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Health System Processes, Clinician Attitudes, And Referrals To Tobacco Treatment Programs, Karma Bryan Cassidy

University of Kentucky Doctoral Dissertations

Assisting smokers to quit and stay quit is the most important intervention clinicians can undertake to improve the length and quality of life of patients who use tobacco. The chronic, relapsing nature of tobacco dependence complicates tobacco treatment. Tobacco treatment counseling programs provide on-going support to help patients avoid relapse. Assistance with a referral increases the likelihood that patients will participate in counseling, but few clinicians regularly assist with referrals to tobacco treatment programs. This dissertation examined health system processes and clinician attitudes that influence the likelihood that clinicians will refer their patients for tobacco treatment counseling.

Three papers examined …

Dysrhythmia Monitoring Practices Of Nurses On A Telemetry Unit, Susan Jane Schultz

UNF Graduate Theses and Dissertations

Standards of practice for hospital electrocardiogram monitoring were recommended in 2004 by the American Heart Association; however they are not widely followed. Many nurses monitor in a single lead regardless of diagnosis and are unable to differentiate wide QRS complex tachycardias. The purpose of this project was to evaluate the effectiveness of an interactive web-based education program combined with unit-based collaborative learning activities on both telemetry staff nurses‘ knowledge of dysrhythmias and their monitoring practices for patients at risk for wide QRS complex tachycardias. This interventional, one group before-and-after cohort study design consisted of four components: interactive web-based educational program …

Culture Change And Quality Of Life In Elderly Persons Living In Long Term Care, Carol S. Jones

UNF Graduate Theses and Dissertations

Quality of life in long term care (LTC) is a concern for many stakeholders. The elders who are living in LTC facilities, their families, the staff, and government and policy makers are all interested in providing quality care and quality of life to those persons living within the facility. Culture change is one way for LTC facilities to begin to give decision making to the residents, and to increase quality of life of these elders. There are different culture change models that embrace the concept of person-centered care. No matter which model is chosen, the essence of the change is …

Using Scorecards To Monitor Program Performance, Donna Stevens, Carol Mcfadden Rn, Bsn, Ccrn

Patient Care Services / Nursing

No abstract provided.

The Effect Of Acupressure On Constipation, Quality Of Life, And Depressive Symptoms In Cancer Patients With Constipation, Eun Jin Lee

University of Kentucky Doctoral Dissertations

Constipation is the most common gastrointestinal complaint in the United States, resulting in about 2 million annual visits to the doctor.

The purposes of this dissertation were to: 1) describe four theories of traditional Korean medicine; 2) review mechanisms of acupuncture and moxibustion and develop a conceptual model; 3) review findings from randomized controlled trials that tested the effects of acupressure used for the management of symptoms such nausea, pain, and dyspnea; 4) examine the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) in heart failure patients with constipation compared to those with gastrointestinal disease; 5) describe how Korean …

Tobacco-Free Prison Policies And Health Outcomes Among Inmates, Alison R. Connell

University of Kentucky Doctoral Dissertations

This study was the first to examine the effect of tobacco policies in prisons on the health of inmates. Kentucky has two types of tobacco policies in its 16 state prisons: indoor smoke-free policies, where smoking is allowed outdoors and tobacco-free policies, in which no tobacco of any kind is allowed on the grounds of the prison. The smoking rate of inmates is three times higher than that of current smokers in the non-incarcerated population which results in high rates of tobacco-related health conditions such as heart disease and lung cancer.

A literature review discussed the evolution of tobacco policies …

What Nurses Say: Communication Behaviors Associated With The Competent Nursing Handoff, Anne Claiborne Ray Streeter

University of Kentucky Doctoral Dissertations

Communication competence and medical communication competence served as the theoretical framework for this research that seeks to identify specific communication behaviors associated with what nurses say constitute a communicatively competent patient handoff at the nursing change of shift. Data collected from 286 nurses responding to an online modified Medical Communication Competence Scale posted at www.allnurses.com supported the hypotheses that information exchange (information giving, seeking and verifying) and socioemotional communication behaviors are rated more highly in the best patient handoffs than in the worst ones. Research questions found that the incoming nursing role rated behaviors associated with information verifying and socioemotional …

Cognitive Therapy For The Treatment Of Depressive Symptoms In Patients With Heart Failure, Rebecca L. Dekker

University of Kentucky Doctoral Dissertations

Depressive symptoms are common in patients with heart failure (HF) and adversely affect mortality, morbidity, and health-related quality of life. Cognitive therapy (CT) has been proposed as a non-pharmacological treatment for depressive symptoms in patients with HF. However, there is currently little evidence to support use of CT in patients with HF.

