Nursing Commons^™

Development Of A Nurse Practitioner First Assistant Orientation Program, Romoanetia Lofton

Doctor of Nursing Practice (DNP) Projects

The demand for surgical services continues to increase, creating a strain in our healthcare system and causing increasing backlog hours for the operating room. Allowing nurse practitioners (NP) to function in an expanded role in the perioperative environment requires additional training beyond the generic NP program. With this additional training, the NP can function as a first assistant, providing delegated medical functions in the perioperative environment. An in-house NP registered nurse first assistant orientation program was developed based on the adult learning theory as a conceptual framework combined with the AORN perioperative standards as a foundation. The cost of using ...

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses and Capstone Projects

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin ...

The Effects Of Perinatal Methamphetamine Use On Maternal And Child Outcomes: Implications For Education Among Bsn Nursing Students, Tina Nguyen

Honors Theses

The implications of methamphetamine use are vast and prevalent in the U.S. This epidemic is also well recognized in Tennessee and in Hamilton County. The number of men and women that continue to use methamphetamine speaks to the importance of this issue. Among these individuals, pregnant women comprise a significant portion of female methamphetamine users across the United States. The potential complications that can arise for not only a mother but also her child due to maternal methamphetamine use pose a much more significant issue. The detrimental effects that a child can experience as a result of maternal methamphetamine ...

A Clinical Nurse Leader Initiative: Promoting Mobility Among Long-Term Care Facility Residents, Ulyses Reamico

Master's Projects and Capstones

Maintenance of mobility during hospitalization or stay in long-term care facility result in improved patient outcomes including but not limited to decreased incidence of falls, non-pharmacological pain intervention, and prevention of further functional decline. In a 45-bed rehabilitation unit of a Veterans Affairs (VA) health care facility, a clinical nurse leader (CNL) initiative was done to promote mobility among the patients to mitigate functional decline. The patients, also referred to as clients or residents in long-term care facilities, were aged between 20s and 90s. The resident population consisted of patients admitted for physical rehabilitation after a stroke or surgical procedure ...

Example Doctor Of Nursing Practice Project, Steven W. Pryor Test

Doctor of Nursing Practice Projects

This is an example of a Doctor of Nursing Practice Project uploaded to SPARK.

This is where the abstract of the submission will appear, briefly summarizing the problem and research results in a few sentences.

Advanced Maternal Age And The Correlation Between Cesarean Birth Rates, Hope Campbell

Grace Peterson Nursing Research Colloquium

According to the Center for Disease Control and Prevention (CDC), the mean age of mothers at the delivery of their first child has increased from 24.9 years to 26.3 years between 2000 and 2014. Miscarriages, financial instability, lack of a partner and more effective contraception may also be associated with the increasing rate of delayed pregnancy. The increasing rate of delayed pregnancy could contribute to the higher rate of cesarean section deliveries in women over the age of 35 which could lead to an increased risk to mother and fetus. The rising cesarean rate is associated with rising ...

Electronic Health Record Utilization And Education: Improving Role-Specific Confidence And Competence In The Outpatient Setting, Nicole Neuman

Master's Projects and Capstones

The call for meaningful use of electronic health records (EHR) and its universal benefits are well known. Despite mandates for change resistance to adoption of paper-less system remains problematic. Non-use of the EHR has persisted in the outpatient specialty care setting in spite of 4 all-staff trainings and stakeholder backing. This project suggests that implementing team leadership and educational tools provides staff with confidence and supportive resources to achieve proficiency. Objectives for this project include (a) providing staff with training and tools to access self-guided troubleshooting videos, follow quick-guide checklists for crucial tasks, and provide handouts for patient portal access ...

Provider Barriers To Delivery Of Quality Transgender Healthcare, Suthiratana Bhudvanbhen-Jung

Grace Peterson Nursing Research Colloquium

Provider Barriers to Delivery of Quality Transgender Healthcare

Background: Transgender encompasses anyone who does not identify with the gender they were assigned at birth. Due to the previous DSM-IV Gender Identity Disorder diagnosis, transgender was considered a pathology. The 2013 DSM-V switch to Gender Dysphoria depathologized the transgender identity. Subsequently, transgender care is now covered by insurance and considered part of expected patient care when before it was not covered. This research study focuses on provider reported barriers to trans healthcare over patient reported, though some patient reports were used in conjunction with provider perspective.

