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Articles 31 - 60 of 77
Full-Text Articles in Medicine and Health Sciences
The Self-Described Experience Of Coping And Adaptation Associated With Workplace Stress Of Registered Nurses In The Acute Care Setting In Florida: An Ethnographic Study, Joyce Burr
Electronic Theses and Dissertations
Little is known about how nurses learn and use coping and adaptation skills in the workplace. Quantitative studies have identified the factors, nature, and outcomes of nursing stress. However, qualitative studies describing the human experience associated with workplace stress are lacking. The phenomenon of interest for this study using focused ethnographic method is the self-described experience of coping and adaptation associated with workplace stress of registered nurses working 12-hour shifts employed in acute care hospital facilities in east central and central Florida. Three aspects of the phenomena were examined: the self-described experiences of stress, the manner in which coping skills …
Impact Of Cancer-Specific Advance Care Planning On Anxiety, Decisional Conflict, And Surrogate Understanding Of Patient Treatment Preferences, Lynn Waser
Electronic Theses and Dissertations
Patients with life-limiting cancer and their families face unique challenges that interfere with their ability to make decisions or adequately express their health care preferences about end of life (EOL) treatment. As a result, patients at EOL often receive aggressive unwanted treatment that nationally costs billions of dollars and results in surrogate distress about not honoring patient wishes. Respecting Choices® DS-ACP is a disease-specific Advance Care Planning (ACP) intervention that is designed to overcome barriers associated with ACP and potentially decrease the incidence of unwanted, overly aggressive treatments at EOL. The intervention is delivered to patient-surrogate dyads by a trained …
Front-Line Registered Nurse Job Satisfaction And Predictors: A Meta-Analysis From 1980 - 2009, Deborah Anne Saber
Front-Line Registered Nurse Job Satisfaction And Predictors: A Meta-Analysis From 1980 - 2009, Deborah Anne Saber
Electronic Theses and Dissertations
Front-line registered nurses (RNs) make up the workforce that directly affect the care of patients in a variety of different healthcare settings. RN job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The strongest predictors have been difficult to determine because workplaces differ, numerous tools to measure satisfaction exist, the workforce is diversified by generations and work positions, and ongoing policy changes directly impact the work of the front-line RN. The strength and stability of the workforce depends on an accurate understanding of the predictors of job satisfaction for the …
Stressors Experienced By Emergency Department Registered Nurses At The Bedside: A Phenomenological Study, Stephen D. Heglund
Stressors Experienced By Emergency Department Registered Nurses At The Bedside: A Phenomenological Study, Stephen D. Heglund
Electronic Theses and Dissertations
The Emergency Department (ED) as a workplace for the Registered Nurse (RN) is a stressful environment. Reasons are thought to include interactions with other members of the interdisciplinary team as well as the situations associated with the environment of the ED such as trauma, death, sadness, joy and the general unpredictability of each moment. Studies have documented general health care workplace stress and its influence on staff, but a very limited number of studies have concentrated on the ED. No widely published studies have identified stressors from the perspective of the ED RN. This dissertation is an interpretive phenomenological study …
Infection Control And Health Care Associated Infection (Hcai) In The Nursing Home: A Study To Determine The Impact Of An Educational Video And Pamphlet About Infection Control On Knowledge And Perception Of Hand Hygiene In Certified Nurse Assistants, Kathe Hypes
Electronic Theses and Dissertations
The impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO’s Hand Hygiene Knowledge Questionnaire and the WHO Perception Survey. Friedman’s test and central tendencies showed no statistical relationship between the educational intervention and the overall knowledge scores of the sample. …
Development And Evaluation Of An Instrument To Measure Mother-Infant Togetherness After Childbirth, Carol Lawrence
Development And Evaluation Of An Instrument To Measure Mother-Infant Togetherness After Childbirth, Carol Lawrence
Electronic Theses and Dissertations