The purpose of this dissertation was to develop and test a brief, nurse-delivered CT intervention for the treatment of depressive symptoms in patients with HF. Prior to testing the intervention, preliminary work was conducted resulting in four manuscripts: 1) a review of the evidence for CT in treating …

Moral Distress And Avoidance Behavior In Nurses Working In Critical Care And Non-Critical Care Units, Mary Jo De Villers

Dissertations

Significance: Nurses facing impediments to what they perceive as moral practice may experience inner turmoil, frustration, and moral distress. These scenarios may culminate in resignation from employment at the individual level, increased attrition at the systems level, and poor patient outcomes, including increased morbidity and mortality.

Purpose: To explore the relationships between moral distress and avoidance thoughts and behavior between nurses currently practicing in critical care and non-critical care settings.

Methods: A descriptive cross-sectional comparative design was used. The sample was comprised of a randomized subset of 370 critical care nurses, a convenience sample of 87 nurses from a nursing …

Improving Quality Care Goals Through Diabetes Collaborative Rounds On An Exemplary Care And Learning Site, Stacey Smith Md, Facp, Marc Shalaby Md, Facp, Joyce Najarian Msn, Rn, Cde, Gretchen A. Perilli Md, Krista Casey Mba

Department of Medicine

No abstract provided.

Leading The Way...Integrating Technology In A Neuroscience Unit, Marjorie Lavin Rn, Ms, Cnrn

Patient Care Services / Nursing

No abstract provided.

Expanding The Treatment Window Raising The Bar For Patient Safety, Claranne Mathiesen Rn, Msn, Cnrn

Patient Care Services / Nursing

No abstract provided.

Parent Involvement In End-Of-Life Care And Decision Making In The Newborn Intensive Care Unit: An Integrative Review, Lacey M. Eden, Lynn Clark Callister

Faculty Publications

Survival rates for very preterm and critically ill infants are increasing, raising complex ethical issues for health-care providers and parents who face the challenge of making end-of-life decisions for newborns. The purpose of this integrative literature review was to evaluate parental involvement in end-of-life care and decision making for their infant in the newborn intensive care unit. Findings revealed that establishing good relationships and clear communication between health-care providers and parents builds trust and eases stress placed on parents making decisions about the care of their infant. Palliative care programs provide support for parents and facilitate their decision making. Parents …

Patient Ventilator Dyssynchrony: Types, Frequency And Patterns In Critically Ill Adults, Karen Mellott

Theses and Dissertations

Patient ventilator dyssynchrony (PVD) occurs frequently, but little is known about the types, frequency and patterns of PVD for longer than 30 minutes. Deeper levels of sedation are associated with PVD. Evaluation of ventilator graphics and the ability to identify PVD should assist clinicians to optimize patient ventilator interactions and promote earlier interventions. The purpose of this study was to identify the different types, frequency and patterns of PVD in critically ill adults and determine the effect of sedation level on PVD. Thirty medical and surgical ICU adult patients were enrolled; 27 were used for analysis. Pressure/time and flow/ time …

The Relationship Between Post Reach Exit Exam (E2) Failure Remediation And Nclex-Rn Success Of Graduates Of Baccalaureate Nursing Programs, Patricia Gale Allen

Student Theses and Dissertations

An ex post facto study was conducted to determine whether any relationship exists between remediation post Reach Exit Exam (E2) failure and NCLEX-RN success of graduates of baccalaureate nursing programs. Data was gathered from responses to the seventh annual validity study (V7S) offered to deans and directors of nursing programs by the Director of Research for Elsevier, Incorporated. Data focused on test groups which received administration of the E2 between September 1, 2006 and August 31, 2007. Responses from 28 baccalaureate nursing programs were included in the study. After considering each program offering of either version one, version two or …

Rx For Change: Nurses' Response To A Smoking Cessation Intervention, Laura Louise Bisch Ochoa

Dissertations

Problem: An evaluation of a smoking cessation educational intervention for direct care RNs. Design: A randomized controlled trial. Methods: The study was conducted at a large Midwestern academic medical center. Direct care Registered nurses (dcRN’s) employed at least .7 FTE and spending 80% of their time in direct patient care on general medicine or general surgery units were recruited. Recruitment occurred between April and May, 2009. Outcome data was abstracted from charts of patients receiving care from the intervention group. Interventions: Participants were randomized to either ‘Rx for Change’ which was a training program regarding tobacco cessation or to a …

