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The Meaning For Elders Of Receiving Family Care, Janice D. Crist

Dissertations

This dissertation reports findings from an interpretive phenomenological study which addressed the question, ";How central, for elders, in their everyday concerns and practices, is the experience of receiving family care?"; The investigator collected data using interviews, observations and questionnaires with a purposive sample of nine elders in their. homes. Data were collected from each elder two to five times.

Findings were that eight of nine elders (1) incorporated both their illness and help from family members comfortably into their lives while still viewing themselves as autonomous; (2) had positive relationships with their family carers; (3) viewed the acceptability of receiving …

Exploration Of Patients' Spiritual/Religious Beliefs And Resuscitation Decisions, Elizabeth A. Freitas

Dissertations

The resuscitation decision, which has the potential to reverse a premature death or prolong the dying process, is complex and can be associated with spiritual/religious beliefs, values, and quality of life. The consequences of the resuscitation decision make it imperative that healthcare providers have an understanding of patients' spiritual/religious beliefs and how those beliefs are associated with their resuscitation decisions. The objective of this study was to determine the associations between hospitalized patients' spiritual/religious beliefs and their resuscitation decisions.

A Cross-Sectional Study To Determine Barriers In The Educational Advancement Of The Licensed Practical Nurse To The Registered Nurse In The State Of North Carolina, Douglas M. Turner

Dissertations

The purpose of this study was to identify barriers that prevent practical nurses in the state of North Carolina from pursuing registered nurse education. A cross-sectional sample of 128 practical nurses completed a modified version of the ";Learning Interests and Experiences of Adult Americans"; (Cross,1981; Powell 1989). A convenience sample of experts in the field of nursing, nursing administration, and nursing education were interviewed to triangulate the data. Logistic regression was used for data analysis.

Two barriers were identified that prevent practical nurses from advancing to registered nurse education in the state of North Carolina: Strict attendance requirements and required …

Informing Cognitive Screening In The Young Adult Population, Samantha L. Mcdaniel

Dissertations

The clock drawing test (CDT) is a cognitive screening measure with sound psychometric properties which has been well researched over the past century. The CDT is a popular tool for many healthcare professionals to administer independently or as part of a more thorough cognitive evaluation. Given the drastic technological and social developments over the years since the CDT was developed as well as the persistent research focus on older adult populations, a gap in the CDT literature presented for young adults, who may have difficulty drawing an analog clock. Identifying cognitive impairment can improve health outcomes. The young adult population …

The Experience Of Nursing Care For Female Medicaid Recipients, Sara K. Kaylor

Dissertations

This phenomenological study is guided by a feminist-informed critical theory for the purpose of exploring the experiences of nursing care for female Medicaid recipients. The goals of this research were to understand how nurses' attitudes and behaviors towards female Medicaid recipients influence the ways in which these patients receive and act upon their health care, and to consider what those understandings suggest for nursing education. Semi-structured interviews with female Medicaid recipients were conducted to understand their experiences of nursing care, and a focus group interview with nurse educators was conducted to consider what those understandings suggest for nursing education.

Current …

The Effect Of An Unfolding Case Study On Critical Thinking, Knowledge Acquisition, And Handoff Communication In Baccalaureate Nursing Students, Antionella M. Upshaw

Dissertations

Miscommunication during handoffs at time of transition for the older adult patient often results in hospital readmissions, penalties and nursing malpractice. Handoff communication (HOC) is a necessary and critical factor in patient safety; therefore, it is imperative that nurses be educated and trained in how to communicate essential geriatric patient data, minimize errors and ensure continuity of care. Nursing researchers report that HOC is a critical responsibility and varies in educational methods creating a latent patient safety risk. The unfolding case study (UCS) is increasingly being used to promote critical thinking and improve communication but lack of evidence to guide …

A Model Of Factors Contributing To Perceived Abilities For Health-Promoting Self-Care Of Community-Dwelling Thai Older Adults, Porntip P. Malathum

Dissertations

The purpose of this descriptive correlational study was to examine factors contributing to perceived abilities for health-promoting self-care of community-dwelling Thai older adults. An integration of selected concepts from Orem's (1995) self-care theory and Bandura's (1997) self-efficacy theory is established to generate a conceptual model for this study. The study variables included age, education, perceived family support, perceived friend support, chronic health problems, functional ability, perceived health status, and perceived abilities for health-promoting self-care.

