Medicine and Health Sciences Commons^™

Recognition Of Compassion Fatigue Among Medical-Surgical Nurses: The Provision Of Education To Manage The Effects, Kandace Woodruff

Doctor of Nursing Practice (DNP) Projects

The Institute of Medicine (IOM) (2010) recommends that healthcare organizations make the “recruitment and retention of qualified nurses a priority”. The ability to comply with the recommendation is fraught with challenges. Nurses are required to care for patients across the age span with varying medical complexities. There are work related stressors which are inherent to the care of a more acutely ill patient population. The tenuousness produced by this type of environment can predispose the nurse to a stress induced phenomenon known as, Compassion Fatigue. The literature is abounding with information related to compassion fatigue among various nursing specialties. However, …

The Role Of The Nurse Practitioner In The Patient-Centered Medical Home, Patricia M. Sohn

Dissertations

The Patient Centered Medical Home (PCMH) was established to improve patient access to high quality, cost-effective primary care. Critical to this new model of care is the optimal utilization of nurse practitioners (NPs) in performing services traditionally offered by physicians. This study compared the roles of NPs and physicians in providing primary care in two PCMHs in a local health care system. During the calendar year 2011, a total of 50,471 patient visits occurred in the two PCMHs. Each PCMH consisted of a Traditional Clinic that saw patients on a scheduled basis and a Convenient Care Clinic that accepted walk-in …

The Feasibility Of An Advanced Practice Registered Nurse-Managed Adhd Resource Center In Missouri, Kara Janelle Stackley

Dissertations

The primary objective of this project was to develop a survey to determine provider receptiveness to referring patients to an advanced practice registered nurse-(APRN) managed center for the diagnosis and management of Attention Deficit/Hyperactivity Disorder (ADHD). A secondary aim of this project was to develop a business plan for the center, provided feedback from the survey was determined to be supportive. Physicians were more likely to use ADHD clinical guidelines (65%) in their practice and expressed greater comfort managing ADHD. Only 50% of APRNs use the clinical practice guidelines and 50% reported they were uncomfortable diagnosing and managing ADHD. Almost …

Identification And Management Of Vertebral Column Fractures In Primary Care, Christopher Richard Hemmer

Dissertations

The purpose of this project is to perform a program evaluation of current treatment patterns of primary care providers for osteoporotic vertebral compression fractures (VCF). VCF’s result in significant morbidity and long term sequelae following a VCF is not uncommon. Additionally, there is controversy regarding the diagnosis and management of this disorder, especially as these relate to the clinical practice guidelines. This practice evaluation project included a pre and post-test survey and a continuing education offering. Thirty-nine physicians and nurse practitioners completed the survey instruments and attended the continuing education sessions. The educational session resulted in improvement of the provider’s …

Text Messaging As Adjunct To Community Based Weight Management Program, Claudia Bouhaidar

Theses and Dissertations

Obesity ascending rates are still a public health priority. The primary aim of the study was to evaluate the effect of tailored text messages on body weight change in overweight and obese adults in a community based weight management program. A secondary aim was to detect behavioral changes in the same population. The study design was quasi-experimental with pre and posttest analysis, conducted over 12 weeks. A total of 28 participants were included in the analysis. Body weight, eating behaviors, exercise and nutrition self-efficacy, attitude toward mobile technology, social support and physical activity were assessed at baseline and at 12 …

A Gap Analysis Of Nursing Systems And Practices In Malaysia: Culturally Appropriate Interventions To Advance Nursing, Chenit Ong-Flaherty

Doctor of Nursing Practice (DNP) Projects

This project comprises a gap analysis of differences between American and Malaysian nursing programs, and additionally, proposes culturally appropriate interventions for Malaysian nursing to adopt American nursing models. The gap analysis was conducted on nursing systems and practices in Malaysia undertaken to identify the differences between Malaysian and American nursing, and the influences that affect Malaysian nursing. The aim is to facilitate the use of the American Nurses Credentialing Center (ANCC) Pathway to Excellence Practice Standard #4: Orientation Prepares New Nurses for the Work Environment, and #6: Professional Development is Provided and Used. The proposal of culturally appropriate interventions as …

Clinical Instructors' Perceptions Of Structural And Psychological Empowerment In Academic Nursing Environments, Sandra E. Wiens

Electronic Thesis and Dissertation Repository

ABSTRACT

The study purpose was to explore clinical instructors’ perceptions of empowerment in academic nursing environments. Clinical instructors (CIs), often part-time faculty, facilitate learning in professional practice environments. However, they also need to function within the academic environment to learn about the curriculum and how students are to be evaluated.

The qualitative description method was used to obtain a broad understanding of CIs’ empowerment experiences and to interpret their perceptions with the framework of Kanter’s (1977, 1993) structural empowerment and Spreitzer’s (1995) psychological empowerment theories. Eight CIs from two nursing programs were interviewed.

