Medicine and Health Sciences Commons^™

Rapid Implementation Of Open-Access Pandemic Education For Global Frontline Healthcare Workers, Jacqueline Christianson, Erica Frank, Stacen Keating, Susan Boyer, Miriam Chickering

College of Nursing Faculty Research and Publications

Background

The recent global pandemic posed extraordinary challenges for healthcare systems. Frontline healthcare workers required focused, immediate, practical, evidence-based instruction on optimal patient care modalities as knowledge evolved around disease management.

Objective

This course was designed to provide knowledge to protect healthcare workers; combat disease spread; and improve patient outcomes.

Methods

A team of global healthcare workers responded by rapidly creating a competency-based online course. To promote transcultural applicability, the course was developed by an international team of more than 45 educators from over 20 countries. Course delivery included a built-in language translation tool, routine updates, and several innovative course …

Nurse Perspectives On Labor Union Participation Prior To Implementation Of A Collective Bargaining Agreement: A Qualitative Study, Jacqueline Christianson, Bonnie Sommers-Olson, Cathleen Fox, Norah L. Johnson

College of Nursing Faculty Research and Publications

Background: Patient advocacy is a duty for professional nurses; however, not all nurses are empowered to advocate for meeting patients’ needs. Participation in labor unions may serve as a venue for nurses with limited institutional decision-making authority to advocate for patient needs; however, unionization can be a time-intensive and fraught process.

Purpose: This study examined how nurses participating in a new union in an urban United States hospital described their reasons for participating in a labor union during collective bargaining.

Methods: Content analysis of participant's interviews that took place between January and March 2023, after the nurses voted to unionize …

Factors Associated With Health Decision-Making Autonomy On Own Healthcare Among Tanzanian Women: A 2022–2023 Demographic Health Survey Study, Tausi Seleman Haruna, Henry Ofori Duah, Rebecca Lee

College of Nursing Faculty Research and Publications

Background

Women’s health decision-making autonomy is fundamental for the health and well-being of women and their children. It empowers women to make health decisions and exercise their rights and choices surrounding their health. Like most parts of Africa, women’s autonomy in Tanzania remains contentious, with an estimated 19% prevalence of health decision-making autonomy in 2015. Given the impact of women’s health decision-making autonomy on women’s health outcomes and the fact that women’s health decision-making autonomy is an ongoing process affected by advancements in technology, economic growth, and social and cultural shifts, understanding the sociodemographic correlates of women’s autonomy is imperative. …

Assessing Family Caregiver Readiness For Hospital Discharge Of Patients With Serious Or Life-Limiting Illness Using Electronic Health Record And Self-Reported Data, Joan M. Griffin, Diane E. Holland, Catherine E. Vanderboom, Brystana G. Kaufman, Allison M. Gustavson, Jeanine Ransom, Jay Mandrekar, Ann Marie Dose, Cory Ingram, Zhi Ven Fong, Ellen Wild, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Objective

To assess how patient and caregiver factors influence caregiver readiness for hospital discharge in palliative care patients.

Study Setting and Design

This transitional care study uses cross-sectional data from a randomized controlled trial conducted from 2018 to 2023 testing an intervention for caregivers of hospitalized adult patients with a serious or life-limiting illness who received a palliative care consult prior to transitioning out of the hospital.

Data Sources and Analytical Sample

Caregiver readiness was measured with the Family Readiness for Hospital Discharge Scale (n = 231). Caregiver demographic, intra- and interpersonal factors were self-reported. Patient demographic, comorbidity score, …

Sex Work Patterns Among Transgender And Gender Diverse People: A Latent Class Analysis, Madeline Stenersen, Anjum Umrani, Irelan Fricke, Jessica L. Zemlak

College of Nursing Faculty Research and Publications

Sex work is a diverse profession encompassing a broad range of people, and services. Though overrepresented in sex work communities, transgender and gender diverse (TGD) individuals are underrepresented in sex work literature. Further, sex work literature continues to underrepresent the heterogeneity evident in the sex work community and the practices that occur within it. The present study utilized data from the 2015 United States Transgender Survey (USTS) to conduct a latent class analysis (LCA) to identify patterns of different types of sex work among TGD adults (N = 2,153) and understand the demographic characteristics associated with engagement in different types …