A Head Injury Teaching Module For Pre-Hospital Assessment: Using The Four Score, Chris A. Wolf

Theses and Graduate Projects

The purpose of this project is to create a teaching module and evaluation tool for a United States Air Force Aeromedical Evacuation Squadron for the pre-hospital assessment of patients with head injuries using the FOUR Score assessment scale. Specifically, this project integrates theory, relevant literature, and reflection on service to and caring for others. Information from published literature supports the development and implementation of a new assessment tool, such as the FOUR Score, to assess patients who have suffered a head injury. Ultimately, a teaching module is presented, described, and evaluated, along with potential questions to be addressed in the …

Strengthening Nurse/Physician Collaborative Relationships To Promote Patient Safety, Julie Lynch Weegman

Theses and Graduate Projects

The purpose of this project is to identify implementable best practices that promote effective nurse physician collaboration in the hospital setting at the unit level for strengthening the culture of patient safety. These best practices will be shared with nurses and physicians at a workshop using the methods of powerpoint presentation and appreciative inquiry. The goal for this workshop is to inspire nurses and physicians to spread the seeds of collaborative practice throughout the organization through the path of shared governance.

A Nursing Educational Program For Recognizing And Managing Emotional Labor, Kathleen Kuzelka

Theses and Graduate Projects

The purpose of this project is to develop a one hour learning module on emotional labor for all staff that will enable them to recognize and manage emotional labor for themselves and their coworkers in their daily work. This project presents the concept of emotional labor and emotional labor in nursing. A one hour learning module is described. The presentation of this module is discussed. There is discussion of the implications of emotional labor for nursing research, nursing practice and nursing education.

Brad: A Model Of Caring For Persons With Frontotemporal Dementia, Jennifer Mcguire

Theses and Graduate Projects

Frontotemporal dementia (FTD) is caused by u progressive degeneration of the frontal and temporal lobes of the brain (Boxer & Miller, 2005), This degeneration causes profound alterations in personality, social behavior, and language skills. FTD is particularly devastating due to the fact that it commonly affects people during mid-life or earlier. Evidence has shown that caregivers face higher rates of burden, distress and isolation when providing care for someone with FTD than other forms of dementia (de Vugt, Riedijk, Aalten, Tibben, van Swieten, & Verhey,2006; Kumamoto, Arai, Hashimoto, Ikeda, Mizuno, & Washio, 2004). The Behavioral Recognition, Assessment and Delivery (BRAD) …

Building Community Among Older Oromo Women Struggling With Sadness In A Large Urban Setting, Fatuma Kotile

Theses and Graduate Projects

Older Oromo women who immigrated to the United States in the early 1990s have experienced several stressful life events including war, famine, acculturation, harsh northern climate, a new language (English), and multiple experiences different from those in their native country, Ethiopia. Coping with these new experiences, correlates with a high level of depressive symptoms that Oromo people call "sadness." The purpose of this project is to create and describe a transcultural model of nursing practice in community that aims to decrease sadness among older Oromo women by promoting community building and healthy life choices in the midst of change. A …

Developing A Community Clinic To Address The Health Needs As Experienced By A Small Rural Village In Sierra Leone, Doris K. Acton

Theses and Graduate Projects

Developing countries experience a disproportionate amount of health care inequities due to extreme poverty, lack of education, minimal resources and marginalization from health care services. Additionally, barriers such as access, availability and affordability prevent people from seeking care. Development of community based clinics can help to address the health disparities that the people of these countries often experience. Utilizing Madeleine Leininger's Culture Care Theory and the Sunrise Enabler provide a framework on which to develop clinics and health care programs in ways that are culturally congruent and acceptable. This paper addresses the health needs of Manonkoh, a small village in …

Effect Of The Interactive Computerized Information For Surrogates Icu Program In Increasing The Understanding Of Informed Consent And The Knowledge Of Genetic And Genomics Research, Ann Kathleen Shelton

Dissertations

Background: A significant and growing number of clinical research studies conducted in Intensive Care Units (ICUs) today have some genetic and genomics component. Surrogates approached to authorize participation in clinical research for a loved-one in the ICU may not be prepared to make informed decisions. A model of stewardship of genetic and genomics research was used as a framework for this study. Purpose: The purpose of this investigation was to examine the effect of an educational program, the Interactive Computerized Information for Surrogates (ICIS) ICU Education Program in assisting surrogates to (1) increase their understanding of the process of informed …