All empowerment components were important in CIs’ …

Maternal Mortality: The Need To Work With Traditional Birth Attendants To Offset The Problem, Nat Quansah

Nat Quansah

The Reninjaza (Traditional Birth Attendant) is recognized as the professional of Traditional Medicine specializing in the provision of maternal and infant health care services just as the Midwife is recognized as the professional of Allopathic Medicine who specializes in the provision of maternal and infant health care services. Having these professionals of the two medical systems work in a complimentary manner, it is argued, will not only result in improving the gathering of information on maternal deaths, the accuracy of reporting and monitoring of maternal deaths but more importantly, will result in the reduction of maternal deaths. This is because …

Identifying The Influence Of Parents' And Children's Perceptions Of Their Built And Social Environments On Children's Mode Of Travel To And From School, Emily S. Hill

Electronic Thesis and Dissertation Repository

This study examined the influence of parents’ and children’s perceptions of their built and social environments on children’s use of active transportation (AT) between home and school. A mixed-methods approach was used including an environmental/behavioural survey completed by students (grades 5 through 8) and parents from 32 schools throughout London, Ontario, (n=1,623); Geographic Information Systems (GIS) for generating built environment variables to be controlled for; Principal Component factor analysis; and step-wise logistic regression models that divided analysis between the journey to and from school to determine the most influential factors in either direction. Children’s personal attitudes were the …

Vulnerability And Adaptation For Traumatic Brain Injury Survivors, Amy Johnson

Nursing Theses and Dissertations

Many of the over 5 million survivors of traumatic brain injury (TBI) with related disabilities living in the community do not have support for their unmet needs. Adapting to life after TBI is difficult because of cognitive, emotional, and behavioral complications. Nurses and other healthcare professionals have the opportunity to promote positive outcomes for persons with TBI. However, to increase the depth and breadth of that support, nurses need a base of knowledge that includes an understanding of the TBI survivors' needs, vulnerabilities, and obstacles to adaptation. TBIs result in physical, psychological, developmental, and emotional losses. The needs that ensue …

Exploring The Differences Between Adult Cancer Survivors And Their Caregivers' Social Support, Self-Efficacy For Physical Activity, Physical Activity Behavior, And Quality Of Life, Fedricker Diane Barber

Nursing Theses and Dissertations

Less than 20% of cancer survivors meet recommended physical activity (PA) guidelines. Research reporting positive impact of social support on PA in cancer survivors has not included their caregivers' PA. A review of the literature examining social support and PA in cancer survivors supported including caregivers in developing strategies to increase PA in cancer survivors. The purposes of this study were: (1) to explore the differences and relationships between adult cancer survivors' and caregivers' social support, self-efficacy for physical activity (SEPA), PA, and quality of life (QOL), and (2) understand cancer survivors and caregivers' perception of social support in PA …

Effect Of Telephone Counseling On Physical Activity Among Older Adult Cancer Survivors, Ellen C. Mullen

Nursing Theses and Dissertations

The elderly population, especially those with cancer coupled with low health literacy, is at high risk for poor health outcomes. Telephone counseling has been shown to be effective in improving health behaviors among other populations, but it has not been studied for older adult cancer survivors. The purpose of this mixed methods study was to examine the effectiveness of telephone counseling on physical activity among older adult cancer survivors (n=50). The relationship between health literacy level and perceived changes in physical activity was assessed. Based on existing literature and Orem's Theory of Self-care, the following hypotheses were tested: H1: Telephone …

The Lived Experience Of Fathers Whose Children Are Diagnosed With A Genetic Disorder, Mary T. Rivard

Nursing Theses and Dissertations

Parenting a child with a genetic disorder requires overcoming numerous obstacles. The purpose of this study was to understand the experience of fathers whose children have been diagnosed with a genetic disorder. By gaining insight into a father's reactions and needs, nurses will be better able to provide anticipatory guidance, emotional support, assistance with stressor identification, development of coping mechanisms, and problem solving strategies to assist him in coping with his child's condition.

“I’Ve Accomplished Something Here” The Lived Experience Of Employed Breastfeeding Mothers: A Phenomenological Analysis, Jennifer Diane Stewart-Glenn

Doctoral Dissertations

Abstract

The purpose of this study was to describe the experience of employed breastfeeding mothers. Using a phenomenological approach based on the works of Merleau-Ponty, the researcher completed 13 interviews in which mothers with experience working full-time while breastfeeding were asked to describe their experiences. The interviews were transcribed verbatim and analyzed using a hermeneutical approach developed by Pollio and applied to nursing research by Thomas. Each interview was examined within the context of all the interviews to identify themes found throughout.