Critical Care Advanced Practice Providers As Partners In Advancing Pediatric Intensive Care Unit Nursing Knowledge: A Needs Assessment., Mary Seidl, Meghan Roller, Whitney Seul, Laura Rose, Christine A. Schindler

College of Nursing Faculty Research and Publications

Background

Critical care advanced practice providers (APPs) are frontline providers in many pediatric intensive care units (PICUs). From 2020 to 2022, there was a significant downward shift in nursing experience level in the PICU at the authors’ institution. APPs may help provide additional in situ education.

Methods

Data were collected using role-specific needs assessment of PICU nursing staff and providers, assessing concept related to knowledge and job stress.

Results

Findings overwhelmingly demonstrated desire for more APP-led education. Overall, 27% of nurse respondents strongly agreed that current knowledge was adequate to provide safe and best care for their patients, and 47% …

Prospective Evaluation Of Plasma Proteins In Relation To Surgical Endometriosis Diagnosis In The Nurses’ Health Study Ii, Naoko Sasamoto, Long H. Ngo, Allison F. Vitonis, Simon T. Dillon, Maryam Aziz, Amy Shafrir, Stacey A. Missmer, Towia A. Libermann, Kathryn L Terry

Health Sciences Faculty Publications

No abstract provided.

Flipped Classroom Versus Lecture: A Quasi-Experimental Study Evaluating The Performance Of Dental Students.”, Manal Elhijazi, Ihsane Benyahya

Health Sciences

Background: The flipped classroom is an active pedagogical modality that improves learning, autonomy and critical thinking. This work aims to evaluate the impact of the flipped classroom on student performance compared to the lecture in a biomaterials course.

Material and methods:Second-year dental students were invited to participate voluntarily in this quasi-experimental study .Thus, they were divided into two groups: one group benefited́ from the flipped classroom while the control group attended the lecture. At the end of a formative evaluation for both groups, their average grades were compared using Student's test (significance threshold set at p

Results : …

Loma Linda Nurse - Vol. 33, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | The Strategic Pillars of LLUSN

6 | Building Campaign Update

8 | Scholarship Opportunities

10 | Andreia Lofthouse: Assistant Dean of Student & Alumni Relations

LLUSN HIGHLIGHTS

12-17 | ALUMNI NEWS

18-27 | ACADEMICS

28-32 | HOMECOMING

33-35 | FACULTY UPDATES

A Mixed Methods Study: The Influence Of Educational Preparation, Clinical Experience, And Orientation On Nursing Professional Development Role Transition Experience, Lauren Elizabeth Moran

Theses & Dissertations

This study explored the role transition experiences of novice Nursing Professional Development (NPD) practitioners, examining how educational preparation, clinical experience, and orientation programs influence successful adaptation. NPD practitioners are essential in facilitating learning, mentoring staff, and advancing nursing excellence; however, transitions from clinical nurse to NPD practitioner are often marked by role ambiguity, limited confidence, and insufficient preparation. Despite the importance of this role, research on novice NPD practitioners’ transition experiences remains limited. This mixed-methods explanatory sequential study, guided by the Nurse Educator Transition (NET) model and From Novice to Expert frameworks, explored factors influencing the role transition of novice …

Factors Influencing Emergency Department Utilization Among Heart Failure Patients In The Home Health Care Setting: A Secondary Data Analysis, Lynette Ramlogan

Theses & Dissertations

Heart failure is a chronic, progressive condition affecting over 6 million adults in the United States and remains a leading cause of morbidity and mortality, contributing to approximately 380,000 deaths annually. Disparities in health outcomes for individuals with heart failure are further exacerbated by social determinants of health (SDoH), including socioeconomic status, healthcare accessibility, and availability of social support, particularly among vulnerable populations. Insurance coverage plays a critical role in influencing access to care, treatment adherence, and overall health outcomes among patients with heart failure. For patients receiving home health care (HHC) services, limited caregiver support and inadequate socioeconomic resources …

Iimproving Discharges Within The Monitored Pod Units Of A Regional Health Center In Bryan, Tx, Paul R. Russell Iii

Doctor of Nursing Practice Final Project Abstract

IMPROVING DISCHARGE RATES WITHIN THE MONITORED POD UNITS OF A REGIONAL HEALTH CENTER IN BRYAN, TX

Purpose

The purpose of this scholarly project was to improve discharges by 11:00 a.m. within the Monitored Pod Units located in a regional hospital in Bryan, Texas.