Objective: The objective of this ...

Clinicians’ Perspectives And Utilization Regarding Harm Reduction In Nursing Practice In Care Of Persons With Addiction: A Literature Review, Audrey Killarney

Grace Peterson Nursing Research Colloquium

Clinicians’ perspectives and utilization regarding harm reduction in nursing practice in care of persons with addiction: A literature review

Audrey Killarney, BS

Prof. Michelle Neuman, MSN, APN, RN

NSG 598: Graduate Research Synthesis

18 August 2017

Introduction

Background & Significance

Harm reduction is a concept best described as the recognition that individuals will engage in unhealthy behaviors, and the goal is to minimize the associated potential harm. (Stockwell, Reist, Macdonald, Benoit, & Jansson, 2010). Classically, it was used an alternative model of care for treating smokers and controlling the spread of HIV and hepatitis B (Henwood, Padgett, & Tiderington, 2014). However, in the context of medicine, harm reduction allows the clinician to accept that the patient may continue a harmful behavior, and their duty as a clinician is to minimize the relative risks and harms associated with that behavior (Öztuna et al., 2014). Most recently, harm reduction has been introduced as a means to address treatment for persons with addiction (Aldridge, 2012). These patients carry complex medical and social histories, for which traditional “treatment first” approaches may not be appropriate (Henwood et al., 2014). For example, Draanen et al. (2013) found an associated mental disorder in over 1/3 of patients who abuse alcohol, and over half of patients who abuse drugs. This finding supports the hypothesis that patients with severe mental illness often self-medicate with drugs and/or alcohol to control their psychosis (Henwood et al., 2014).

Previous studies have consistently reported that patients with addiction are more likely to be immune-compromised and have poor nutritional status, which can greatly affect their response to medical treatment (Bartlett, Brown, Shattell, Wright, & Lewallen, 2013). These individuals are also more likely to delay seeking medical treatment for acute issues, resulting in hospital visits for far more severe and advanced illnesses (Ford, Bammer, & Becker, 2008). Harm reduction allows for clinicians to assess other aspects of a patient’s well-being, such as secure housing, employment, and social support, which may contribute to recovery and/or relapse (Henwood et al., 2014).

Harm reduction holds great significance in current nursing practice given the recent rise of substance abuse and overdose deaths in the United States. In 2014, it was estimated that abuse of tobacco, alcohol and drugs cost the United States over $700 billion in loss of productivity, healthcare, and crime (National Institute on Drug Abuse, 2015). These numbers are significant, as harm reduction interventions in Canada have been able to alleviate hospital-based costs, reduce ED visits, as well as reduce overnight hospital stays (Draanen et al., 2013). A growing problem in the United States surrounds the epidemic of opioid overdose. Heroin overdoses account for the fastest growing group of overdose deaths, with a 6-fold rise over the period of 2001-2013 (National Institute on Drug Abuse, 2015). In response to rising heroin overdose rates, overdose education and naloxone distribution (OEND) programs are increasing nationwide. These types of programs are commonly sponsored by the Harm Reduction Coalition, as they seek to reduce potential risks and mortality associated with drug use. This finding further supports the argument for inclusion of harm reduction in the care of persons with addiction (Lewis et al., 2016).

Nurses in particular, are positioned to experience situations in which harm reduction strategies may be appropriate. Nursing staff are frequently involved in patient education, and re-education, of hospitalized patients; while an individual may not be ready to receive treatment, nursing staff could be qualified to provide information regarding self-help groups (Bartlett et al., 2013). Additionally, nurses conduct many of the initial screenings during hospitalization; these screenings include alcohol and drug abuse questionnaires that provide a bridge to discussions regarding use and healthy use of alcohol, prescription drugs and illicit substances (Bartlett ...

