Medicine and Health Sciences Commons^™

Evaluation Of An Innovative Program To Improve Outcomes Among Military Beneficiaries With Diabetes, Carol A.B. Andrews

Nursing Theses and Dissertations

Patient Centered Medical Home (PCMH) is a health care model implemented in all United States Air Force (USAF) medical facilities which uses a team-based approach to promote accessibility, quality care, and appropriate service utilization, while decreasing costs. To measure the effectiveness of this model, the National Committee for Quality Assurance (NCQA) has developed a tool to document and recognize facilities that incorporate all model elements. However, the effects of the full model implementation on patient outcomes in military settings have not been studied. This research fills an important gap in the literature because it studies the effect of PCMH implementation …

Challenges Of Smoking Cessation Research In Mongolia, Carol M. Rowley

Nursing Theses and Dissertations

The deleterious impact of tobacco use on health has been well-known for years. Nevertheless, cigarette smoking is a behavior which generally is not easily abandoned due to its addictive propensities. Thus, it is important for nurses to be competent in the delivery of evidence-based smoking cessation interventions which can help their clients achieve tobacco-free status. This need is particularly urgent in nations with high smoking prevalence rates, including many developing nations. The purpose of this study was two-fold. First, an investigation was undertaken to determine the smoking habits and influences among Eastern European nations, the former Soviet Union, and Mongolia. …

Fit To Care: An Action Research Study Exploring The Use Of Communication Theory To Strengthen Caring Relationships Between Teachers And Students, Pamela K. Lake

Nursing Theses and Dissertations

Watson's Theory of Human Caring lends theoretical structure to nursing curricula grounded in Caring Science. A key principle within the theory is the caring trusting teacher-student relationship. This relationship can be threatened by the need to relay instructional feedback to students when performance has fallen below standards. The tension resulting from this exchange is uncomfortable to all concerned and can damage the relationship and lead to even worse student performance. Nursing literature has not reported studies addressing this problem. Communication studies have extensive reports of such research. Feedback Intervention Theory (FIT) is based on skilled facework to improve student outcomes …

Breastfeeding Influencing Factors In Thai Adolescent Mothers, Supannee Kanhadilok

Theses and Dissertations

Background: Breastfeeding is well established as the optimal method for ensuring healthy infant nutrition. However, many adolescents remain unaware of the role of breastfeeding. Adolescent mothers continue to have the lowest rate of breastfeeding in many countries including Thailand, with only 17% of Thai adolescent mothers continuing to breastfed at 6 months postpartum. Objective: Examine factors influencing breastfeeding behaviors in adolescent mothers, particularly those in Thailand. Methods: This dissertation project involved two research studies focusing on breastfeeding influencing factors in adolescent mothers. The first study was an integrative review of 22 articles published in 2000-2012. The findings revealed that personal …

Predictors Of Agitation In The Critically Ill, Ruth Burk

Theses and Dissertations

BACKGROUND: Agitation is a common complication in the intensive care unit (ICU) manifested in behavior and actions that range from simple apprehension or anxiety to frankly combative behavior.5 Agitation is associated with significant adverse outcomes.1-3 Studies report up to 71% of ICU patients have some degree of agitation during their ICU stay and that agitation is observed 32% of the time.3;4 Potential causes of agitation in critically ill patients are numerous; however, data about factors that predict agitation are limited. OBJECTIVE: The specific aim of this study was to identify predictors of agitation on admission to the ICU as well …

Perception, Expression And Management Of The Pain Of Childbirth, Mary H. Christenson

Senior Honors Theses

In order to be a competent nurse on an American labor and delivery unit it is important to have an understanding of the pain of childbirth. This includes a thorough understanding of pain as a sensation and its manifestation during the birthing experience. An understanding of pain is useless, however, unless standardized pain assessment practices are used. The most accurate pain assessment is associated with a general understanding of cultural trends in pain perception and expression. Along with culture, other factors also influence how a woman senses and copes with the pain of labor. Anxiety is one of these influential …

Chhs May/June 2013 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.