While participants’ experiences were grounded in the unsupportive world of the workplace, aspects of their experience became figural …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

• Greetings
• Pacesetter Grads Feel Boost in Entry to Nursing Workforce
• UTHealth-UH Dual Bachelors Program for First-Time Students
• UTHealth School of Nursing – By the Numbers
• 2012 PARTNERS Spring Luncheon – honored “Generations of Nurses” – guest speaker Naomi Judd
• UT Health Services Expands Care for Patients
• When I Grow Up, – A UTHealth Nursing Student’s Story
• Donors Support Start of New Accelerated Family Nurse Practitioner Program
• Giuseppe Colasurdo, M.D. – Appointed Sixth President in U THealth’s 40-Year History
• Dean Starck Named to UT Academy of Health Science Education, Marcus Honored by Regents for Outstanding Teaching
• Students Select Two for 2012 …

Understanding And Treating Smoking Among Individuals With A Mental Illness, Chizimuzo T.C. Okoli

Nursing Presentations

• Background and significance

• Reasons for smoking among individuals living with a mental illness

• Smoking cessation treatment for individuals living with a mental illness

How Do Psychiatric Healthcare Workers Prevent The Use Of Restraint And Seclusion?, Kelly A. Carlson

Doctoral Dissertations

The purpose of this grounded theory method study was to understand the complex, interactive, and interrelated processes that psychiatric healthcare workers engage in to prevent the use of restraint and seclusion. Without supporting evidence of therapeutic validity, restraint and seclusion are commonly used by psychiatric healthcare workers to control disruptive patients. The Substance Abuse and Mental Health Services Administration issued a call for the elimination of restraint and seclusion use in psychiatric care settings in 2003. Workplace violence, another major public health concern, is both a cause and effect of the restraint and seclusion use. Individuals continue to be needlessly …

Predictors Of Drug Court Client Graduation, Marie E. Gill

Theses and Dissertations (ETD)

Background: Substance use disorder in the United States adversely effects society by burdening the justice system with offender incarceration for drug-related crimes, it also strains in the healthcare system with costs in excess of $216 billion dollars for treatment of drug-related mental and physical illnesses. Many offenders of nonviolent crimes with substance use disorder have been diverted to Drug Court (DC) for year-long supervised community-based drug addiction treatment as an alternative to incarceration for non-violent drug-related crimes. Drug Court program outcomes, however, have been studied as a criminal justice intervention, rather than a primary care mental health intervention. The majority …

The Relationship Among Maternal Parenting Stress, Coping, And Depressive Symptoms Across Time, Karen Foren Lake

Theses and Dissertations

This study was a secondary analysis in which the relationship among maternal parenting stress, coping, and depressive symptoms over time in 161 low-income mothers who participated in an Early Head Start Pathways Project were examined. Measurements were assessed longitudinally over a 12 year period of time. Direct and indirect relationships were proposed between maternal mastery, pre-existing depressive symptoms, relationship with significant other, child behavior, child temperament, maternal parenting stress, coping, and later depressive symptoms. Results from path analyses showed that when assessed earlier in the childbearing years, mastery, depressive symptoms, relationship with significant other, child temperament, child behavior, and maternal …

Listening To The Voices Of Emerging Adults: The Experience Of Living With Phiv, Constance D. Hill

Theses and Dissertations

The purpose of this descriptive study was to explore the research question: "As an emerging adult what is your everyday experience of living with PHIV?" The purposive sample consisted of six emerging adults living with perinatally acquired HIV (PHIV), who are 18-29 years of age, speak English, and live in the greater Chicago area.

This was an exploratory study using a participatory action approach of photovoice. Photovoice methodology combines photography and participatory action to provide images and the participants' interpretations of their everyday health realities. Five themes which describe the everyday experience of living with PHIV emerged from the thematic …

Childhood Obesity And The Relationship To Well-Child Visits, Nancee Croatt Wozney

Theses and Dissertations

Trends during the past 20 years have revealed a dramatic increase in childhood obesity in the United States. At present, approximately nine million children over 6 years of age are considered obese (Institute of Medicine [IOM], 2011). According to (American Academy of Pediatrics [AAP], 2009) the protocol for obesity care for youth is to monitor the body mass index (BMI) routinely (at least annually) and offer appropriate counseling and guidance to children and their families. A report in the literature indicated that the number of children attending yearly well-child visits that include measurement of BMI is well below the AAP …

Pepsin And Amylase In Oral And Tracheal Secretions Of Patients With Standard Versus Continuous Subglottic Suctioning Endotracheal Tubes, Katherine Allen

HIM 1990-2015

The aspiration of oral and gastric substances is a well-known risk for ventilator associated pneumonia (VAP) in the intubated, mechanically ventilated (MV), patient of the intensive care unit (ICU) population. The gastric biomarker pepsin and the oral biomarker salivary amylase have been identified as evidence of aspiration prior to the manifestation of acute pulmonary illness. In an effort to decrease the risk for aspiration, several evidence based nursing practices are in place. Actions include 30 degree head of the bed positioning, oral care, suctioning, and circuit change interval protocols, as well as the administration of medication with the objective of …

