Digital Commons Network^™

Evaluating The Effectiveness Of Crucial Conversations® Training On Nurses’ Self-Efficacy, Deeanna R. Mccallie

DNP Projects

Background: The history of nurse/physician communication is well documented. Although there is no universal definition of nurse-physician communication, an increasing body of evidence identifies this factor as an important component of organizing and delivering safe, quality care to patients. Communication has been identified as the root cause in 65% of sentinel events and noted as having significant effect on patient outcomes; contributing significantly to increasing care coordination, decreasing length of stay, and decreasing mortality rates. Purpose: To examine whether Crucial Conversations® training improves nurses’ self-efficacy scores and assess whether clinical nurse report improved ability to communicate with physicians. Methods: A …

Assessment Of Nurses’ Views And Current Practice Of Trauma-Informed Pediatric Nursing Care: Oncology, Alesandra S. Conley

DNP Projects

Purpose: The purpose of this project is to: (i) assess and evaluate the awareness, knowledge and current practice trends of pediatric oncology nurses as they relate to pediatric trauma-informed care. Methods: A prospective, cross-sectional sample of convenience was used to assess pediatric nursing staff at the Kentucky Children’s Hospital. The survey used in this study was replicated from a previous study, “Nurses’ Views and Current Practice of Trauma-Informed Pediatric Nursing Care,” authored by Kassam-Adams et al., nurses and doctors affiliated with Children's Hospital of Philadelphia, University of Pennsylvania, Penn State Hershey Children's Hospital, Nemours Child Health System, Children's Hospital of …

Childhood Nutrition And Lifestyle In Owensboro, Kentucky, Mckenzie J. Mattingly

DNP Projects

According to the CDC, childhood obesity is now one of the leading health problems in the United States. Thirty-five percent of adults in the United States are obese. Kentucky is the 12th most obese state for adults. and the 7th most obese state for children. The State of Obesity: Better Policies for a Healthier America, states that Kentucky’s adult obesity rate is currently 31.6 percent. This is up from 21.7 percent in 2000 and 12.7 percent in 1990. Primary care providers must work to help prevent these numbers from continuing to climb. Since our population of children who are overweight …

Improving Nutritional Status In The Hematologic Oncology Population, Mary A. Malone

DNP Projects

Background: Patients undergoing treatment for both solid tumor and hematologic malignancies experience numerous symptoms that greatly affect their nutritional status. Malnutrition can have a negative impact on oncology patient outcomes. There is a reduced response to treatment, reduced survival and quality of life. Early and consistent interventions have proven beneficial in the oncology population.

Most hematologic cancer patients have good nutritional health. However, as their treatments intensify, side effects compared to their solid tumor counterparts can adversely affect nutrition. Interventions, consisting of total parenteral or enteral nutrition are initiated but only after oral intake has been impeded for 2-3 days. …

Examining The Relationship Between Type And Extent Of After-School Care Use And High Bmi In Children Ages 5-17, Morgan E.B. Chojnacki

DNP Projects

Objectives: The purpose of this study was to examine the relationship between body mass index (BMI) and after-school care use in school age children and adolescents in Kentucky. The specific aims of this study were to examine differences in BMI groups (high versus normal/low) by: a) type and b) extent of after-school care use.

Methods: Parents of children age 5-17 years were administered a 21-item survey which assessed the amount of time their children spent in specific types of after-school care. BMI of the child/adolescent participants were obtained at the time of the survey. High BMI was defined …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

Delirium Screening Instrument Knowledge And Perception Among Cardiovascular Intensive Care Nurses, Brittany Lynn Dahl

DNP Projects

Background: Delirium is a serious condition that affects critically ill adult patients in the intensive care unit. Bedside nursing delirium measurements are considered a dependable source of information that can be used for clinical decision-making. Nurse education and assessment of perceptions is important when building a framework for successful delirium assessment. However, few data exist about nursing perceptions and practices associated with delirium screening instruments. The overall purpose of this project is to examine nurse perceptions and knowledge about delirium and delirium screening instruments at the University of Kentucky (UK) Hospital’s Cardiovascular Intensive Care Unit (CVICU).