An Examination Of Faith Community Nursing Interventions In The Promotion Of Successful Aging, Lina B. Hixson

Dissertations

Faith Community Nursing is a specialty nursing practice providing ongoing supportive health care to community dwellers of all ages. Practicing within the context of a community of faith, these nurses focus on health promotion and disease prevention using their expertise to combine spiritual and physical dimensions of care. As the population of Americans continues to age at a rapid rate, the number of older adults is expected to more than double by the year 2060. Many older individuals live with one or more chronic diseases, however living with a chronic disease does not always require inpatient or home care services. …

Family Nurse Practitioners' Use Of Mhealth Apps For Health Promotion With Patients, Rebecca Coyle Mueller

Dissertations

Due to the significant prevalence of chronic illnesses in the United States, engaging patients in health promotion activities is imperative. mHealth apps have the ability to complement the family nurse practitioner's (FNP) prescribed care plan, and offer a user friendly, convenient method to promote healthy behaviors and lessen the prevalence of chronic disease. The purpose of this descriptive, quantitative study was to describe FNPs' intent to use and use of mHealth apps for health promotion with their patients using the Unified Theory of Acceptance and Use of Technology (UTAUT), and to determine the types and frequencies of apps recommended by …

The Lived Experience Of Nurse Practitioners In Independent Practice, Annmarie Waite

Dissertations

The purpose of this qualitative phenomenological study was to explore the lived experience of Nurse Practitioners in independent practice. The aim was to give NPs a voice to express their individual experience, provide an inductive description of the lived experience, and gain understanding of the essence of being an independent practitioner. Philosophical Underpinning: This qualitative study was guided by the hermeneutic phenomenological approach of Max van Manen (1990).

Senior Nursing Students' Knowledge, Attitudes, And Perceived Competency About Older Adults, Deborah Denise Brabham

Dissertations

Nurses entering the workforce may have limited education in gerontological nursing. Therefore, many nurses are unprepared to provide quality care to older adults. An unprepared nursing workforce could negatively influence older adults' health outcomes and care experience.

To determine differences in senior nursing students' knowledge, attitudes, and perceived competency about older adults based on enrollment in a bachelor of science in nursing degree (BSN), associate's degree nursing (ADN), and practical nursing (PN) program that offers geriatric content in curricula.

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice X. Woods

Dissertations

Objective: The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method: A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician's orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

Evaluating Loneliness In An Older Adult Population, Kelli Rowland

Dissertations

Problem: Loneliness and social isolation are severe burdens on global public health and can impair overall health outcomes. Unfortunately, both loneliness and social isolation are prevalent in the older adult population. The purpose of this quality improvement project was to evaluate loneliness in older adults enrolled in a weekly socialization program and its impact on loneliness.

Methods: A descriptive cohort design was utilized to analyze surveys completed three months apart. A convenience sample was used with older adults already enrolled in a weekly socialization program. The Iowa Model of Evidence-Based Practice was applied to evaluate and promote quality …

Simultaneous Experiences Of Type 2 Diabetes And Symptoms Of Depression And/Or Anxiety Among Latina Women 60 And Older, Adrienne S. Martinez-Hollingsworth

Dissertations

Latina older adult women disproportionately suffer from type 2 diabetes (diabetes) and symptoms of depression and/or anxiety. These disease states are associated with serious declines in health outcomes and a three-fold reduction in treatment compliance. Few studies have examined this phenomenon exclusively among Latina older adult women or have captured the impact of intersectional identity on their experiences, values or problem-solving methods related to self-management.

The purpose of this study was to examine how Latina women, 60 and over, emotionally experience both diabetes and interactions with care providers during help-seeking and care engagement.

The_Instaprep_Project: A Social Marketing Intervention On Instagram To Increase Oral Hiv Prophylaxis In Black Men Who Have Sex With Men, James Q. Simmons

Dissertations

Incidence of HIV diagnoses is higher in Black men who have sex with men (BMSM) than any other socio-demographic population in the United States. BMSM account for 26% of all new HIV diagnoses in the U.S. yet make up an estimated 1% of the U.S population. In 2017, Centers for Disease Control and Prevention (CDC) predicted 50% of BMSM would be diagnosed with HIV in their lifetime. Oral HIV pre-exposure prophylactic (PrEP) medications developed to prevent sexual transmission of HIV are 95-99% effective. However, Blacks represent only 10% of PrEP prescriptions. Targeted Social Marketing initiatives on Instagram need to be …

Effectiveness Of The Nurse-Practitioner-Driven Enteral Nutrition Protocol, Jho Mary Tangcora

