Medicine and Health Sciences Commons^™

The Effectiveness Of Implementing Standard Of Care Best Practices Including Use Of Daily Incentive Spirometry To Improve Dyspnea And Quality Of Life In Adults With Chronic Obstructive Pulmonary Disease (Copd), Christine Gallagher

Doctor of Nursing Practice (DNP) Program

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by symptoms of dyspnea, cough, and wheezing. Many patients with COPD are on daily medications for their symptoms yet these symptoms continue to persist, impairing their quality of life. Patients with COPD experience respiratory muscle weakness that contributes to dyspnea and an inability to participate in daily activities. GOLD (2014) guidelines state that the goal of therapy in these patients is to reduce symptoms, increase participation in activities, and restore the highest level of independent functioning. The guidelines recommend the use of inspiratory muscle training (IMT) in …

Lipid Management Of Patients With Probable Familial Hypercholesterolemia By A Nurse Practitioner, Carla Weidner

Doctor of Nursing Practice (DNP) Program

Heart disease remains the number one killer of Americans. Patient’s high cholesterol numbers are a major risk factor for the development of heart disease. Studies performed by the Centers for Disease Control (CDC) and the U.S. Department of Health and Human Services (DHHS) have recognized this as an area in need of improvement. Strategies for improvement of patients’ serum cholesterol and adherence to the recommended therapies have been explored. The purpose of this evidence based project is to compare cholesterol management outcomes in patients cared for by a nurse practitioner, with lipid management certification, to patients cared for by their …

The Retrospective Evaluation Of The Effectiveness Of Implementing Standard Of Care Best Practices On Fear Of Hypoglycemia (Foh) In Insulin Requiring Diabetics, Melissa Laporte

Doctor of Nursing Practice (DNP) Program

The population of individuals with diabetes is expected to rise along with a rise in the use of insulin therapy to control hyperglycemia and prevent diabetic complications. Insulin therapy is implicated as one of the leading causes of hypoglycemia, a potentially life-threatening adverse drug event. Hypoglycemia is recognized by patients and clinicians as the greatest barrier to achieving adequate glycemic control and it causes physical, psychosocial, financial, and safety concerns for individuals, their families, communities and health care systems. Hypoglycemia often causes insulin requiring diabetics to develop a fear of hypoglycemia, a complex phenomenon that manifests as avoidance of hypoglycemia …

Chhs August 2015 E-Newsletter,, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Simulation And Educational Strategies To Decrease The Incidence Of Medication Errors In A Small Rural Acute Care Hospital, Queen Victoria Walters

Doctoral Projects

The Institute of Medicine (IOM) estimates 1.5 million medical errors occur per year (2007). Medication errors are the leading medical error. Medication errors are defined as adverse drug events, and are 100% preventable. Some categories of adverse drug events include, medications administered at the wrong time, by the wrong route, using the wrong method of administration, and administration of the wrong dose of medication. Adverse drug events also include administration of an overdose of medication or the omission of medications as well as administering the wrong medication.

The purpose of this capstone project was to increase the competency of nurses …

The Evolution Of Physical Activity Promotion, Elizabeth Richards

School of Nursing Faculty Publications

Overview: A physically active lifestyle has numerous physical and mental health benefits for patients of all ages. Despite these significant benefits, a majority of Americans do not meet current physical activity guidelines. Health care providers, especially nurses, play a vital role in physical activity promotion. Over the past several decades, exercise and physical activity guidelines have evolved from a focus on structured, vigorous exercise to a focus on moderate-intensity “lifestyle” physical activity. The author updates nurses on physical activity guidelines and provides tips for promoting physical activity, with a focus on lifestyle activities such as walking to work. This article …

The Risk Of Secondary Lymphedema Due To Procedures In The Affected Arm Post-Mastectomy: A Literature Review, Lindsay Perna

HIM 1990-2015

The risk for upper extremity lymphedema post-mastectomy in women surgically treated for breast cancer is a concern since it is often painful, aesthetically displeasing, and can increase the risk of infection. However, there is a paucity of data examining if diagnostic procedures performed in the ipsilateral arm post-mastectomy increases the risk of lymphedema. The purpose of this research is to examine the relationship between diagnostic procedures performed in the ipsilateral arm post-mastectomy and the occurrence of lymphedema with or without related complications. A systematic review of the literature was conducted from multiple, online databases available from 1992 through 2014, and …

Expert Clinician To Novice Nurse Educator. Learning From First-Hand Narratives, Jeanne Merkle Sorrell, Pamela Cangelosi