Non-Invasive Positive Pressure Ventilation (Nppv) Its Uses, Complications, & Implications Within Nursing Practice In Acute Care Settings, Alexis Marano

HIM 1990-2015

The use of noninvasive positive pressure ventilation (NPPV) in acute care settings has drastically increased within the past 20 years. Research has indicated that NPPV is equally as effective as traditional mechanical ventilation(MV) in treating acute exacerbations of chronic pulmonary obstructive disease (COPD) and cardiogenic pulmonary edema. Furthermore, the risk of complication from NPPV is much lower than MV, in terms of ventilator-associated pneumonia and sepsis. It is imperative for the nurse to understand the various indications, interfaces, and potential complications associated with NPPV use. In addition to treating acute exacerbations of COPD and cardiogenic pulmonary edema, NPPV has been …

Pepsin And Salivary Amylase Biomarkers Of Microaspiration In Oral And Tracheal Secretions Of Intubated Patients, Aurea Middleton

HIM 1990-2015

Introduction: The presence of an endotracheal tube (ETT) increases the risk for microaspiration of secretions around the ETT. Biomarkers of pepsin and salivary amylase may be used to identify microaspiration in intubated patients because of their naturally occurring presence in the stomach or oral cavity and non-occurrence in the respiratory tract. Microaspiration may be difficult to detect until pulmonary complications, such as lung injury or infection, occur. This study assessed the presence of pepsin and salivary amylase in oral and tracheal secretions of ventilated adults. Method(s): This is a secondary analysis of data collected from 11 critically ill, adult patients …

Literature Review Examining Continuous Subcutaneous Insulin Infusion And Effects On Hemoglobin A1c, Hypoglycemia, Hyperglycemia/Diabetic Ketoacidosis, And Quality Of Life, Jamie Moses

Graduate Research Projects

No abstract provided.

Central Line-Associated Bloodstream Infection Prevention In The Long-Term Acute Care Setting, Mary Lisbeth Dougherty Msn Rn Aocna

Doctoral Dissertations

Sustained reduction of central line-associated bloodstream infections remains elusive in many institutions, including the long-term acute care hospital (LTACH), despite a focus on improving patient outcomes. A clinical practice survey was distributed electronically to nurses working in the LTACH setting. The survey provided for an anonymous assessment of knowledge related to policy/procedure, fidelity to practice as well as site-specific barriers to adherence to clinical practice guidelines. Results revealed opportunities for education related to clinical practice guidelines and basic central line-associated bloodstream infection strategies as well as perceived barriers to adherence to policy/procedure. Strategies aimed at mitigating gaps and barriers are …

Media Created Violence: A Social Determinant Of Mental Health., Shamshad Begum, Shaneela Sadruddin Khowaja, Gulnar Ali

School of Nursing & Midwifery

In today's high technological world, scientific discoveries contribute remarkable development to human life, but it could also have an adverse impact on mankind. Among all these advancements, media is one of the inventions which aims at capturing a countless group of viewers and transmit information via various mediums. Media violence is considered one of the hampering determinants which harms an individual psychologically. The primary goal of a health professional is to work for the maintenance of mental health. Therefore, it is imperative to create an understanding about the impact of media violence on mental health, particularly in the Pakistani context. …

Immersion Research Education: Students As Catalysts For International Collaboration Research, Kathryn H. Anderson, Marie-Luise Friedemann, Andreas Buescher, Julita Sansoni, Donna R. Hodnicki

Kathryn H. Anderson

Background:  This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research. Aim:  To narrow the healthcare gap for disadvantaged families in the USA and partner countries. Methods:  Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the …

Immersion Research Education: Students As Catalysts For International Collaboration Research, Kathryn H. Anderson, Marie-Luise Friedemann, Andreas Buescher, Julita Sansoni, Donna R. Hodnicki

School of Nursing Faculty Publications

Background:  This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research.

Aim:  To narrow the healthcare gap for disadvantaged families in the USA and partner countries.

Methods:  Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA …

The Associations Of The Level Of School Wellness Policy Implementation And School Nurse Activities To Weight Status Of School Children In Massachusetts, Mary Jane F. O'Brien

Graduate Doctoral Dissertations

The increase in prevalence of childhood obesity has prompted child health authorities to propose mandates focusing on population health efforts that may be implemented in public schools. In 2010, the federal government passed the Healthy, Hunger-Free Kids Act, reinforcing the 2004 regulations to guide school districts in development and implementation of school wellness policies.

The purpose of this secondary data analysis was an examination of the association between implementation of the school wellness policy and school nurse activities to the absolute change in percent of students with body mass index in the obese weight category between the school years 2005-2006 …