No existing measure to date captures mother-infant togetherness. A valid measure of togetherness is essential to engage in evidence-based practice, evaluate obstetric delivery models and nursing interventions, and measure the level of togetherness which promotes optimal maternal-infant outcomes. When together and in close proximity, a women and her infant have access to one another to allow for mutual caregiving or caregiving on cue. A new measure entitled the Mother-Infant Togetherness Scale (MITS) was developed based on a review of the literature and conceptual framework of Mother-Newborn Mutual Caregiving. The MITS is a 35- item instrument composed of four subscales that …
Noncardiac Chest Pain: The Use Of High Resolution Manometry As A Diagnostic Tool, Iman Hilal
Noncardiac Chest Pain: The Use Of High Resolution Manometry As A Diagnostic Tool, Iman Hilal
Electronic Theses and Dissertations
Chest pain is one of the most common symptoms responsible for emergency department and primary care office visits in the United States. Chest pain can be noncardiac and may be attributed to multiple causes. Esophageal disorders including reflux, motility and functional conditions, affect a large proportion of patients with NCCP and lead to significant morbidity. The use of HRM has changed the diagnostic approach to esophageal motility disorders. It is the most specific and sensitive test for diagnosing motor disorders and a promising procedure in detecting dysmotility disorders in patients with NCCP. Despite the increased sensitivity of HRM, the main …
An Exploratory Study Of Physiologic Responses To A Passive Exercise Intervention In Mechanically-Ventilated Critically Ill Adults, Christina M. Amidei
An Exploratory Study Of Physiologic Responses To A Passive Exercise Intervention In Mechanically-Ventilated Critically Ill Adults, Christina M. Amidei
Electronic Theses and Dissertations
Muscle weakness is the most common and persistent problem after a critical illness. Early mobilization of the critically ill patient, beginning with passive exercise and progressing to ambulation, may mitigate muscle effects of the critical illness. However, mobilization may produce adverse effects, especially early in the illness when risk for physiologic deterioration is common. If safe, introducing a mobility intervention early in the illness may facilitate ventilator weaning, shorten intensive care unit and hospitals stays, and improve functional status and quality of life for mechanically ventilated critically ill patients. The aim of this study was assess the cardiopulmonary and inflammatory …
Barriers To Timely Administration Of Thrombolytics In Acute Ischemic Stroke Patients, Elizabeth Joseph
Barriers To Timely Administration Of Thrombolytics In Acute Ischemic Stroke Patients, Elizabeth Joseph
Electronic Theses and Dissertations
Stroke is a leading cause of long term disability in the United States. The therapeutic benefits of intravenous thrombolytics is time dependent in an acute ischemic stroke patient and is an important determinant of 90 day and one year functional outcomes. This study investigated areas in the stroke alert process of a community based primary stroke care center that resulted in the delay of administration of thrombolytics within 60 minutes of an acute ischemic stroke patient's arrival to the emergency room. A retrospective descriptive design was utilized and chart reviews were done on 40 patients that received thrombolytics in the …
Perceptions Influencing School Nurse Practices To Prevent Childhood Obesity, Susan Quelly
Perceptions Influencing School Nurse Practices To Prevent Childhood Obesity, Susan Quelly
Electronic Theses and Dissertations
Approximately one-third of children in the United States are overweight or obese with increased risks for numerous physical and psychosocial comorbidities. Schools are ideal environments to address this serious health crisis and school nurses are uniquely positioned qualified healthcare providers to actively participate in childhood obesity prevention (COP). A review of the literature provided findings to identify a gap in the knowledge regarding the association between school nurse COP perceptions and practices. A modified theoretical framework based on Bandura’s health promotion by social cognitive theory guided this study. The purpose of this study was to identify the key perceptions (self-efficacy, …
Adherence Practices Of Caucasian Women With Hypertension Residing In Rural Florida An Exploratory Study, Jeanne M. Hopple
Adherence Practices Of Caucasian Women With Hypertension Residing In Rural Florida An Exploratory Study, Jeanne M. Hopple
