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Critical Access Hospital Nurses' Qualitative Reports Of Major Obstacles In End-Of-Life Care, Con K. Newman

Theses and Dissertations

Background: Critical Care Nurses have previously noted obstacles in caring for dying patients. Obstacles noted by nurses working in more urban settings have been reported. What is not known is the obstacles to providing end-of-life (EOL) care as perceived by nurses working in Critical Access Hospitals (CAHs). Objective: To determine the stories/experiences related to obstacles in providing EOL care as reported by nurses working in CAHs. Methods: This was an exploratory, cross-sectional study. Previous quantitative data has been reported. Documentation of the qualitative stories/experiences of nurses working in CAHs related to obstacles to providing EOL care for dying patients and …

Frequency And Magnitude Of Obstacles And Helpful Behavior Items In End-Of-Life Care As Perceived By Nurses Working In Critical Access Hospitals, Shalyn C. Larsen

Theses and Dissertations

Background: Twenty percent of Americans live in rural areas where most of their healthcare is provided in Critical Access Hospitals (CAHs). It is unknown how frequently obstacle and helpful behavior items occur in End-of-Life (EOL) care in CAHs. Objectives: To determine the frequency of occurrence scores of obstacle and helpful behavior items in providing EOL care in CAHs. To also determine which obstacles and helpful behaviors have the greatest or least impact on EOL care based on the magnitude scores. Methods: A questionnaire was sent to nurses working in 39 CAHs in the United States. Nurse participants were asked to …

Critical Access Hospital Nurses' Perceptions Of Obstacles And Helpful Behaviors In End-Of-Life Care, Trissa Michelle Lyman

Theses and Dissertations

Background: The Critical Access Hospitals (CAHs) system was developed to bring health care to rural populations. Although CAHs lack equipment and resources, CAH nurses still provide end-of-life (EOL) care to critically-ill and dying patients. Objectives: To determine the largest and smallest ranked obstacles and helpful behaviors to providing EOL care to rural patients as perceived by CAH nurses. Also, to determine how CAH nurses' perceptions of obstacles and helpful behaviors to providing EOL care compare to that of their urban counterparts. Methods: A cross-sectional, nationally representative sample of nurses working in 39 CAHs were sent a questionnaire. Nurse participants were …

Early Premature Infant Physiologic And Behavioral Indicators Of Ans Instability, Karen Popp Becker

Theses and Dissertations

The advanced survival of the early premature infant (EPI) since the post-surfactant era has not improved many comorbidities. EPI comorbidities influence their lifelong health, social, and cognitive outcomes. EPIs often have immature and disorganized responses to stimuli during the neonatal period. EPIs respond to stressors from the Neonatal Intensive Care Unit’s (NICU) environment, stimulation, or disease states based on physiologic system changes, often resulting in observable behavioral changes. Both physiologic and behavioral changes reflect autonomic nervous system (ANS) disruption, thus instability. Instability of the ANS due to chronic stressors, can lead to chronic physiologic dysregulation and lead to lifelong health …

An Evaluation Of The Healthfulness Of The Hospital Food Environment, Cynthia Elaine Horton Dias

Theses and Dissertations

Though nurses may have knowledge about the health promoting benefits of a healthy diet, many do not consume enough fruits or vegetables. For hospital shift nurses to achieve healthy eating while at work, environmental barriers were reportedly the most challenging to overcome. To better understand the hospital food environment from the nurses’ perspective, two mechanisms for workplace food acquisition were studied: 1.) hospital consumer food environment, which includes cafeterias, vending machines, and gift shops; and 2.) free food at work.

Through observations of 31 South Carolina hospitals using the Hospital Nutrition Environment Scan (HNES), descriptive data was collected to illuminate …

The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early

Theses and Dissertations

Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level …

Critical Care Nurses' Experiences Of Family Behaviors As Obstacles In End-Of-Life Care, Caitlin Brook Mallory

Theses and Dissertations

Background: Critical care nurses (CCNs) frequently provide end-of-life care for critically ill patients. CCNs may face many obstacles while trying to provide quality EOL care. Some research focusing on obstacles CCNs face while trying to provide quality EOL care has been published; however, research focusing on family behavior obstacles is limited. Research focusing on family behavior as an EOL care obstacle may provide additional insight and improvement in care. Objective: What are the predominant themes noted when CCNs share their experiences of common obstacles, relating to families in providing EOL care? Methods: A random geographically dispersed sample of 2,000 members …