Objectives: The aims of …

Relational Coordination: An Exploration Of Nursing Units, An Emergency Department And In-Patient Transfers, Mary Coffey

Theses and Dissertations

Emergency department (ED) crowding is a patient safety concern that has been increasing for more than a decade. Increased visits have resulted in ED crowding, longer wait times, ambulance diversions, and boarding of admitted patients (Hing & Bhuiya, 2012). Numerous factors affect ED crowding. Once various extraneous issues are resolved and a bed is available for a patient, it becomes the responsibility of nurses across unit boundaries to coordinate the patient transfer. This study applies Relational Coordination Theory (RCT) as a framework to provide nurses insight into the relational aspects of their work in the transfer of ED patients to …

Rapid Response Teams Versus Critical Care Outreach Teams: Unplanned Escalations In Care And Associated Outcomes, Valerie Danesh

Electronic Theses and Dissertations

The incidence of unplanned escalations during hospitalization is undocumented, but estimates may be as high as 1.2 million occurrences per year in the United States. Rapid Response Teams (RRT) were developed for the early recognition and treatment of deteriorating patients to deliver time-sensitive interventions, but evidence related to optimal activation criteria and structure is limited. The purpose of this study is to determine if an Early Warning Score-based Critical Care Outreach (CCO) model is related to the frequency of unplanned intra-hospital escalations in care compared to a RRT system based on staff nurse identification of vital sign derangements and physical …

Impact Of Interruption Frequency On Nurses' Performance, Satisfaction, And Cognition During Patient-Controlled Analgesia Use In The Simulated Setting, Kristi Campoe

Electronic Theses and Dissertations

Problem: Interruption during medication administration is a significant patient safety concern within health care, especially during the administration of high risk medications in nursing. Patient-controlled analgesia (PCA) devices are frequently associated with adverse events and have a four-fold increased risk of patient injury compared to non-PCA related adverse events. While the nature and frequency of interruptions have been established for nurses* medication processes, the impact of interruption frequency on nurses* PCA interaction has not been fully measured or described. Purpose: The purposes of this study were to quantify the impact of interruption frequency on registered nurses* (RN) performance, satisfaction, and …

Family Care Giver Knowledge, Patient Illness Characteristics, And Unplanned Hospital Admissions In Older Adults With Cancer, Patricia Geddie

Electronic Theses and Dissertations

Unplanned hospital admissions (UHA) in older adult populations are a recurring problem in older adults with cancer. Older adults comprise approximately 60% of cancer diagnoses and receive the majority of cancer treatment. However, little is known about why older adults under treatment for cancer experience a high number of unplanned hospital admissions. A review of the literature provided few study findings and a gap in the current knowledge was identified regarding the factors associated with unplanned hospital admissions in older adults under treatment for cancer. A conceptual framework based on the literature and this researcher's clinical experienced guided this study. …

Nurse Managers, Work Environment Factors And Workplace Bullying, Joy Parchment

Electronic Theses and Dissertations

The purpose of this dissertation is to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of nurse managers in acute care settings across the United States. Over 30 years of workplace bullying research exists. Consequences are linked to intent to leave, turnover, and harmful emotional and physical effects. Published studies identifying nurse managers as targets of workplace bullying and work environment factors that contribute to nurse managers being recipients of workplace bullying either, downward from their leaders, horizontally from their nurse manager peers, and upwards from their clinical nurses were not identified. …

Flipping The Classroom To Teach Population Health: Increasing The Relevance., Vicki Simpson, Elizabeth Richards

