Medicine and Health Sciences Commons^™

Nutrition-Related Experiences Of Women With Perinatal Depression During The Covid-19 Pandemic: A Qualitative Study, Dahlia Stott, Cynthia Klobodu, Lisa A. Chiarello, Bobbie Posmontier, Mona Egohail, Pamela A. Geller, June Andrews Horowitz, Brandy-Joe Milliron

College of Nursing Faculty Papers & Presentations

Women with perinatal depression are at a high risk for unhealthy dietary behaviors but whether the coronavirus disease 2019 (COVID-19) pandemic has exacerbated this risk is unknown. Here we report the findings of a qualitative study exploring the impact of the COVID-19 pandemic on nutrition-related experiences of women with perinatal depression. Using a qualitative descriptive approach, in-depth interviews were conducted with 18 women with a history of perinatal depression and 10 healthcare providers. A semistructured format elicited how food and nutrition-related behaviors of women with perinatal depression were affected by the COVID-19 pandemic. Thematic analysis identified 4 themes related to …

What Were The Information Voids? A Qualitative Analysis Of Questions Asked By Dear Pandemic Readers Between August 2020-August 2021, Rachael Piltch-Loeb, Richard James, Sandra S. Albrecht, Alison M. Buttenheim, Jennifer Beam Dowd, Aparna Kumar, Malia Jones, Lindsey J. Leininger, Amanda Simanek, Shoshana Aronowitz

College of Nursing Faculty Papers & Presentations

In the current infodemic, how individuals receive information (channel), who it is coming from (source), and how it is framed can have an important effect on COVID-19 related mitigation behaviors. In light of these challenges presented by the infodemic, Dear Pandemic (DP) was created to directly address persistent questions related to COVID-19 and other health topics in the online environment. This is a qualitative analysis of 3806 questions that were submitted by DP readers to a question box on the Dear Pandemic website between August 30, 2020 and August 29, 2021. Analyses resulted in four themes: the need for clarification …

Strategies To Prevent Clostridioides Difficile Infections In Acute-Care Hospitals: 2022 Update, Larry K Kociolek, Dale N Gerding, Ruth Carrico, Philip Carling, Curtis J Donskey, Ghinwa Dumyati, David T Kuhar, Vivian G Loo, Lisa L Maragakis, Monika Pogorzelska-Maziarz, Thomas J Sandora, David J Weber, Deborah Yokoe, Erik R Dubberke

College of Nursing Faculty Papers & Presentations

No abstract provided.

Dear Pandemic: A Topic Modeling Analysis Of Covid-19 Information Needs Among Readers Of An Online Science Communication Campaign., Aleksandra M Golos, Sharath Chandra Guntuku, Rachael Piltch-Loeb, Lindsey J Leininger, Amanda M Simanek, Aparna Kumar, Sandra S Albrecht, Jennifer Beam Dowd, Malia Jones, Alison M Buttenheim

College of Nursing Faculty Papers & Presentations

BACKGROUND: The COVID-19 pandemic was accompanied by an "infodemic"-an overwhelming excess of accurate, inaccurate, and uncertain information. The social media-based science communication campaign Dear Pandemic was established to address the COVID-19 infodemic, in part by soliciting submissions from readers to an online question box. Our study characterized the information needs of Dear Pandemic's readers by identifying themes and longitudinal trends among question box submissions.

METHODS: We conducted a retrospective analysis of questions submitted from August 24, 2020, to August 24, 2021. We used Latent Dirichlet Allocation topic modeling to identify 25 topics among the submissions, then used thematic analysis to …

A Qualitative Exploration Of The Use Of Service Dogs In Veterans With Post Traumatic Stress Disorder And Traumatic Brain Injury, Jennifer Shiroff, Kathy Gray, Gabrielle Santulli, Stephen Didonato, Jacqueline O'Rourke Fulford

College of Nursing Faculty Papers & Presentations

Objective

This qualitative research was conducted to add to the body of knowledge that supports the benefits of service dogs (SDs), as a tertiary treatment modality, to veterans with post‐traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI).

Methods

This grounded theory research design utilized open‐ended, semi‐structured interviews with veterans (n = 10) who were using SDs as a treatment modality for PTSD and/or TBI. Transcripts were analyzed using NVivo qualitative software until data saturation was achieved.

