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Systematic Review Of Family Engagement Interventions In Neonatal, Paediatric, And Adult Icus, Natalie S. Mcandrew, Teresa Jerofke-Owen, Christine A. Fortney, Breanna Hetland, Deena K. Costa, Jill L. Guttormson, Eric Harding

College of Nursing Faculty Research and Publications

Aims and objectives

The purpose of this systematic review was to evaluate interventions that have been used to engage families in direct care activities (active family engagement) in adult, paediatric, and neonatal intensive care unit (ICU) settings.

Background

Family engagement is universally advocated across ICU populations and practice settings; however, appraisal of the active family engagement intervention literature remains limited.

Search strategy

Ovid Medline, PsycArticles & PsycInfo, Scopus, and CINAHL were searched for family interventions that involved direct care of the patient to enhance the psychological, physical, or emotional well‐being of the patient or family in neonatal, paediatric, or adult …

Postoperative Pulmonary Complications In Complex Pediatric And Adult Spine Deformity: A Retrospective Review Of Consecutive Patients Treated At A Single Site In West Africa, Irene Wulff, Henry Ofori Duah, Henry O. Tutu, Gerhard Ofori-Amankwah, Kawdwo P. Yankey, Mabel Adobea Owiredu, Halima Bidemi Yahaya, Harry Akoto, Audrey Oteng-Yeboah, Oheneba Boachie-Adjei, Focos Spine Research Group

College of Nursing Faculty Research and Publications

Study Design: Retrospective review of consecutive series. Objectives: This study sought to assess the incidence, risk factors, and outcomes of pulmonary complication following complex spine deformity surgery in a low-resourced setting in West Africa. Methods: Data of 276 complex spine deformity patients aged 3 to 25 years who were treated consecutively was retrospectively reviewed. Patients were categorized into 2 groups during data analysis based on pulmonary complication status: group 1: yes versus group 2: no. Comparative descriptive and inferential analysis were performed to compare the 2 groups. Results: The incidence of pulmonary complication was 17/276 (6.1%) in group 1. A …

When Pandemics Collide: The Impact Of Covid-19 On Childhood Obesity, Nancy T. Browne, Julia A. Snethen, Cindy Smith Greenberg, Marilyn Frenn, Jill F. Kilanowsky, Bonnie Gance-Cleveland, Pamela J. Burke, Linda Lewandowski

College of Nursing Faculty Research and Publications

• Children with obesity face increased biopsychosocial risks during COVID-19.

• Stress exacerbates inflammation and immune response in obesity and COVID-19.

• The COVID-19 pandemic has significantly interrupted children's daily routines.

• The health effects of the obesogenic environment are exacerbated by COVID-19.

• Access to timely, comprehensive healthcare is critical during COVID-19.

Questionnaires To Measure Process And Structure Of Quality Indicators For Pediatric Nursing, Maria Forsner, Evalotte Mörelius, Lena Hanberger

Research outputs 2014 to 2021

Introduction The quality of nursing care has a significant impact on the outcomes of care. The specific needs of children requiring hospital care make it essential to monitor and compare data not only on the medically oriented outcome measure but also on nursing care, structure, and process, requiring perspectives from registered nurses (RNs) and nurse managers (NMs). Thus, this project aimed to evaluate the structure and process of nursing quality indicators in pediatric hospital care with questionnaires distributed to RN and NM. Methods We developed separate questionnaires for NMs and RNs to assess the process and structure of the quality …

Fathers’ Experiences Of Feeding Their Extremely Preterm Infants In Family-Centred Neonatal Intensive Care: A Qualitative Study, Evalotte Mörelius, Sofia Brogren, Sandra Andersson, Siw Alehagen

Research outputs 2014 to 2021

Background:

Extremely preterm infants need advanced intensive care for survival and are usually not discharged before they reach the time of expected birth. In a family-centred neonatal intensive care unit both parents are involved at all levels of care including the feeding process. However, studies focusing on fathers in this situation are scarce. The purpose of this study was to explore the experiences of feeding extremely preterm infants in a neonatal intensive care unit from fathers’ perspectives.