Evaluating The Role Of Community Advisory Boards: With Persons Who Inject Drugs In Photovoice Research, Nicole Pallas

Grace Peterson Nursing Research Colloquium

Background: The use of community advisory boards (CABs) is a source of leadership in community-based participatory research (CBPR); however, not all researchers have incorporated CABs, and others have restricted CAB involvement for feasibility purposes. Although there is literature about utilizing CABs in a variety of CBPR studies, less is known about the challenges and successes of working with persons who inject drugs (PWIDs) as CAB members in photovoice methodology, as well as their perceptions throughout the process.

Objectives: The purpose of this qualitative study was to investigate the role CABs play in photovoice research while determining PWIDs’ capacity to fulfill ...

Perceptions Of Stress In Parents Of Preterm Infants In The Nicu, Karina Ortiz

Grace Peterson Nursing Research Colloquium

Background: The NICU plays an important role in extending the life of newborns that are in need of specialized pediatric diagnostic and therapeutic services, however, it can be an unfamiliar and stressful environment that can affect parents’ perceptions and mental health.

Objectives: The purpose of this literature review is to focus on parental perceptions of stress of premature infants as well as the negative effects on the psychological well-being of the parents.

Method: This study will examine the impact of perceptions of stress in parents of pre-term infants while in the NICU through an integrative literature review. Different combinations of ...

Best Evidence-Based Best Practices For Helping Women That Are Addicted To Opiates During Pregnancy, Jordan Edwards

Grace Peterson Nursing Research Colloquium

Background: Women of childbearing age that are active opiate users are at high risk of inflicting irreversible damage on not only themselves but onto their unborn children as well. There are limited studies on effective treatment options and education models for pregnant women addicted to opiates. Current practices for helping women that are addicted to opiates do not address the importance of education models for successful cessation of opiate abuse, and defer to treatment options that are used for the general population.

Objectives: The purpose of this integrative literature review was to identify what evidence-based best practices are being used ...

The Benefits Of And Barriers To Psychiatric Advance Directive Implementation, Lauren Haindfield

Grace Peterson Nursing Research Colloquium

The Benefits of and Barriers to Psychiatric Advance Directive Implementation

Lauren Haindfield

Faculty Sponsor: Dr. Barbara Harris

Background: Psychiatric advance directives can be beneficial for patients with mental disorders, but their implementation is limited in large part due to a knowledge gap.

Objectives: The purpose of this integrative literature review was to identify both the benefits of and barriers to psychiatric advance directives.

Methods: This integrative literature review used the databases of CINAHL, PubMEd, and PsychInfo. Search terms included pad implementation, barriers to pad implementation, psychiatric advanced directives, benefits of psychiatric advanced directives, and current pad practices.

Results: PAD implementation ...

Mesenchymal Stem Cells As An Alternative To Knee Replacement Surgery, Michelle Villegas-Downs

Grace Peterson Nursing Research Colloquium

Knee osteoarthritis is a degenerative disease that causes disability and persistent pain. Currently, treatment modalities for osteoarthritis focus on pain reduction and symptom management, but do little to address disease modification. Presently, the treatment of choice for knee osteoarthritis is total knee replacement surgery. Total knee replacement surgery carries significant risks and does not guarantee improvement in joint pain or function. In the last decade, advances in regenerative medicine have proposed the use of mesenchymal stem cells as a treatment strategy for joint preservation, cartilage regeneration and improved joint function in patients with osteoarthritis. The aim of this integrative literature ...

Nurses Lack Education In Caring For Patients With Down Syndrome, Sarah Coughlin

Grace Peterson Nursing Research Colloquium

Abstract

Individuals with Down Syndrome have a longer life expectancy due to medical advancements made over the past several years. This creates a concern that nurses are not being effectively educated to provide competent care for this population. The purpose of this research was to conduct an integrated literature review which identified nursing knowledge deficits in providing competent care for patients with Down Syndrome. It also examined how nurses can be best educated to provide care for individuals with Down Syndrome to improve their quality of life. Scholarly articles were found searching scholarly databases such as PubMed and CINAHL Complete ...