Dissertations

The delay in initiating enteral feeding (EF) in the critical care unit is known to cause malnutrition which may lead to poor patient outcomes. The purpose of this quasi-experimental quantitative project was to determine if the nurse practitioner (NP)-driven enteral nutrition protocol recommended by the Society of Critical Care Medicine (SCCM) and the American Society for Parenteral and Enteral Nutrition (ASPEN) will psychologically empower the NP toward reducing the delay on initiating EF and lowering the length of stay (LOS) of adult patients an intensive care unit in urban California over four weeks. This project utilized the theoretical foundation of …

Identification Of Primary Care Nurse Practitioner Clinical Procedural Skills Used In Practice: Examination Of Frequency Of Use, Importance Of Skill, And Training For Skill, David R. Want

Dissertations

With primary care NPs functioning in varied settings and roles requiring additional CPS knowledge and skills, NPs have expressed lack of preparedness regarding CPS. Although some evidence identified those CPS considered important to and frequently performed by NPs, the literature provides insufficient evidence to identify the CPS performed most frequently and rated as most important by primary care NPs in practice, and existing curricular standards lack clarity regarding which CPS to include in program curricula. This project aimed to conduct a practice analysis of the most frequently performed and most important CPS to primary care NPs in one region of …

Impact Of Aging Information On The Continuing Education Preferences Of Behavioral Health Clinicians, Nicholas Schmidt

Dissertations

The United States population is aging rapidly and the behavioral health workforce is ill-prepared to meet the concurrent rise in demand for services for older adults. Clinicians specializing in working with older adults make up a very small portion of providers and the majority of service provision falls on general practitioners. The discipline of counseling has emphasized multicultural competencies in training and practice but has not specified standards of competence for work with older adults; little is known about the interests and training preferences of Licensed Professional Counselors (LPCs). This study examined the impact of receiving foundational information about aging …

Mental Health Effects Of The Covid-19 Pandemic On Older Adults, Elizabeth Kerr

Dissertations

Problem: Significant psychological effects such as anxiety, depression, stress, and loneliness are shown to affect the older adult population, aged 65 years and older. The social isolation and disconnectedness related to the COVID-19 pandemic potentially worsens anxious and depressive feelings, increasing the risk for adverse outcomes in the high-risk older adult population. This project aimed to identify older adults at risk for acute, situational mental health issues associated with the pandemic.

Methods: A descriptive study design was used. Telephone interviews were conducted to explore effects of the COVID-19 pandemic on mental health responses in older adults. A convenience sample …

A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad

Dissertations

Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff's minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging …

Evaluation Of Telehealth Training To Teach The Stimulus Identification Questionnaire And Multiple Stimulus Without Replacement, Andrea Perez

Dissertations

The field of behavioral gerontology has seen a paucity in literature within the past 15 years focused on updating training technology and teaching best practice skills to staff. Specifically, there is a need to expand the breadth of training research focus areas could more broadly the elderly population (e.g., increasing engagement), to ensure that trainings are designed to equip caregivers with the skills to be independent, and finally, given the frequent staffing challenges experienced by aging settings (Harrington et al., 2020), to explore effective and efficient training techniques that are alternatives to lengthy, in-person training modalities. Given the personnel challenges, …

Life Satisfaction: Aging Female Informal Caregivers Of Persons With Dementia, Deborah Ann Monson

Dissertations

Purpose/Aims

The purpose of this study was to describe the relationship between aging female informal caregivers of persons with dementia (PWD) and care recipients’ PWD demographic factors, aging female informal caregivers of PWD social support factors, positive and negative feelings, a sense of flourishing, stress, and life satisfaction.

Background/Rationale

Older adults with dementia are living longer and the majority are receiving care by aging female informal caregivers. Dementia incrementally worsens over time impacting informal caregiver life satisfaction. Most studies have focused on negative aspects of informal caregiving. Therefore, this study investigated both positive and negative aspects of caregiving.

Conceptual Basis …

Utilization Of Asthma Guidelines In Primary Care, Kate R. Miller

Dissertations

Background: Chronic lower respiratory disease, including asthma, is the fourth leading cause of death in the U.S. Financially, asthma accounts for approximately 54 billion dollars in healthcare spending annually. The National Heart Lung and Blood Institute [NHLBI] established guidelines to reduce impairment and to reduce future asthma attacks.