Methods:

The study adopts a qualitative inductive method, reported according to the COREQ checklist. Seven fathers of extremely preterm infants (gestational age 24–27 …

Global Impact Of Physical Inactivity And Implications For Public Health Nursing, Elizabeth A. Moxley, Kashica Webber-Ritchey, Laura Hayman

Faculty Articles, Papers, and Other Scholarship

Physical inactivity has been a public health problem worldwide for more than a decade. Of those who are physically active, a substantial percentage engage solely in low or very low physical activity (PA) levels. In the last 3 decades, the prevalence of PA in the United States has decreased with approximately 80% of adults not meeting the recommended guidelines for aerobic and muscle strengthening PA. The PA levels of youth have dramatically decreasedwith 85% of adolescents reporting no PA. Regular PA participation can aid in preventing chronic diseases. A strong inverse dose-response relationship exists between PA and the incidence of …

Factors Influencing Health Service Utilization Among The Elderly In Insein Township, Yangon Region, Sandar Min Min Hlaing, Naw Clara, Aye Nanda Han

Makara Journal of Health Research

Background: With the increasing needs of the aging population and the increasing prevalence of non-communicable diseases, assessment of the equity and accessibility of health care among the elderly has become important.

Methods: A cross-sectional descriptive study was conducted from December 2018 to December 2019 among 225 elderly to describe the factors influencing health service utilization. Multistage sampling was applied, and structured questionnaire was used to interview the elderly. Chi-squared test and multiple logistic regression were performed in data analysis.

Results: The average age of the respondents was 71.7 ± 8.17 years old, and 68.4% of the respondents …

Employee Wellness Pilot Program, Michelle Van Kirk

Nursing Doctoral

Background: Mental health professionals caring for the veteran population are at increased risk for compassion fatigue, burnout, and secondary traumatic stress based on the nature of their work. While mental health professionals may experience positive outcomes from providing compassionate care to veterans, compassion fatigue can lead to instability of the workforce. Methods: A pilot employee wellness program was implemented over a 9-week period, offering a different wellness module weekly during the employee lunch hour. Demographic data were collected pre-program, and mental health employees were surveyed pre- and post-program using an intent to stay scale and the Professional Quality of Life …

Integument: Guidelines For The Care Of People With Spina Bifida, Patricia Beierwaltes, Sharon Munoz, Jennifer Wilhelmy

School of Nursing Publications

PURPOSE:

Skin-related issues have a significant impact on health, activities of daily living, and quality of life among people with spina bifida. Data presented by select clinics that participate in the National Spina Bifida Patient Registry reported that 26% of individuals had a history of pressure injuries with 19% having had one in the past year. The spina bifida community lack direct guidelines on prevention of these and other skin related issues. The Integument (skin) Guidelines focus on prevention, not treatment, of existing problems.

METHODS:

Using a consensus building methodology, the guidelines were written by experts in spina bifida and …

Care Coordination Guidelines For The Care Of People With Spina Bifida, Alexander Van Speybroeck, Patricia Beierwaltes, Betsy Hopson, Suzanne Mckee, Lisa Raman, Ravindra Rao, Rebecca Sherlock

School of Nursing Publications

Care coordination is the deliberate organization of patient care activities between two or more participants (including the patient) involved in a person’s care to facilitate the appropriate delivery of health care services. Organizing care involves the marshalling of personnel and other resources needed to carry out all required patient care activities. It is often managed by the exchange of information among participants responsible for different aspects of care. With an estimated 85% of individuals with Spina Bifida (SB) surviving to adulthood, SB specific care coordination guidelines are warranted. Care coordination (also described as case management services) is a process that …

Association Between Dietary Macronutrient Intake And High-Sensitivity C-Reactive Protein Levels Among Obese Women In Kuantan, Malaysia, Siti Zuhaidah Shahadan, Azlina Daud, Muhammad Ibrahim, Muhammad Lokman Md. Isa, Samsul Draman

Makara Journal of Science

Elevated high-sensitivity C-reactive protein (hs-CRP) levels may be associated with an increased risk of cardiovascular disease (CVD). In general, an individual’s dietary intake may influence the hs-CRP level. However, evidence on the influence of dietary macronutrient intake on hs-CRP levels among obese Malaysian women remains fragmented. Therefore, this study aims to investigate the association between the hs-CRP level and dietary macronutrient intake of obese adults living in Kuantan. The assessment of 24-hour dietary recall and venous hs-CRP levels were investigated in 67 women with a body mass index of 27.5 to 39.9 kg/m². The findings revealed that obese women living …

