve The Management Of Medically Uninsured Adult Patients With Type 2 Diabetes Mellitus In Primary Care, Community-Based Settings, Lynn Miskovich

Evidence-Based Practice Project Reports

This project measured the effect of a clinical algorithm on the provision of care to medically uninsured adult patients with type 2 diabetes and a low socioeconomic status (SES). Primary providers often fail to implement established standards for diabetes care to their maximal benefit and do not achieve American Diabetes Association (ADA) treatment standards. Saydah, et al. (2004) reported that only 48% of patients with diabetes achieved the recommended HbA1c goal, and 33% reached blood pressure and LDL targets. Goals for all three clinical parameters were obtained by only 7% of patients. The Stetler Model of Evidence-based Practice (EBP) provided …

The Effect Of Tai Chi Exercise On Balance And Falls In Persons With Parkinson’S, Beth A. Gladfelter

Evidence-Based Practice Project Reports

Parkinson’s disease (PD) is a neurodegenerative disease that progresses to impair one’s gait and balance, often causing falls and subsequent disability. Current management of PD is aimed at treating the symptoms but is not effective in treating the underlying cause, nor does typical treatment effectively improve postural stability. Exercise can decrease symptoms of the disease and lessen disability. Providers need to find alternatives to the costly physical therapy that is prescribed to treat progressive and debilitating PD. Tai Chi (TC) has been shown to offer an enjoyable exercise routine that participants want to maintain. There is evidence to support the …

Cord Blood Collection In Pregnant Women For Stem Cell Research, Irene Carr Phd

Dissertations

Umbilical cord blood (UCB) stem cells form commonly banked types of human tissue. Confusion remains about sources of stem cells and their use. Birth is a once in a lifetime opportunity with 74 million births per year in the world and four million occur in the United States. Cord blood contains hematopoietic stem cells and pluripotent mesenchymal cells (Moise, 2005). There is a surge of interest in the clinical use and research investigation of umbilical cord blood for transplantation and regenerative medicine. Clinicians need increased awareness and education of options for private versus public donation and banking of cord blood …

The Professional Practice Leader: The Role Of Organizational Power And Personal Influence In Creating A Professional Practice Environment For Nurses, Sara L. Lankshear

Electronic Thesis and Dissertation Repository

Professional Practice Leadership (PPL) roles were introduced in response to health care professionals’ concerns about the loss of professional autonomy and other possible negative consequences on professional practice arising out of the widespread implementation of program management during health care restructuring. Despite the extensive implementation of the PPL role in Ontario, there is a paucity of empirical studies examining the impact of the PPL role. The main purpose of this study was to address this knowledge gap by determining the role of organizational power and personal influence in enabling the PPL to fulfill their role functions toward creating a positive …

Exploring The Sleeping Experiences Of Shiftwork Nurses, Patricia A. Doty

Master's Theses

Shiftwork scheduling in nursing can lead to diminished health status, quality of life and job dissatisfaction, and it can contribute significantly to decreases in the quality of patient care. In light of the current nursing shortage, and the increasing need for healthcare professionals and services in the coming years, it is imperative that nursing administrators focus on identifying and implementing interventions that counteract the deleterious effects of shiftwork now. This investigation was conducted to explore the sleeping experiences of shiftwork nurses. A convenience sample of 69 (N = 69) licensed nurses working day shift, evenings, nights and rotating shifts at …

A Quantitative Inquiry Into Moral Distress And Psychological Empowerment In Critical Care Nurses Caring For Adults During End Of Life, Annette Marie Browning Phd, Rn, Cns

Dissertations

Background Critical care nurses care for many adults at end of life and it is known that these nurses can experience moral distress. Moral distress occurs when nurses are unable to perform what they believe is ethically correct. There has been speculation that psychological empowerment may ameliorate moral distress among critical care nurses. However, research has yet to examine the relationship between moral distress and psychological empowerment in the population of critical care nurses.

Objectives To describe the relationships between moral distress, psychological empowerment and select demographics in critical care nurses caring for patients at EOL.

