Medicine and Health Sciences Commons^™

Acute Pain Symptom Assessment And Management In Nonverbal Puerto Rican Patients In The Early Postoperative Period, Sherily Pereira

Doctoral Dissertations

Acute pain is a symptom that represents significant concern for surgical patients during the early postoperative period. This is probably due to the use of ineffective instruments or protocols for assessment in patients with different levels of sedation after general anesthesia. This study described the relationships between the total scores obtained from two pain assessment instruments, the Non-verbal Pain Scale Revised (NVPS-R) and Critical Care Pain Observation Tool (CPOT), during the early postoperative period for non-verbal patients at Post Anesthesia Care Unit (PACU). After assessing patient’s pain with both instruments simultaneously, we determined, and evaluated the relationships between the two …

The Effect Of Interruptions On Primary Task Performance In Safety-Critical Environments, Cheryl Ann Nicholas

Doctoral Dissertations

Safety critical systems in medicine utilize alarms to signal potentially life threatening situations to professionals and patients. In particular, in the medical field multiple alarms from equipment are activated daily and often simultaneously. There are a number of alarms which require caregivers to take breaks in complex, primary tasks to attend to the interruption task which is signaled by the alarm. The motivation for this research is the knowledge that, in general, interrupting tasks can have a potentially negative impact on performance and outcomes of the primary task. The focus of this research is on the effect of an interrupting …

Design, Implementation, And Evaluation Of A User Training Program For Integrating Health Information Technology Into Clinical Processes, Ze He

Doctoral Dissertations

Health information technology (IT) implementation can be costly, and remains a challenging problem with mixed outcomes on patient safety and quality of care. Systems engineering and IT management experts have advocated the use of sociotechnical models to understand the impact of health IT on user and organizational factors. Sociotechnical models suggest the need for user-centered implementation approaches, such as user training and support, and focus on processes to mitigate the negative impact and facilitate optimal IT use during training. The training design and development should also follow systematic processes guided by instructional development models. It should take into account of …

Physical Activity Assessment And Intervention Among Adult Patients At A Community Health Center, Michelle L. Vandentoorn

Doctoral Dissertations

Low levels of physical activity are associated with a number of serious health conditions in adults. These conditions include hypertension, diabetes, certain types of cancers, cardiovascular disease, and an increased risk of mortality. In spite of these serious health risks, few adults in the United States are achieving the recommended levels of physical activity. The diseases associated with low physical activity levels contribute to high healthcare costs.

Healthcare providers claim that they are not aware of available interventions and resources to increase physical activity levels in their patients. Through screening patients for physical activity levels during office visits, providers can …

A Process Improvement Project: Demonstrating A Patient Portal To Increase Enrollment And Use In An Underserved Population With Chronic Illness, Jonathan Gibson

Doctoral Dissertations

High risk, high cost chronic conditions such as diabetes, asthma, and congestive heart failure are prevalent in the United States. Nearly half of all Americans have at least one chronic condition (Centers for Disease Control and Prevention, 2009). Almost four-fifths of total health care spending in the U.S. is related to high risk, chronic conditions (Baker, Johnson, Macaulay, & Birnbaum, 2011). The use of patient portals in ambulatory care may be an avenue toward improving chronic disease management. Portals can be used by patients to schedule appointments, send secure messages to their providers, request medication refills, review lab and test …

Implementation Of The Evidence-Based Cope Intervention In An Elementary Classroom To Promote Mental Health, Maria Mccormick

Doctoral Dissertations

There is a growing incidence of suicide and suicide attempts in the adolescent population. This is largely impacted by the increasing rates of mental illnesses such as anxiety and depression as well as instigating factors such as negative behaviors and stressful life events. In order to prevent these rates from continuing to rise, it is imperative that mental health promotion interventions be implemented in young children in order to facilitate positive behaviors and coping skills that can be used when stressors occur. The purpose of this scholarly project was to implement the cognitive-behavioral therapy intervention, the Creating Opportunities for Personal …

Designing, Implementing, And Evaluating A Community-Based Antenatal Education Program, Jennifer L. Zachary

Doctoral Dissertations

The United States has higher fetal and infant mortality than the majority of developed countries around the world. As of 2008, the United States was ranked 27th internationally for infant mortality among all developed countries (MacDorman, Hoyert, & Mathews, 2013). Infant morbidity and mortality is associated with numerous factors within a country; including access and quality of health care, maternal health status, public health, and socioeconomic status.

Despite recent declines in infant mortality across the country, the infant mortality rates for both Michigan and the project county remain alarmingly higher than the national averages. It is clear that innovative measures …

Knowledge Development In Undergraduate Clinical Nursing Education, Nancy A. Craig-Williams

Doctoral Dissertations

ABSTRACT KNOWLEDGE DEVELOPMENT OF UNDERGRADUATE NURSING STUDENTS DOCTOR OF PHILOSOPHY FEBRUARY 2016 NANCY A. CRAIG-WILLIAMS B.S. ELMS COLLEGE, CHICOPEE, MA M.S. UNIVERSITY OF MASSACHUSETTS, AMHERST Ph. D. UNIVERSITY OF MASSACHUSETTS, AMHERST Directed by Genevieve Chandler ABSTRACT The changes in the healthcare environment, safety concerns of the practice setting and patient acuity has supported reform and research to identify areas for improvement (IOM, 2001, 2003). The Carnegie Foundation’s Educating Nurses, A Call for Radical Transformation (Benner, P., Sutphen, M., Leonard, V. & Day, L., 2010) explored the state of American nursing education. Among the findings are: patient safety issues, higher patient …

Motivations And Barriers For Saudi Nurses To Pursue A Doctoral Degree, Abdualrahman Alshehry

Doctoral Dissertations

Background/ Purpose: A shortage of Saudi PhD prepared nursing school faculty and a limited number of advanced degree programs in Saudi Arabia, are preventing the education of enough nurses to meet growing healthcare demands and the preparation of nurses for faculty roles. The purpose of this study was to identify motivating and barrier factors that may influence the decision of a nurse to seek further education at the doctorate level. Theoretical Framework: Cross’s (1981) Chain-of-Response Model was used as to guide this study and the interpretation of findings. Methods: A mixed method design was used for this study. A questionnaire …

Acceptability Of The Interpersonal Needs Questionnaire As A Suicide Risk Screening Tool For Veterans In A Non Veterans Health Administration Primary Care Clinic, Jeffrey M. Bird

Doctoral Dissertations

Suicide among veterans is a growing concern. The Department of Veterans Affairs (VA) estimates that a veteran dies by suicide once every 60-80 minutes with 18 to 22 veterans killing themselves every day. Many veterans receive healthcare in the community (outside of the VA), but are typically not identified in these settings. Veteran-centric policies are typically absent in settings outside of the VA. Screening for suicide risk at the primary care level has been largely ineffective with some patients dying from suicide within a week of a negative screen. The Interpersonal Needs Questionnaire (INQ), which measures thwarted belongingness and perceived …

Workplace Violence, Organizational Culture, And Registered Nurses' Incident Reporting Patterns In Acute Hospitals In California, Feodora Jacobsen

Doctoral Dissertations

The purpose of this study was to increase understanding of the reporting patterns of WPV Type II in acute hospital settings. Although some patients are abusive toward nurses, that the abuse is underreported to hospital administrators. Qualitative studies identified common themes for underreporting including fear of being blamed, abuse considered part of the job, and not having sufficient time to fill out a formal report. This study is the first quantitative study to explore the changes in mean scores of organizational-culture factors under two mutually exclusive conditions: registered nurses (RNs) who do not report hospital incidents and RNs who do …