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Full-Text Articles in Medicine and Health Sciences

Pre And Post Implementation Evaluation Of An Emergency Department Severe Sepsis Alert And Practice Protocol, Darleen Williams Jan 2015

Pre And Post Implementation Evaluation Of An Emergency Department Severe Sepsis Alert And Practice Protocol, Darleen Williams

Electronic Theses and Dissertations

Severe sepsis kills an estimated 1,400 people worldwide every day. This often fatal infectious process accounts for an estimated 215,000 deaths in the United States (US) annually. The main goal of this project was to evaluate the impact of the Emergency Department Severe Sepsis Alert and Practice Protocol (EDSSAPP) post implementation, on time to first antibiotic administration, length of stay, and mortality in patients admitted via the ORMC ED with severe sepsis. This study evaluated the time to first antibiotic administration, total ED and hospital length of stay (LOS) and mortality of severe sepsis patients either with a severe sepsis …


Family Care Giver Knowledge, Patient Illness Characteristics, And Unplanned Hospital Admissions In Older Adults With Cancer, Patricia Geddie Jan 2015

Family Care Giver Knowledge, Patient Illness Characteristics, And Unplanned Hospital Admissions In Older Adults With Cancer, Patricia Geddie

Electronic Theses and Dissertations

Unplanned hospital admissions (UHA) in older adult populations are a recurring problem in older adults with cancer. Older adults comprise approximately 60% of cancer diagnoses and receive the majority of cancer treatment. However, little is known about why older adults under treatment for cancer experience a high number of unplanned hospital admissions. A review of the literature provided few study findings and a gap in the current knowledge was identified regarding the factors associated with unplanned hospital admissions in older adults under treatment for cancer. A conceptual framework based on the literature and this researcher's clinical experienced guided this study. …


Rapid Response Teams Versus Critical Care Outreach Teams: Unplanned Escalations In Care And Associated Outcomes, Valerie Danesh Jan 2015

Rapid Response Teams Versus Critical Care Outreach Teams: Unplanned Escalations In Care And Associated Outcomes, Valerie Danesh

Electronic Theses and Dissertations

The incidence of unplanned escalations during hospitalization is undocumented, but estimates may be as high as 1.2 million occurrences per year in the United States. Rapid Response Teams (RRT) were developed for the early recognition and treatment of deteriorating patients to deliver time-sensitive interventions, but evidence related to optimal activation criteria and structure is limited. The purpose of this study is to determine if an Early Warning Score-based Critical Care Outreach (CCO) model is related to the frequency of unplanned intra-hospital escalations in care compared to a RRT system based on staff nurse identification of vital sign derangements and physical …


Perceived Social Support And Self-Care In Patients Hospitalized With Heart Failure, Lyne Chamberlain Jan 2015

Perceived Social Support And Self-Care In Patients Hospitalized With Heart Failure, Lyne Chamberlain

Electronic Theses and Dissertations

Problem: Heart failure is the most frequent cause for hospital readmissions in Medicare recipients, with an estimated annual cost of $12 billion. Heart failure hospitalizations are also an independent risk factor for increased mortality. Self-care, thought to be enhanced by perceived social support, is key to managing this syndrome, and up to 50% of readmissions are considered the result of inadequate self-care. Purpose: To evaluate perceived social support and self-care characteristics of patients hospitalized with an exacerbation of heart failure, and to compare these characteristics with a study of ambulatory patients with heart failure. In addition, to assess the relationship …


The Impact Of Relational Coordination And The Nurse On Patient Outcomes, Fanya Dejesus Jan 2015

The Impact Of Relational Coordination And The Nurse On Patient Outcomes, Fanya Dejesus

Electronic Theses and Dissertations

Healthcare quality remains a significant issue due to fragmentation of care in our complex U.S. healthcare systems. While coordination of care is foundational to healthcare quality as well as identified as a National Priority, fragmentation and uncoordinated care continues to afflict our systems. The purpose of this study was to explore the relationship between relational coordination and adverse nurse sensitive patient outcomes, namely hospital acquired pressure ulcers, patient falls with injury, catheter- associated urinary tract infection, and central line-associated blood stream infection. A retrospective correlational survey design using cross sectional data was used to conduct this quantitative study. An electronic …


Nurse Managers, Work Environment Factors And Workplace Bullying, Joy Parchment Jan 2015

Nurse Managers, Work Environment Factors And Workplace Bullying, Joy Parchment

Electronic Theses and Dissertations

The purpose of this dissertation is to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of nurse managers in acute care settings across the United States. Over 30 years of workplace bullying research exists. Consequences are linked to intent to leave, turnover, and harmful emotional and physical effects. Published studies identifying nurse managers as targets of workplace bullying and work environment factors that contribute to nurse managers being recipients of workplace bullying either, downward from their leaders, horizontally from their nurse manager peers, and upwards from their clinical nurses were not identified. …


A Faith-Based Primary Diabetes Prevention Intervention For At-Risk Puerto Rican Adults: A Feasibility Study, Sylvia Torres-Thomas Jan 2015

A Faith-Based Primary Diabetes Prevention Intervention For At-Risk Puerto Rican Adults: A Feasibility Study, Sylvia Torres-Thomas

Electronic Theses and Dissertations

Diabetes is a serious health threat that disproportionately affects Hispanics of Puerto Rican heritage. Current evidence supports diabetes prevention programs to change health behaviors in people who are at risk and thus prevent the development of type 2 diabetes. However, few interventions exist for Hispanics, and even fewer have been designed for Puerto Rican adults. A literature review of community-based diabetes prevention programs involving at-risk Hispanics was conducted using a cultural sensitivity framework to determine the state of the science and identify gaps in knowledge regarding diabetes prevention for Puerto Ricans. An integrated theoretical framework was developed using constructs from …


Helping Mothers Defend Their Decision To Breastfeed, Kandis Natoli Jan 2015

Helping Mothers Defend Their Decision To Breastfeed, Kandis Natoli

Electronic Theses and Dissertations

The United States has established breastfeeding as an important health indicator within the Healthy People agenda. Healthy People target goals for breastfeeding initiation, duration, and exclusivity remain unmet. The US Surgeon General's Office reports that lack of knowledge and widespread misinformation about breastfeeding are barriers to meeting Healthy People goals. Breastfeeding mothers are vulnerable to messages that cast doubt on their ability to breastfeed. Very little research has examined specific approaches to help people resist negative messages about health beliefs and behaviors. The objective of this quasi-experimental study was to test an intervention designed to help mothers defend their breastfeeding …


Impact Of Interruption Frequency On Nurses' Performance, Satisfaction, And Cognition During Patient-Controlled Analgesia Use In The Simulated Setting, Kristi Campoe Jan 2015

Impact Of Interruption Frequency On Nurses' Performance, Satisfaction, And Cognition During Patient-Controlled Analgesia Use In The Simulated Setting, Kristi Campoe

Electronic Theses and Dissertations

Problem: Interruption during medication administration is a significant patient safety concern within health care, especially during the administration of high risk medications in nursing. Patient-controlled analgesia (PCA) devices are frequently associated with adverse events and have a four-fold increased risk of patient injury compared to non-PCA related adverse events. While the nature and frequency of interruptions have been established for nurses* medication processes, the impact of interruption frequency on nurses* PCA interaction has not been fully measured or described. Purpose: The purposes of this study were to quantify the impact of interruption frequency on registered nurses* (RN) performance, satisfaction, and …