Community Building Through A Recovery Oriented Sytems Of Care Model For Tobacco Cessation In The Elderly, Ginny L. Hamolsky

Senior Honors Projects

Abstract

Community building is an important concept for all healthcare providers to understand in order to implement effective health promotion and empower members of a community. The World Health Organization (WHO) states that community building involves action at three levels to improve health. These actions include the advancement of skills among practitioners, expansion of support and infrastructure for health promotion, and the development of cohesiveness and partnerships within communities. If implemented effectively, the benefits of community building include enhancing quality of life, promoting health and well being, empowering individuals, and creating sustainable health care organizations that conduct and maintain successful …

Depression Screening Of Young Adult Freshmen Students, Marlee R. Steele

Evidence-Based Practice Project Reports

Depression is a mental health issue that requires prompt identification and treatment. According to the CDC, it is estimated that in the U.S .one in 10 adults suffer from depression (CDC, 2011) with 4.7% of young adults, 18-39 years, suffer from depression (CDC, 2006). Many young adults report that college life is often more stressful than anticipated and the demands placed not only academically, but also socially, adversely affect their psychological and physical health (Dyson & Renk, 2006). The purpose of this EBP project was to answer the PICOT question: How does a depression screening tool in combination with a …

First Year Baccalaureate Nursing Program Outcomes: Effects Of Prerequisite Courses And Preadmission Testing, Sonya House

Dissertations

Schools of Nursing are faced with the difficult task of selecting students for admission into nursing programs. This responsibility is challenging as the number of students applying to programs typically outweighs the number of students who can be admitted. As a result, faculty must identify methods for selecting students who have the greatest likelihood of being successful. As noted in the literature, attrition that occurs as the result of being academically underprepared is found in the beginning of nursing programs (Murray, Merriman, & Adamson, 2008). The central research question represents the purpose of the study: To what extent do prerequisite …

Nursing Interventions That Facilitate End-Of-Life Decision-Making In Pediatric Oncology, Lauren Baeringer

HIM 1990-2015

Nearly one-third of all pediatric oncology patients die from their disease, so nurses need to have an evidence-based standard of practice to guide their role in end-of-life decision-making. The purpose of this integrative review is to analyze current research on end-of-life decision-making within pediatric oncology to create a practice guideline for nurses working with this patient population. Eleven studies were examined to identify nursing interventions regarding the role of the nurse in end-of-life care, the role of the nurse in end-of-life decision-making, parent involvement in end-of-life decision-making, and child involvement in end-of-life decision-making, including the child's ability to participate in …

Stress Relief Habits And Perceived Stress Among College Nursing Students., Geneva Record

Undergraduate Honors Theses

With healthcare reform on the rise and the population of Baby Boomers increasing exponentially, nurses are in higher demand than ever before. Students in nursing school are under a great deal of stress as they balance a heavy academic load with outside responsibilities to jobs and families. These stressors often carry into professional practice, resulting in nurses that are constantly stressed. This study asks nursing students about their perceived stress and about the specific ways they cope with their stress.

The study’s results show that most students wish they had more time to engage in stress relieving activities. When students …

Interventions For Treatment Related Side Effects In Older Women With Breast Cancer, Stephanie Suarez

HIM 1990-2015

Over half (57%) of the women diagnosed with breast cancer are age 65 and older. Treatment for breast cancer may exacerbate current chronic illnesses and/or cause multiple treatment related side effects such as insomnia, fatigue, decreased physical functioning, alterations in body image, poorer quality of life, and changes in psychosocial health. While many women with breast cancer experience these changes, research suggests that older women have different needs than younger women and may not always benefit from interventions. The purpose of this integrative review of literature was to evaluate interventions designed to improve treatment related side effects in female breast …

Barriers Affecting Compliance With The Implementation Of Early Goal Directed Therapy In The Emergency Department, Ivan Castro

HIM 1990-2015

Early Goal Directed Therapy (EGDT) has been thoroughly researched and clinically supported to be effective at lowering morbidity and mortality associated with severe sepsis and septic shock. Due to the strengths of its efficacy, it has been integrated as an essential component of the Surviving Sepsis Campaign. However, very few studies have explored the barriers that affect compliance of the protocol in actual practice. The purpose of this study was to synthesize current research findings regarding nursing barriers associated with EGDT. This research was limited to studies performed in the United States between 2003-2012, with patients at least 18 years …

Women's Perceptions Of Nursing Care And Management After First Trimester Miscarriage, Jennifer Mcgee

