Digital Commons Network^™

Testing A New Creighton Competency Evaluation Instrument For Pediatric Nursing, Elizabeth Anne Flasch

Dissertations (1934 -)

A descriptive multi-site correlational study design was used to test a modified instrument to determine its ability to assess students consistently across settings using a group of prelicensure pediatric students enrolled in two different pediatric clinical environments. Two participant groups were intentionally recruited including clinical instructors teaching in pediatric clinical environments and their corresponding students practicing in pediatric simulation and traditional clinical environments. Inter-rater reliability of the instrument was achieved. Prelicensure nursing students were deemed competent in the care of children across settings. No statistically significant correlations were found between environments. There was a relationship between student perception of confidence …

Supporting Discharge Preparation For Children With Medical Complexity: A Scoping Review, Emily Moore, Mia Waldron, Darlene Acorda, Cara Gallegos, Barbie Giambra, Stacee M. Lerret, Christine R. Platt, Danielle A. Sarik, Zara Sajwani-Merchant, Nesibe Sumeyye Kutahyalioglu, Pamela Gampetro, Susan Groshong, Marianne Weiss, Teri L. Hernandez, Sandra Staveski

College of Nursing Faculty Research and Publications

Background

The transition from hospital to home is a critical period for children with medical complexity (CMC) and their caregivers, often associated with increased risks and stress. Both registered nurses and advanced practice nurses play a pivotal role in facilitating this transition through discharge preparation, including planning, coordination, and teaching. However, best practices for optimizing discharge processes for CMC remain unclear. The need for a comprehensive understanding of hospital discharge during this crucial time is apparent as adverse events following discharge are common and are often attributed to insufficient preparation and communication. This scoping review aims to identify key nursing …

Natural Health Community Program And Well-Being: An Uncontrolled Study Of Women Survivors Of Domestic Violence, Madeline M. Glawe, Lee Za Ong, Karisse A. Callender, Barbara Wesson, Erin C. Schubert

College of Education Faculty Research and Publications

The purpose of this study was to evaluate a local natural healing service program and to explore how engagement in natural healing services related to the well-being of survivors of domestic violence. Using longitudinal secondary data, we conducted t-tests, regression, and correlation analysis on three measures (hope, distress, and empowerment) that were completed by the participants (N = 31). We provided evidence of the positive impact of a community-based natural healing services program on the well-being of survivors of domestic violence, specifically their sense of hope. This research represents the potential for natural healing services provided at the …

Pediatric Respite Homes: A Call To Action, Amy S. Porter, Jennifer M. Snaman, Jonathan Cottor, Kim Whitmore, Joanne Wolfe

College of Nursing Faculty Research and Publications

Approximately 1 million children with medical complexity (CMC) live in the United States, and although their health care needs comprise 40% of child health costs, most of their care is provided at home by their parents and other family caregivers. Around-the-clock care encompasses direct medical care, including administration of medications and nutrition, care coordination and supplies management, emotional work of vigilance and worry, financial planning, and more. This intensive caregiving offers meaning and joy for many of those parents, yet its constancy can threaten their emotional well-being, physical health, and financial security, presumedly negatively influencing their capacity to provide care …

Organizational Commitment Of Korean American Nurses: A Cross-Sectional Study, Myunghee Jun, Hye-Kyung Kim, Sungsu Kim, Michael Wreen, Yeon Hee Kim, Christine L. Vandenhouten, Soo Ii Shin

Philosophy Faculty Research and Publications

Background:

Studies on reducing the turnover of foreign-educated nurses (FENs) can help address the nursing shortage in the United States. Organizational commitment and associated factors have been explored in relation to lower turnover. Nursing researchers have identified job satisfaction, psychological contract breach, person-organization fit, and person-work setting fit as major factors in enhancing nurses’ organizational commitment. Research on the organizational commitment of Korean American (KA) nurses would provide insights into reducing turnover among FENs.

Objectives:

This study identifies some of the key factors that significantly enhance the organizational commitment of KA nurses.

