Digital Commons Network^™

Providing A "Good Death": Critical Care Nurses' Suggestions For Improving End-Of-Life Care, Renea L. Beckstrand, Lynn Clark Callister, Karin T. Kirchhoff

Faculty Publications

• Background Providing appropriate end-of-life care has become a primary concern of nurses and the public. The highly technological critical care environment may not facilitate such care.
• Objective To collect suggestions from critical care nurses for improving end-of-life care in intensive care units.
• Methods A geographically dispersed, random sample of 1409 members of the American Association of Critical-Care Nurses was sent a 72-item survey on perceptions of end-of life care. The survey included a request for suggestions on ways to improve end-of life care.
• Results Of the 861 critical care nurses whoo responded to the survey, 485 offered 530 suggestions for …

We Have Arrived!: Magnet Status 2006, Maine Medical Center

Annual Reports

Report on Nursing Research and Outcomes, vol. 2, 2005 & 2006

Women Who Continue Hormone Replacement Therapy Despite Findings From The Women's Health Initiative, Catherine Margaret Greenblum

UNF Graduate Theses and Dissertations

Since the results of the Women's Health Initiative (WHI) study were published in 2002, millions of women and their healthcare practitioners have had to re-examine decisions about the use of hormone replacement therapy. This level one descriptive study explored the characteristics of menopausal women who could not tolerate estrogen withdrawal and continued taking hormone replacement therapy despite findings of risk published in the Women's Health Initiative. The sample included the medical records of 1,195 patients in a single-physician OB-GYN practice in northeast Florida. All records of women with a birth date in 1954 or prior and a visit to the …

Linking Nursing Workload And Performance Indicators In Ambulatory Care, Karen F. Griffin Msn, Rn, Cnaa, Beth Ann Swan Phd, Crnp, Faan

College of Nursing Faculty Papers & Presentations

More and more ambulatory care organizations are using nursing report cards to monitor and evaluate the quality and effectiveness of nursing care in the ambulatory setting.

Nurse staffing levels is usually one of the items included in a nursing report card and the one most scrutinized by ambulatory care administrators.

One strategy employed by the nursing leadership at the South Texas Veterans Healthcare System to justify nurse staffing levels is linking administrative staffing monitors with nurse-sensitive outcomes via workload and performance indicators.

Through this approach, nurse leaders are able to justify nurse staffing level changes, needed technology changes, process improvements, …

Towards Health Informatics 2.0: Blogs, Podcasts And Web 2.0 Applications In Nursing And Health Informatics Education And Professional Collaboration, Peter J. Murray, Margaret M. Hansen Edd, Msn, Rn

Nursing and Health Professions Faculty Research and Publications

Health professionals and students are expected to be proficient in basic information technology so as to mitigate error, communicate effectively, manage information and collaborate with peers. Web 2.0 applications such as blogs, podcasts and wikis are social networking tools that may enhance health professionals' development of such skills. As Web 2.0 application use by health professionals is in its infancy, the purpose of this paper is to present examples of the use of such tools that hold potential for online and mobile information dissemination, knowledge building in education, and professional collaboration. Examples based in a collaborative model of virtual conference …

Factors Associated With Prolonged Prehospital Delay Of African Americans With Acute Myocardial Infarction, Angela D. Banks, Kathleen Dracup

Nursing and Health Professions Faculty Research and Publications

BACKGROUND: Delays in seeking treatment for signs and symptoms of acute myocardial infarction are longer for African Americans than for whites.

OBJECTIVE: To determine factors associated with prolonged delay and the extent to which perceived racism influences prehospital delay in African Americans with acute myocardial infarction.

METHODS: Sixty-one African Americans with acute myocardial infarction were interviewed within 1 month of hospital admission. Delay times were calculated on the basis of the interviews. Independent t tests and chi(2) tests were used to determine factors associated with prolonged delays. RESULTS: Median delay was 4.25 hours and did not differ significantly between women …

Teaching And Learning In Urology Nursing, Karen A. Karlowicz

Ellmer School of Nursing Faculty Publications

No abstract provided.