Electronic Theses and Dissertations
Hypertension, or high blood pressure, is a major risk factor for heart disease and stroke. Elevated blood pressure is often a silent process affecting multiple organ systems. Risk for heart disease is associated with poorly treated or unrecognized hypertension that is more common among women than men. Non-adherence to prescribed treatment regimens has been identified as a major reason for inadequate hypertension management. This exploratory descriptive qualitative study using narrative inquiry investigated adherence practices among Caucasian women with diagnoses of hypertension from a rural area of Florida. The purpose of this study was to gain an understanding from women who …
Comparative Retrospective Analysis Assessment Of Extracellular Volume Excess In Hypertensive Hemodialysis Patients, Amma Serwaah-Bonsu
Comparative Retrospective Analysis Assessment Of Extracellular Volume Excess In Hypertensive Hemodialysis Patients, Amma Serwaah-Bonsu
Electronic Theses and Dissertations
Cardiovascular disease, including hypertension, accounts for almost 50% of the deaths in patients with end stage renal disease (ESRD) on hemodialysis (HD) yet hypertension remains very poorly controlled in this population. The purpose of this study was to retrospectively compare control of hypertension in hemodialysis (HD) patients when extracellular volume (ECV) was assessed and managed by clinical parameters and physical assessment data alone with control of hypertension when data from blood volume monitoring (BVM) technology was also used to assess and manage ECV in a freestanding outpatient hemodialysis unit. The main cause of hypertension in the ESRD population has been …
Duplicated Laboratory Tests : A Hospital Audit And Evaluation Of A Computerized Alert Intervention, Sharon Bridges
Duplicated Laboratory Tests : A Hospital Audit And Evaluation Of A Computerized Alert Intervention, Sharon Bridges
Electronic Theses and Dissertations
Laboratory testing is necessary when it contributes to the overall clinical management of the patient. Redundant testing, however, is often unnecessary and expensive and contributes to overall reductions in healthcare system efficiency. The purpose of this study is two-fold. First, to evaluate the frequency of ordering duplicate laboratory tests in hospitalized patients and the costs associated with this practice. Second, it was designed to determine if the use of a computerized alert or prompt will reduce the total number of unnecessarily duplicated Acute Hepatitis Profile (AHP) laboratory tests. This two-phase study took place in an inpatient facility that was part …
Exploring Women's Life Course Experiences With Weight Using Story Theory, Poff Allison Edmonds
Exploring Women's Life Course Experiences With Weight Using Story Theory, Poff Allison Edmonds
Electronic Theses and Dissertations
This qualitative study included women who had gone through the menopausal transition and had experienced obesity, and it focused on their weight histories and experiences across the life course. The goal of this research was to add to the body of knowledge concerning weight gain by applying a novel middle range theory (story theory). Story theory was used to collect and interpret from women’s life course stories the critical themes and patterns of their weight gain. Oral accounts were elicited during personal interviews from a convenience sample of ten women recruited from a weight loss and exercise program in Central …
The Lived Experience Of Young-Onset Dementia, Debra A. Hunt
The Lived Experience Of Young-Onset Dementia, Debra A. Hunt
Electronic Theses and Dissertations
The lived experiences of dementia in older persons have been well studied, but the unique experiences of persons between ages 35 and 65 years who are living with young-onset dementia have not been closely examined. The purpose of the research was to explore the experiences of middle-aged individuals living with young-onset dementia. Van Manen‘s (1990) approach to interpretive phenomenological inquiry was used to answer the research question. Purposive sampling was used to recruit 9 people between 42 to 61 years of age who had received a formal diagnosis of mild or early-stage dementia. Participants were prescreened for the ability to …
Identifying Patients At Risk For Obstructive Sleep Apnea In Primary Health Care : Can Obesity In Combination With Other High-Risk Diagnoses Be Used For Screening Purposes?, Clelia Lima
Electronic Theses and Dissertations