Investigating The Relationship Between Unavoidable, Hospital Acquired Pressure Injury And Mortality: Is Unavoidable, Hospital Acquired Pressure Injury A Signal Of Increased One-Year Mortality Risk?, Eileen Jimenez

Theses & Dissertations

The purpose of this dissertation was to explore the strength of the relationship between unavoidable Hospital Acquired Pressure Injury (HAPI) and increased risk of one-year mortality for patients age 55 and older who were admitted to a hospital from 2015 to 2018. A quantitative, retrospective case-control study was designed to compare demographics, comorbid conditions, pressure injury risk, and living situation of those patients that developed unavoidable HAPI and hospitalized adults with similar physiological burdens that remained injury-free. The one-year mortality for the HAPI group was 27 of 48 (56%), and 26 of 47 patients (55%) for the Control group. The …

Glycemic Variability In Patients With Stage Ii-Iii Colon Cancer, Natalie Mandolfo

Theses & Dissertations

Patients with cancer experience metabolic changes such as hypoglycemia, hyperglycemia, and glycemic variability; collectively termed malglycemia. Glycemic variability, defined as fluctuations in glucose, is a marker of metabolic instability. Higher glycemic variability is associated with adverse health outcomes in the general population and in those with diabetes. Little is known about glycemic variability in patients with cancer, especially those with solid tumor malignancies. Glycemic variability is associated with increased infection, shorter periods of remission, and higher mortality in patients with hematological cancer. This body of work describes the concept and measurement of glycemic variability to assess glycemic control in patients …

Development And Implementation Of An Orthopedic Enhanced Recovery After Surgery Protocol, Beth Mccoy

Doctor of Nursing Practice Projects

Abstract

As life expectancy rates have grown and individuals desire a more active lifestyle the number of total hip arthroplasty and total knee arthroplasty surgeries performed has grown significantly. Enhanced recovery after surgery (ERAS) protocols have been shown to decrease the financial impact and improve patient outcomes in total joint surgeries. After a literature review a multidisciplinary team met and developed an ERAS protocol for total joint replacement surgeries to be implemented at a 250-bed community hospital in central Illinois. After an eleven-question pre-test was given to 34 participants consisting of perioperative nursing staff, anesthesia, and surgeons assessing their knowledge …

The Crossroads Of Wellness And Second Victim Syndrome: Identifying Factors That Alter The Pathway Of Caregiver Recovery Following An Unanticipated Adverse Patient Outcome, Kimia Zarabian, A. Katharine Hindle, Ivy Benjenk, Anita Vincent, Jamil M. Kazma, Benjamin Shambon, Raymond Pla, Eric Heinz

Journal of Wellness

Introduction: Second Victim Syndrome (SVS) describes the phenomenon in which a caregiver experiences a traumatic psychological and emotional response to an adverse patient event or medical error. Using quantitative survey analysis, we aim to better understand the personal factors that affect SVS development and recovery.

Methods: Caregivers at a small urban academic medical center who had experienced an adverse patient event in the past six months were invited to take part in this institution-wide, voluntary, quantitative, cross-sectional study. Three surveys were administered; the Holmes-Rahe Life Stress Inventory (HRLSI) was used as a surrogate to measure stressful life events. The …

Mexican Americans' Perspectives On "Borderline Diabetes" In Amarillo, Texas, Priscella Pena-Correa

Nursing ETDs

The purpose of this study was to explore the meaning of and experiences living with “borderline diabetes” among Mexican American adults residing in or around Amarillo, Texas. Sixteen Mexican Americans who self-identified as having “borderline diabetes” participated. Research questions focused on how participants understood the condition, self-care practices, and recommendations for improving prediabetes healthcare and education. An interpretive description approach was used to analyze data from phone interviews. Principal findings revolved around issues of disclosure vs. secrecy, information seeking, and challenges or “struggle” to change lifestyle, particularly diet. Self-care was managed in a relational way with support of family, friends, …

Continuous Glucose Monitoring And Diabetes Management During Pregnancy, Nicole Beamish