Walden Faculty and Staff Publications

The nurse educator role often looks deceptively simple. Compared to the complexity of bedside care for a patient with multiple comorbidities and hour-by-hour monitoring, watching over students to guide their learning may appear easy. Yet, when experienced nurse clinicians try out this new endeavor for the first time, they often describe themselves as frustrated and uncertain about how to best implement the role. Through years of experience as clinicians, nurses often arrive at a comfort zone where they know what to do for their patients in order to keep them safe and enhance their healing. When moving to the nurse …

Partnering To Improve Patient Outcomes: A Qualitative Study Of Adult Patient Experiences With Orthopedic Surgical Care, Sacha L. Degraffenreid-Yates

Electronic Theses & Dissertations

The purpose of this study was to explore adult orthopedic surgical patient experiences during their preoperative, perioperative and postoperative care; utilizing the results to discuss specific interactions in care that produced positive or negative outcomes. Partnering with patients to understand shared decision making and patient centered care has been previously researched in literature, and continued research is key to discover effective care practices. The Centers for Disease Control and National Center for Health Statistics (2015) reports total knee and hip joint replacement surgeries of more than one million yearly. The large patient population magnifies the need to understand patient experiences …

The Effects Of Auditory Stimuli On Stress Levels Of Adult Patients In The Critical Care Setting, Jessica Ellermets

HIM 1990-2015

The purpose of this review of literature is to explore the effects of interventional and environmental auditory stimuli on the adult critical care population. Current research has yet to compare and contrast the effectiveness of various interventional auditory stimuli on stress relief, an oversight this thesis aims to remedy. Modern day critical care settings demand the identification of the most therapeutic interventional auditory stimulus and the most stress-inducing environmental stimuli, so that interventions can be made to optimize patient stress levels and improve outcomes. Suggestions will be made on how to simultaneously reduce harmful or stress inducing auditory stimuli in …

Nursing Interventions To Prevent Necrotizing Eterocolitis: A State Of The Science Literature Review, Katherine Casto

HIM 1990-2015

The purpose of this review of literature is to understand the current state of the science and to make recommendations for practice and research in regards to the gastrointestinal condition affecting premature infants, necrotizing enterocolitis (NEC). Emphasis is placed on reviewing the literature to identify prevention strategies nurses can use to reduce the incidence, morbidity and mortality of NEC. The introduction will focus on discussing the problem of NEC including its risk factors, pathophysiology, and disease presentation. The findings sections will focus on the most promising and researched areas of intervention. The discussion section will focus on how this knowledge …

Analyzing The Relationship Between Women's Decisions To Use Contraception And Their Partners' Perceptions Of Preventative Behavior, Kayla Gayle-Campbell

HIM 1990-2015

A majority of adolescents and young adults report inconsistent use of safe sexual behaviors and contraception methods due to a variety of influencing factors. These practices can lead to limited future reproductive choices and can spread communicable disease in the population. The purpose of this study was to determine if a woman's decision to use a specific type of contraceptive method is influenced by her partner's attitude toward preventive sexual health practices. A secondary purpose was to analyze women's attitudes towards safe sex and contraceptive practices as independent entities of disease and pregnancy in the reproductive cycle. A literature review …

Census-Based Socioeconomic Indicators For Monitoring Injury Causes In The Usa: A Review, Nathaniel Bell, Amanda Arrington, Swann Arp Adams

Faculty Publications

BACKGROUND:

Unlike the UK or New Zealand, there is no standard set of census variables in the USA for characterising socioeconomic (SES, socioeconomic status) inequalities in health outcomes, including injury. We systematically reviewed existing US studies to identify conceptual and methodological strengths and limitations of current approaches to determine those most suitable for research and surveillance.

METHODS:

We searched seven electronic databases to identify census variables proposed in the peer-reviewed literature to monitor injury risk. Inclusion criteria were that numerator data were derived from hospital, trauma or vital statistics registries and that exposure variables included census SES constructs.

RESULTS:

From …

Prevalence Of Steroid-Induced Hyperglycemia In Patients With Mantle Cell Lymphoma Receiving High Dose Steroids, Veronica Brady

Dissertations and Theses (Open Access)

Background

Hyperglycemia as a result of glucocorticoid administration (steroid-induced hyperglycemia [SIH]) occurs in 32-37% of adult patients with cancer both with and without previous history of diabetes. Patients diagnosed with mantle cell lymphoma (MCL) are often treated with chemotherapy regimens that include high dose steroids as first line therapy. Little is known about the prevalence of steroid-induced hyperglycemia in patients with MCL receiving high dose steroids. Moreover it is not known if how the resulting hyperglycemia is managed impacts time to relapse or death.