The Availability & Efficacy Of Non-Pharmacological Interventions For Pain Management For Children With Sickle Cell Disease: A Systematic Review Of The Literature, Uchenna Onyema-Jones

Grace Peterson Nursing Research Colloquium

The Availability & Efficacy of Non-Pharmacological Interventions

For Pain Management for Children with Sickle Cell Disease:

A Systematic Review of the Literature

Uchenna N. Onyema-Jones

Faculty Sponsor: Tamara Poole, MS, APN, FNP-BC

Background: Pain is the leading cause of hospitalizations for many pediatric patients with sickle cell disease and unfortunately it is often sub-optimally managed by healthcare professionals with pharmacological interventions.

Objectives: The purpose of this systematic literature review was to examine the availability and efficacy of non-pharmacological interventions used to manage pain in pediatric patients with sickle cell disease.

Method: A systemic literature review was conducted using the databases of Cumulative Index of Nursing and Allied Health (CINAHL) Complete, ProQuest Nursing & Allied Health Source, and PubMed. The keywords used in this search included: sickle cell disease, child, pain, management, nursing, and interventions.

Results: From the extensive review of literature, four non-pharmacological pain interventions were deemed effective to reduce pain for pediatric patients with sickle cell disease. Those interventions included; guided imagery, massage therapy, use of video games as a distraction modality, and omega-3 supplementation.

Conclusion: Additional studies are needed to find more effective non-pharmacological interventions for pain in pediatric patients with sickle cell disease. Furthermore, nurses who care for these pediatric patients should be able to help them cope, recognize signs of complications, involve appropriate support agencies, but most importantly recognize, assess, and treat pain.

Barriers To Advance Directives, Anna Malia Connor Ticknor

Grace Peterson Nursing Research Colloquium

Abstract

Background: Advanced directives (ADs) are legal documents that allows an individual to document their specific wishes for medical care should they be unable to speak for themselves. The use of advanced directives has implications directing the course of end-of-life care affecting both the cost and direction of care. Advance directives can clarify confusion and provide guidance, but their implementation is not clearly defined within the healthcare system. Despite their implications, multiple surveys indicate these documents have limited use within the United States for reasons that are not easily isolated including lack of knowledge of advanced directives and lack of ...

Barriers To Accessing And Utilizing Preventative Healthcare For The U.S. Hispanic Population, Maya Rosenberg

Grace Peterson Nursing Research Colloquium

Background: Utilization of healthcare in U.S. Hispanic populations is significantly lower compared to other population groups in the U.S. Many of the prevalent health conditions in the Hispanic population are ones that can be prevented or at least have better outcomes if detected and treated earlier. Despite the understanding that the Hispanic population is rapidly increasing and the growing concern of underutilization of healthcare services amongst Hispanics, there are limited studies that identify factors affecting healthcare access and utilization for this target population.

Objectives: The purpose of this integrative literature review is to identify barriers to accessing and ...

The Effectiveness Of Discharge Planning In Mental Health: An Integrative Review Of Literature, Lindsey Meyers

Grace Peterson Nursing Research Colloquium

Background: Mental health inpatient treatment goals revolve around crisis stabilization and structure. In recent years, an evolution of mental health care has led to shorter inpatient hospital stays because insurance driven health plans place pressure on providers to expedite discharge.

Objective: The aim of this study was to explore the most effective discharge planning practices for inpatient mental health that are currently in practice.

Method: An integrative review of literature was conducted using CINAHL, PsycINFO, and PubMed with specific search terms.

Results: The results of the integrative literature review suggest that the discharge process is most effective when healthcare providers ...

The Effect Of Motivational Interviewing On Medical Adherence In The Homeless Population, Kimberly Britt

Grace Peterson Nursing Research Colloquium

Abstract

Background: Methods of improving homelessness medical adherence are important because homeless populations incur higher than average costs in hospitalizations and medical treatment, disease rates, incarceration, police intervention, and emergency shelter expenses (“Cost of Homelessness,” n.d.). It is valuable to understand the role which Motivational Interviewing (MI) could play in improving medical adherence within the homeless population, thereby increasing the stabilization of homeless individual’s health, and decreasing needless overspending on emergency services.

Objectives: The purpose of this paper is to conduct an integrative literature review to determine if motivational interviewing can improve medical non-adherence with the homeless population ...