A Biobehavioral Approach To Examining Moral Distress In Critical Care Nurses, Marian Altman

Theses and Dissertations

Moral distress is a complex and challenging problem that may cause negative biopsycohosical and professional outcomes for critical care nurses. The purpose of this work was to explore the relationship between the ethical climate of the work environment and moral distress as experienced by critical care nurses; and to explore relationships among mediators of stress (nurse characteristics e.g. education (BSN, nonBSN), years certified as a critical care nurse, and tolerance of ambiguity) and their relationship with perceived stress, moral distress, health status and salivary alpha amylase. A descriptive correlational cross-sectional design was used for this pilot study of 100 critical …

Barriers To Nurses’ Promoting Mobility In Hospitalized Older Adults, Gordana Dermody

Theses and Dissertations

Objectives: To examine the association between nurses’ knowledge, attitude and external barriers and the nurse’s mobility-promoting behavior. Nurse perception of the priority organizations place on mobility, and the relationship of nurses’ level of experience to nurse prioritization for promoting mobility was also investigated.

Design: Cross-sectional, descriptive, correlation study with convenience sampling.

Setting: Two community-based hospitals in the Pacific Northwest of the U.S.

Participants: Eighty-five nurses caring for 98 inpatients 65 and older.

Measurement: Nurses’ knowledge, attitude and external barriers were examined with a validated 5-point Likert Scale. Patient-related and other clinical barriers and the nurses mobility-promoting behavior was obtained with …

Rn Perceptions Of Coworker Incivility And Collective Efficacy As Influential To Hospital Structures And Outcomes, Jessica Grace Smith

Theses and Dissertations

Background: An aging population and retiring workforce might affect United States health delivery care and could threaten the quality of care in hospitals. Nurses, as the largest profession in healthcare, can buffer these effects if supported in a safe nurse work environment. The purpose of this dissertation was to understand how peer-to-peer registered nurse workplace incivility as a mediator, and collective efficacy as a moderator, influence relationships among hospital structures (i.e. nurse manager leadership and staffing) and hospital outcomes (i.e. missed nursing care and patient safety cultures).

Methods: Donabedian’s (1980) structure-process-outcomes conceptual framework was the theoretical basis for this study. …

Nurses Utilizing The V.O.I.C.E.S. Hiv Prevention Intervention In The Black Church Community, Jason Richard

Theses and Dissertations

The Human Immunodeficiency Virus (HIV) epidemic is a significant problem in the United States, especially in the “Bible Belt” Deep South where the epidemic is hitting this region the hardest. The HIV epidemic in the state of South Carolina is very real, significant, and quite alarming. In fact, the Center for Disease Control and Prevention (CDC) labels South Carolina as an HIV “hot spot.” All racial and ethnic groups are susceptible and impacted by HIV. However, evidence shows that African Americans – especially young adults 18-35, bear the brunt of the burden to the extent that the “new face” of …

Consequences Of Providing Nursing Care In The Neonatal Intensive Care Unit, Riko Sano

Theses and Dissertations

Compassion fatigue is a negative consequence of providing nursing care. It impacts nurses physically, emotionally, and psychologically. The purpose of this cross-sectional study was to examine a model of negative consequences of providing nursing care including compassion fatigue, secondary traumatic stress, and burnout in the Neonatal Intensive Care Unit (NICU). The conceptual model of consequences of providing nursing care was identified, and then specifically applied to NICU nurses for this study. The conceptual model consists of five main concepts: patient factor, personal factor, work environment factor, positive consequences of providing nursing care, and negative consequences of providing nursing care. The …

Oncology Nurses' Suggestions For Improving Obstacles In End-Of-Life Care, Rosanne Johnson Oliver

Theses and Dissertations

The purpose of this paper was to determine the most important changes needed to improve the quality of end-of-life (EOL) care to terminal cancer patients as perceived by experienced oncology nurses. The study was designed as a cross-sectional survey, sampling 1,000 Oncology Nursing Society members from the United States with experience caring for inpatient cancer patients, who could read English, and had experience in EOL care. Eligible nurses responded to an open-ended item sent to them as part of a mailed questionnaire. Nurses were asked to respond to the following question: “If you had the ability to change just one …