Method Using a quantitative …

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 …

The Post Deployment Lived Experience Of U.S. Military Troops After Combat-Related Blast Exposure, Shirely A. Jett Phd

Dissertations

Blast-induced neurotrauma (BINT) is a newly emerging re-occurrence of an old combat-related injury in U.S. military troops returning from deployment in Afghanistan and Iraq. BINT is leading to a silent epidemic of symptomatic troops who face barriers to accessing healthcare and suffer debilitating symptoms in silence. The purpose of this hermeneutic phenomenological study was to discover the meaning of the lived experience of U.S. troops returning from Afghanistan and Iraq after combat-related blast exposure. Eleven service members and veterans ranging in age from 21 to over 30 years old participated in semi-structured face to face interviews. These service members and …

Mother-Son Connectedness, Substance Use, And Young Men's Criminal Justice System Involvement, Kim L. Moreno Phd

Dissertations

The relationship between a mother and her son and its influence on health and risk behaviors as a boy becomes a man has had little exploration. The purpose of this study was to examine the relationships between mother-son connectedness, substance use, serious delinquency, violent delinquency, and criminal justice system involvement in young men. This study uses data from The National Longitudinal Study of Adolescent Health (ADD Health), a school-based study of students in grades 7–12 in the United States. Multiple regression, ANOVA, and logistic regression were used to analyze independent and dependent variables. Results show a perception of connectedness, which …

Nutritional Status And Clinical Outcomes Of Residents Admitted To A Nursing Home, Sheryl Nespor Phd

Dissertations

Purpose The purpose of this research study was to describe the nutritional status (well nourished, at risk for malnutrition, or malnourished) of residents admitted to nursing homes and adverse clinical outcomes in those residents after four weeks. Methodology A descriptive, correlational design utilizing medical record data was used to examine the relationship between nutritional status and adverse clinical outcomes of weight loss and pressure ulcers. Results The sample (n=69) was predominately Caucasian (90%) with 38% having one or more pressure ulcers on admission. Most of the residents were admitted from an acute care facility (97%) and were either malnourished or …

California School Nurse Survey, Rachel Van Niekerk Phd

Dissertations

The purpose of this study was to obtain evidence to support the assumption that school nurses have a positive effect on school attendance and medication administration practices and to hear the voice of the California school nurse. Data from this exploratory, descriptive study came from an online researcher developed survey consisting of both forced choice and open-ended questions completed by California school nurses representing the three major regions of California (Northern, Central, and Southern). The following three research questions guided the study: 1) What is the relationship between school and nurse factors on student outcomes? 2) How valued do California …

Emergence Delirium In U.S. Military Combat Veterans, Jason M. Mcguire Phd, Crna

Dissertations

This dissertation study examined the phenomenon of emergence delirium in U.S. military combat veterans. Emergence delirium is a post-anesthetic phenomenon that occurs immediately following emergence from general anesthesia and is characterized by agitation, confusion, and violent physical and/or verbal behavior. Clinical evidence suggests that emergence delirium is occurring with greater frequency among military personnel returning from conflict in the Middle East. This body of work is a culmination of three distinctive phases and is presented in three individual manuscripts. The first manuscript, "Risk Factors for Emergence Delirium in U.S. Military Members," was published in the Journal of PeriAnesthesia Nursing with …

Triage In The Emergency Department: Role Challenges, Satisfaction, And Perceptions Of Staff, Jaclyn Gardner

Undergraduate Theses and Capstone Projects

The goal of this study is to describe staff satisfaction and role challenges among Registered Nurses (RN’s) and Emergency Department technicians in a 43 bed Emergency Department (ED) at a community hospital. This is an exploratory study to determine the factors that create an efficient ED, from staffs perspective, to facilitate improvement for other Emergency Departments. Four RN’s were interviewed, including at least one manager, and ED staff completed a survey to determine role challenges involved in the triage process, perceptions of qualifications needed for triage, and overall satisfaction with the comprehensive triage method used in this setting. Surveys were …

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 …

Fibromyalgia Self-Care Management: Use Of Essential Oils, Regina Ann Sacco Izu Phd

Dissertations

Fibromyalgia is a female dominant chronic syndrome of diffuse muscle pain on palpation of at least 11 of 18 syndrome-associated tender points present for 3 months or longer. There is no cure. Self-care management involving multimodal integrative medicine approaches may increase treatment involvement resulting in a sense of control and pain relief. This embedded, single case study explored 'how' and 'why' an informant with fibromyalgia chose to initiate and continue self-care management using essential oils over several years to treat symptoms within context reality. Orem's Self-Care Deficit Model and the Principles of Integrative Medicine from the University of Arizona formed …

Relationship Between Self-Stigma And Personal Empowerment Among People Who Have Severe Mental Illness, Diane Fischer Hickman Phd

Dissertations

The purpose of this study was to examine the relationship between self-stigma of mental illness and personal empowerment among people who have a severe mental illness. It had been hypothesized that self-stigma of mental illness and personal empowerment are at opposite end of a continuum. As such, individuals who perceive themselves in a stigmatized manner tend to reciprocally perceive themselves as being relatively powerless, rather than having a strong sense of personal empowerment. Likewise, individuals who perceive themselves as having a relatively strong sense of personal empowerment tend to experience a low degree of self-stigma. To test this hypothesis, a …

