Digital Commons Network^™

Short Of Transformation: American Adn Students' Thoughts, Feelings, And Experiences Of Studying Abroad In A Low-Income Country, Cynthia Foronda, Ruth Ann Belknap

College of Nursing Faculty Research and Publications

ADN students are a large yet distinct subgroup of nursing students who require research and understanding. The purpose of this study was to describe the thoughts, feelings, and experiences of American associate degree nursing (ADN) students who participated in a short study abroad course in a low-income country. A qualitative, narrative method was used. Three categories emerged from the analysis. Participants revealed thoughts of “constant comparisons”, feelings of an “emotional journey”, and they experienced “learning”. Participants did not demonstrate perspective transformation as defined by Mezirow as participants signified no intent for social action. Several potential blocks to perspective transformation were …

Clinical Observation Reflections From Students In An Interdisciplinary Palliative Care Course, Marcia Phillips, Susan Breakwell, Kim Minju, Margaret Faut Callahan

College of Nursing Faculty Research and Publications

The purpose of this study was to gain insight into how a brief clinical observation encounter contributed to students’ experiences in an interdisciplinary palliative care course. This course was required of all graduate nursing students and was available as an elective for medical and other healthcare professions students at a healthcare sciences university. The students were required to spend approximately 8 to 12 hours attending interdisciplinary team meetings or accompanying a team on rounds and patient visits.

The students’ summary narratives of their observation experience were analyzed in this qualitative study that focused on six categories of feedback: (1) patients’ …

Diffusion Of The Egfr Assay: The Underutilization And The Urban/Rural Divide, Julie Ann Lynch

Graduate Doctoral Dissertations

Purpose - The EGFR assay is a molecular diagnostic test which identifies a targetable mutation in lung tumors. Guidelines call for EGFR testing for non-small cell lung cancer patients to direct first line treatment. We explored institutional and regional factors predicting the likelihood acute care hospitals ordered the assay. Methods: This was a retrospective study which analyzed US acute care hospitals (n=4780). We linked proprietary industry data for orders of the EGFR assay to public datasets that provided hospital and regional characteristics. We conducted logistic regression to identify significant characteristics that predict likelihood a hospital ordered the assay. Results - …

Relevancy=Qsen + Complete Baccalaureate Curriculum Redesign, Charlene M. Smith

Nursing Faculty/Staff Publications

Faculty in the WSON opted to consider a complete curriculum redesign of the baccalaureate nursing program to assure relevancy to practice. A quality improvement process was used to accomplish the curriculum redesign.

Nursing Informatics Competencies: Implications For Safe And Effective Practice, Hayes Greer

Honors Theses

The purpose of this thesis is to examine the implications and availability of nursing informatics competencies, and to address the current state of informatics competency guidelines and assessment tools. To possess competence in nursing informatics, one must possess the ability to obtain, store, retrieve, and communicate data, information, knowledge, and wisdom, which is essential to nursing practice. Nurses must be educated and competent in nursing informatics in order to exhibit safe and effective nursing practice. Many various lists and guidelines exist to address the distinct competencies that nurses must possess; however, very few resources are available to assess the degree …

Student Attitudes Toward Older Adults, Anna Feenstra

Honors Theses

An aging American population means more older adults will be entering the health care system. The purpose of this study is to evaluate the attitudes of nursing students toward older adults and to determine if these attitudes change over the course of a nursing program. This study was carried out in a university in the Midwest United States. A pre-test post-test single group design was used for this study. Students were surveyed three times throughout the program using Kogan’s Old People scale (KOP) and a demographic questionnaire. Testing was conducted at the beginning and end of the sophomore geriatric course …

Self-Tracking, Social Media And Personal Health Records For Patient Empowered Self-Care, C Paton, Margaret M. Hansen Edd, Msn, Rn, L Fernandez-Luque, Ays Lau