Validity And Reliability Of The Perceived Readiness For Discharge After Birth Scale, Marianne E. Weiss, Polly Ryan, Lisa Lokken

College of Nursing Faculty Research and Publications

Objective: To assess the psychometric properties of a scale measuring mothers’ perceptions of readiness for discharge after birth.

Design: Psychometric analyses including construct validity using factor analysis and known groups comparisons, predictive validity, and reliability. Data were collected at discharge and 6 weeks postdischarge. Setting: Tertiary-level perinatal center in the Midwestern United States. Participants: 1,462 postpartum mothers. Intervention: None. Main Outcome Measures: Perceived Readiness for Discharge After Birth Scale scores; subscale scores for personal status and knowledge factors.'

Results: Exploratory and confirmatory factor analyses indicated that the scale contained two factors. Perceived Readiness for Discharge After Birth Scale scores were …

The Present State Of Nfp Science, The Challenges We Face, Richard J. Fehring

College of Nursing Faculty Research and Publications

No abstract provided.

The Flame, Winter 2005-2006, Mennonite College Of Nursing

The Flame (1985-present)

The Flame is a newsletter of Illinois State University's Mennonite College of Nursing

A Survey Of Foreign-Educated Nurses: Workforce Experience, Melissa Giegerich

Honors Projects

The United States (US) is currently undergoing a nursing shortage. As a result, many health care agencies in the US and around the world are turning to nurses educated in other countries to fill vacant positions. Despite the increased utilization of foreign-educated nurses, there is a lack of understanding of how these nurses transition into the US workforce. This study describes foreign-educated nurses who work in Illinois and the factors that affected their transition into the US professional nursing workforce. By focusing on nurses who were educated abroad and work in Illinois, this study will help Illinois nurses and Illinois …

Barriers And Facilitators To Prenatal Care For Pregnant Latina Women In Cobb County, Georgia, Carol Holtz, Annette Bairan

Faculty Articles

This research study seeks to identify factors that serve as barriers and/or facilitators to prenatal care for Latina women and to provide data to assist health care providers, health care agencies, and policy makers in developing programs that maximize access to prenatal care for Latina women. In addition, other groups may also find this data useful, such as scholars in Latin American studies, immigration, cultural diversity, minority health care, and health care in general. The research questions consist of the following: (1) What do indigent pregnant (or recently delivered) Latina women believe about prenatal care? (2) What are the barriers …

A Life Disrupted: Still Lived, Judith M. Jarosinski

Theses and Dissertations

This research illustrates the experience of living with hallucinations from the perspective of being, and sought to answer the questions: what is the meaning of hallucinations and how do hallucinations connect to one's sense of self?A phenomenological Heideggerian hermeneutic approach was used to guide data collection and analysis. In this study, 12 individuals with schizophrenia or schizoaffective disorders were asked to describe their experience of hallucinations within the context of being. An overarching constitutive pattern emerged with four themes. The constitutive pattern, "A Life disrupted: Still lived," described a pattern of survival and perseverance on one's own terms; a common …

The Criminal Justice Response To Elder Abuse In Nursing Homes: A Routine Activities Perspective, Brian K. Payne, Randy R. Gainey

Sociology & Criminal Justice Faculty Publications

Politicians and researchers have begun to pay more attention to elder abuse in recent times. Most of the research on elder abuse has focused on cases of abuse perpetrated by family members, treating the phenomenon as a social problem, but it is increasingly being conceptualized as a crime problem. The current study examines elder abuse in nursing homes from a criminological perspective. Using routine activities theory as a guide, particular attention is given to the criminal justice system's response to abusive activities committed by nursing home employees. In all, 801 cases of abuse investigated by Medicaid Fraud Control Units are …