School of Nursing Faculty Publications

In recent years, there have been multiple calls to enhance the population health and health promotion aspects of nursing programs. Further impetus has been provided by passage of the Affordable Care Act in 2010 with its focus on prevention. The need to develop students who can critically think and apply knowledge learned is crucial to the development of nurses who can integrate and apply the concepts of population-focused practice in society and a healthcare system undergoing transformation. This coupled with the ever changing needs of learners requires a different approach to content delivery and presentation. Flipped classroom courses, with an …

Nursing Students' Perceived Value Of The Pre-Briefing Phase Of Simulation, Jill Renae Chamberlain

Student Theses, Dissertations and Capstones

As technology has grown, many healthcare professions’ programs, including nursing, have incorporated simulation into their curricula. Overwhelmingly, research has highlighted the last phase of simulation, debriefing, as the most important component influencing learning outcomes, with limited focus on prebriefing. The purpose of this study was to describe the influence the prebriefing phase during simulation has on undergraduate nursing students’ perceptions of overall simulation effectiveness, learning, and self-confidence. Situated learning theory was selected to guide the research design due to its unique view that learning is a social process that is enhanced within the authentic environment. The quasi-experimental design study compared …

Reliability And Validity Of A Tool Measuring Preceptor Evaluations Of Competencies Among New Rn Graduates In A Transition-To-Practice Program, Susan K. Prion, A Berman, Arthur Karshmer, P Van, J Wallace, N West

Nursing and Health Professions Faculty Research and Publications

Four transition-to-practice programs for new RN graduates who had not yet found employment in nursing were based on the Quality and Safety Education for Nurses (QSEN) competencies of knowledge, skills, and attitudes (KSAs). To support consistent evaluation of participants by preceptors, a 35-item tool was developed that used a 4-point scale to assess selected behaviors. This article describes the initial reliability and validity testing of the tool, which had good internal consistency, with a Cronbach's alpha of 0.92 for preceptor evaluation of participants and 0.82 when used as a self-evaluation tool. Six content experts evaluated the tool's face validity; it …

Critical Cultural Awareness And Diversity In Nursing: A Minority Perspective, Chenit Ong-Flaherty

Nursing and Health Professions Faculty Research and Publications

Increasing multiculturalism and ongoing issues related to poor patient-centered care, teamwork, and safety call for urgent readdressing of cultural competency training. Critical cultural awareness education is needed to improve diversity in the nursing profession. Using Hofstede’s cultural dimension of Invidualism-Collectivism, this paper proposes that the dominance of one culture may be the contributory factor in the slow acceptance of change towards critical cultural awareness education. Experiential learning by way of gaming and critical reflection on cross-cultural interactions can contribute to the development of critical cultural awareness.

Job Satisfaction And Horizontal Violence In Hospital Staff Registered Nurses: The Mediating Role Of Peer Relationships, Christina Purpora, Mary A. Blegen

Nursing and Health Professions Faculty Research and Publications

Aims and objectives

To describe the association between horizontal violence and job satisfaction in hospital staff registered nurses and the degree to which peer relationships mediates the relationship. Additionally, the association between nurse and work characteristics and job satisfaction were determined.

Background

Horizontal violence is a major predictor of nurses' job satisfaction. Yet, not enough is known about the relationship between these variables. Job satisfaction is an important variable to study because it is a predictor of patient care quality and safety internationally. Peer relationships, a job satisfier for nurses, was identified as a potential mediator in the association between …

A Cross Sectional Exploration Of Emotional Intelligence In Us Baccalaureate Nursing Students, Marcianna Nosek

Nursing and Health Professions Faculty Research and Publications

Objective: New nurses may be vulnerable to bullying as they often lack confidence or do not have the skills or maturity to communicate their needs or those of their patients. Increasing emotional intelligence particularly in at-risk nursing students may be one way to foster resiliency. This exploratory cross sectional study aimed to exam the overall level and specific components of emotional intelligence as well as associations with age, ethnicity, gender, or academic standing in baccalaureate nursing students.