Nursing and Health Professions Faculty Research and Publications

Objectives: This paper explores the range of self-tracking devices and social media platforms used by the self-tracking community, and examines the implications of widespread adoption of these tools for scientific progress in health informatics. Methods: A literature review was performed to investigate the use of social media and self-tracking technologies in the health sector. An environmental scan identified a range of products and services which were used to exemplify three levels of self-tracking: self-experi- mentation, social sharing of data and patient controlled electronic health records. Results: There appears to be an increase in the use of self-tracking tools, particularly in …

Smoking Cessation Education: A Prescription And Opportunity For Change, Amanda Aust

Evidence-Based Practice Project Reports

Tobacco usage is the second leading cause of death worldwide. Smoking claims the lives of people more than acquired immunodeficiency syndrome, alcohol, accidents, homicides, suicides, fires, and drugs combined (Green & Briggs, 2006). In 2009, 46 million people in the United States were estimated to be smokers (Regents of the University of California, 2011). Despite the availability of guidelines to assess and provide smoking cessation interventions to patients, a disconnect exists in nurses being able to implement these guidelines. The purpose of this evidence-based practice project was to determine if an educational intervention for nurses about smoking cessation, as compared …

Emergency Nurses' Perception Of Department Design As An Obstacle To Providing End-Of-Life Care, Renea L. Beckstrand, Ryan J. Rasmussen, Karlen E. (Beth) Luthy, Sondra Heaston

Faculty Publications

Introduction: Of the 119.2 million visits to the emergency department in 2006, it was estimated that about 249,000 visits resulted in the patient dying or being pronounced dead on arrival. In 2 national studies of emergency nurses' perceptions of end-of-life (EOL) care, ED design was identified as a large and frequent obstacle to providing EOL care. The purpose of this study was to determine the impact of ED design on EOL care as perceived by emergency nurses and to determine how much input emergency nurses have on the design of their emergency department.

Methods: A 25-item questionnaire regarding ED …

Computer-Based Sex Education For High School Students, Ashley Jones

Evidence-Based Practice Project Reports

Adolescents are four times more likely than other age groups to contract chlamydia or gonorrhea. In the USA, young people between 15 to 24 years of age acquire almost half of all newly diagnosed sexually transmitted infections (STI) a year. The purpose of this computer-based sex education EBP project was to increase student knowledge regarding transmission, disease process, and treatment for STIs, as well as to reduce high risk sexual behaviors. The evidence-based practice model for change and the Modeling, Role-Modeling nursing theory guided this project. Computer-based sex education is supported in research. Articles critiqued, utilizing Melnyk and Fineout-Overholt (2011) …

Patient Safety Competencies In Rural Asn Students: An Evidence-Based Curricular Innovation, Janeen Berndt

Evidence-Based Practice Project Reports

Hospital clinical experiences are important events in prelicensure nursing education. Benefits include the opportunity for students to experience actual nursing responsibilities, immersion into environment, and professional socialization. However, challenges in finding appropriate clinical experiences include competition over clinical sites, decreasing patient acuity, and high student-faculty ratios. Rural schools of nursing have these challenges and those inherent in rural environments such as limited health care access, restricted critical access hospitals, and limited resources. The purpose of this evidence-based practice project was to plan, implement, and evaluate the use of a series of patient care simulations as an educational intervention to improve …

Delivering Quality Care: The Roles And Future Of Midwives In Southern California, Abigail Jones

Scripps Senior Theses

The United States is ranked 27^th in the world for maternal mortality, yet spends twice as much on maternity care services as countries with better maternal health indicators. Stuck in a technocratic and physician-dominated maternity care system, the U.S. depends on expensive technologies to control birth out of fear of pain and litigation, costing Americans billions of dollars and depriving women of the opportunity to have a transformative birth experience. Through an analysis of the medicalization of birth and the current biomedical model in birth, in conjunction with open-ended interviews with 5 hospital midwives and 3 homebirth midwives, the …

Obesity Trends In Head Start Preschoolers, Anna Sanders

Honors Theses

The purpose of this natural comparative study is to see if changes in diet, education, and activity made in a South Mississippi Head Start (HS) preschool from Fall 2007 through Fall 2010 made any changes in the Body Mass Index (BMI) trends in two cohorts of low-income African American 3-year-olds. Cohort 1 BMI trends were measured in Fall 2006 and Spring 2007, before major HS changes in diet, education and activity were made (pre-treatment), and Cohort 2 was measured in Fall 2010 and Spring 2011, after major changes were made (post-treatment).