Evaluation Of An Oral Health Training Program For School Nurses, Linda Drengler

Master's Projects

Pediatric dental disease is a silent epidemic (Committee on Health, Education, Labor, and Pensions, 2002). Dental decay is commonly unrecognized and under-treated, and can affect children's growth and development as well as their ability to perform in school. Effective interventions to prevent dental decay include water fluoridation, dental sealants, pediatric dental screenings, and dental health education programs. This pre-experimental design study evaluated the effectiveness of an oral health training program for school nurses. This training program was designed based on the First 5 California <;>ral Health Training Program (2003). A non-randomized sample of fourteen (N=l4) school nurses participated in the …

Evaluation Of An Oral Health Training Program For School Nurses, Kelley Haines-Kolostian

Master's Projects

Pediatric dental disease is a silent epidemic (Committee on Health, Education, Labor, and Pensions, 2002). Dental decay is commonly unrecognized and under-treated. Dental disease can affect children's growth and development as well as their ability to perform in school. Effective interventions to prevent dental decay include water fluoridation, dental sealants, pediatric dental screenings, and dental health education programs. This pre-experimental design study evaluated the effectiveness of an oral health training program for school nurses. This training program was designed based on the First 5 California Oral Health Training Program, First Smiles (First Smiles Program of California, 2003). The presentation was …

Perceptions Of High Risk Behaviors Among Culturally Diverse Adolescents And The Role Of Parental Influence And Parent Communication, Sharlene E. Junio

Master's Projects

Eighty seven ethnically diverse 9th and 1oth graders from an urban high school in Northern California were studied. Students were mostly female, between 14 and 16 years of age, and reported to be mostly Asian and Filipino. Students completed an 18-item Likert scale questionnaire requesting information about their overall relationship with their parents and their communication with their parents about drugs, sex, alcohol, birth control, and personal problems. Results of this study showed that participants rated their overall relationship with their parents as "good" or "very good." Despite this, communication was lacking among parents and adolescents in all topics of …

Job Satisfaction Among Staff Nurses In Mental Health Units In A Va Facility, Edith R. Lombard

Master's Projects

Studies have indicated that work environment in mental health is stressful, however, few studies have focused on staff working in acute mental health settings (Jenkins & Elliott, 2004). The purpose of this study was to describe job satisfaction among a sample of mental health staff nurses who were caring for patients with acute psychiatric disorders in a federal hospital. The second purpose was to determine if there were relationships between global job satisfaction and ethnicity, years in the organization, current unit, field of nursing, working with patients with mental disorders and age of staff nurses. An anonymous survey was distributed …

Nurses' Perception Of Family Presence During Resuscitation, Josephine Njoku

Master's Projects

Background Family witnessed resuscitation (FWR) is the concept of allowing family members at bedside during cardiopulmonary resuscitation. Studies have shown that the lack of standard policies by hospitals regarding FWR forces nurses to make different decisions regarding family presence at bedside during resuscitation. The framework for this study is Sandman's teleological model. Objectives To examine nurses' perceptions of having family members present during adult cardiac resuscitation. Methods A descriptive study of 57 registered nurses (n = 57) from northern California was conducted. Participants completed a mailed survey consisting of a 22-item Likert scale questionnaire titled "Family Presence Risk-Benefit Scale." Results …

Nurse's Perceptions Of Causes Of Medication Errors And Barriers To Reporting, Virginia M. Ulanimo

Master's Projects

Objective: To describe medical-surgical nurses' perceptions of frequent causes of medication errors, of what constitutes a medication error, and of what are the barriers and empowerments to reporting. The study also explored the nurses' perceptions of the effect of physician order entry (POE) and barcode medication administration (BCMA) on medication errors. Background: Causes of medication errors have been investigated by numerous researchers in an attempt to determine safe medication administration process. Information technology (IT) systems enhance patient safety. No published studies were found on nurses' perceptions of medication errors in a setting with IT systems in place. Method: A descriptive …

Evaluation Of The Effectiveness Of A Diabetes Managment Training Program For Unlicensed Assistive Personnel In Schools, Elaine M. Gomer