Purpose

The primary aim of this study was to determine the prevalence of SIH in MCL …

Content Validity Of A Tool Measuring Medication Errors., Nishat Tabassum, Saleema Allana, Tanveer Saeed, Jacqueline Maria Dias

School of Nursing & Midwifery

The objective of this study was to determine content and face validity of a tool measuring medication errors among nursing students in baccalaureate nursing education. Data was collected from the Aga Khan University School of Nursing and Midwifery (AKUSoNaM), Karachi, from March to August 2014. The tool was developed utilizing literature and the expertise of the team members, expert in different areas. The developed tool was then sent to five experts from all over Karachi for ensuring the content validity of the tool, which was measured on relevance and clarity of the questions. The Scale Content Validity Index (S-CVI) for …

Improving Screening And Outcomes For Postpartum Depression, Elizabeth Jahn

Nursing Capstones

No abstract provided.

Improving Patient Safety By Decreasing Restraint Use, Francesca R. Pearl

Master's Projects and Capstones

Restraints are among the top 15 most frequently reported sentinel events (Cosper et al., 2013). An improvement project was undertaken to reduce restraint use on a medical/surgical acute care unit within a 200 bed not-for-profit teaching hospital. The project aimed to reduce physical restraint use prevalence by 10%. After conducting a literature review and a microsystem assessment, Multidisciplinary Rounding (MDR) was identified as an evidence-based intervention to address physical restraint use. A reduction in restraint prevalence was noted from 2.4% to 1.6%. This equates to a 33% reduction in restraint prevalence. Other interventions implemented during the same time frame may …

Performing A Correct Surgical Time Out, Natalia E. Mariscal

Master's Projects and Capstones

The ending data reflected what we expected in that we would see a significant incline but

not quite the 100% compliance rate we are looking for. Our highest compliance rate has reached

90% and we have contributed the margin error to new staff that requires the proper teaching and

education. In conclusion I feel that the majority of staff was aware that they were not in

compliance with the time out but would proceed anyways due to the rush of the case or surgeon

or simply that they had become laxed in practice. Once the data was brought to staff …

Health-Related Quality Of Life In Children With Cancer, Tha'er Ghandi Almomani

Theses and Dissertations (ETD)

Health-related quality of life is an important phenomenon to measure in children undergoing treatment for cancer. However, the effects of different treatment modalities and cancer related factors over the duration of treatment have not been explored. To assess the effects of different child-, cancer-, and treatment-related factors, we analyzed a large sample of children undergoing curative treatment for 5 different childhood cancer diagnoses. These diagnostic groups were Hodgkin Lymphoma (HL), Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML), Osteosarcoma (OS), and Melanoma. We analyzed a sample of 710 patients across the five diagnostic groups over four time-points in treatment. These …

Losartan Treatment Attenuates Tumor-Induced Myocardial Dysfunction, Sarah C.W. Stevens, Markus Velten, Dane J. Youtz, Yvonne Clark, Runfeng Jing, Peter J. Reiser, Sabahattin Bicer, Raymond D. Devine, Donna O. Mccarthy, Loren E. Wold

College of Nursing Faculty Research and Publications

Fatigue and muscle wasting are common symptoms experienced by cancer patients. Data from animal models demonstrate that angiotensin is involved in tumor-induced muscle wasting, and that tumor growth can independently affect myocardial function, which could contribute to fatigue in cancer patients. In clinical studies, inhibitors of angiotensin converting enzyme (ACE) can prevent the development of chemotherapy-induced cardiovascular dysfunction, suggesting a mechanistic role for the renin–angiotensin–aldosterone system (RAAS). In the present study, we investigated whether an angiotensin (AT) 1-receptor antagonist could prevent the development of tumor-associated myocardial dysfunction. Methods and results: Colon26 adenocarcinoma (c26) cells were implanted into female CD2F1 mice …

Predictors Of Engagement In Postpartum Weight Self-Management Behaviours In The First 12 Weeks After Birth, Jennifer M. Ohlendorf, Marianne E. Weiss, Debra L. Oswald

College of Nursing Faculty Research and Publications

Aim

To explore factors that influence postpartum weight self-management behaviours. Transitions Theory and the Integrated Theory of Health Behaviour Change guided selection of variables. Transition conditions, level of patient activation and social facilitation were examined for association with postpartum weight self-management behaviours.

Background

Retention of pregnancy weight increases risk of overweight and obesity later in life. Little is known about what women do to self-manage return to pre-pregnant weight and how providers can influence their behaviours.