Barriers And Motivators For Influenza Vaccination Compliance Among Healthcare, Shelby Rogers

Honors Theses

The influenza vaccine is a topic of much debate and concern throughout the healthcare profession. This vaccination has been shown to drastically reduce the number of nosocomial infections of the flu among hospitalized patients. While many healthcare professionals are aware of the benefits of obtaining the influenza vaccination, many remain noncompliant to actually getting vaccinated. This research will use a form of evidence-based practice known as an integrative review of literature in order to determine the course of nursing action to implement regarding influenza vaccination that will best increase the rates of its compliance among health professionals. A number of …

Symptom Clusters In Lung Cancer Patients, Debra Rattican

Theses and Dissertations

SYMPTOM CLUSTERS IN LUNG CANCER PATIENTS By Debra Rattican, PhD, RN A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2012 Major Director: Debra E. Lyon, PhD. Professor and Chair Family and Community Health Nursing The purpose of the study was to examine selected relationships among symptoms common to individuals with lung cancer. The specific aims were: 1) To examine the relationship between the symptoms of dyspnea and anxiety in patients with lung cancer. 2) To examine the relationships among the symptoms of dyspnea, anxiety, and …

A Multi-Component Intervention To Reduce Alcohol Consumption In College Freshmen, Kimberley L. Jelinek

Evidence-Based Practice Project Reports

Alcohol consumption is a health concern on all college campuses in the United States. College students’ alcohol consumption is a highly prevalent behavior, with 44% reporting that they are consuming alcohol at the binge level or greater (Wechsler & Nelson, 2008). The purpose of this evidence-based practice (EBP) project was to answer the clinical question: In college freshmen, how does a multi-component intervention influence alcohol consumption over a four-month period? The Transtheoretical Model of Behavioral Change (TTM) and Diffusion of Innovations (DoI) were used to guide the project. Evidence demonstrates that implementing brief intervention, promoting substance-free events, and increasing campus …

Effect Of The Total Girl Wellness Program On Wellness Behaviors In Adolescent Females, Jenifer M. Chilton

Nursing Theses and Dissertations

Adolescent females perceive themselves to be healthy but research suggests this population engages in unhealthy and risky behaviors. Health habits established during youth transition into adulthood and may contribute to chronic diseases later in life. Guided by Bandura's Social Cognitive Theory (SCT), the purpose of this study was to test the effect of a comprehensive wellness intervention on overall wellness, physical fitness, and self-efficacy for health promoting behaviors in female adolescents. A multidisciplinary concept analysis of shame suggested components of shame can impact environment, personal factors, and behavior, the key concepts of SCT. An intervention based on SCT and titled …

Early Term Infant Care: Hospital Utilization And Breastfeeding Practices, Debra Craighead

Nursing Theses and Dissertations

Early term infants (ETI), with gestational ages from 37 to 38 weeks, have higher morbidity and mortality rates when compared with later term infant counterparts born at 39 to 41 weeks. Although this newly identified term infant subcategory is gaining attention, the immediate and long term health outcomes and care needs of ETI remain largely unexplored. The purpose of this research project was to examine the current research documenting ETI health and explore care practices that are currently utilized to promote ETI health. The original research study describes care practices used to promote health for ETIs born in Louisiana in …

The Use Of Provider Audit And Feedback On Improving Hypertension Control In The Type 2 Diabetic Population, Kara Painton