Results

Results from the data analysis identified 4 major themes with concurrent subthemes. The most prominent themes were functional status, impact of …

Health Status And Preventive Health Services Among Reproductive-Aged Women In Treatment For Opioid Use Disorder, Vanessa Short, Dennis J. Hand, Lauren Pyfer, Hanna Steiger, Meghan Gannon, Gregory A. Jaffe, Diane J. Abatemarco

College of Nursing Faculty Papers & Presentations

OBJECTIVE: To assess the utilization of preventive health services and the prevalence of chronic health conditions among a cohort of women in treatment for opioid use disorder (OUD).

METHODS: Ninety-seven women who were receiving treatment for OUD from a single urban treatment program completed a self-administered anonymous online questionnaire that asked about demographics, health, receipt of preventive health services, and utilization of health care. Descriptive statistics were used to describe data.

RESULTS: More than one-third of respondents reported that their health was fair or poor, whereas one-quarter were very concerned with their health. Most participants (59%) reported at least one …

Hospital Nursing Factors Associated With Decreased Odds Of Mortality In Older Adult Medicare Surgical Patients With Depression, Aparna Kumar, Douglas Sloane, Linda Aiken, Matthew Mchugh

College of Nursing Faculty Papers & Presentations

Background: Depression is common, costly, and has deleterious effects in older adult surgical patients. Little research exists examining older adult surgical patient outcomes and depression and the potential for nursing factors to affect these outcomes. The purpose of this study was to determine the relationship between hospital nursing resources, 30-day mortality; and the impact of depression on this relationship.

Methods: This was a retrospective cohort study employing a national nurse survey, hospital data, and Medicare claims data from 2006-2007. The sample included: 296,561 older adult patients, aged 65-90, who had general, orthopedic, or vascular surgery in acute care general hospitals …

Breastfeeding Awareness And Empowerment (Bae): A Black Women-Led Approach To Promoting A Multigenerational Culture Of Health, Rebecca Duncan, Jabina Coleman, Sharon Herring, Meg Kawan, Christy Santoro, Meghana Atre, Aleigha Mason, Shawana S Moore, Aparna Kumar

College of Nursing Faculty Papers & Presentations

(1) Background: Critical gaps in the U.S. healthcare system perpetuate adverse reproductive health outcomes for Black people. Grounded in reproductive justice and trauma-informed care, Breastfeeding Awareness and Empowerment (BAE) has developed a program titled BAE Cafe to directly address these gaps by providing community-based lactation and perinatal mental health support. A literature review identified key programmatic gaps, namely, access to knowledge relevant to troubleshooting breastfeeding, peer support, community support and healthcare system support, and system-level factors that impede families and communities from accessing lactation support. (2) Methods: This paper describes BAE Cafe through a group process observation and participant survey. …

Diversity And Inclusion Or Tokens? A Qualitative Study Of Black Women Academic Nurse Leaders In The United States, Kechi Iheduru-Anderson, Florence O Okoro, Shawana S Moore

College of Nursing Faculty Papers & Presentations

Severe under-representation of Black women academic nurse leaders persists in United States higher education, and a major research gap still exists regarding experiences of these leaders, and facilitators of and barriers to their success. Our objective was to examine how race and gender influence how Black women academic nurse leaders’ function in their leadership positions, how they are perceived by their peers, and how their perception of race, gender, class, and power influences diversity, equity, and inclusion initiatives in the workplace. Critical race theory was used as a guiding theory, and the study design involved narrative inquiry followed by thematic …

A Novel Framework To Guide Antibiotic Stewardship Nursing Practice., Mary Lou Manning, Monika Pogorzelska-Maziarz, Cindy Hou, Nikunj Vyas, Marianne Kraemer, Eileen Carter, Elizabeth Monsees

College of Nursing Faculty Papers & Presentations

BACKGROUND: There is a pervasive view among some nurses and health care disciplines that antibiotic stewardship (AS) is solely a physician or pharmacist responsibility. There is an urgent need to alter this view so that nurses can seize every opportunity to prevent patient harm from antibiotics and optimize antibiotic use. One challenge to achieving full nurse engagement as equal members of the AS team is lack of an organizing framework to illustrate relationships of phenomena and concepts inherent to adoption of AS nursing practices.

