Medicine and Health Sciences Commons^™

Patient And Nurse Considerations In Home Health Routing With Remote Monitoring Devices, Jessica Spicer

Graduate Theses and Dissertations

We build on the current consistent vehicle routing problem literature by formulating a novel multi- objective mathematical model of the home health scheduling and routing problem that includes the option of assigning some patient visits to remote monitoring devices, with the objectives of mini- mizing total cost, achieving nurse consistency and creating balanced nurse workloads. A heuristic solution approach that approximates the efficient frontier of this multiobjective problem is pre- sented and validated, and the results of using this methodology to solve several realistic instances are included. We also analyze the assignment of patients to devices and present some managerial …

Identifying The Relationship Between Benzene Exposure And The Development Of Acute Myeloid Leukemia, Jacqueline G. Tally

Senior Honors Projects

My interest in epigenetic carcinogenesis-related research stems from both academic and personal experiences. I have come to recognize the significance of environmental chemical exposures in the development of cancer through my studies in nursing, and nutrition and food science. I am particularly interested in the epigenetics of acute myeloid leukemia (AML) because I am an AML survivor.

AML is a rare and highly malignant cancer. It is estimated 13,780 new cases of AML will be identified in theUnited Statesthis year with a 74% mortality rate (calculated 10,200 deaths/13,780 new cases). AML develops from alterations in the survival and proliferation of …

Cultural Competence In The Baccalaureate Degree Nursing Curriculum, Angela Elizabeth Silvestri

UNLV Theses, Dissertations, Professional Papers, and Capstones

Health care providers are members of a helping profession and need to provide quality care to all members of society. As a result of current and projected demographic changes within the United States (U.S.), health care professionals are faced with the challenges of providing culturally competent care and fulfilling the role as the "helping profession." In the past 10 years, minority populations have increased in the U.S. For example, the African American population experienced an approximate 12.3% increase, and the Hispanic population increased by 43%. Just as it is necessary for health care professionals to respond to the increase in …

Breast Health And Mammography Screening In Older Women, Martha A. Ibarra Phd, Msn, Anp, Rn

Dissertations

Age-related health disparities in breast cancer screening are a public health concern. From 2002 to 2006, the median age for newly diagnosed cases of breast cancer was 61 years and the median age for breast cancer mortality was 68 years of age (Surveillance Epidemiology and End Results [SEER], 2009). Mammography is the best available screening tool for breast cancer detection (Susan G. Komen Foundation, 2008). The Centers for Medicare and Medicaid Services (CMS, 2006) reported that only about half of older women who are eligible for mammograms through Medicare obtain a mammogram every two years. The literature identifies psychosocial barriers, …

Inpatient Glycemic Management: Glucose Control Relationship With Hospital Variables, Discharge Planning And Education, Crisamar Javellana-Anunciado Phd, Fnp-Bc, Rn

Dissertations

This dissertation study examined the relationship of glucose control with clinical outcomes, costs, discharge planning and education. Extant studies showed that hyperglycemia, in the presence or absence of a diabetes diagnosis, is prevalent in hospitalized patients. Hyperglycemia is found in one-third of all hospital admissions and is linked to poor clinical outcomes and increased healthcare costs. Furthermore, clinical evidence suggests that lack of discharge coordination associated with medical errors and readmission. This entire body of work contains three distinct sections: Two manuscripts and a grant proposal. The two manuscripts in this study were based on more current retrospective data at …

Tobacco-Use Promotional Environment And Intrapersonal Environment: Predictors Of Smoking Intention Among Young Southern California Thai-American Adolescents, Arpakorn Magkunthod Phd, Msn, Rn

Dissertations

This study explores tobacco-use related environment, intrapersonal factors, and smoking initiation in Thai-American adolescents aged 10 to 16 living in Southern California. A purposive sample of 217 youth was recruited from seven Thai-community centers located in four counties of Southern California: The sample was fairly evenly distributed by gender with female (54.5%) and almost three quarters (70.9%) were born in the United States (70.9%). Age ranged from 10 to 16 years, with the mean age 12.71 years old (SD =1.835); 27% reported age of 11. Data were collected using the 97 item Teen Tobacco-Use Questionnaire. Findings indicated 12 participants (6.3%) …

Nurse Manager Transformational Leadership Practices And Patient Outcomes Among Magnet And Non-Magnet Hospitals, Bridgett Byrd Sellars Phd, Msn, Ma, Rn