Comparing Perceptions Of The Nursing Profession Among Associate And Baccalaureate Nursing Students And Registered Nurses, Sherry R. Lovan

Nursing Faculty Publications

The inconsistencies between the perception of the profession of nursing and the reality of practice can lead to problems in student attrition or result in disillusionment with a career in nursing after a new graduate enters practice. With the nursing shortage reaching critical levels, it is important to examine possible discrepancies that exist and address strategies to reduce them.

For this study, a quantitative design was selected to explore how the perception of the nursing profession compared among first-semester associate degree nursing students, first-semester baccalaureate nursing students, and registered nurses. A convenience sample N = 238 included 69 ADN students, …

Giving End Of Life Care To Persons With Intellectual Disabilities: A Model Of Support For Community Based Caregivers, Emily K. Gress

Theses and Graduate Projects

Persons with intellectual disabilities are living longer lives, often outliving family caregivers, and experiencing chronic illnesses known to the general aging population. Ultimately, this translates to a need for end of life care. Hospice care seeks to provide individualized physical, emotional, and spiritual support to assist persons and their families in attaining the highest quality of life in the face of a life limiting illness. Hospice services have been underutilized for persons with intellectual disabilities and little has been studied about end of life care provided by community based residential caregivers. The purpose of this project is to use Margaret …

From Means To Ends: Artificial Nutrition And Hydration, Cheryl Monturo, Kevin Hook

Nursing Faculty Publications

No abstract provided.

Can We Get Nurses To Stay? A Qualitative Study To Evaluate The Effectiveness Of A Formal Mentoring Program In An Acute Care Health System, Eileen M. Willits

Dissertations

This qualitative phenomenological case study was designed to investigate the affect that a formal mentoring program had on job satisfaction including a nurse's intent to stay with their current employer and their intent to stay in the nursing profession. The research was intended to determine whether mentoring programs could be used to help avoid the affect of the upcoming predicted nursing shortage in the acute care hospital.

The findings were based on the results of a sample of twelve nurses who had voluntarily signed up to take part in a formal mentoring program sponsored by the staff development department of …

Is Parenting Style Related To Overweight In Mexican Or Mexican-American Preschoolers?, Darlene Mcpherson-Ventura Phd

Dissertations

The prevalence of childhood overweight (OW) continues to rise and children from low-income, Mexican or Mexican-American families are disproportionately affected. The preschool years have been identified as a critical period for excessive weight gain and during this time children respond to parental cues as they form their early eating habits. Certain parenting styles have been associated with improved health outcomes in children. The purpose of this study was to evaluate the relationship of parenting styles and feeding practices to the Mexican or Mexican-American preschool child's risk of overweight. Interdependence Theory was used to inform this study to understand the interaction …

Function And Pain In Community-Dwelling, Adult Mid-Southerners With Limb Loss, Cecile B. Evans

Theses and Dissertations (ETD)

Background: Limb loss affects about 1 in 190 people in the US. Risk factors for limb loss include diabetes, obesity, smoking, minority race, and poverty, which are all common in the Mid-South population. Function is impaired by limb loss, and pain associated with limb loss may further impair function.

Purpose: Describe the function, pain, health status, and demographics of community-dwelling, adult Mid-Southerners with limb loss. Estimate the relationship between function and pain, health status, and demographics of community-dwelling, adult Mid-Southerners with limb loss. Estimate the joint influences on function by pain, health status, and demographics of community-dwelling, adult Mid-Southerners with …

The Professional Portfolio: An Evidence-Based Assessment Method, Michelle Byrne, Kathryn Schroeter, Shannon Carter, Julie Mower

College of Nursing Faculty Research and Publications

Competency assessment is critical for a myriad of disciplines, including medicine, law, education, and nursing. Many nurse managers and educators are responsible for nursing competency assessment, and assessment results are often used for annual reviews, promotions, and satisfying accrediting agencies' requirements. Credentialing bodies continually seek methods to measure and document the continuing competence of licensees or certificants. Many methods and frameworks for continued competency assessment exist. The portfolio process is one method to validate personal and professional accomplishments in an interactive, multidimensional manner. This article illustrates how portfolios can be used to assess competence. One specialty nursing certification board's process …