METHODS: We sought to create a framework derived from the peer-reviewed literature, systematic and scoping reviews, …

The Impact Of Covid-19 On Healthcare Delivery For People Who Use Opioids: A Scoping Review., Karen Alexander, Monika Pogorzelska-Maziarz, Angela Gerolamo,, Nadia Hassen, Erin L Kelly, Kristin L. Rising

College of Nursing Faculty Papers & Presentations

RESEARCH OBJECTIVE: The COVID-19 pandemic disrupted healthcare delivery worldwide with likely negative effects on people who use opioids (PWUO). This scoping review of the original research literature describes the impact of the COVID-19 pandemic on healthcare delivery for PWUO and identifies gaps in the literature.

METHODS: This scoping review of the original research literature maps the available knowledge regarding the impact of the COVID-19 pandemic on healthcare delivery for PWUO. We utilized the methodology developed by the Joanna Briggs Institute for scoping reviews, and content analyses methodology to characterize the current state of the literature.

RESULTS: Of the 14 included …

Nurses' Pandemic Lives: A Mixed-Methods Study Of Experiences During Covid-19., Kathleen Gray, Paulette Dorney, Lori Hoffman, Albert Crawford

College of Nursing Faculty Papers & Presentations

BACKGROUND: The US healthcare settings and staff have been stretched to capacity by the COVID-19 pandemic. While COVID-19 continues to threaten global healthcare delivery systems and populations, its impact on nursing has been profound.

OBJECTIVES: This study aimed to document nurses' immediate reactions, major stressors, effective measures to reduce stress, coping strategies, and motivators as they provided care during COVID-19.

DESIGN: Mixed-methods, cross sectional design. Participants responded to objective and open-ended questions on the COVID-19 Nurses' Survey.

PARTICIPANTS: The survey, was sent to nurses employed in health care settings during the pandemic; 110 nurses participated.

RESULTS: Immediate reactions of respondents …

Timing Of Home Health Care Initiation And 30-Day Rehospitalizations Among Medicare Beneficiaries With Diabetes By Race And Ethnicity., Jamie M Smith, Haiqun Lin, Charlotte Thomas-Hawkins, Jennifer Tsui, Olga F Jarrín

College of Nursing Faculty Papers & Presentations

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health …

Racial Disparities In Post-Acute Home Health Care Referral And Utilization Among Older Adults With Diabetes, Jamie Smith, Olga Jarrín, Haiqun Lin, Tina Dharamdasani, Jennifer Tsui, Charlotte Thomas-Hawkins

College of Nursing Faculty Papers & Presentations

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and outcomes including disabling and life-threatening complications among patients with diabetes. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordination, and psychosocial support for patients and their caregivers. The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The study was limited to patients who were continuously enrolled in Medicare for at …

Assessing Civility At An Academic Health Science Center: Implications For Employee Satisfaction And Well-Being., Lisa A Campbell, Jenna R Lafreniere, Mhd Hasan Almekdash, David D Perlmutter, Huaxin Song, Patricia J Kelly, Rohali Keesari, Kay Leigh Shannon

College of Nursing Faculty Papers & Presentations

Incivilities are pervasive among workers in healthcare institutions. Previously identified effects include deterioration of employee physical and mental health, absenteeism, burnout, and turnover, as well as reduced patient safety and quality of care. This study documented factors related to organizational civility at an academic health sciences center (AHSC) as the basis for future intervention work. We used a cross-sectional research design to conduct an online survey at four of five campuses of an AHSC. Using the Organizational Civility Scale (OCS), we assessed differences across gender, race (White and non-White) and job type (faculty or staff) in the eleven subscales (frequency …

Redesigning Nursing Education To Build Healthier Communities: An Innovative Cross-Sector Collaboration., Beth Ann Swan, Peggy Hilden, Nikki West, Garrett Chan, Kathryn Shaffer, Judith G Berg, Mary Dickow, Deloras Jones

College of Nursing Faculty Papers & Presentations

Today's health care environment requires registered nurses to be prepared for an array of practice settings, providing care outside the hospital and directly in the community. There is increasing focus on wellness, prevention, access to care, and mental health services for an aging and more diverse population. To improve alignment of education with increasingly complex needs, donor-advised funding supported four prelicensure nursing schools to transform their curricula. Selected schools were guided through a curriculum redesign process emphasizing community and continuum of care. This innovation was consistent with meeting challenges to realize the Institute of Medicine's 2011 Future of Nursing recommendations.

