Medicine and Health Sciences Commons^™

Impact Of Culturally Tailored Shared Medical Appointments On Diabetes Self-Care Ability And Knowledge In African Americans, Adrienne L. Reddick, Deborah C. Gray

Nursing Faculty Publications

Background: Type 2 diabetes mellitus (T2DM) continues to disproportionately affect African Americans, significantly impacting morbidity and mortality. Research suggests that addressing barriers that stem from socioeconomic circumstances, systemic inequalities, biological factors, and cultural factors may positively influence biometric indicators of health and diabetes control. Objective: The aim of this study was to evaluate a diabetes shared medical appointment (SMA) model program that has been culturally tailored to address the unique social determinants of health barriers faced by an inner city African American population in Norfolk, Virginia. Methods: A pilot study using a within-group pretest–posttest design was conducted. Information was collected …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews Protocol, Kelley Kilpatrick, Isabelle Savard, Li-Anne Audet, Abby Kra-Friedman, Reneé Atallah, Mira Jabbour, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Colette Henderson, Lori A. Spies, Heather Mcgrath, Melanie Rogers

Nursing Faculty Publications

Introduction

In 2020, the World Health Organization called for the expansion and greater recognition of all nursing roles, including advanced practice nurses (APNs), to better meet patient care needs. As defined by the International Council of Nurses (ICN), the two most common APN roles include nurse practitioners (NPs) and clinical nurse specialists (CNSs). They help ensure care to communities as well as patients and families with acute, chronic or complex conditions. Moreover, APNs support providers to deliver high quality care and improve access to services. Currently, there is much variability in the use of advanced practice nursing roles globally. A …

Contributing Factors To Withdrawal Decisions Of Military And Nonmilitary Nursing Students, Beth Tremblay, Janice E. Hawkins, Robert E. Hawkins, Karen Higgins, Lynn Wiles, Jamela Martin

Nursing Faculty Publications

Retaining nursing students in courses is key to increasing the number of new nurses. This study examined factors associated with nursing course or program withdrawal among students with and without prior military experience. The purpose of this study was to uncover differences between groups of students who withdrew compared to those who did not. A cross-sectional study using an online questionnaire surveyed current or recent nursing students (n = 420) using the Educational Requirement Subscale and the Student Withdrawal Questionnaire from Jeffreys’ toolkit. Uncovering differences between groups of students who did and did not withdraw from nursing courses or programs …

Creating A Primary Care Track In Prelicensure Nursing Education, Janice E. Hawkins, Lynn L. Wiles, Jamela Martin, Beth Tremblay, Karen Higgins, Ingrid Mahoney

Nursing Faculty Publications

BACKGROUND: RNs practicing in primary care (PC) increase access to health care and contribute to better patient outcomes and cost savings, yet undergraduate nursing education traditionally focuses on disease-oriented care. This article describes a curricular track for infusing PC prelicensure programs.

METHOD: PC content is threaded across four semesters with targeted assignments and clinical experiences. Providing clinical immersion experiences with practicing RNs as preceptors in community and PC settings is a key component of this initiative.

RESULTS: Student feedback has been favorable. Students stated they gained insight to the role of RNs in PC through class assignments and clinical rotations. …

Use Of The Rasch Model For Fit Statistics And Rating Scale Diagnosis For The Student Perception Appraisal- Revised, Robert J. Hawkins, Janice Hawkins, Beth Tremblay, Lynn Wiles, Karen Higgins

Nursing Faculty Publications

Background and Purpose: Nursing student retention is essential to meet workforce demands. Jeffrey's Nursing Student Retention Student Perception Appraisal-Revised (SPA-R1) has been used extensively to understand factors that impact retention. Psychometric testing of the SPA-R1 contributes to greater confidence in the instrument's reliability and validity.

Methods: Item response theory and specifically, the single parameter polytomous Rasch model was used as a framework for fit statistic testing and rating scale diagnostics of the SPA-R1. This was a secondary analysis of a convenience sample of undergraduate prelicensure nursing students. The setting for the previous study was virtual, and the study period was …

Advanced Practice Nursing Initiatives In Africa, Moving Towards The Nurse Practitioner Role: Experiences From The Field, Deborah C. Gray, Melanie Rogers, Minna K. Miller

Nursing Faculty Publications

AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa.

BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue.

SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects.

DISCUSSION: Four African countries have …

Advanced Practice Nursing Roles, Regulation, Education, And Practice: A Global Study, Kathy J. Wheeler, Minna Miller, Joyce Pulcini, Deborah Gray, Elissa Ladd, Mary Kay Rayens

Nursing Faculty Publications

Background and Objectives: Several subgroups of the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network (ICN NP/APNN) have periodically analyzed APN (nurse practitioner and clinical nurse specialist) development around the world. The primary objective of this study was to describe the global status of APN practice regarding scope of practice, education, regulation, and practice climate. An additional objective was to look for gaps in these same areas of role development in order to recommend future initiatives.

Methods: An online survey was developed by the research team, and included questions on APN practice roles, education, regulation/credentialing, and practice climate. The …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews, Colette Henderson, Abby Kra-Friedman, Li-Anne Audet, Isabelle Savard, Lori A. Spies, Heather Mcgrath, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Mra Jabbour, Renée Atallah, Melanie Rogers, Kelley Kilpatrick

Nursing Faculty Publications

No abstract provided.

Guidelines On Prescriptive Authority For Nurses 2021, David Stewart, Madrean Schober, Lisa Nissen, Elissa Ladd, Kimberley Lamarche, Marie-Lyne Bournival, Deborah Gray, Sonia Sevilla, Marieke Kroezen, Frances Wong

Nursing Faculty Publications

[First paragraph] Nurse prescribing has existed for over 50 years in some regions of the world. The diverse global nurse prescriptive authority landscape will be highlighted in this important publication. A framework embedding core components for safe and competent prescribers necessitates appropriate education, aligned regulatory authority and continuing professional development to uphold competencies. Evidence-informed models of nurse prescribing will weave in organisational and team support considerations required.

Using Social Media As A Platform For Increasing Knowledge Of Lung Cancer Screening In High-Risk Patients, Aimee Strong, Michelle Renaud

Nursing Faculty Publications

Background: Uptake in lung cancer screening for high-risk patients remains low. Eligible patients may not know that this preventive service is available and covered by insurance.

Objectives: The objective of this study was to explore using social media to educate patients about lung cancer screening and assess motivation to discuss lung cancer screening with health-care providers after viewing the educational program. Methods: Subjects ages 55 to 77 who were current smokers or former smokers who quit in the past 15 years with a more than 30-pack-year smoking history were recruited via a Facebook advertisement. Subjects completed a demographic survey and …

High School Competitive Diving Injuries: National Athletic Treatment Injury And Outcomes Network (Nation), Susan M. Braid, Eric Schussler

Nursing Faculty Publications

Purpose: Elite diving coaches and USA diving officials have become increasingly concerned about injury prevention among adolescent divers. However, little is known about such injuries. The purpose of this study was to describe the injuries among high school students who participated on high school diving teams.

Subjects: High school students who participated on the diving teams of high schools that were included in the National Athletic Treatment, Injury and Outcomes Network (NATION) for 2011–2014.

Methods: Descriptive epidemiology using injury exposure data on 56 boys' Swimming and Diving teams and 55 girls' Swimming and Diving teams from the National Athletic Treatment, …

Just Culture: It's More Than Policy, Linda Paradiso, Nancy Sweeney

Nursing Faculty Publications

[Description] Paradiso and Sweeney discuss the relationship between trust, just culture, and error reporting in medical care. Errors rarely occur in a vacuum, rather they're a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. Just culture is a safe haven that supports reporting. In a just culture environment, organizations are accountable for systems they design and analysis of the incident, not the individual. The shift to a just culture is a slow process that takes years to develop and hardwire. Hospital-wide policies that incorporate …

How To Prepare Interprofessional Teams In Two Weeks: An Innovative Education Program Nested In Telehealth, Tina S. Haney, Karen Kott, Carolyn M. Rutledge, Bruce Britton, Christianne N. Fowler, Rebecca D. Poston

Nursing Faculty Publications

PROBLEM:

Preparing health professional students for interprofessional collaborative practice, especially at a distance where provider shortages prevail remains difficult.