Master's Projects

This study evaluated the diabetes management-training program for unlicensed assistive personnel (UAP). The purpose of the program was to prepare UAP to recognize and respond to the health care needs of students diagnosed with diabetes mellitus. Twenty UAP participated. Teaching strategies were based on Albert Bandura' s social learning theory~ Two instruments were administered before and after the program. One was a 1 0-question survey addressing self-efficacy; the other was a 10 question multiple-choice test measuring knowledge of diabetes. Results of paired t tests indicate consistent and significant improvement in both perceptions of self-efficacy and knowledge (p < .05). This program provides a framework for school nurses training UAP that assist in the health care of students with diabetes. It is important that school nurses capitalize on the contribution that informed confident UAP might contribute to the provision of safe quality care to students with diabetes.

Psychometric Evaluation Of The Shared Care Instrument In A Sample Of Home Health Care Family Dyads, Margaret Sebern

College of Nursing Faculty Research and Publications

Researchers have studied negative effects of caregiving on a family caregiver; however, less is known about positive aspects of exchanging assistance for both members of a family caregiving dyad. In a previous naturalistic inquiry the author indentified a basis for studying caregiving interactions was a construct called shared care. The three components of shared care identified in the naturalistic inquiry were communication, decision making, and reciprocity. The Shared Care Instrument (SCI) was developed to measure the construct. The purpose of this study was to assess the psychometric properties of the SCI, and to assess its construct and criterion-related validity. A …

Nursing Education And Service Collaboration: Making A Difference In The Clinical Learning Environment, Sheri P. Palmer, Amy Harmer Cox, Lynn Clark Callister, Vickie Johnsen, Geraldine Matsumura

Faculty Publications

This article focuses on innovative collaborative steps that were identified in recent research conducted by these authors on the relationship between academia and service. These steps are currently being implemented in the hope of improving the important role that the critical environment plays in student nurses' education. Few factors in nursing education are as important as the clinical environment in which students do their training. This article elaborates on these steps and offers practical suggestions for improving the relationship between academia and service.

A Systematic Review Of Mammography Educational Interventions For Low-Income Women, Tatiana Bailey, Jorge Delva, Kimberlee A. Gretebeck, Kristine Siefert, Amid I. Ismail

College of Nursing Faculty Research and Publications

Objective

We conducted a systematic review to examine the effectiveness of educational interventions in increasing mammography screening among low-income women.

Data Sources

Bibliographic databases, including MEDLINE, The Cochrane Central Register of Controlled Trials, The Cochrane Database of Systematic Reviews, and the ISI Web of Science, were searched for relevant articles.

Study Inclusion and Exclusion Criteria

Randomized, community-based trials targeting low-income women and published between January 1980 and March 2003 were included.

Data Extraction

The search yielded 242 studies; 24 met all inclusion criteria.

Data Synthesis

Three studies used mammography vans, three used low-cost vouchers or provided free mammograms, three used …

Experts Recommend Strategies For Strengthening The Use Of Advanced Practice Nurses In Nursing Homes., Mathy Mezey, Sarah Greene Burger, Harrison G Bloom, Alice Bonner, Mary Bourbonniere, Barbara Bowers, Jeffrey B Burl, Elizabeth Capezuti, Diane Carter, Jacob Dimant, Sarah A Jerro, Susan C Reinhard, Marilyn Ter Maat

College of Nursing Faculty Papers & Presentations

In 2003, The John A. Hartford Foundation Institute for Geriatric Nursing, New York University Division of Nursing, convened an expert panel to explore the potential for developing recommendations for the caseloads of advanced practice nurses (APNs) in nursing homes and to provide substantive and detailed strategies to strengthen the use of APNs in nursing homes. The panel, consisting of nationally recognized experts in geriatric practice, education, research, public policy, and long-term care, developed six recommendations related to caseloads for APNs in nursing homes. The recommendations address educational preparation of APNs; average reimbursable APN visits per day; factors affecting APNs caseload …

Shared Care, Elder And Family Member Skills Used To Manage Burden, Margaret Sebern

College of Nursing Faculty Research and Publications

Aim. The aim of this paper is to further develop the construct of Shared Care by comparing and contrasting it to related research, and to show how the construct can be used to guide research and practice.