Identified Gaps And Opportunities In Perinatal Healthcare Delivery For Women In Treatment For Opioid Use Disorder., Karen Alexander, Vanessa Short, Megan Gannon, Neera Goyal, Madeline Naegle, Diane J Abatemarco

College of Nursing Faculty Papers & Presentations

Pregnancy and the delivery of an infant mark a unique time of engagement in healthcare for women in treatment for opioid use disorder (OUD). The American College of Obstetrics and Gynecology calls for a comprehensive approach to perinatal healthcare delivery for pregnant women with OUD in order to facilitate improved health outcomes and increase patient-provider collaboration. Yet, there is little knowledge regarding the perceptions of women with OUD regarding the current delivery of healthcare which could inform a personalized, tailored approach to perinatal healthcare delivery. Methods: Four focus groups consisting of 22 women with OUD were conducted, transcribed, and analysed …

Shedding Light On Endometriosis: Patient And Provider Perspectives On A Challenging Disease, Madalene Zale, Emily Lambert, Marianna Lanoue, Amy E. Leader

College of Nursing Faculty Papers & Presentations

Background: Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide.

Methods: This mixed methods study aimed to understand health care provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using …

Care Coordination: Roles Of Registered Nurses Across The Care Continuum, Beth Ann Swan, Sheila Haas, Anne T. Jessie

College of Nursing Faculty Papers & Presentations

Lack of coordination leads to health care that is fragmented, inconsistent, and poorly planned. Conversely, effective care coordination supports achieving the Quadruple Aim. Care coordination, roles of RNs in care coordination, and implications for healthcare delivery are explored.

Developing A Business Case For The Care Coordination And Transition Management Model: Need, Metrics, And Measures, Sheila Haas, Phd, Rn, Faan, Regina Conway-Phillips, Phd, Rn, Beth Ann Swan, Phd, Crnp, Faan, Laura De La Pena, Msn, Rnc, C-Efm, Rachel Start, Msn, Rn, Ne-Bc, Diane Storer Brown, Phd, Rn, Cphq, Fnahq, Faan

College of Nursing Faculty Papers & Presentations

In this descriptive qualitative study, nurse and healthcare leaders' experiences, perceptions of care coordination and transition management (CCTM®), and insights as to how to foster adoption of the CCTM RN role in nursing education, practice across the continuum, and policy were explored. Twenty-five barriers to recognition and adoption of CCTM RN practice across the continuum were identified and categorized. Implications of these findings, recommendations for adoption of CCTM RN practice across the care continuum, and strategies for reimbursement policies are discussed.

Optimizing Strategies For Care Coordination And Transition Management: Recommendations For Nursing Education, Beth Ann Swan, Regina Conway-Phillips, Sheila Haas, Laura De La Pena

College of Nursing Faculty Papers & Presentations

The purpose of this descriptive qualitative study was to explore nurse and healthcare leaders' experiences and perceptions of care coordination and transition management (CCTM®). Four barriers emerged that added insight into the lack of adopting and integrating CCTM knowledge, skills, and attitudes in nursing education in the following categories: curriculum redesign, silos of care settings and care providers, knowledge gap, and faculty development/resistance. Recommendations and implications for education, for both nursing students and practicing nurses, are described.

The Voices Of Graduates: Informing Faculty Practices To Establish Best Practices For Readying Nclex-Rn Applicants, Mary Hanson-Zalot, Angela Gerolamo, Julia Ward

College of Nursing Faculty Papers & Presentations

Changes in the National Council of State Boards of Nursing along with other factors influence graduates’ successful completion of a nursing program and the licensing examination. Literature is scarce in the area of examining stu-dent perceptions of preparing for and taking the NCLEX-RN examination. Our study sought to fill this gap in knowledge by conducting a focus group and interviews with individuals who passed the NCLEX-RN on their first at-tempt and those who did not. This was a descriptive qualitative study which used semi-structured interviews and a focus group to examine graduates’ perceptions related to preparing for and taking the …

The American Academy Of Ambulatory Care Nursing's Invitational Summit On Care Coordination And Transition Management: An Overview, Sheila Haas, Beth Ann Swan

College of Nursing Faculty Papers & Presentations

The American Academy of Ambulatory Care Nursing convened an Invitational Summit of national leaders to assist with strategic planning for promulgation of the care coordination and transition management (CCTM™) model. The conference was devoted to CCTM and the roles of registered nurses (RNs) across the care continuum to ensure safety and quality health care. The specific emphasis was on embedding the CCTM RN in healthcare policy and payment reform, as well as integration into academic and ongoing education across all care settings and specialties.

Treatment-Related Decisional Conflict, Quality Of Life, And Comorbidity In Older Adults With Cancer., Jeannette M. Kates

College of Nursing Faculty Papers & Presentations

Objective: The present study aims to examine the relationships between and among cancer treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer.