Dissertations

In 2004 the Institute Of Medicine called for healthcare leaders to embrace and adopt transformational leadership practices to promote quality of care and favorable patient outcomes. Nurse managers are accountable for 24-hour operations of their departments and influence patient outcomes. The purpose of this research was to examine the relationships among nurse manager transformational leadership practices, patient outcomes and hospital types (Magnet, On The Journey, and Non-Magnet). A correlational study examined relationships between self-reported transformational leadership practices of nurse managers and patient outcomes by hospital types. The study was conducted using a purposive sample of Association of California Nurse Leader …

Relationship Between Delirium And Night-Time Interruptions In Icu, Amy R. Stuck Phd, Rn

Dissertations

Background: This dissertation examined the phenomenon of delirium in the intensive care unit (ICU) setting. Delirium is a form of cognitive disturbance with a physiologic etiology and complex, multifactorial mechanisms of causation and risk. Delirium in the ICU patient presents a significant risk for adverse outcomes including increased mortality, length of stay, falls, and restraint use. ICU delirium can lead to persistent cognitive impairment beyond discharge and frequent skilled nursing placement. Identifying delirium requires accurate diagnosis that is optimized when validated instruments are used. Sleep deprivation has been linked to adverse health consequences including delirium. Previous studies investigating the relationship …

Use Of Standardized Mastery Content Assessments Given During The First Year Of A Baccalaureate Nursing Program For Predicting Nclex-Rn Outcomes, Deanna Jan Emory

Graduate Theses and Dissertations

The purpose of this study was to evaluate the relationship between standardized content specific mastery assessments and NCLEX-RN outcomes. Three content-specific standardized assessments testing Fundamentals, Pharmacology and Mental Health concepts were used to explain the dichotomous NCLEX-RN outcome of pass or fail. The three assessments were developed by Assessment Technologies Institute, LLC (ATI). The assessments were administered to baccalaureate nursing students (N = 119) during the first year of a nursing program in one public university over a period of five consecutive semesters. Group comparisons between those passing and those failing NCLEX-RN on the first attempt and correlations were calculated …

The Lived Experiences Of Mexican Heritage Mothers Caring For Overweight Preschool Children, Susan Mcdonald

Nursing Theses and Dissertations

Mexican heritage children are at greater risk to become overweight or obese than children of other ethnic or racial groups. The objective of this study was to gain insight into the lived experiences of Mexican-heritage mothers caring for overweight or obese preschool children. A qualitative, hermeneutic phenomenological design was selected for this study. Saturation was achieved with 12 mothers of Mexican heritage. Data collection and analysis was guided by the phenomenological approach of Max van Manen. Six themes and sixteen subthemes emerged from the data. Maternal caring practices were influenced by their Mexican heritage, emotional burdens, perceptions of child's weight …

Using Structural Equation Model To Study The Impact Of Organization Culture And Nursing Work Environment In Nursing And Patient Satisfaction, Taher Giaedi

MUSC Theses and Dissertations

No abstract provided.

An Investigation Of Obstetrical Practice Patterns Through Secondary Data Analysis And Qualitative Inquiry, Barbara Shippey Mcalister

Nursing Theses and Dissertations

Mothers and their unborn are a vulnerable population. Despite overwhelming advances in health care and technology, the United States' indicators of maternal and infant mortality are dismal. To lay the foundation for a research trajectory ultimately aimed at improving the experiences and outcomes of pregnancy, two research projects were undertaken to investigate the impact of practice patterns for elective delivery on the current obstetrical paradigm. A qualitative clinical case study explored antepartum recommendations for cesarean section following the implied diagnoses of inevitable labor dystocia secondary to maternal physical stature in two healthy women. The women's perspectives on their experiences of …

Military Service Members’ Attitudes Towards Mental Illness And Access To Mental Health Services: A Matter Of Stigma., Virginia Delbusto-Cohen

Nursing Doctoral

It has been clinically observed and the literature concurs that military service members often fail to access mental health services in spite of availability of care. The reasons for failure to access care appear to be that military service members are fearful of accessing mental health services for fear of being stigmatized. Failure to receive care for mental health problems can result in deleterious results, some of which may culminate in inability to function or even loss of life. Additionally, failure to access mental health care can result in massive monetary costs in terms of loss and replacement of personnel …

A Two-Stage Cluster Sampling Method Using Gridded Population Data, A Gis, And Google Earth(Tm) Imagery In A Population-Based Mortality Survey In Iraq, Lp Galway, Nathaniel Bell, Al Shatari Sae, Amy Hagopian, Gilbert Burnham, Abraham Flaxman, Wiliam M. Weiss, Julie Rajaratnam, Tim K. Takaro

Faculty Publications

BACKGROUND:

Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys.