Methods:

A cross-sectional study conducted with a survey …

Outpatient Physical Therapy Attendance By Older Adults After Emergency Department Discharge Was A Predictor For Lower 30-Day Revisits—But Demographic Factors Affected Attendance, Suzanne Ryer, Michelle Simpson, Maharaj Singh

College of Nursing Faculty Research and Publications

Objective

Given the high risk of functional loss and revisits among older adults presenting to the emergency department (ED), there is a need to understand how post-ED discharge outpatient physical therapy affects outcomes. This study sought to examine patient demographics and their association with outpatient physical therapy utilization after ED discharge and physical therapy attendance with 30-day ED revisits among older adults discharged to home.

Methods

In this retrospective cohort study, we analyzed data from 1395 older adults (65 years old and older) who had a referral to outpatient physical therapy upon discharge from 15 EDs between January 2021 and …

Resilience As Accusation: A Critical Examination Of Individual Resilience Training For Burnout Mitigation, Jacqueline Christianson, Bonnie Sommers-Olson, Jessica Leiberg, Dana Kaminstein

College of Nursing Faculty Research and Publications

Burnout, a syndrome of work-related exhaustion and cynicism, is prevalent among nurses and is associated with workplace stressors. Resilience training programs are a prevalent method of burnout mitigation employed by healthcare institutions that aim to improve or alter how individuals respond to chronic stressors. Through the lens of General Systems Theory, we describe resilience training as a method of individualizing a systemic problem by problematizing a response to chronic stress exposure. Resilience training may furthermore serve as a mechanism which allows subversion of institutional responsibility for nurses’ well-being in the workplace. We describe several suggestions for nurses to resist being …

Mesenchymal-Type Genetic Mutations Are Likely Prerequisite For Glioblastoma Multiforme To Metastasize Outside The Central Nervous System: An Original Case Series And Systematic Review Of The Literature, Bryce J. Laurin, Randall Treffy, Jennifer M. Connelly, Michael Straza, Wade Mueller, Max O. Krucoff

Biomedical Engineering Faculty Research and Publications

Background

Glioblastoma Multiforme (GBM) is the most aggressive and prevalent type of malignant brain tumor, yet it metastasizes outside the central nervous system (CNS) in only 0.4% of cases. Little is known about what enables this subset of GBMs to take root outside the CNS, but genetic mutations likely play a role.

Methods

We conducted a PRISMA-compliant systematic review of metastatic GBM wherein we reviewed 3579 search results and 1080 abstracts, analyzing data from 139 studies and 211 unique patients. In addition, we describe 4 cases of patients with pathologically confirmed GBM metastases outside the CNS treated at our institution. …

Impact Of Social Risk Screening On Discharge Care Processes And Postdischarge Outcomes A Pragmatic Mixed-Methods Clinical Trial During The Covid-19 Pandemic, Andrea S. Wallace, Alycia A. Bristol, Erin Phinney Johnson, Catherine E. Elmore, Sonja E. Raaum, Angela Presson, Kaleb Eppich, Mackenzie Elliott, Sumin Park, Benjamin S. Brooke, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background: 

Social risk screening during inpatient care is required in new CMS regulations, yet its impact on inpatient care and patient outcomes is unknown.

Objectives: 

To evaluate whether implementing a social risk screening protocol improves discharge processes, patient-reported outcomes, and 30-day service use.

Research Design: 

Pragmatic mixed-methods clinical trial.

Subjects: 

Overall, 4130 patient discharges (2383 preimplementation and 1747 postimplementation) from general medicine and surgical services at a 528-bed academic medical center in the Intermountain United States and 15 attending physicians.

Measures: 

Documented family interaction, late discharge, patient-reported readiness for hospital discharge and postdischarge coping difficulties, readmission and emergency department visits …

Ensuring Intervention Fidelity Of An Attention Control Arm In A Multisite Randomized Controlled Trial, Amy R. Newman, Karen M. Moody, Kerri Becktell, Erin Connelly, Cynthia Holladay, Katie Parisio, Jonathan L. Powell, Verna L. Hendricks-Ferguson

College of Nursing Faculty Research and Publications

Background

Intervention fidelity is a critical element of randomized controlled trials, yet reporting of intervention fidelity among attention control arms is limited. Lack of fidelity to attention control procedures can affect study outcomes by either overestimating or underestimating the efficacy of the intervention under examination.