Background

The current discharge rate by 1100 for the monitored pod units at the regional health center was below the health system goal of 50%. The impacts of delayed discharges are broad and can be seen throughout the regional health center. Delayed discharges have a direct effect on staff satisfaction, patient satisfaction, and decreased revenue.

Methodology

This …

Reducing Hospital-Acquired Pressure Injuries: A Quality Improvement Project Implementing A Visual Reminder System In The Intensive Care Unit, Henry H. Remschel Iii

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to reduce hospital-acquired pressure injuries (HAPIs) by 10% in an intensive care unit through the implementation of a skin risk assessment form and a visual reminder system.

Background

Hospital-acquired pressure injuries negatively impact patient outcomes and can increase costs associated with a hospital stay. Studies have shown that visual reminders can improve nursing intervention compliance and correlate with improved patient outcomes.

Methodology

The project implemented a skin-risk assessment form to identify patients at risk for developing pressure injuries during their hospital stay. For high-risk patients, a “High Skin Risk” magnet was placed outside …

A Framework For Mixed Reality Within Healthcare Education, Benyamin Ebadinia

Theses

Understanding complex three-dimensional systems and spatial relationships is a recurring difficulty in healthcare education, where students are often expected to reason about internal structures and multi-system processes from 2D diagrams, textbook figures, and static mannequins. This thesis presents the design, implementation, and mixed-methods evaluation of Systems Simulation, a reusable mixed reality (MR) application intended to help undergraduate nursing students explore human anatomy and pathophysiology using immersive 3D visualization.

Built in C# with the StereoKit framework for Microsoft HoloLens 2, Systems Simulation organizes nine anatomical body systems within a shared application. Learners can select a system, anchor the model in their …

Investigating The Impact Of Game-Based Immersive Learning On Nursing Students' Communication Skills And Attitudes Toward Serving In Underserved Communities, Lin Zhong, Debra Penrod, Brandon Hirsch, Kelli Whittington

Journal of Educational Technology Development and Exchange (JETDE)

Many nursing education programs incorporated service learning, particularly community immersion, into the curriculum to improve students’ communication skills and foster favorable attitudes towards caring underserved populations who face health disparities delivery. However, the teaching modality in community immersion is still lecturing sessions. This traditional teaching modality could not fully address the learning preferences of the new generation of nursing students, who are enthusiastic consumers of technology and active participants in the digital world. There is a demand of innovative teaching strategies, such as game-based learning (GBL), to engage the new generation of nursing students. Unfortunately, empirical studies of exploring the …

Physiological Plateaus During Normal Labor And Birth: A Novel Definition, Marina Weckend, Kylie Mccullough, Christine Duffield, Sara Bayes, Clare Davison

Research outputs 2022 to 2026

Background: Diagnoses of labor dystocia, and subsequent labor augmentation, make one of the biggest contributions to childbirth medicalization, which remains a key challenge in contemporary maternity care. However, labor dystocia is poorly defined, and the antithetical concept of physiological plateaus remains insufficiently explored. Aim: To generate a definition of physiological plateaus as a basis for further research. Methods: This qualitative study applied grounded theory methods and comprised interviews with 20 midwives across Australia, conducted between September 2020 and February 2022. Data were coded in a three-phase approach, starting with inductive line-by-line coding, which generated themes and subthemes, and finally, through …

Health Professional Perceptions Of Delivering Hospital Falls Prevention Education—A Qualitative Study, Anne Marie Hill, Cheng Yen Loo, Steffanie Coulter, Carol Watson, Sharmila Vaz, Meg E. Morris, Leon Flicker, Tammy Weselman