HIM 1990-2015

Spontaneous abortion, or miscarriage, is an event that affects approximately one in four women during their reproductive years. Despite the psychological and physiological trauma associated with the loss of pregnancy, few evidence-based practice recommendations exist to guide nursing care of women experiencing first trimester miscarriage. The purpose of this integrative review of literature was to examine research related to women's health care experiences of first trimester miscarriage and discuss common themes relating to nursing care. Inclusion criteria consisted of peer review research articles published after 2001 and available in the English language and women that experienced miscarriage during the first …

Evaluation Of Computer-Based Simulation For Pain Management Education, Nicole Gerardi

HIM 1990-2015

Effective pain management is an elusive concept in the acute care setting. Improving nurses' knowledge about optimal pain management is one way to improve the patient's pain experience. A computer-simulation game was developed as an alternative method of teaching the subject of pain management to nursing students. In the game, two patient scenarios are presented, one male and one female. Both patients present with acute pain and request help from the nurse. The player progresses through a series of nine questions as the scenarios unfold, each with one best or correct answer. The purpose of this study was to evaluate …

Factors Contributing To The Commission Of Errors And Omission Of Standard Nursing Practice Among New Nurses, Rachel Knowles

HIM 1990-2015

Every year, millions of medical errors are committed, costing not only patient health and satisfaction, but thousands of lives and billions of dollars. Errors occur in many areas of the healthcare environment, including the profession of nursing. Nurses provide and delegate patient care and consequently, standard nursing responsibilities such as medication administration, charting, patient education, and basic life support protocol may be incorrect, inadequate, or omitted. Although there is much literature about errors among the general nurse population and there is indication that new nurses commit more errors than experienced nurses, not much literature asks the following question: What are …

Support Systems In Adolescents With Type 1 Diabetes Mellitus And The Relationship To Diabetes-Related Stress, Conflict, And Metabolic Control, Samuel Foarde

HIM 1990-2015

The purpose of this integrated review of the literature was to explore the effects of social support on diabetes-related stress, conflict, and metabolic control in adolescents with type 1 diabetes mellitus (T1DM). Social support was examined in four subgroups: adolescents with T1DM, family caregivers, peers, and teachers. Relevant findings in the literature revealed a significant deficiency of research devoted to adolescent males with diabetes as well as fathers as primary and secondary caregivers. Studies highlighted the importance of fostering autonomy and positive self-image in adolescents with T1DM and described effective interventions to improve diabetes-related stress, reduce disease-related conflict, and improve …

Assessment Of Perinatal Nurses' Knowledge Of Antiphospholipid Syndrome And Nursing Management Of Pregnant Women With Antiphospholipid Syndrome, Gabrielle Dennen

HIM 1990-2015

No abstract provided.

Influential Variables On The Timing Of Help-Seeking Behavior In Lung Cancer Patients., Lisa Carter-Harris

Electronic Theses and Dissertations

Lung cancer kills more people than any other cancer worldwide primarily because it is often diagnosed at an advanced stage. One factor that can influence advanced stage lung cancer diagnosis is delayed help-seeking behavior in individuals with symptoms suggestive of lung cancer. Delayed help-seeking behavior has been investigated in acute cardiovascular events and breast cancer, but there is little evidence on specific factors that influence the timing of help-seeking behavior in lung cancer patients. The purpose of this study was to explore the influence of healthcare system distrust, lung cancer stigma, and smoking status on the timing of help-seeking behavior …

Performance Differences Between Novice And Experienced Critical Care Nurses: A Replication Study, Josefina Inoturan Alejandro

Doctoral Projects

No abstract provided.

Management Of The Medically Fragile Child In The K- Fifth Grade Classroom Setting, Mandy M. Cranney

Theses and Dissertations

The aim of this focused project was to explore perceptions and identify needs of teachers of medically fragile children (MFC), in the grade setting, with the hope of designing educational modules to be utilized as supportive measures by the teachers for the classroom setting. The focused project consisted of an extensive literature review of medical fragility in school age children as well as a literature review of teachers' perceptions and needs identified in the past. Nola Pender's Health Promotion Model served as the conceptual framework in designing the study. Two focus groups were conducted among grade teachers enrolled in Masters …

The Association Between Maternal Resiliency, Perceptions Of Touch, And Reports Of Infant Touch, Lisa D'Agostino

HIM 1990-2015

No abstract provided.