Objectives

This brief report describes the approach researchers took to promote fidelity to the attention control arm of a pediatric palliative care randomized controlled trial funded by the National Institutes of Health.

Methods

The Informational Meetings for Planning and Coordinating Treatment trial aims to determine the efficacy of a communication intervention that uses care team …

Fostering Flexibility: How Medicare Advantage Potentially Accelerated Telehealth Benefits, Lisa M. Grabert, Grace Mccormack, Erin Trish, Kathryn L. Wagner

Economics Faculty Research and Publications

In 2018, the US Congress enacted a policy permitting Medicare Advantage (MA) plans to cover telehealth services in a beneficiary’s home and through audio-only means as part of the basic benefit package of services, where prior to the policy change such benefits were only allowed to be covered as a supplemental benefit. MA plans were afforded 2 years of lead time for strategizing, negotiating, and capital investment prior to the start date (January 1, 2020) of the new coverage option. Our data analysis found basic benefit telehealth was offered by plans comprising 71% of enrollment in 2020 and increased to …

Home Health Nurses For Children With Invasive Mechanical Ventilation (Imv): Perspectives On Gaps And Opportunities For Recruitment, Sarah A. Sobotka, Emma Lynch, Sarah Laudon, Kim Whitmore

College of Nursing Faculty Research and Publications

Background

Children with medical complexity (CMC) dependent on invasive mechanical ventilation (IMV) often require private duty home nursing; however, there are ubiquitous shortages. Home health is an especially vulnerable nursing sector because of less competitive wages and less prominence during nursing education. We sought to understand nurses' perspectives on gaps and opportunities for recruiting home care nurses for children with IMV.

Methods

Home health nurses experienced with children with IMV were recruited for semi-structured interviews. The interview guide served as the initial codebook which was iteratively modified as themes emerged. This study presents an analysis of quotes related to field …

Palliative Care Interventions Among Adolescents And Young Adults With Serious Illness: A Scoping Review, Amy R. Newman, Ansley E. Kenney, Elizabeth Witkowski, Jeffrey Karst, Stacee Lerret, W. Hobart Davies, Charles B. Rothschild

College of Nursing Faculty Research and Publications

Objective:

To map the range of multidisciplinary palliative care interventions that are available to adolescents and young adults (AYAs) with serious illness.

Methods:

Scoping review methodology as outlined by Arksey and O’Malley.

Results:

Twenty-two articles describing nine specific AYA-focused, multidisciplinary palliative care interventions were included in this review. Interventions focused on supporting advance care planning, facilitating treatment decision making, managing pain, and promoting resilience, psychosocial well-being, and quality of life. Interventions were delivered face-to-face and via different eHealth platforms and were targeted to AYAs with cancer, HIV/AIDS, and cystic fibrosis in both inpatient and outpatient settings.

Conclusions:

Few evidence-based multidisciplinary …

Work-Related Burnout, Compassion Fatigue, And Nurse Intention To Leave The Profession During Covid-19, Jacqueline Christianson, Norah L. Johnson, Amanda Nelson, Maharaj Singh

College of Nursing Faculty Research and Publications

The purpose of this mixed-method study was to understand the relationships between work-related burnout (WRB), compassion fatigue (CF), and intention to leave the nursing profession. The Job Demands-Resources model was used to predict intention to leave as a function of WRB, CF, and caring for COVID-19 patients in a sample of 1299 US nurses. Greater WRB and CF scores were associated with intention to leave the profession. Contrary to prior research, working with COVID-19 patients was associated with greater intention to stay in nursing. Personal finances may represent the rationale for nurses to choose to stay nurses despite burnout.

Nonlinear Association Of Nurse Staffing And Readmissions Uncovered In Machine Learning Analysis, Olga Yakusheva, James Bang, Ronda G. Hughes, Kathleen L. Bobay, Linda L. Costa, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Objective: Several studies of nurse staffing and patient outcomes found a curvilinear or U-shaped relationship, with benefits from additional nurse staffing diminishing or reversing at high staffing levels. This study examined potential diminishing returns to nurse staffing and the existence of a "tipping point" or the level of staffing after which higher nurse staffing no longer improves and may worsen readmissions.