Methods: A cross sectional analytical study was conducted using a paper demographic survey and an online emotional intelligence (EI) instrument, the …

Recommendations For Enhancing Psychosocial Support Of Nicu Parents Through Staff Education And Support, S L. Hall, J Cross, Nancy Selix, C Patterson, L Segre, R Chuffo-Siewert, P A. Geller, M L. Martin

Nursing and Health Professions Faculty Research and Publications

Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents’ functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU …

Use Of Root Cause Analysis In Nursing Education: Best Practice From The Quality And Safety Officer, Elizabeth E. Cooper, Susan Pauly-O’Neill

Nursing and Health Professions Faculty Research and Publications

Teaching nursing students to be safe in practice is a key element to any nursing curriculum. This article will discuss the use of a Root Cause Analysis (RCO) framework with prelicensure nursing students, by the Quality and Safety Officer (QSO) in a School of Nursing and Health Professions, as a method to enhance transparency and improve patient safety. The aim is to provide a rationale for using this strategy, to identify the steps of a root cause analysis, to disclose barriers to its successful use, and to explore dissemination to the partnering healthcare environments.

Stress Factors Among Caregivers Of Children With Thalassemia, Valliammal _. Shanmugam Ms, Ramachandra

Manipal Journal of Nursing and Health Sciences

Introduction: Thalassemia is one of the most common genetic diseases known to mankind. Children with Thalassemia require medical, surgical and nursing care. Family members and caregivers of the affected children play a vital role during treatment. Moreover, they also undergo abundant stress and emotional changes concerning their children’s lives. Objective: To identify factors associated with stress and to correlate the factors with selected demographic variables in caregivers of children with Thalassemia. Materials and Methods: A descriptive survey was conducted among sixty caregivers of children with Thalassemia, admitted in the Thalassemia ward of a selected hospital in Bangalore. Demographic data of …

Decreased Pain Severity And Differential Gene Expression Following Calmare Therapy, Jeffrey Petraco, Angela R. Starkweather, Amy Heineman

UROP Posters

We present the results of a double-blinded randomized sham-controlled research study of a non-pharmacologic low back pain intervention. Calmare therapy is an neurocutanous electrical stimulation approach for pain management. The intervention group received Calmare therapy and the other received sham. Differences in pain severity and interference scores, pain sensitivity measures and gene expression profiles are reported. Patterns of downregulated gene expression suggest that Calmare may alter proteins involved in pain transduction may have implications for the treatment of other chronic pain conditions.

The Lasting Effects Of History On African American Attitudes And Beliefs Towards The American Healthcare System, Kendra Redding

Honors Theses

This thesis explores the effects that a history of medical exploitation has had on the African American community's likelihood of seeking healthcare. The thesis first delves into prominent historical instances that have had an impact on the way that the African American community views the medical community; next, the thesis explores institutional barriers to seeking healthcare that African Americans have faced; then, the thesis discusses the current health status of African Americans; lastly, the thesis discusses current improvements in healthcare relations, and explores future implications of the research.

Geographic Access To Interventional Cardiology Services In Maine, James P. Rhudy

All ETDs from UAB

Introduction: Acute coronary syndrome is the most common cause of death in the U.S. and the world; ST segment elevated myocardial infarction is the most acute form. The preferred reperfusion therapy is immediate primary percutaneous coronary intervention at an interventional cardiology center. It is intuitive, but not known, whether delay in receipt of reperfusion therapy because of geographic distance is associated with increased coronary mortality. Even so, clinical practice guidelines recommend organizing coronary care in each community in regional systems. Hub-and-spoke has been proposed as a regionalized coronary care model. Article synthesis: The first article in this dissertation, titled Effectiveness …

Infant Feeding Practices, Weight Gain, And Blood Pressure In Toddlers Born Very Preterm, Doris Rodriguez