Research outputs 2022 to 2026

Background: Providing patient falls prevention education can help reduce falls in hospitals, yet research exploring staff perceptions about providing falls education in hospitals is limited. Objective: We sought to determine enablers and barriers to implementing a hospital falls prevention education program (the Safe Recovery Program) from the clinical staff perspective. Methods: Purposive sampling was used to recruit health professionals (N = 40) from 12 acute medical and surgical wards at a 450-bed hospital in Perth, Western Australia. Participants were given the option to take part in a focus group or semi-structured interview. Data were analyzed via directed content analysis. Results: …

Implementation Of The Novel Nurse Intuition Patient Deterioration Scale To Assess For A Correlation Among Nurse Intuition And Patients Returning To The Intensive Care Unit, Janie L. Walsh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Adult hospitalized medical and surgical patients at an academic medical center are being transferred out of the Intensive Care Unit (ICU) to the step-down floor and having rapid response calls in less than 48 hours after the transfer. Nurse intuition is not a consideration in the decision to transfer a patient. Physiological variables such as Modified Early Warning Scores (MEWS) and vital signs are relied on heavily as indicators for escalation or de-escalation of care. There is evidence supporting the use of acknowledging nurse intuition to better predict a patient’s readiness for transitions of care.

Purpose: To evaluate the …

An Evidence-Based Practice Initiative To Improve Blood Pressure Control, Teresa D. Hines

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: High blood pressure (HBP) is a significant public health concern. It affects millions of adults in the United States (US) and half of the adult population in the Appalachia regions. High blood pressure is a known risk factor for cardiovascular disease (CVD), which is the leading cause of morbidity and mortality Appalachia. Complications associated with high blood pressure result in substantial economic burdens for patients and their families, healthcare systems, and national economies. High blood pressure is a significant health issue in West Virginia (WV), with an estimated 602,000 people suffering from HBP.

Purpose: The purpose of this …

Aboriginal, Torres Strait Islander And Māori Nursing And Midwifery Academic Workforce Across Australia And Aotearoa New Zealand, Ann Bonner, Linda Deravin, Jan Dewar, Moira Williamson, Kerri Gillespie, Cheryl Atherfold, Karen Nightingale, Caryn West, Karen Strickland

Research outputs 2022 to 2026

Background: Promoting a representative and supportive industry for Aboriginal, Torres Strait Islander and Māori nursing and midwifery academic staff is a key tenet of Australian and Aotearoa New Zealand universities, and fundamental to strengthening the health workforce. Surprisingly, information about this workforce is unknown. Aim: The aim of the study was to gain an understanding of the Aboriginal, Torres Strait Islander and Māori nursing and midwifery academic workforce. Methods: A cross-sectional study was conducted using an online survey of organisations that provide accredited nursing and midwifery education within Australia and Aotearoa New Zealand. Demographic, academic and employment information relating to …

The Effects Of Interventions On Health-Related Quality Of Life Of People Living With Cardiovascular Disease: A Systematic Review, Amineh Rashidi, Lisa Whitehead, Lisa Newson, Helen Walthall, Clare Van Miert, Vivien Kemp, Ian Jones

Research outputs 2022 to 2026

Aim: To synthesise the evidence from randomised controlled trials on the effectiveness of interventions to improve health-related quality of life in people living with cardiovascular disease. Design: Systematic review and narrative synthesis. Data Sources: A systematic search of eight databases was conducted to identify relevant papers that were published in English and peer-reviewed. Review Methods: The titles and abstracts of the articles were screened by two independent reviewers. The remaining articles underwent full text screening, followed by quality appraisal conducted by two independent reviewers. Results: This review included 13 studies. The intervention in all studies was cardiac rehabilitation. In spite …

Determining Space Requirements For Small And Sick Newborns And Their Mothers In Health Facilities: A Systematic Review, Natalie Strobel, Georgia Whisson, Derek Swe, Rajesh Mehta, Amy Budrikis, Karen Edmond