Doctor of Nursing Practice (DNP) Projects

Continuous Glucose Monitoring and Diabetes Management During Pregnancy

Abstract

According to the Scope of Practice, Standards of Practice, and the Standards of Professional Performance for Diabetes Educators, registered nurses play an integral role in the promotion of diabetes self-management education and training in diabetes care (AADE, 2017). This paper upholds the standards set forth by the American Association of Diabetes Educators (2017) governing body, to stimulate the process of peer review, promote documentation of the outcomes of diabetes self-management education and training (DSME/T), encourage research to validate practice and improve quality DSME/T and diabetes care for pregnant women who use …

Relationship Between Diabetic Self-Management Education And Microvascular Complications In Adults With Type Ii Diabetes: An Integrative Review, Emily Hallberg

Master of Science in Nursing Final Projects

Aims. The aim of this integrative review is to explore the impact of diabetic self-management education on reduction or delay in progression of microvascular complications in adults age 18 and older.

Background. According to the Center of Disease Control, more than 34 million Americans have diabetes. Between 90 and 95% of them have type II diabetes making it the most prevalent type of diabetes. Microvascular complications are a sad reality for people diagnosed with diabetes with poor glycemic control. Microvascular complications of diabetes are long term complications that affect small blood vessels including neuropathy, nephropathy and retinopathy. These microvascular complications …

Nurse Interrupted: Educating Nurses To Reduce Work Interruptions In The Intensive Care Unit, Lelayitu Shiferaw

Master's Projects and Capstones

Background: Interruptions occur in high frequency in the critical care hospital setting.

The purpose of this study is to understand the impact of work interruption for the critical care nurse and to examine ways to mitigate predominant, non-urgent interruptions.

Methods: The nurse interrupted project followed the Lean methodology framework to identify which high-frequency interrupters to address. Baseline assessment of the intensive care unit (ICU) nurses identified alarms and patient family member calls as predominant causes of interruption. A literature review was conducted to understand work interruption for nurses and to identify available solutions.

Intervention: To address the …

Aiming For Zero: Creating A Culture Of Safety And Improving Cauti Outcomes In The Microsystem, Shiela Escobar

Master's Projects and Capstones

Abstract

Problem: Catheter-associated urinary tract infection (CAUTI) remains the leading cause of hospital-acquired infection (HAI) despite being preventable. CAUTI increases the length of stay, morbidity, mortality, readmissions, and costs. There is also increasing antimicrobial resistance in pathogens causing CAUTI. Thus, reducing HAIs such as CAUTI should be a priority for every institution.

Context: The microsystem for this CAUTI quality improvement project is a 24-bed adult medical-telemetry unit in an acute care teaching hospital with excessive CAUTI. This project aims to improve the unit’s CAUTI standardized infection ratio (SIR) from a baseline of 2.54 to 1.75 by October 2020. A SIR …

Managing Hypertension With Lifestyle Modifications, Ladonna D. Willis

MSN Capstone Projects

Cardiovascular disease has taken the lives of millions of Americans, specifically, African Americans who do not have access to health care, which leads to morbidity and increased mortality. This benchmark project proposes to provide cardiovascular educational packets to patients who are admitted to the hospital and have been diagnosed with hypertension.

Using The Model For Improvement To Address Invasive Hemodynamic Safety Concerns In Critical Care, Selena Truban

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The use of invasive catheters to monitor hemodynamic readings is common in the critical care setting and requires the use of specialized equipment. Variation in equipment set-up impacts operational efficiency and creates the potential for improper patient treatment based on inaccurate readings. The methodology of setting up and maintaining hemodynamic pressure lines in the critical care units lacked structural and processional measures, creating the potential for patient harm. Multimodal strategies, guided by the Model for Improvement, were used to increase the use of evidence-based methods for setting up and maintaining invasive hemodynamic lines in the critical care units. A …

Decreasing The Fall Rate On A Medical Surgical Unit With An Enhanced Fall Algorithm In The Electronic Medical Record, Natali Sokolovski

Master's Projects and Capstones

This paper summarizes the quality improvement falls prevention project on a Medical-Surgical unit with an Enhanced Fall Algorithm incorporated in the Electronic Medical Record conducted by two Clinical Nurse Leader students of the University of San Francisco.