APPROACH:

A two-week interprofessional education (IPE) immersion experience preparing students from 11 disciplines and four universities was implemented. Week-one, using online technology, students develop/present an interprofessional careplan for a complex patient. Students then meet face-to-face to conduct group interviews with two standardized patient dyads. Week-two, students develop a website for use of the patient dyads. Websites are presented to faculty and fellow students via an online virtual meeting space.

OUTCOMES:

To date, 594 students have participated demonstrating capacity to: 1.effectively engage …

Making A Global Impact One Vaccine At A Time, Janice E. Hawkins, Deborah C. Gray

Nursing Faculty Publications

(First paragraph) Did you know that, worldwide, almost one third of deaths among children under age 5 can be prevented by vaccines? It's stunning to think that one child dies every 20 seconds from an immunization-preventable disease. That equates to 12 lives that could be saved in the time it takes to read this brief article!

Telehealth And Ehealth In Nurse Practitioner Training: Current Perspectives, Carolyn M. Rutledge, Karen Kott, Rebecca Poston, Christianne Fowler, Tina S. Haney

Nursing Faculty Publications

Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this …

Dna Methylation Patterns In Cord Blood Of Neonates Across Gestational Age Association With Cell-Type Proportions, Susan M. Braid, Kwame Okrah, Amol Shetty, Hector Corrada Bravo

Nursing Faculty Publications

Background: A statistical methodology is available to estimate the proportion of cell types (cellular heterogeneity) in adult whole blood specimens used in epigenome-wide association studies (EWAS). However, there is no methodology to estimate the proportion of cell types in umbilical cord blood (also a heterogeneous tissue) used in EWAS.

Objectives: The objectives of this study were to determine whether differences in DNA methylation (DNAm) patterns in umbilical cord blood are the result of blood cell type proportion changes that typically occur across gestational age and to demonstrate the effect of cell type proportion confounding by comparing preterm infants exposed and …

Holistic Self-Care: Tai Chi, Qigong Training For Caregivers At An Alzheimer Disease Assisted Living Facility, Sunny Alperson, Christianne Fowler

Nursing Faculty Publications

With the growing number of older persons with chronic illnesses, the demand for professionals who can provide complex care is increasing as well. However, evidence shows that health professionals’ burnout rate has been consistently increasing for the last 3 decades. In an effort to alleviate some of the issues associated with caregiver burnout, we conducted mind-body training of self-compassion for professional caregivers at an Alzheimer disease (AD) specialty center for 5 weeks. The intervention combined seven simple centering movements of tai chi and qigong in a context of mettā (loving kindness meditation) language mindfulness. Data showed significant improvements in caregiver …

Detecting Agitation Onset In Individuals With Dementia Using Smart Phone Sensors, Christianne Fowler, Ajay Gupta, Kurt Maly, Karen Karlowicz, Maheedhar Gunnam, Rohila Gudipati, Mahesh Kukunooru, Rahul Rachamalla

Nursing Faculty Publications

Individuals living with dementia (ILWD) often experience problematic agitated behaviors, this occurs in up to 80% of ILWD. These behaviors lead to stress for caregivers and increased frequency of institutionalization. There are many proven methods to intervene during agitated behavior outburst and the earlier these methods are used the better the results. Technology has been used successfully to monitor many aspects of health monitoring for older adults. Technology is now being investigated to evaluate the effectiveness of predicting the onset of problem behaviors, especially escalating agitation in ILWD. Off the shelf technology, smart watches and android phones, are being tested …

Stand At Ease, Then Forward, March!, Janice E. Hawkins

Nursing Faculty Publications

(First paragraph) I enlisted in the U.S. Army in 1985. After reporting for basic training, I learned to execute military formation maneuvering commands. Military formations help organize ceremonial parades, gain tactical advantage, and create discipline. It occurs to me that the same elements that contribute to effective functioning of a military unit- ceremony, tactical planning, and discipline- also contribute to achieving one's goals after completing graduate school.