RESULTS:

We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling …

The Immigrant Hispanic Population: Perceptions About Cultural Competency In The Healthcare Setting, Cheryl Swanson

Nursing Theses and Dissertations

Cultural competence has been reported as a means of impacting health disparities in minority populations. The Hispanic population has grown exponentially in the United States accounting for over fifty million people on the latest census report. Continued immigration by persons of Hispanic origin occurs for many reasons offering a challenge to nurses and other healthcare workers to provide culturally competent care. The majority of research on cultural competence and the immigrant Hispanic patient has been conducted from the viewpoint of the healthcare provider. Additionally, most research that has taken into account the perspective of the immigrant Hispanic patient focuses on …

School Age Children: The Effects Of Hunger, Dacia Bessler

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

The Lived Experiences Of Intended Parents During Surrogate Pregnancy And Transition To Parenthood In Relation To The United States Healthcare System., Kim L. Armour

Nursing Theses and Dissertations

Problem: A state of the science surrogate pregnancy manuscript revealed a dearth of research regarding intended parents of surrogate pregnancy. Not one U.S. study could be located. Intended parents are overlooked by the healthcare system during pregnancy due to the fact that that their surrogate is receiving obstetric care. Research was proposed and completed. Purpose: The aim of the research was to fill a gap by improving our understanding of intended parents lived experience during surrogate pregnancy and transition to parenthood with relation to the United States healthcare system Design: A study of phenomenology using van Manen's methodology Participants: Eleven …

A School-Based Intervention Of Adolescent Obesity Prevention In At-Risk Youth, Leah M. Potecha

Senior Honors Theses

Obesity has become an epidemic in the United States, affecting individuals of all ages. Adolescents are particularly susceptible to obesity due to their decrease in physical activity, as well as to the greater availability of foods void of nutritional value. Adolescents’ impressionable natures and changing bodies also contribute to their increased weights. To combat the problem of obesity, many schools have implemented obesity prevention programs. Most of these programs are based on physical education and nutrition education. However, some schools have started mentorship programs, or worked with organizations that employ mentorship programs, to prevent obesity. The Lynchburg Healthy Living program …

Evaluation Of Methods To Relieve Parental Perceptions Of Vaccine-Associated Pain And Anxiety In Children: A Pilot Study, Karlen E. (Beth) Luthy, Renea L. Beckstrand, Amy Pulsipher

Faculty Publications

Introduction: The pain and anxiety associated with vaccination is a significant reason why parents are reluctant to have their children vaccinated. Distraction methods and vapocoolant sprays may be use to modify the parent's perceptions of their child's pain and anxiety, thus encouraging parents to return for the child's next vaccination.

Methods: A convenience sample of 68 parents with children ranging in age from 2 to 12 years was selected. The parents and the child were randomly assigned to three groups: a control group, a DVD distraction group, or a vapocoolant spray group. After the child was vaccinated, parents evaluated the …

An Investigation Of The Effects Of Pitocin For Labor Induction And Augmentation On Breastfeeding Success, Megan J. Lewis

Scripps Senior Theses

Rates of labor induction and augmentation have been increasing in recent decades (Glantz, 2005). According to the Listening to Mothers II survey, half of all labors in the U.S. are induced or augmented with Pitocin or other synthetic form of the hormone oxytocin (Declercq et al., 2006). Oxytocin, a naturally occurring hormone released in the pituitary gland, is involved in the stimulation of uterine contractions during labor and in the milk ejection reflex during breastfeeding, and research suggests it also has various effects on the brain, such as eliciting maternal behavior. However, studies have shown that exogenous oxytocin can interfere …

Documentation: Delirium In The Hospitalized Older Adult, Jacqueline Fitzgerald Close Phd

Dissertations

Background: Delirium is a common, life threatening and preventable geriatric syndrome. Because this condition is frequently addressed by administering dangerous antipsychotic drugs, it is imperative that accurate systematic assessments are charted to determine the actual need for these medications. The purpose of the study was to describe medical record documentation of a systematic assessment of delirium in older adults who had been administered an antipsychotic medication. Methods: A descriptive correlational retrospective design was used for this medical record data based study. The setting was a 107 bed acute care community hospital located in southern California. Inclusion criteria were medical records …