Obstructive sleep apnea (OSA) affects about 15 million adults in the United States, and is an independent risk factor for all-cause mortality. The under-diagnosing of OSA has been linked to the inadequate screening by primary care practitioners (PCPs). Existing screening tools are not widely used by PCPs possibly due to time constraints they experience as providers. This study demonstrates how common high-risk diagnoses (obesity, hypertension, diabetes mellitus type 2, dyslipidemia, arrhythmia, and coronary artery disease) can be used to help PCPs identify adult patients at risk for OSA. Unlike other screening tools, these diagnoses are easy to identify in a …
Nursing Homes' Compliance With State Nurse Staffing Standards And Its Relation To Quality-Of-Care Deficiencies, Seung Chun Paek
Nursing Homes' Compliance With State Nurse Staffing Standards And Its Relation To Quality-Of-Care Deficiencies, Seung Chun Paek
Electronic Theses and Dissertations
The purpose of this dissertation is to examine nursing homes‟ compliance with state minimum nurse staffing standards and its relation to quality-of-care deficiencies. Specifically, this study, reviewing staffing standards from 50 states and the District of Columbia for the year 2007, proposes a unique algorithm to calculate the states‟ expected nurse staffing levels for individual nursing homes in order to investigate their compliance with the state nurse staffing standards. By using hierarchical linear modeling method, this study attempts to capture the impact of the staffing standards on actual nurse staffing levels under resource dependence perspectives. Path analysis using structural equation …
Spirituality And Expectations Of Care Providers Of Older Patients With Chronic Illnes In North Central Florida, Myra Sherman
Spirituality And Expectations Of Care Providers Of Older Patients With Chronic Illnes In North Central Florida, Myra Sherman
Electronic Theses and Dissertations
A qualitative design was used to explore the use of spirituality and prayer by older adults who have chronic illness and reside in a rural community. Thirteen individuals responded to a flyer soliciting participation in a study of the use of spirituality as part of health care. Participants were at least 60 years of age, had at least one chronic illness and resided in North Central Florida. Twelve participants then responded to six open-ended questions based on an adaption of an instrument used by Dr. Shevon Harvey in her doctoral dissertation. The data was analyzed to identify themes and answer …
Factors Related To Birth Transition Success Of Late-Preterm Infants, Karen L. Wright
Factors Related To Birth Transition Success Of Late-Preterm Infants, Karen L. Wright
Electronic Theses and Dissertations
Problem: Identifying the factors effecting birth transition success of late preterm infants may improve early recognition of newborn compromise. Multiple explanatory variables may be associated with birth transition success or failure. The purpose of the study was to determine the prevalence of, and clinical-epidemiological and demographic predictive factors for birth transition success of late preterm infants. Methods: A retrospective case-control chart review was used to compare the characteristics of successful and unsuccessful birth transition of 35 and 36 week gestational age late-preterm infants delivered in a large tertiary-care center during calendar year 2007. A mixture of categorical and numeric variables …
Clopidogrel Provision For Indigent Patients With St-Elevation Myocardial Infarction, Sita S. Price
Clopidogrel Provision For Indigent Patients With St-Elevation Myocardial Infarction, Sita S. Price
Electronic Theses and Dissertations
The Joint Commission in a joint effort with the Centers of Medicare and Medicaid Services (CMS) has established certain "core measures" by which hospital performance is measured. One of these is the measure for patients with ST-elevation myocardial infarction (STEMI) recommending percutaneous coronary intervention within 90 minutes of presentation to the Emergency Department in institutions that are able to provide this service. This recommendation does not take into account the long-term use of clopidogrel that is recommended by the American College of Cardiology and American Heart Association for patients that are treated with coronary stents. The purpose of this study …
A New Measure Of Parental Self-Efficacy For Enacting Healthy Lifestyles In Their Children, Jonathan W. Decker
A New Measure Of Parental Self-Efficacy For Enacting Healthy Lifestyles In Their Children, Jonathan W. Decker
Electronic Theses and Dissertations