Research outputs 2022 to 2026

Background There are currently no World Health Organization and United Nations Children Fund benchmarks or ‘norms’ for scaling up small and sick newborn (SSN) service delivery in health facilities in low- and middle-income countries (LMICs). Specifically, there is limited evidence on optimal bed space requirements in SSN units such as special care nurseries and neonatal intensive care units (NICUs). Through this systematic review, we aimed to gather evidence on the optimal space requirements needed for SSNs and their mothers in health facilities, particularly at level 2 district hospitals. Methods We included simulation, experimental, and observational studies, as well as guidelines …

The Impact Of A Planned Change To Nurse Staffing Levels In Emergency Departments: A Pre-Test, Post-Test Design, Vera J.C. Mc Carthy, Noeleen Brady, Ashling Murphy, Aileen Murphy, Jane Ball, Robert Crouch, Christine Duffield, Peter Griffiths, Anne Scott, Jonathan Drennan

Research outputs 2022 to 2026

Aim: To examine burnout levels, nurse perceptions of the work environment, job satisfaction, intention to stay and quality of care for nurses working in emergency departments before and following a planned change to nurse staffing levels. Design: A pre-post observational design. Methods: A systematic approach (Nursing Hours per Patient Presentation) was introduced to determine nurse staffing levels based on patient presentations resulting in adjustments to nurse staffing. Data on burnout, the work environment, intention to stay, job satisfaction and quality of care were collected from three emergency departments prior to and following the adjustments to nurse staffing. Results: An adjustment …

Assessing The Effect Of Awareness Of International Oxygen Therapy Guidelines On Oxygen Administration Practices Among Nurses During The Covid-19 Pandemic: A Survey Of Nurses Working In The Pediatric And Medical Departments Of A National Teaching And Referral Hospital In Low-Resource Settings, Joseph Odhiambo, Lucy W Kivuti-Bitok, Solomon Omare, Irene Ngune

Research outputs 2022 to 2026

Awareness of International Oxygen Therapy Guidelines (IOTG) may have impacted oxygen therapy experience during the coronavirus (COVID-19) pandemic. This study explored if nurses at Kenyatta National Hospital (KNH) were aware of IOTG and if this awareness influenced their practice of oxygen administration during Covid-19 era. A survey of 80 nurses, from both pediatric and medical departments was carried out. Data collection was done through a self-administered questionnaire. Data were analyzed using descriptive statistics and the association between variables with Chi-square and t-test at p < 0.05. The mean age of the respondents was 39.82 ± 9.32, and 66.3 % were females. Respondents had an average of 2.47 years (±2.35) since the last oxygen therapy refresher training. Over 60 % of participants had been administered oxygen less than a month preceding the survey. Lack of awareness of IOTG (X2 = 7.113 (df = 1, n = 80), p = 0.008) and experience administering oxygen to a covid-19 patient (X2 = 6.851 (df = 1, n = 80), p = 0.018), were associated with low awareness of Covid-19 ventilation and oxygenation guidelines. Experience of having administered Oxygen to a Covid-19 patient (X2 = 6.851 (df = 1, n = 80), p = 0.018) and having reviewed or used any guidelines on oxygen therapy (X2 = 7.113 (df = 1, n = 80), p = 0.008) were significantly associated with awareness of covid 19 ventilation and oxygenation guidelines. Further regular training in oxygen therapy is needed to ensure good clinical practice.

Child And Family Centred Care: A Three-Phased Principle-Based Concept Analysis, Maggie Zgambo, Julie Blamires, Mandie Foster, Mohammad Al-Motlaq, Therese A. O'Sullivan, Davina Houghton, Evalotte Mörelius

Research outputs 2022 to 2026

Introduction: Despite a growing multidisciplinary interest in the Child and Family Centred Care approach, its meaning remains unclear in extant literature. It is, therefore, crucial to explore, analyse, describe, and clarify the concept of the Child and Family Centred Care approach and its associated terms. Method: A three-phased principle-based concept analysis approach was used to analyse the concept of Child and Family Centred Care. A systematic search of literature was completed using the CINAHL, PsycINFO, Medline, Scopus, and Web of Science databases. Peer-reviewed articles on Child and Family Centred Care, published from inception to 2023 were included if they were …