Design

Prospective, longitudinal, correlational.

Methods

Data collection occurred from March through October, 2013. One hundred and twenty-four women completed surveys during postpartum hospitalization; telephone …

The Influence Of Contraception, Abortion, And Natural Family Planning On Divorce Rates As Found In The 2006–2010 National Survey Of Family Growth, Richard J. Fehring

College of Nursing Faculty Research and Publications

The purpose of this study was to determine the influence of contraception, abortion, and natural family planning (NFP) on divorce rates of US women of reproductive age. The variables of importance of religion and frequency of church attendance were also included in the analysis. The study involved 5,530 reproductive age women in the (2006–2010) National Survey of Family Growth who indicate that they were ever married. Among the women who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who were currently divorced among the women who never used NFP (x² = 5.34, …

Current Medical Research: Summer/Fall 2014, Richard J. Fehring

College of Nursing Faculty Research and Publications

No abstract provided.

Compassion Satisfaction And Compassion Fatigue Among Critical Care Nurses, Tara L. Sacco, Susan M. Ciurzynski, Megan Elizabeth Harvey, Gail L. Ingersoll

Nursing Faculty/Staff Publications

BACKGROUND Although critical care nurses gain satisfaction from providing compassionate care to patients and patients’ families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life.

OBJECTIVES To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics.

METHODS In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction.

RESULTS Nurses (n = 221) reported …

Evaluation Of Vaccination Policies Among Outpatient Oncology Clinics In Utah: A Pilot Study, Sarah Louise Stocksdale

Theses and Dissertations

Background: In Utah, all major hospital facilities have employee vaccination policies. However, the presence of health care worker vaccination policies in the Utah outpatient oncology setting was unknown. Objectives: The objectives were to identify Utah oncology outpatient employee vaccination policies and to identify what consequences, if any, were present for unvaccinated employees. Methods: This was a cross-sectional, descriptive study design in which clinic managers from outpatient oncology clinics in Utah were asked, via questionnaire, to describe the clinic's employee vaccination policy and the consequences for refusing the policy. Findings: Most vaccination policies applied to employees primarily assigned to work in …

Do Stress Levels Differ Between First Semester Nursing Student Early In The Semester Vs. The End Of The Semester?, Alissy Heisey

Undergraduate Honors Theses

This study intends to determine how stress levels change over time in nursing students in the Baccalaureate program at East Tennessee State University. The instrument utilized for this survey was the Perceived Stress Scale by Mind Garden, Inc. This survey was passed at the beginning of the semester and at the end of the semester. There was no-significant difference found between the two time spots, leading us to conclude that the level of stress perceived by nursing students is a steady factor during their school semester.

Breastfeeding With The Bronson Mothers’ Milk Bank, Marykate Bodnar

Masters Theses

Bronson Methodist Hospital in Kalamazoo is home to one of only 15 certified breast milk banks in the United States. Women have shared breast milk for centuries through wet nurses, but this institutionalized and regulated version of sharing is distinct from previous forms. Breastfeeding has become a symbol of successful motherhood; donor milk adds a new dimension to this aspect of idealized motherhood. This study explores how the milk bank works: its organizational structure within a hospital, how donors are selected, and how recipients qualify for donor milk. It is grounded in Feminist and Medical Anthropology literature. Using semi-structured interviews …

Undergraduate Nursing Students’ Attitudes Toward Mental Health Nursing, Vipavee Thongpriwan, Susan E. Leuck, Rhonda L. Powell, Staci Young, Suzanne Schuler, Ronda G. Hughes

College of Nursing Faculty Research and Publications

Objectives: The purpose of this study was to describe undergraduate nursing students’ attitudes toward mental health nursing and how these attitudes influenced their professional career choices in mental health nursing.

Design: A descriptive, online survey was utilized to examine students’ perceptions of mental health nursing. A total of 229 junior and senior nursing students were recruited from eight nursing colleges in Midwestern United States to participate in this survey.

Results: Students of different ages, genders, ethnicities, and nursing programs did not report significantly different perceptions of: (a) knowledge of mental illness; (b) negative stereotypes; (c) interest in mental health nursing …

The Identification Of Maltreatment In Children With Disabilities: An Education Program, Jessica Leigh Ahmann

Nursing Capstones

No abstract provided.

Assessment Of Chronic Dyspnea In Older Adults: Impact Of The Dyspnoea-12 Questionnnaire On Nurse Self-Efficacy, Illaria C. Moore

Nursing Capstones

No abstract provided.