The Use Of Wet-To-Dry Dressings For Mechanical Debridement, Katherine Villa

HIM 1990-2015

Clinical management of complex wounds is essential to promote wound healing. Prolonged healing time may lead to longer and more costly hospitalizations and poorer patient outcomes. The removal of nonviable, necrotic tissue via debridement is vital to the healing process. One of the most common debridement techniques, in the United States, is the use of wet-to-dry dressings. There are no defined guidelines or protocols for the timing of dressing changes and subsceequent debridement. The purpose of this study was to perform a review of literature to determine the rationale for the use of wet-to-dry dressings, explore alternative time sequences of …

Young-Onset Dementia: The Child's Experience With Coping, Jamie Zeher

HIM 1990-2015

Young onset dementia (YOD) affects not only the person diagnosed, but the family unit as a whole. It is estimated that as many as 500,000 people in the United States have YOD and around 250,000 children are involved in caring for these people. A child of a parent with YOD can begin to experience negative effects when the child begins to take part in caregiving for the person with young onset dementia (PWYOD). Feelings of stress, anger, fear of the future, depression, social isolation, and increasing responsibility of caring for the PWYOD can be felt by children as caregivers. Research …

Perceptions Of Hospital Patient Safety Culture In Department Of Veterans Affairs Station 593 Southern Nevada, Kimberly Falco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opportunities for error exist, adverse events occur, and challenges endure. However, patients will continue to experience preventable adverse events unless steps are taken. Efforts to improve patient safety are critical to today's healthcare environment. The Department of Veterans Affairs (VA) believes that the identification of adverse events allows for creation of system improvements to increase patient safety.

Implementing safety culture requires a proper assessment of existing barriers and potential challenges. Patient safety culture assessments start by evaluating the current patient care environment. This assists the organization in identifying barriers to patient safety and in working toward creating a culture of …

Development And Implementation Of A Quality Improvement Initiative: Systematic Follow-Up Of Patients Who Have Spinal Cord Stimulator Implants, Irina Rajala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recent medical advances and the rising prevalence of chronic pain in the US population contribute to the use of spinal cord stimulator (SCS) implant as a treatment modality for chronic pain management. As the numbers of patients receiving SCS implants steadily increases, the challenge of managing this device grows and the need for SCS implants follow-up programs rises. Follow-up programs need to focus on implant longevity and efficacy to improve the quality of care outcomes.

This Doctor of Nursing Practice (DNP) quality improvement initiative was developed to provide systematic follow-up for patient with SCS implant. The project includes the creation …

School Nurses' Recognition, Attitudes, And Educational Needs Regarding The Care Of Children With School Refusal Behavior, Heather Strasser

UNLV Theses, Dissertations, Professional Papers, and Capstones

School refusal behavior can prevent a child from attending school or staying in class for a full day of instruction. School nurses are often one of the first professionals in the school with the opportunity to interact with these children, recognize school refusal behavior and its debilitating impact, and positively intervene to assist these children to stay in school. Few studies have examined school nurse recognition and attitudes regarding school refusal behavior. The purpose of this study was to assess school nurses' recognition of school refusal behavior, their attitudes regarding the nursing care of children with school refusal behavior, and …

A Comparison Of Nursing Service Demand In Title 1 Schools And Non-Title 1 Schools, Karen Ray Stratford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Children from low-income families are known to struggle academically, but lack of health services may also impact their education. School nurses must identify and manage health problems in the school-age child to improve academic success. Unfortunately, the school nurse-to-student ratio may limit the amount of time nurses can give to the recognition of health problems and appropriate follow-up. The Elementary and Secondary Education Act of 1965 provides Title 1 funding to schools whose enrollment includes at least 40% of low-income families. These federal funds are intended to be used to bridge the achievement gap between low-income students and other students. …

The Perception Of Health Assets Of A Rural Idaho Community Based On The Community-As-Partner Model, Cherno Bah

Boise State University Theses and Dissertations

To improve the health status of rural communities, it is important to recognize and utilize all available health assets the community has to offer. When considering health assets, community members often fail to recognize resources such as economic status, communication, education, recreation, and politics, and instead focus only on obvious resources such as available physicians, Emergency Medical Technician (EMT) services and access to health clinics. The purpose of this study was to identify what community health assets are perceived among members of the rural community of Grangeville, Idaho and how these assets might be categorized according to the nine sub-systems …