Purpose: This Quality Improvement (QI) pilot implemented the Asthma Control Test (ACT) and the Asthma Action Plan (AAP) per NHLBI guidelines. This project aimed to increase provider use of the ACT and AAP to 50% in patients with a diagnosis of asthma over one month.

Methods: A convenience sample of six adult …

Chronicling Resident And Staff Outcomes Throughout The Implementation Of A Professional Nursing Practice Model In One Midwest Continuing Care Retirement Community: A Longitudinal Analysis, Kimberly Michele Bergen-Jackson

Dissertations

This research used a case study approach to chronicle the process of seeking the American Nurse Credentialing Center's Pathway to Excellence in Long-Term Care designation in one Midwest community. The PTE-LTC practice standards framework guided the implementation of professional nursing practice which focused on a positive practice environment, shared decision-making, accountability for resident care, and the leadership development of nursing staff. These practice standards are outlined in the study and incorporated the major components necessary to implement Professional Nursing Practice and Shared Governance in long-term care. The components of the designation process over a five-year period were documented and compared …

Bedside Nurse Recognition Of Delirium In The Medical-Surgical Setting, Bridget Ann Denzik

Dissertations

Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was …

Using Two Reinforcement Contingencies To Alter Teachers' Rates Of Praise, Ashleigh Eaves

Dissertations

The current study evaluated the effects of a positive and negative reinforcement contingency on teachers’ use of behavior specific praise (BSP) in the educational setting. An alternating treatments design was used across four participants in a rural, Southern elementary to determine if one or both conditions was successful in increasing the use of BSP. Data were collected on teachers’ use of BSP, general praise, general reprimands, and behavior specific reprimands (BSR). Additionally, student engagement in academically-associated and/or disruptive behaviors was measured throughout baseline, treatment, and follow-up phases. Results indicate both the positive and negative reinforcement contingency were successful in improving …

Comparing Student Nurse Experiences With Developing Psychiatric Mental Health Nursing Competencies In Hospital And Nursing Homes: A Mixed Methods Study, Maria M. Tice

Dissertations

Tice, Maria M. Comparing Student Nurse Experiences with Developing Psychiatric Mental Health Nursing Competencies in Hospital and Nursing Homes: A Mixed Methods Study. Published Doctor of Philosophy dissertation, University of Northern Colorado, 2020. Nurse educators today face many barriers to attracting and retaining an adequate workforce of nurses to serve two significantly underserved and growing populations: elders and persons with mental illnesses. The primary purpose of this study was to compare and contrast how baccalaureate student nurses’ level of engagement and the perceived quality of the learning environments in inpatient mental health units and nursing homes were related to students’ …

Screening For Delirium In The Emergency Department, Melissa Minks

Dissertations

Abstract

Delirium is a problem for many older adults who are acutely ill. Delirium often comes on suddenly, can be severe, and is often difficult to diagnose, especially in the presence of dementia. Missed delirium has a mortality rate of 30.8% and costs millions. What is the purpose of this study?

Methods The 4A’s Test screening instrument was implemented and evaluated in the Emergency Department of a rural Midwestern hospital from May 1, 2019 through August 31, 2019.

Results There were 122 participants in the study with 61 in each cohort. In 2018, three (5%) were diagnosed with delirium without …

Impact Of The Hester Davis Fall Risk Scale On Inpatient Falls, Amelia Payne

Dissertations

Problem: During a three month period in 2018, a rural acute care facility experienced a fall rate of 3.4 falls per 1,000 patient days. The aim of this clinical scholarship project was to implement the Hester Davis Fall Risk Scale (HDFRS) for adult inpatients in a rural acute care facility.

Methods: Utilizing the Find, Organize, Clarify, Understand, Select- Plan, Do, Study, Act (FOCUS-PDSA) model, the HDFRS was implemented and evaluated using a pre and post design to determine its impact on falls per 1,000 patient days and falls with injury per 1,000 patient days. The method of evaluation was a …

Academic Disciplinary Differences In The Perceived Value Of The Community Of Practice Model, Alyssa Marie Hill

Dissertations

Through a multi-layered review of United States University, a gap in professional development for adjunct faculty was identified. To ensure that students’ are best supported in the online classroom, ensuring that faculty are provided with training around pedagogical and instructional skills aligned with the University mission is essential. The perceived value of the Community of Practice model was assessed to address the gap in faculty development through a mixed-methods convergent design study. The quantitative data and qualitative data were merged under the unidirectional framework for convergent design integration, and presented in a narrative discussion format. Themes which emerged included knowledge …