The issue of childhood obesity has become a pandemic of increasing prevalence and concern. Many behaviors contributing to overweight and obesity, such as dietary intake and physical activity, are learned in childhood. It is known that parents are key agents for change in their children. Therefore, interventions aimed at decreasing childhood overweight and obesity should be targeted at parents. Many parents state that they know the healthy dietary and physical activity behaviors they should adopt for their children, but lack the confidence, or self-efficacy, to enact these behaviors. A review of the literature for self-efficacy for behaviors in these domains …
Retrospective Analysis Of Screening Patterns In Cirrhotic Patients With Heptocellular Carcinoma, Shelly-Ann Scott-Castell
Retrospective Analysis Of Screening Patterns In Cirrhotic Patients With Heptocellular Carcinoma, Shelly-Ann Scott-Castell
Electronic Theses and Dissertations
The incidence of hepatocellular carcinoma (HCC) in cirrhotic patients is increasing worldwide. Cirrhotic patients are recommended by the American Association for the Study of Liver Disease (AASLD) to receive HCC screening and surveillance every 6 months to a year. The purpose of this study was to identify the current screening and surveillance patterns for cirrhotic patients with HCC in clinical practice. Hepatocellular carcinoma can be detected by radiological studies in addition to laboratory testing. It is important to implement the AASLD screening guidelines, as early identification might decrease the mortality rate of patients with cirrhosis and HCC. The research question …
A Phenomenological Description Of The Lived Experience Of Creating Art For Women With Breast Cancer, Laurie Stark
A Phenomenological Description Of The Lived Experience Of Creating Art For Women With Breast Cancer, Laurie Stark
Electronic Theses and Dissertations
Conventional approaches to cancer treatment typically do not address the personal experiences of the women with breast cancer. The aim of this study was to develop a structural description of the lived experience of women with breast cancer who create art, specifically through painting, sketching or drawing. A phenomenological approach was employed to explore the meaning of creating art for four women with a diagnosis of breast cancer. The philosophical underpinnings for this study were based on the phenomenological method of bracketing which allows the researcher and subjects to focus on lived experience. This qualitative methodology provided a means to …
The Experiences Of Health Care Providers Providing Comfort For Nursing Home Patients At The End Of Life, Herma Baker
The Experiences Of Health Care Providers Providing Comfort For Nursing Home Patients At The End Of Life, Herma Baker
Electronic Theses and Dissertations
Research shows that healthcare providers (HCPs) are not adequately prepared to provide comfort care for patients who are at the end of life. Since the 1990s, numerous legislative, research, and clinical initiatives have addressed concerns about improving care at the end of life. The purpose of this study was to describe the experiences of HCPs providing comfort for patients in the nursing home who are at the end of life. This study focused on physicians, nurse practitioners, nurses and nurses' aides at a central Florida nursing home. A descriptive qualitative design was done utilizing a focus group discussion, individual interviews, …
Comparison Of Arnp And Physician Malpractice In States With And Without Controlled Substance Prescribing Authority, Deborah Chandler
Comparison Of Arnp And Physician Malpractice In States With And Without Controlled Substance Prescribing Authority, Deborah Chandler
Electronic Theses and Dissertations
Florida is one of two states that do not allow ARNPs to prescribe controlled substances. The Florida Legislature has expressed concern regarding the safety of ARNPs prescribing controlled substances. The purpose of this study was to compare malpractice rates of ARNPs and physicians in states with and without controlled substance prescribing. The design was a direct comparison of malpractice rates in states with and without ARNP controlled substance prescriptive authority. Comparison of malpractice claims was made between physicians (MDs and DOs collectively) and ARNPs in the United States and by state ARNP prescribing authority. Comparison of malpractice claims was also …
Effectiveness Of Probiotics In Preventing Antibiotic Associated Diarrhea And Clostridium Difficile In Long Term Care, Marva Edwards-Marshall