Data Sources/Study Setting: The Readiness Evaluation And Discharge Interventions (READI) study database of over 130,000 adult (18+) inpatient discharges from 62 medical, surgical, and medical-surgical (noncritical care) units from 31 United States (US) hospitals during October 2014-March 2017.

Study …

A Scoping Review Of The Experiences Of Adolescents And Young Adults In The Icu, Their Family Members, And Their Health Care Team, Natalie S. Mcandrew, Jeanne Erickson, Jill L. Guttormson, Alexandrea Bear, Sean Marks, Jayshil Patel, Eric Harding

College of Nursing Faculty Research and Publications

No abstract provided.

Complete (Communication Plan Early Through End Of Life): Development Of A Research Program To Diminish Suffering For Children At End Of Life, Verna L. Hendricks-Ferguson, Amy R. Newman, Katharine E. Brock, Joan E. Haase, Jennifer L. Raybin, Shermini Saini, Karen M. Moody

College of Nursing Faculty Research and Publications

While overall survival has improved significantly for children with cancer over the past 75 years, cancer remains the leading cause of death from disease among children and adolescents. Further, despite the many advances in medical and nursing care, children with cancer still experience significant physical and emotional suffering over the course of their illness, especially at the end of life (EOL). Children endure significant rates of high-intensity medical interventions (e.g., intubation, intensive care unit admission) at the EOL despite many parents, adolescents, and young adult patients identifying home as their preferred location of death. Hospice care has the potential to …

Examining The Course Of Transitions From Hospital To Home-Based Palliative Care: A Mixed Methods Study, Stephanie Saunders, Marianne E. Weiss, Chris Meaney, Tieghan Killackey, Jaymie Varenbut, Emily Lovrics, Natalie Ernecoff, Amy T. Hsu, Maya Stern, Ramona Mahtani, Kirsten Wentlandt, Sarina R. Isenberg

College of Nursing Faculty Research and Publications

Background:

Hospital-to-home transitions in palliative care are fraught with challenges. To assess transitions researchers have used patient reported outcome measures and qualitative data to give unique insights into a phenomenon. Few measures examine care setting transitions in palliative care, yet domains identified in other populations are likely relevant for patients receiving palliative care.

Aim:

Gain insight into how patients experience three domains, discharge readiness, transition quality, and discharge-coping, during hospital-to-home transitions.

Design:

Longitudinal, convergent parallel mixed methods study design with two data collection visits: in-hospital before and 3–4 weeks after discharge. Participants completed scales assessing discharge readiness, transition quality, and …

Effectiveness Of Home Health Care In Reducing Return To Hospital: Evidence From A Multi-Hospital Study In The Us, Danielle M. Siclovan, James Bang, Olga Yakusheva, Morris Hamilton, Kathleen L. Bobay, Linda L. Costa, Ronda G. Hughes, Jane M. Miles, Sarah J. Bahr, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background

Home health care, a commonly used bridge strategy for transitioning from hospital to home-based care, is expected to contribute to readmission avoidance efforts. However, in studies using disease-specific samples, evidence about the effectiveness of home health care in reducing readmissions is mixed.

Objective

To examine the effectiveness of home health care in reducing return to hospital across a diverse sample of patients discharged home following acute care hospitalization.

Research design

Secondary analysis of a multi-site dataset from a study of discharge readiness assessment and post-discharge return to hospital, comparing matched samples of patients referred and not referred for home …

Providing Palliative And Hospice Care To Children, Adolescents And Young Adults With Cancer, Kimberly A. Pyke-Grimm, Beth Fisher, Amy Haskamp, Cynthia J. Bell, Amy Rose Newman

College of Nursing Faculty Research and Publications

Objectives

To describe palliative, concurrent, and hospice care in pediatric oncology in the United States (US), we present a clinical scenario illustrating palliative and hospice care, including eligibility for concurrent care, insurance coverage and billing, barriers to accessing quality pediatric palliative and hospice care, and implications for oncology nursing practice.