Background. While researchers have identified negative outcomes for family caregivers caused by providing care, less is known about positive aspects of family care for both members of a family dyad. Understanding family care relationships is important to nurses because family participation in the care of chronically ill elders is necessary to achieve optimal outcomes from nursing interventions. A previous naturalistic inquiry …

Cigarette Smoking Among Low-Income African Americans: A Serious Public Health Problem, Jorge Delva, Marisol Tellez, Tracy L. Finlayson, Kimberlee A. Gretebeck, Kristine Siefert, David R. Williams, Amid I. Ismail

College of Nursing Faculty Research and Publications

Background

This study examines the current prevalence of cigarette smoking and the number of cigarettes smoked in a community-based sample of 1021 low-income African-American men and women.

Methods

Participants were selected using a two-stage, area probability sample design. Data were collected in 2002–2003 in face-to-face interviews and analyzed in 2005. All data and analyses were weighted to account for the complex sampling design.

Results

Fifty-nine percent of men and 41% of women were current smokers, with younger individuals apparently initiating smoking at an earlier age than older individuals.

Conclusions

The high prevalence of cigarette use provides further evidence that the …

Providing End-Of-Life Care To Patients: Critical Care Nurses' Perceived Obstacles And Supportive Behaviors, Renea L. Beckstrand, Karin T. Kirchhoff

Faculty Publications

• Background Critical care nurses care for dying patients daily. The process of dying in an intensive care unit is complicated, and research on specific obstacles that impede delivery of end-of-life care and/or supportive behaviors that help in delivery of end-of-life care is limited.
• Objective To measure critical care nurses' perceptions of the intensity and frequency of occurrence of (1) obstacles to providing end-of-life care and (2) supportive behaviors that help in providing end-of-life care in the intensive care unit.
• Methods An experimental, posttest-only, control-group design was used. A national, geographically dispersed, random sample of members of the American Association of …

Measuring Nurse Workload In Ambulatory Care, Beth Ann Swan Phd, Crnp, Karen F. Griffin Msn, Rn, Cnaa

College of Nursing Faculty Papers & Presentations

Nurses and adequate nurse staffing are critical to the delivery of safe, cost-effective, and quality patient care in every health care setting.

This has been proven time and again through various research studies and recognized by various accrediting bodies such as JCAHO.

However, the information available on required or optimal ambulatory care nurse staffing is limited and varies across ambulatory care settings.

An overview of instruments for measuring nursing workload in ambulatory care, a critical prerequisite when identifying best nurse staffing models for diverse ambulatory care settings, is provided.

Impact Of An Adherence Program On The Health And Outlook Of Hiv-Infected Patients Failing Antiretroviral Therapy, Michael F. Parry, Pamela Wright, Julie G. Stewart, Gavin Mcleod, James Tucker, Amy R. Weinberg

Nursing Faculty Publications

Background: We prospectively studied the impact of an adherence counselor on the outcome of patients failing antiretroviral therapy because of nonadherence. Methods: Forty-six patients, identified as chronically nonadherent were enrolled. Individual attention was provided using the information, motivation and behavioral methodology. HIV RNA (viral load, in copies/mL), CD4 count (in cells/[mm.sup.3]), and body weight before and after the adherence counselor were measured. Qualitative outcome and patient satisfaction were assessed by deidentified third-party interviews. Results: Over half completed at least 1 year; only 8 patients were lost to follow-up. Mean CD4 counts increased significantly (P < .05) for completers at 6 and 12 months. Viral loads decreased between baseline and 6 months. Most clients reported subjective benefit from working with the adherence counselor. Conclusion: Although few clients showed complete virologic suppression, the value of an adherence counselor was validated. Longer term adherence programs should be evaluated.