Evidence-Based Practice Project Reports

As the seventh leading cause of death, diabetes affects more than 25 million Americans and contributes to major cardiovascular diseases and complications (CDC, 2011). The cost of care for these Americans is astounding: $174 billion dollars was spent on diabetes care in 2007 (ADA, 2011). Furthermore, an estimated 75% of patients with type 2 diabetes have concomitant hypertension, and nearly one-half of these patients have uncontrolled hypertension (Thomas & Kodack, 2011; USDHHS, 2011). An initial chart audit at an outpatient, rural clinic in east central Illinois revealed that 90% of the type 2 diabetic population had concomitant hypertension, and only …

Predictors Of Sexual Relationship Power, Communication And Sexual Decision Making Among Latino Couples, Yui Matsuda

Theses and Dissertations

Unintended pregnancy (UP) is increasing among Latinos in the United States. Unintended pregnancy contributes to many negative consequences for infants, mothers and families. Concurrently, various factors affect Latino couples’ sexual relationship power, communication and decision making about family planning, including sexual relationship power, relationship commitment, dyadic adjustment, individual background, and cultural characteristics. Previous research has not focused on understanding the factors that affect Latino couples’ sexual relationship power, communication and sexual decision making from each partner’s perspective. The purpose of this study was to examine the association between sexual relationship power, communication, and sexual decision making from each partner’s perspective …

Creating An Interactive Dnp Project Repository:A Model For Change, Sara D. Guido Dr.

Doctor of Nursing Practice (DNP) Projects

The creation of systems that can provide bridges to information technology requires rethinking old ways of doing business. In the past, individual universities and colleges would accommodate theses and dissertations on their library sites. Some of these sites are public and can be accessed by everyone, while some require university-specific affiliation.

This project aims to apply knowledge and skills related to information systems and technology. With the growth of the DNP clinical doctorate programs, and final outcome projects there is a need for specialized DNP database for a new method of data entry and retrieval for DNP’s. The creation of …

Effect Of A Multimedia Intervention On Outcomes Expectations And Perceived Self-Efficacy For The Sex Educator Role For Parents/Caregivers Of African American Adolescent Males, Carmon V.N. Weekes

Nursing Theses and Dissertations

Risky sexual behavior among youth is a national concern and places adolescents at high risk for undesirable health outcomes. According to the Youth Risk Behavior Surveillance System, African American males are more likely to engage in intercourse before age 13 than other racial groups. Research reporting positive impact of parent-adolescent sex communication on influencing risky behaviors has rarely included parents of African American adolescent males. A systematic review of the literature examining health literacy in African Americans supported the importance of including non-print sources of information for this population. The purpose of this study was to test the effect of …

Chronic Kidney Disease Educational Sessions: Assessment Of Current Practices And Attendance Barriers And Facilitators, Della Connor

Nursing Theses and Dissertations

Chronic kidney disease (CKD) educational sessions, whether part of a multidisciplinary plan of care or separate entities, have been increasingly utilized over the last 20 years. Although literature reviews exist in which randomized controlled studies concerning CKD educational sessions are addressed, none of the studies reviewed specifically addressed the low attendance rates of CKD educational sessions. The purpose of this research was to describe current and recommended CKD (predialysis) educational interventions and outcomes in controlled and multidisciplinary studies, examine documented issues related to attendance, and determine barriers and facilitators that affect attendance at educational sessions for CKD patients.