Improving Diabetic Outcomes With Caring Communication: Identifying Communication Patterning For The Human Diabetic, James R. Kennett Phd

Dissertations

Introduction. The purpose of this study was to identify the influence of caring communication for people living with diabetes (PLD) and the relationship to diabetic outcomes. Caring communication has not been studied for improving diabetic outcomes. Randomized control trials (RCTs) direct care, however people do not do what they told, they need to be included in their care. PLD need a voice to establish what is important to them. Incorporating medical, communication, and nursing science as multidisciplinary approach within a theoretical framework can be predictive diabetic outcomes. Methods. A correlational cross sectional survey design study was done. A sample of …

Factors That Influence Smoking Cessation In Women Following An Invasive Cardiovascular Procedure, Leslie C. Moore

Nursing Dissertations (PhD)

Women smokers with heart disease (HD) are at increased risk for negative health effects. At the time of invasive cardiovascular (CV) interventions is a critical opportunity to make lifestyle changes to reduce future CV interventions. The purposes of this study guided by the Health Belief Model were to determine which factors predict smoking cessation (SC) in women following an invasive CV procedure and to explore assistance received with SC.

A correlational, prospective design was used. Data were collected from women smokers at the time of an invasive CV intervention and three months later. Instruments measured commitment to stop smoking, perceived …

Spiritual Well-Being And Quality Of Life Among Persons With Paraplegia, Darlene Nelson Finocchiaro Phd, Msn, Rn, Crrn

Dissertations

With the advent of better emergency response and medical advances, the life expectancy of persons with spinal cord injury (SCI) is about 85% to 90% compared to that of non-disabled persons. Since SCI survivors are living well into their 70s, quality of life (QOL) is a major concern. The purpose of this study, informed by Ferrell and Grant's Quality of Life Model, was to examine relationships between spiritual well-being (SWB), existential well-being (EWB), religious spiritual well-being (RWB), depression, length of injury, age, gender, ethnicity, and QOL while living with paraplegia one year and longer. A descriptive, correlational, cross-sectional design, with …

A Retrospective Study Of Substance Use And Mental Health Disorders In A Sample Of Urban American Indian And Alaska Natives, Kathryn Aimee Fuller Phd

Dissertations

This retrospective study examined the prevalence of mental health disorders, co-occurring disorders (COD), and alcohol, tobacco, and other drug use (ATOD) among a sample of urban-dwelling adult American Indian and Alaska Natives (AI/ANs) seeking behavioral health services from one metropolitan Indian clinic in Southwestern United States. A descriptive quantitative design employed retrospective data from AI/AN subjects (N = 123) verified as tribally enrolled and receiving outpatient behavioral health services. Chart abstraction included patient demographics, substance use and mental health diagnoses, and ATOD scores from the Patient Health Questionnaire-9 (PHQ-9) and the Addiction Severity Index-NAV (ASI-NAV). The t-test compared gender differences …

Improving Blood Pressure Control In Esrd Through A Supportive Educative Nursing Intervention, Zorica Kauric-Klein

Wayne State University Dissertations

ABSTRACT

IMPROVING BLOOD PRESSURE CONTROL IN ESRD THROUGH A

SUPPORTIVE EDUCATIVE NURSING INTERVENTION

by

ZORICA KAURIC-KLEIN

May 2011

Advisor: Dr. Nancy T. Artinian

Major: Nursing

Degree: Doctor of Philosophy

Problem: Hypertension in chronic hemodialysis (HD) patients contributes significantly to their morbidity and mortality. Statistics indicate the hypertension rate amongst HD patients ranges from 75 to 100 %. Studies have indicated that adherence rates to self-care behaviors related to salt and fluid intake and medication regimens are very poor in the HD population. Traditional hypertension management strategies have been found to be largely ineffective. There is modest evidence indicating that interventions …

Exploring Women's Life Course Experiences With Weight Using Story Theory, Poff Allison Edmonds

Electronic Theses and Dissertations

This qualitative study included women who had gone through the menopausal transition and had experienced obesity, and it focused on their weight histories and experiences across the life course. The goal of this research was to add to the body of knowledge concerning weight gain by applying a novel middle range theory (story theory). Story theory was used to collect and interpret from women’s life course stories the critical themes and patterns of their weight gain. Oral accounts were elicited during personal interviews from a convenience sample of ten women recruited from a weight loss and exercise program in Central …