All ETDs from UAB

Little is known about how weight gain in those born very preterm is associated with blood pressure and if cortisol, a stress biomarker, plays a mediating role. Also, the influence of infant feeding practices on weight gain has been only sporadically addressed. The purpose of this exploratory, descriptive, cross-sectional study was to examine the relationships between infant feeding practices, weight gain, and blood pressure noting any mediating effect cortisol may have between weight gain and blood pressure in 18-to-24 month old corrected age toddlers born very preterm. A convenience sample of 36 18-to-24 month old corrected age toddlers were enrolled. …

Nursing Care Of Terminal Patients In Intensive Care Units, Pervell Velethia Dunbar

Walden Dissertations and Doctoral Studies

Nursing Care for Terminal Patients in Intensive Care Units

by

Pervell Dunbar

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Although the goal of the ICU has always been to save lives, ICU now additionally provides end-of life (EOL) care. The objective of this project was to provide ICU nurses with a comprehensive awareness of physical, emotional, and spiritual EOL care issues of patients and their families in order to be better equipped to handle EOL care. The framework used was Jean Watson's Caring model (10 Caritas). A …

Deleterious Effects Of Hyperglycemia On Cognitive Functioning In The Cardia Study Cohort, Michele Holland Talley

All ETDs from UAB

DELETERIOUS EFFECTS OF HYPERGLYCEMIA ON COGNITIVE FUNCTIONING IN THE CARDIA STUDY COHORT MICHELE LYN HOLLAND TALLEY SCHOOL OF NURSING ABSTRACT With an aging society, maintaining cognitive functioning into older age is becoming more important. Because of the impact cognitive functioning has on daily activities, any disruption may inhibit the ability to perform such daily activities successfully. To prevent disruptions, determinants of cognitive functioning must be considered. Such determinants may or may not be modifiable. Some predictors may be demographic, metabolic, or inflammatory in nature. In addition, predictors or determinants may differ based on genetic predisposition to Alzheimer’s disease. As part …

Stress, Bullying, Cortisol, And Depresive Symptoms In 9th Grade Adolescents, Susan Gordon Williams

All ETDs from UAB

ABSTRACT Stress and bullying are known contributors to depressive symptoms in adolescents. Prevalence of depressive symptoms in adolescents is estimated to range from13% to 34% in recent studies. Ninth graders are in a transitional period developmentally,biologically, physically, and psychosocially. Few studies have examined the relationship between stress, bullying, and depressive symptoms from a biobehavioral perspective in 9th graders. The purpose of this study was to examine stress, bullying, and depressive symptoms including a biomarker of stress, salivary cortisol diurnal rhythm, to determine if there is mediation between the individual variables of stressful life events, perceivedstress, bullying, and depressive symptoms. The …

Program For Healthcare Personnel To Improve Anti-Hypertensive Medication Adherence In Black Adults, Verena D. Johnson

Walden Dissertations and Doctoral Studies

Medication nonadherence is a healthcare problem that costs the United States billions of dollars annually. The purpose of this project was to propose an evidence-based program for healthcare personnel to increase the rate of medication adherence in hypertensive Black adults who require daily, oral medication. The transtheoretical model of change was used to explain the process of change and to identify approaches to changing non-adherent behaviors related to medications. Motivational interviewing was used to explain the process that nurse-educators would use to guide patients through the stages of change. In the initial step of this quality improvement program, a convenience …

Effects Of Education On Victims Of Domestic Violence, Julette N. Anderson

Walden Dissertations and Doctoral Studies

The purpose of this project was to improve support for victims of domestic violence. To that end, this project developed an evidence-based program to provide information about domestic violence including safe and confidential ways to seek assistance, rights as cohabiting intimate partners, and the resources available to community members. Several approaches were used to develop, validate, and plan for implementation and evaluation of this program, which was developed for 3 sites in Broward and Miami-Dade counties where the project is situated. The program logic model and the social ecological model, including the individual, relationship, community, and societal levels, were used …