Data Sources

Peer-reviewed articles, clinical practice guidelines, professional organizations, and expert clinical opinion examining pediatric oncology, palliative care, and hospice care.

Conclusion

Understanding the goals of palliative and hospice care and the differences between them is important in providing holistic, goal-directed care.

Implications for Nursing Practice

Oncology nurses play …

Using A Four-Phased Process When Implementing A Multisite Simulation Study, Aimee A. Woda, Kristina Dreifuerst, Jamie Hansen

College of Nursing Faculty Research and Publications

Multisite simulation studies are critical in nursing research as they allow researchers to obtain larger sample sizes, however, many components need to be addressed to ensure adequate compliance with research protocols. Multisite studies are important in research as they help promote generalizability. Many components go into successfully conducting multisite simulation studies. The purpose of this paper is to describe how the four-phase process of planning, project development, study execution, and dissemination of study findings were contributed to the success of this multisite simulation study. Locating sites that met inclusion criteria, keeping consistent communication with all sites, and ensuring that participants …

Intensive Care Unit Nurse: Could We Call A Palliative Care Consult? Intensive Care Unit Provider: It's Too Early. Palliative Care Integration In The Intensive Care Unit: The Struggle To Translate Evidence Into Practice, Natalie S. Mcandrew, Jill L. Guttormson, Sean Marks, Mary Rhodes, Jayshil Patel, Colleen Mccracken

College of Nursing Faculty Research and Publications

Despite evidence regarding the value of palliative care, there remains a translation-to-practice gap in the intensive care setting. The purpose of this article is to describe challenges and propose solutions to palliative care integration through the presentation and discussion of a critical care patient scenario. We also present recommendations for a collaborative palliative care practice framework that holds the potential to improve quality of life for patients and families. Collaborative palliative care is characterized by close working relationships with families, interprofessional intensive care unit healthcare teams, and palliative care specialists. The shortage of palliative care specialists has become a pressing …

Nurse Continuity At Discharge And Return To Hospital, Sarah J. Bahr, James Bang, Olga Yakusheva, Kathleen L. Bobay, Janet W. Krejci, Linda L. Costa, Ronda G. Hughes, Morris Hamilton, Danielle M. Siclovan, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background Promoting continuity of nurse assignment during discharge care has the potential to increase patient readiness for discharge—which has been associated with fewer readmissions and emergency department visits. The few studies that examined nurse continuity during acute care hospitalizations did not focus on discharge or postdischarge outcomes. Objectives The aim of this research was to examine the association of continuity in nurse assignment to patients prior to hospital discharge with return to hospital (readmission and emergency department or observation visits), including exploration of the mediating pathway through patient readiness for discharge and moderating effects of unit environment and unit nurse …

Modeling Heart Failure Predictive Mortality In Skilled Nursing Facilities, Stephen Charles Biondi

Dissertations (1934 -)

Problem: Approximately 25% of skilled nursing facility (SNF) patients are diagnosed with heart failure (HF). The heart failure mortality trajectory is non-linear and there are no useable mortality models from clinical records for use by healthcare providers in the SNF setting. A mortality risk model for patients with HF is important so that palliative care interventions may be offered to improve patients’ quality of life during the end stages of dying. Assessment items captured routinely by the SNF Resident Assessment Instrument –Minimum Data Set 3.0 (RAI-MDS) instrument may be useful in identifying those patients whose declining condition warrants discussion of …

Advance Directives And Intensity Of Care Delivered To Hospitalized Older Adults At The End-Of-Life, Marsha Helen Tyacke, Jill L. Guttormson, Mauricio Garnier-Villarreal, Kathryn Schroeter, Wendy Peltier

College of Nursing Faculty Research and Publications

Background

Older adults prefer comfort over life-sustaining care. Decreased intensity of care is associated with improved quality of life at the end-of-life (EOL).

Objectives

This study explored the association between advance directives (ADs) and intensity of care in the acute care setting at the EOL for older adults.

Methods

A retrospective, correlational study of older adult decedents (N = 496) was conducted at an academic medical center. Regression analyses explored the association between ADs and intensity of care.