Effectiveness Of Probiotics In Preventing Antibiotic Associated Diarrhea And Clostridium Difficile In Long Term Care, Marva Edwards-Marshall
Electronic Theses and Dissertations
Problem/Purpose: Antibiotic associated diarrhea (AAD) and clostridium-difficile diarrhea (CDAD) are the most common forms of infectious diarrhea in long-term care facilities. The purpose of this study was to determine the effectiveness of probiotics in preventing AAD and CDAD in the long term care geriatric population, and to identify interventions that can be used to improve clinical practice. Background/Significance: Prophylactic use of probiotics have been purported to decrease the incidences of AAD and CDAD. Previous studies have yielded contradictory results on the efficacy of probiotics. The objective of this study was to evaluate the impact of administration of probiotics on the …
The Impact Of Pre-Operative Mupirocin Prophylaxis On Surgical Site Infections In Same-Day Admission Open Heart Patients, Joanna Gerry
The Impact Of Pre-Operative Mupirocin Prophylaxis On Surgical Site Infections In Same-Day Admission Open Heart Patients, Joanna Gerry
Electronic Theses and Dissertations
The CDC estimates that one in 20 patients admitted to the hospital is a carrier of methicillin-resistant Staphylococcus aureus (MRSA). Staphylococci are commonly found on the skin and mucous membranes within the anterior nares, which provides the principle reservoir for this organism. These organisms can go on to cause surgical site infections in hospitalized patients. Mupirocin is an effective topical medication used to eliminate nasal carriage of Staphylococcus aureus (S. aureus). Based on Level A evidence, the 2007 Society of Thoracic Surgeons has made a Class I recommendation for the use of mupirocin for all patients undergoing cardiac surgery in …
The Incidence And Epidemiologic Factors Of Community-Acquired Methicillin-Resistant Staphylococcus Aureus Skin And Soft Tissue I, Ivonne Johnson
The Incidence And Epidemiologic Factors Of Community-Acquired Methicillin-Resistant Staphylococcus Aureus Skin And Soft Tissue I, Ivonne Johnson
Electronic Theses and Dissertations
Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem nationwide, threatening to develop into an epidemic. Many of these patients are presenting to their primary care clinics with skin and soft tissue infections (SSTIs). The CDC has reported that in 2005, MRSA was responsible for an estimated 94,000 life-threatening infections and 16,650 deaths. The purpose of this study is to estimate the incidence of CA-MRSA within a specific family practice in Florida and to identify epidemiologic factors, classify antibiotic susceptibility patterns, and evaluate patient education in regard to disease management and prevention. This study was a descriptive, epidemiologic, three-year …
Advanced Practice Nursing In The Faith Community Setting: A Case Study, Chianta Lindsey
Advanced Practice Nursing In The Faith Community Setting: A Case Study, Chianta Lindsey
Electronic Theses and Dissertations
The purpose of this case study is to demonstrate the effectiveness of an Advanced Practice Nurse in providing spiritual and nursing care within a faith community setting. The study will describe the process of developing a Parish Nurse program using a Nurse Practitioner to offer wholistic health care to parishioners. It will also illustrate the collaborative process of developing a free health center within a faith based organization, using the Nurse Practitioner to manage the health center and deliver health care services. In order to demonstrate the need for parish nurse care, the case study used an anonymous survey to …
Assessing Adult Attitudes Toward End-Of-Life Issues And Advanced Directives After Implementing An Educational Intervention In A, Marchina Tolbert-Jones
Assessing Adult Attitudes Toward End-Of-Life Issues And Advanced Directives After Implementing An Educational Intervention In A, Marchina Tolbert-Jones
Electronic Theses and Dissertations
Purpose: There is a lack of discussion regarding end-of-life care planning which results in low advanced directive execution (AD) rates. This can lead to decision making by family, friends, and the health care team on behalf of patients whose end-of-life care wishes are unknown. The purpose of this study was to determine the effectiveness of an educational intervention in the work setting to increase end-of-life discussions and the execution of advanced directives. Methods: A descriptive design was used in an occupational workplace setting at a local bottling company after appropriate IRB approval was obtained. An educational intervention based on the …