The Effectiveness Of An Anesthesia Handoff Tool: An Electronic Health Record Application To Enhance Patient Safety, Karen Gillikin, Nathaniel Apatov

Nursing Faculty Publications

Perioperative patient care handoffs are complex and multidimensional and require accurate attention to detail. Communication failures among healthcare providers increase the risk of morbidity and mortality. Utilizing a standardized handoff tool located within the electronic anesthesia record formalizes the handoff process and improves patient safety. Prior to the introduction of the Electronic Anesthesia Handoff Tool, 82 patient care transfer observations were conducted; subsequent to the launch of the tool, 75 patient care transfer observations were conducted, and then before and after comparisons were made. Descriptive statistics, a two-tailed t-test, and Spearman’s correlations were conducted. Alpha level was set at p < 0.05. There were significantly (p< .05) fewer errors made in all categories of patient information following the introduction of the Electronic Anesthesia Handoff Tool. Though there were trends towards more omissions occurring after 3:00 p.m., the difference in most patient information categories was not significant (p< .05). In addition, there were no differences in omissions related to the severity of patient co-morbidities based on patients’ American Society of Anesthesiologists physical status classification. This study provided information regarding the incidence of patient information inaccuracies and omissions during patient care transfer before and after implementation of an electronic patient care transfer tool.

Assent Described: Exploring Perspectives From The Inside, Rebecca D. Poston

Nursing Faculty Publications

Purpose- The purpose of this study was to describe the informed consent and assent experience for oncology research from the perspective of the participants: adolescents, their parents, and their physician providers.

Design & Methods- This descriptive mixed-methods study included the pilot use of the Quality of Informed Consent Questionnaire (QuIC) with an adolescent population and semi-structured interviews with adolescents, their parents, and their physician providers within 48-72 hours of the informed consent and assent discussion for a pediatric oncology clinical trial and again 6-9 weeks later. Results: Adolescents and their parents scored considerably lower on part A of the QuIC …

An Overview Of Antithrombotics In Ischemic Stroke, Patricia A. Schweickert, John R. Gaughen, Elizabeth M. Kreitel, Timothy J. Shephard, Nina J. Solenski, Mary E. Jensen

Nursing Faculty Publications

The use of antithrombotic medications is an important component of ischemic stroke treatment and prevention. This article reviews the evidence for best practices for antithrombotic use in stroke with focused discussion on the specific agents used to treat and prevent stroke.

A "Clarion" Call For Embracing Ipe As The Status Quo For Preparing Health Professionals To Engage In Interprofessional Health Research, Kimberly Adams Tufts

Nursing Faculty Publications

Complex health conditions and the social-economic determinants that contribute to disease and injury incidence, prevalence, and health inequalities require multifaceted evidence-based interventions that only interprofessional research teams who collaborate across traditional disciplinary lines can generate. Interprofessionally driven and derived research evidence is the method of du jour. Nonetheless as a whole, health professionals who are often members of interprofessional health research teams are products of educational systems wherein they were educated in disciplinary silos. Health professionals that learn about, with, from, each other during their foundational education will be better prepared to function as interprofessional research team members. With the …

I'M Still Standing, But I'M Not Standing Still, Janice E. Hawkins

Nursing Faculty Publications

(First paragraph) When I made the decision to return to school for a PhD, I anticipated hard work, challenges, and a demanding schedule. Two years into my part-time program, I proudly informed readers of Reflections on Nursing Leadership that I was still standing and happy with my decision (Hawkins, 2014). Two years later, I'm not quite done.

Promoting Interprofessional Collaboration, Global Health Awareness And Leadership Skills Through International Service-Learning, Janice E. Hawkins, Christine A. Sump

Nursing Faculty Publications

Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015: International service-learning programs offer a unique opportunity to incorporate interprofessional education and global health awareness into health science curriculums. Through service activities, students develop leadership skills and collaborative team approaches to promote the health of diverse populations. Appreciation, respect, integration of knowledge, and communication between multiple disciplines are crucial components of international health care teams and desired outcomes for health science students. Graduates of health science programs must have the knowledge, skills, attitudes, and values that prepare them to be "collaborative practice-ready" for the healthcare workforce. According to …