Results

Advance directives were not independently predictive of aggressive care but were independently associated with referrals to palliative care and hospice; however, …

Foundations In Wisconsin: A Directory (39th Ed. 2020), Mary C. Frenn, John Brick, Kelly Coughlin, Madeline Murphy, Catherine Simmerer

Foundations in Wisconsin: A Directory

The 2020 publication of Foundations in Wisconsin is the 39^th edition of the print directory and the 20^th year of the online database. The directory is designed as a research tool for grantseekers interested in locating information on private, corporate, and community foundations registered in Wisconsin. Each entry in this new edition has been updated or reviewed to provide the most current information available. Most of the data was drawn from IRS 990-PF tax returns filed by the foundations. Additional information was obtained from surveys, foundation websites, and annual reports.

Wisconsin foundations showed continued growth in both the …

The Nurse’S Role In Prognosis-Related Communication In Pediatric Oncology Nursing Practice, Amy Rose Newman, Lauri Linder, Kristin Haglund

College of Nursing Faculty Research and Publications

The experiences of pediatric oncology nurses with prognosis-related communication (PRC) remain largely unknown. The purpose of this article is to report results of focus groups wherein 15 pediatric oncology nurses from three Midwestern pediatric cancer programs provided descriptions of PRC and how they experience PRC within their daily practice. Data from focus groups were analyzed via an interpretive descriptive approach, which resulted in three themes: (1) nurses’ operational definition of PRC, (2) nurses’ roles in PRC, and (3) nurses’ preparation for engagement in PRC. From discussions within the focus groups, nurses recognized that PRC occurs across a continuum. Nurses distinguished …

The Bundled Hospital Elder Life Program—Help And Help In Home Care—And Its Association With Clinical Outcomes Among Older Adults Discharged To Home Healthcare, Michelle Simpson, Jonny Macias Tejada, Amy Driscoll, Maharaj Singh, Matthew Klein, Michael Malone

College of Nursing Faculty Research and Publications

OBJECTIVES To describe the Bundled Hospital Elder Life Program (HELP and HELP in Home Care), an adaptation of HELP, and examine the association of 30-day all-cause unplanned hospital readmission risk among older adults discharged to home care with and without Bundled HELP. DESIGN Matched case-control study. SETTING Two medical-surgical units within two midwestern rural hospitals and patient homes (home health). PARTICIPANTS Hospitalized patients, aged 65 years and older, discharged to home healthcare with and without Bundled HELP exposure between January 1, 2015, and September 30, 2017. Each case (Bundled HELP, n = 148) was matched to a control (non-Bundled HELP, …

The Benefits And Burdens Of Pediatric Palliative Care And End-Of-Life Research: A Systematic Review, Meaghann S. Weaver, Kim Mooney-Doyle, Katherine Patterson Kelly, Kathleen Montgomery, Amy Rose Newman, Christine A. Fortney, Cynthia J. Bell, Jessica L. Spruit, Melissa Kurtz Uveges, Lori Wiener, Cynthia M. Schmidt, Vannessa N. Madrigal, Pamela S. Hinds

College of Nursing Faculty Research and Publications

Objective: The aim of this study is to report the benefits and burdens of palliative research participation on children, siblings, parents, clinicians, and researchers.

Background: Pediatric palliative care requires research to mature the science and improve interventions. A tension exists between the desire to enhance palliative and end-of-life care for children and their families and the need to protect these potentially vulnerable populations from untoward burdens.

Methods: Systematic review followed PRISMA guidelines with prepared protocol registered as PROSPERO #CRD42018087304. MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and The Cochrane Library were searched (2000–2017). English-language studies depicting the benefits or burdens of palliative …

Sensemaking And Identity In Complementary Alternative Medicine: Communication Study On Reiki, Caroline Reese

Master's Theses (2009 -)

Complementary alternative medicine (CAM) is rising in popularity, in particular, the practice of Reiki. While there is substantial research that focuses on the medical benefits of Reiki, little work has been done that addresses what Reiki means to participants and how it impacts an individual's sense of self. This study seeks to fill that void. To explore this, I argue that Reiki practice should be viewed through a communication lens that draws from theories of identity and sensemaking. Results show that identity is not seen as an individualistic concept but rather as a social process that shifts to a more …