This project addresses the patient falls events in a San Francisco-Bay Area Hospital on a Medical-Surgical unit. The aim is to decrease the rate of falls on a Medical-Surgical microsystem unit by 50% with an Enhanced Fall Algorithm incorporated into the Electronic Medical Record by June 2021. The patient population consists of general medical surgical patients where many of the patients have an …

Benchmark Project On Interactive Education Class For Osteoporosis Patients, Adrienne N. Johns

MSN Capstone Projects

Research project focusing on providing patients that have been diagnosed with osteoporosis with an non-traditional interactive educational opportunity to better their health and improve quality of life.

Implementation Of A Palliative Care Program In Rural Minnesota, Barbara Lenarz

Nursing DNP Projects

Background: Rural areas have higher percentages of older adults with multiple chronic illnesses yet disparities exist with access to palliative care (PC) in rural areas. Palliative care can improve quality measures that positively impact care and health outcomes.

Objective: The evidence-based project’s (EBP) objective was to implement a community-based PC program in a rural primary care clinic in rural Minnesota, US and evaluate quality metrics to further support program sustainability.

Design: The project developed and implemented a community-based PC program in rural Minnesota. A tool kit was created for use for the site’s care providers and leaders.

Setting/Subjects: …

Eliminating Barriers To Chinese American Diabetic Patients: Implementation Of Diabetic Cantonese Group Visits, Sabrina Wong

Doctor of Nursing Practice (DNP) Projects

Problems: Asian Americans have higher incidence and prevalence of diabetes mellitus type 2 and less preventive care and higher complication rates than the rest of the American population.

Context: According to the National Healthcare Quality and Disparities Reports (2016), Asian Americans are more likely to be diagnosed with diabetes compared to non-Hispanic whites by over ten percent.

Interventions: A comprehensive group visit program was implemented in a clinic in Oakland, Chinatown catered towards Cantonese-speaking diabetic patients. The group visit included culturally and linguistically appropriate materials related to nutrition, exercise, and diabetes knowledge. Each cohort attended a ninety-minute group visit session …

Exercise To Improve Cancer-Related Fatigue, Jennifer Watson

MSN Capstone Projects

For the average patient, medical professionals typically recommend exercise to enhance the health of their patients in multiple ways. Oncology patients, however, often have different issues that the treating physicians are more concerned about, so physical activity gets placed on the back burner. The need for exercise in oncology patients is certainly a decision that should be part of an individualized treatment plan, but it is reasonable to believe that most of these patients will benefit from participating in an exercise program. With the high demanding need to decrease chemotherapy side effects and improve lives of those undergoing it, this …

Is Anybody Listening?: Factors Affecting Pain Management In Veterans Within An Acute Care Rehab Setting, Laura Oseghae

Doctor of Nursing Practice

Background: In the United States, pain is a widely discussed issue due to the opioid epidemic stemming from a history of pain mismanagement. Clinical guidelines for successful pain management techniques are readily available for providers to incorporate into the individualized patient care plan.

Purpose: The purpose of this project is to improve pain management through implementation of the VA pain management guidelines and improved interdisciplinary team communication.

Objectives: This project aims to decrease the number of patients reporting moderate to severe pain, enhance staff/provider communication, and improve the provider’s overall process for managing pain with an individualized treatment plan.

Interventions: …

Developing An Interdisciplinary Team Checklist To Assess Readiness For Appropriate Medical Removal Of Central Venous Catheter (Cvc), Miranda Harper

Doctoral Projects

Healthcare-associated infections are not a new concept in health care. Many different health-care-associated infections have been established over the years including but not limited to healthcare-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bacterial infection. While these infections are common in healthcare facilities, the rates of these infections are still prevalent in hospitals across the United States. This DNP project focused on central line-associated bacterial infections.

An interdisciplinary team checklist to assess readiness for appropriate medical removal of central venous catheter (CVC) was developed to assess intensive care unit patients for early appropriate medical CVC removal. The interdisciplinary team …

Improving Colorectal Cancer Screening And Testing In A Primary Care Clinic, Leslie Michelle Dubois

Doctor of Nursing Practice

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer-related deaths worldwide (World Health Organization, 2019a). In the United States, CRC was the fourth most common cancer in 2016 (Centers for Disease Control and Prevention, 2019a). The American Cancer Society (2020a) estimated that there will be 147,950 estimated new cases and 53,200 estimated deaths of CRC in the U.S. in 2020. The purpose of the project was to improve CRC screening completion rates and follow up referrals from 27.5% to 35% for adult patients, 50-75 years of age, within a family medicine clinic …