An Intersectional Perspective On Stigma As A Barrier To Effective Hiv Self-Management And Treatment For Hiv-Infected African American Women, Kimberly Adams Tufts

Nursing Faculty Publications

Among those who are HIV-infected and striving to live well with HIV, African American women have poorer health outcomes and represent a higher portion of those women who die from HIV-related causes. Those health inequalities have been associated with the presence of social determinants of health such as stigma. This analytical review asserts that stigmas precipitated by gender, race, and class in the context of HIV-related stigma constitute substantial barriers to active engagement in HIV self-management, care, and treatment for HIV-infected African American women. The utility of the intersectionality framework for analyzing how these various stigmas interact to create unique …

Effectiveness Of Health Education Teachers And School Nurses Teaching Sexually Transmitted Infections/ Human Immunodeficiency Virus Prevention Knowledge And Skills In High School, Elaine A. Borawski, Kimberly A. Tufts, Erika S. Trapl, Laura L. Hayman, Laura D. Yoder, Loren D. Lovegreen

Nursing Faculty Publications

BACKGROUND- We examined the differential impact of a well-established human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) curriculum, Be Proud! Be Responsible!, when taught by school nurses and health education classroom teachers within a high school curricula.

METHODS- Group-randomized intervention study of 1357 ninth and tenth grade students in 10 schools. Twenty-seven facilitators (6 nurses, 21 teachers) provided programming; nurse-led classrooms were randomly assigned.

RESULTS- Students taught by teachers were more likely to report their instructor to be prepared, comfortable with the material, and challenged them to think about their health than students taught by a school nurse. Both groups reported …

The Noncompete Clause And The Nurse Anethetist: An Assessment Of Knowledge, Perception, And Experience, Briana K. Meseroll, Nathaniel M. Apatov, Carolyn M. Rutledge

Nursing Faculty Publications

Economic pressures and the challenge to maintain competitive advantage have resulted in many health-care entities requiring their practitioners to contractually enter into noncompete clauses (NCCs). Many student registered nurse anesthetists (SRNAs) and Certified Registered Nurse Anesthetists (CRNAs) are unaware of NCCs in employee contracts.

An anonymous, web-based questionnaire regard-ing NCCs was distributed to SRNAs and CRNAs nation-wide. Of 242 practicing CRNAs who responded, 147 (60.7%) were employed without a noncompete clause and 22 (9.1%) were unaware whether they had such a provision in their employment contracts. The knowledge level of the nurse anesthetist respondents was low (average score of 55.3%). …

Adverse Health Effects Of Spousal Violence Among Women Attending Saudi Arabian Primary Health-Care Clinics, H. M. Eldoseri, K. A. Tufts, Q. Zhang, J. N. Fish

Nursing Faculty Publications

This study aimed to investigate the frequency of spousal violence among Saudi women and document the related health effects and injuries, as well as their attitudes to gender and violence. Structured interviews were conducted with 200 ever-married women recruited from primary-care centres in Jeddah. Nearly half of the surveyed women (44.5%) reported ever experiencing physical violence from their spouse. Although 37 women (18.5%) had received violence-related injuries, only 6.5% had reported these injuries to a health-care provider. Victims of spousal violence had poor perceptions of their overall health, and reported pain or discomfort, antidepressant use and suicidal thoughts. Women mostly …

Telehealth: Preparing Advanced Practice Nurses To Address Healthcare Needs In Rural And Underserved Populations, Carolyn M. Rutledge, Tina Haney, Michele Bordelon, Michelle Renaud, Christianne Fowler

Nursing Faculty Publications

Healthcare is being confronted with questions on how to deliver quality, affordable, and timely care to patients, especially those in rural areas, in systems already burdened by the lack of providers. Advanced Practice Registered Nurses (APRNs) have been challenged to lead this movement in providing care to these populations through the use of technologies, specifically telehealth. Unfortunately, APRNs have limited exposure to telehealth during their educational experience, thereby limiting their understanding and comfort with telehealth. To address this problem, a telehealth program was developed at a large university that prepares Doctor of Nursing Practice (DNP) APRN students. The telehealth program, …