Mild Traumatic Brain Injury: Educational Techniques, Katherine R. Racanelli

Honors Projects

The awareness of mild traumatic brain injury as a health concern has increased across a multitude of athletic settings due to a plethora of research and clinical findings that indicate the serious threat concussions pose, particularly to young athletes. The need to provide risk reduction and health promotion education to athletes and parents necessitates an innovative approach. This study explores the effectiveness of an educational intervention based on information from the Centers for Disease Control and Prevention to promote awareness regarding the pathophysiology, symptoms, consequences, and prevention of sports-related mild traumatic brain injury. An interactive educational program was administered to …

The Effect Of Oral Care On Intracranial Pressure In Critically Ill Adults, Christina Szabo

Theses and Dissertations

A major goal in the care of patients with neurological problems is to prevent or minimize episodes of increased intracranial pressure (ICP). Elevations in ICP in response to nursing interventions have been acknowledged since the 1960’s when ICP monitoring was first introduced in the clinical setting. Until recently few studies have specifically examined the effect of oral care on ICP and oral care and other hygiene measures were combined or not specified, prohibiting a direct interpretation of the influence of oral care alone on ICP. The purpose of this study was to describe the relationship between routine oral care interventions …

Surgical Delay For Hip Fracture Clients And The Use Of Clopidogrel: An Integrative Review, Phoebe Genevieve Waller

Senior Honors Theses

Abstract

Hip fractures in elderly patients have very high postoperative mortality rates and the number of hip fractures in the United States is expected to increase exponentially before 2030. Early surgery is essential to improve outcomes, but patients on clopidogrel (Plavix) have a high risk for increased bleeding if surgery is performed within the usual 72 hour window. This paper presents literature and research addressing the dangers of delaying surgery versus undergoing surgery before the effects of the clopidogrel are gone. Based on articles published after 2006, most researchers advocated earlier surgical intervention than previously recommended and emphasized an individualized …

Bowling Green Warren County Medical Society Alliance, 1952-2011 (Mss 402), Manuscripts & Folklife Archives

Manuscript Collection Finding Aids

Finding aid only for Manuscripts Collection 402. Organizational materials including constitution, by-laws, membership directories and scholarship files for the Bowling Green Warren County Medical Society Alliance of Bowling Green, Kentucky. The bulk of the collection relates to the two Western Kentucky University nursing scholarships granted by the group: the Newman & Lena Harris Scholarship and the Maydelle Johnson Funk Scholarship.

Redesign Of A Medical Crash Cart, Jozey Mitcham, Brittany Ireland, Tyler Towner, Scott Winston

College of Engineering Poster Presentations

For the 2011/2012 school year at Boise State University, the health science department has requested that a Mechanical Engineering senior design project be focused around the redesign of a medical crash cart. A crash cart, more commonly known as a code cart, is a set of trays, drawers, and shelves on wheels used in hospital emergency rooms for the transportation and dispensing of emergency supplies and equipment for use in cardiac emergencies. The current crash cart design is top heavy, unstable, inefficient, unorganized, and unsafe. In an attempt to increase functionality, efficiency, and safety, a new design is being developed …

Nature Versus Nurture: A Study Of Adopted And Biological Children And Their Behavioral Patterns, Courtney Janaye Grenke

Senior Honors Theses

Nurses encounter many different populations of people every day and they must know how to treat them. Adopted children are a population that nurses encounter and there are disagreements concerning whether they are at an increased risk for developing behavioral problems as compared to biological children. It is also debated whether genetics or environment plays a more prominent role in childhood development. Most studies conclude that adopted children are at an increased risk for more behavioral problems due to the unique struggles and challenges they must overcome with genetics playing a bigger role than environment. Nurses can use this information …

Community Healthcare Clinics: An Answer To Reducing Misuse Of Emergency Department, Kelly Cantlin, Lisabeth Searing, Faculty Advisor

John Wesley Powell Student Research Conference

No abstract provided.

Traumatic Brain Injury Awareness: Educational Techniques, Katherine Racanelli, Victoria Folse, Faculty Advisor

John Wesley Powell Student Research Conference

No abstract provided.

A Social Controversy: Autism Spectrum Disorder's Correlation To The Measles-Mumps-Rubella Vaccination, Lindsay A. Frye

Senior Honors Theses

A 1998 research study lead by Dr. Andrew Wakefield linked the measles-mumps-rubella (MMR) vaccination as a probable cause to autism spectrum disorder. This publication has started a significant debate among healthcare professionals and instigated an anti-vaccination movement within the general population. This vaccination controversy was started by parents who readily accepted Wakefield’s findings as truth and frequently would choose to withdrawal the administration of vaccinations from their children’s care plans. There has also been disapproval by healthcare professionals over Wakefield’s study since numerous research teams have been unable to replicate his findings. This disagreement surrounding the MMR vaccination is likely …