The Effect Of Guided Observation On Learning Outcomes In Simulation-Based Learning, Jamil Norman

Nursing Theses and Dissertations

Nurse educators have been faced with the challenge of providing adequate clinical preparation for nursing students. Implementation of simulation-based learning (SBL) has been used to meet these challenges. Current research indicates that students and faculty are both satisfied with simulation; however, faculty concerns with improving student learning during SBL have led to a research intervention on the use of an Observation Guide. The purpose of this research was to examine differences in knowledge, self-confidence, satisfaction, and collaboration between baccalaureate nursing students using an Observation Guide when observing a simulated clinical experience (SCE) and those observers without an Observation Guide. Additionally, …

The Use Of Positive Deviance To Deliver Patient-Centered Care, Jodie Gary

Nursing Theses and Dissertations

What happens when critical care nurses find themselves in situations where patient care needs are not covered by practice guidelines or standard orders or when the needs conflict with those guidelines and orders? Sometimes usual practices such as call the supervisor, call the physician, or follow the protocol just do not meet the needs of the patient at the exact time and place. Experienced critical care nurses often discuss such situations in private; however, there is little information in the literature about the types of situations encountered and the decision- making processes used in these situations. Those discussions that were …

Differences In Substance-Related Risk Behavior Between Dual And Triple Diagnosed Severely Mentally Ill Adults, Michelle Hampton, Linda Chafetz, Carmen Portillo

Faculty Publications

No abstract provided.

Chattanooga Community Members Willingness To Use Retail Clinics: A Quantitative Approach, Yasmine M. Swistek, Casey M. Waddle

Graduate Research Projects

This study explored the willingness of Chattanooga community members to utilize retail clinics for simple ailments rather than the area EDs. Specifically, community members ages 25-45 were surveyed and asked to rate their willingness to use a retail clinic for their acute healthcare needs rather than the overcrowded local EDs. Additionally, this study explored community members’ perceived barriers to use retail clinics. Results were compared between demographic variables such as yearly income, race, gender, and age.

The Meaning Of Parenteral Hydration To Family Caregivers And Patients With Advanced Cancer Receiving Hospice Care., Marlene Z. Cohen, Isabel Torres-Vigil, Beth E. Burbach, Allison De La Rosa, Eduardo Bruera

Journal Articles: College of Nursing

CONTEXT: In the U.S., patients with advanced cancer who are dehydrated or have decreased oral intake almost always receive parenteral hydration in acute care facilities but rarely in the hospice setting.

OBJECTIVES: To describe the meaning of hydration for terminally ill cancer patients in home hospice care and for their primary caregivers.

METHODS: Phenomenological interviews were conducted at two time points with 85 patients and 84 caregivers enrolled in a randomized, double-blind, controlled trial examining the efficacy of parenteral hydration in patients with advanced cancer receiving hospice care in the southern U.S. Transcripts were analyzed hermeneutically by the interdisciplinary research …

Breast Health And Mammography Screening In Older Women, Martha A. Ibarra Phd, Msn, Anp, Rn

Dissertations

Age-related health disparities in breast cancer screening are a public health concern. From 2002 to 2006, the median age for newly diagnosed cases of breast cancer was 61 years and the median age for breast cancer mortality was 68 years of age (Surveillance Epidemiology and End Results [SEER], 2009). Mammography is the best available screening tool for breast cancer detection (Susan G. Komen Foundation, 2008). The Centers for Medicare and Medicaid Services (CMS, 2006) reported that only about half of older women who are eligible for mammograms through Medicare obtain a mammogram every two years. The literature identifies psychosocial barriers, …

Inpatient Glycemic Management: Glucose Control Relationship With Hospital Variables, Discharge Planning And Education, Crisamar Javellana-Anunciado Phd, Fnp-Bc, Rn

Dissertations

This dissertation study examined the relationship of glucose control with clinical outcomes, costs, discharge planning and education. Extant studies showed that hyperglycemia, in the presence or absence of a diabetes diagnosis, is prevalent in hospitalized patients. Hyperglycemia is found in one-third of all hospital admissions and is linked to poor clinical outcomes and increased healthcare costs. Furthermore, clinical evidence suggests that lack of discharge coordination associated with medical errors and readmission. This entire body of work contains three distinct sections: Two manuscripts and a grant proposal. The two manuscripts in this study were based on more current retrospective data at …