Clinical Is The Pinnacle: Nurse Academics' Perspectives And Opinions Of Their Students Undertaking Mental Health Clinical Placements, Lorna Moxham, Kim Foster, Brenda Happell, Richard Lakeman, Michael Hazelton, John Hurley

Research outputs 2022 to 2026

Clinical placements form an integral and important part of preregistration nursing student learning. The theory–practice gap has been identified as problematic, with clinical experience being a key strategy to address this. Despite this, the perceptions of nurse academics teaching preregistration mental health nursing regarding clinical placements have not been widely explored. To garner perspectives and experiences of mental health clinical placements from nurse academics teaching mental health nursing to preregistration nursing students. A descriptive qualitative study involving 19 nurse academics from 13 metropolitan and regional Australian universities, who were involved in the design and delivery of preregistration mental health nursing …

Nursing Assessment Of Mental Health Issues In The General Clinical Environment: A Descriptive Study, Irene Ngune, Beverley Ewens, Sharlene Bell, Brendon Burns, Claire Sutton, Craig Creswell, Yvonne Middlewick

Research outputs 2022 to 2026

Aims: To evaluate the effectiveness of a mental health screening form for early identification and care escalation of mental health issues in general settings. A secondary aim was to explore general nurses' use of the form and their confidence to discuss mental health issues with patients. Methods: A cross-sectional design comprising a review of clinical records to determine use of the form, instances of missed care and escalation to the mental health team. The survey focused on nurses' confidence in general settings to engage in discussions with patients about mental health. Data were collected from April to December 2022. The …

Emotional Safety In Maternity Care: An Evolutionary Concept Analysis, Elliesha O'Reilly, Kate Buchanan, Sara Bayes

Research outputs 2022 to 2026

Background: Safety in maternity care is a priority, and a broadened view of safety (e.g., emotional, psychological, cultural) is evident in scientific literature and in lay discourse. ‘Emotional safety’ is being referred to with increasing frequency in this context; however, there is a lack of clarity in its use and meaning. Aim: The aim of this concept analysis was to examine the concept of emotional safety in maternity care. Methods: The evolutionary approach was used for this concept analysis. Data sources: This concept analysis was literature-based, with a systematic search conducted of CINAHL, MIDIRS, and MEDLINE databases. Ten articles published …

How Does Trauma Informed Care Education For Paediatric Healthcare Professionals’ Impact Self-Reported Knowledge And Practice. An Integrative Review, Megan Thornton, Julie Blamires, Mandie Foster, Rebecca Mowat, Stephanie Haven

Research outputs 2022 to 2026

Aim: To examine the literature on the impact of Trauma Informed Care education on paediatric health care practitioners’ self-reported knowledge and practice. Background: Psychosocial trauma during childhood is prevalent and linked to increased risk of adverse physical and mental health outcomes. Trauma Informed Care recognises the significant impact of childhood trauma in health outcomes. Education is key to health care practitioners’ integrating Trauma Informed Care into practice. Design: Integrative review of the literature. Methods: The review employed Whittemore and Knafl's (2005) framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2021 statement. A systematic search …

Implementing A Routine Patient Health Questionnaire-9 (Phq-9) Screening Bundle For Adults (18-65 Years) Scheduled For A Psychiatric Evaluation, Olivier Bertrand Djoumessi

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Depression affects 21 million American adults (8.4%), yet only 28% receive appropriate screening. In Texas, where 20.8% of adults experience depression, systematic screening remains inconsistent. This quality improvement project addressed a critical gap at an outpatient mental health clinic in the Dallas-Fort Worth metroplex, where Patient Health Questionnaire-9 (PHQ-9) screening occurred in only 40% of psychiatric evaluations, resulting in missed diagnoses and inconsistent treatment. Using the Plan-Do-Study-Act framework, the project implemented a comprehensive PHQ-9 screening bundle consisting of staff training, electronic health record integration, and a treatment algorithm based on severity thresholds. The intervention targeted adults, aged 18-65, scheduled for …