Methods: A convenience sample of 200 older adults was recruited from outpatient medical oncology and radiation oncology practices in the northeastern United States. A cross-sectional, descriptive, correlational study design was used employing a survey method. Survey instruments included the Decisional Conflict scale (DCS) (with five subscales, including informed, values clarity, support, uncertainty, and effective decision); Self-administered comorbidity questionnaire (SCQ); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (including five function …

Clinical Framework For Quality Improvement Of Cancer Cachexia., Clara Granda-Cameron, Mary Pat Lynch

College of Nursing Faculty Papers & Presentations

The objective of this article is to introduce the Clinical Framework for Quality Improvement of Cancer Cachexia (Cachexia Care Framework) as a tool to demonstrate the relevance of integrating the clinical components of cancer cachexia and the organizational strategies of a cancer institution on the quality of patient care and delivery of services throughout the cancer cachexia continuum. The data sources included peer-reviewed literature relevant to cancer cachexia and quality cancer care, and the authors' expertise. The Cachexia Care Framework results from a combination of the international consensus definition of cancer cachexia, the Institute of Medicine report Ensuring Quality Cancer …

Differences In Work Environment For Staff As An Explanation For Variation In Central Line Bundle Compliance In Intensive Care Units., Yuna S.H. Lee, Patricia W. Stone, Monika Pogorzelska-Maziarz, Ingrid M. Nembhard

College of Nursing Faculty Papers & Presentations

BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals.

PURPOSE: The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs).

METHODOLOGY/APPROACH: A cross-sectional study of hospital medical-surgical ICUs in the United States was done. …

Nursing Home Infection Control Program Characteristics, Cms Citations, And Implementation Of Antibiotic Stewardship Policies: A National Study., Patricia W. Stone, Carolyn T.A. Herzig, Mansi Agarwal, Monika Pogorzelska-Maziarz, Andrew W. Dick

College of Nursing Faculty Papers & Presentations

Recently, the Centers for Medicare & Medicaid Services (CMS) final rule required that nursing homes (NHs) develop an infection control program that includes an antibiotic stewardship component and employs a trained infection preventionist (IP). The objectives of this study were to provide a baseline assessment of (1) NH facility and infection control program characteristics associated with having an infection control deficiency citation and (2) associations between IP training and the presence of antibiotic stewardship policies, controlling for NH characteristics. A cross-sectional survey of 2514 randomly sampled US NHs was conducted to assess IP training, staff turnover, and infection control program …

Designing A New Model For Clinical Education: An Innovative Approach., Kathryn Shaffer, Beth Ann Swan, Mary Bouchaud

College of Nursing Faculty Papers & Presentations

To keep pace with the ever-changing health care delivery system, it is important to transform the way future nurses are educated, both in classroom and in clinical settings, to care for people along the life and care continuum, not only in acute-care settings. The purpose of this article is to describe a new approach to educating baccalaureate nursing students using immersion practicums that expose students to population health, transitions of care, care coordination, and the multiple roles a nurse engages in along the continuum. The curriculum includes 5 immersions, each with a specific life and care continuum focus to develop …

A Retrospective Analysis Of Nursing Students' Clinical Experience In An All-Male Maximum Security Prison., Mary T. Bouchaud, Madeline Brooks, Beth Ann Swan

College of Nursing Faculty Papers & Presentations

Prisons provide an ideal learning experience to prepare prelicensure students with the knowledge and skill set needed for practice in the 21st century. Beginning descriptive evidence demonstrates that correctional health is an innovative community resource to educate nursing students in today's changing model of health care delivery and practice. This article shares results from a retrospective analysis of the perceptions and experiences of nursing students during their community clinical rotation in an all-male maximum security prison.

Utilization Of Care By Infants With Neonatal Abstinence Syndrome In Delaware, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

From 1999-2013, the nationwide incidence of neonatal abstinence syndrome (NAS) due to maternal drug use rose from 1.5/1000 to 6/1000 hospital births. There is a dearth of information regarding what happens to these children when they are discharged. The purpose of this Practice Inquiry Project is to utilize existing Delaware Medicaid data to retrospectively explore the utilization of services and gaps in care for the infant with NAS in the first year of life. Key findings include less than expected well child visits and immunizations along with higher hospital re-admission rates. This represents missed opportunities for care, also demonstrating the …