Medicine and Health Sciences Commons^™

Description Of Medical-Surgical Nurses Care Of Patients At Risk For Pressure Ulcers, Barbara Jean Mayer Phd

Dissertations

Aim: The purpose of this qualitative study was to explore and describe the level of understanding of PU development and prevention and perceptions of implementing PU prevention measures in nurses caring for patients in medical-surgical units. Method: The study was conducted in three (3) community hospitals within the same healthcare system using an Interpretive Description approach. Six (6) focus groups were conducted including thirty (30) participants. Findings: Participants described their knowledge of PU development and prevention as good and perceived continuing education as important in maintaining knowledge levels. Two (2) methods of identifying patients at risk for PU development were …

Risk-Appropriate Maternal Care: Identifying Risk Factors That Effect Maternal Outcome, Lucy R. Van Otterloo Phd, Msn, Rnc, Cns

Dissertations

Although maternal deaths are the most tragic of obstetric events it continues to be a rare event. Maternal morbidity, on the other hand, is increasing and poses a greater impact on the economic, psychological, and physical health of the woman and her family, yet it has not been the focus of measurement or research since there is no systematic collection of data available. As complications increase, the likelihood of adverse maternal outcomes such as longer postpartum stays due to the need for more extensive care will also increase. Nurses are being challenged to use their knowledge and skills to identify …

Nutritional Status Of Patients With End Stage Liver Disease: An Outpatient Assessment, Anna Marie Cumming-Browne Hefner Phd, Msn, Cpnp, Rn

Dissertations

Cirrhosis is the 12th leading cause of death in the United States. It is well documented end stage liver disease drives a patient to a catabolic state thus depleting them of essential nutrients. Malnutrition is often unrecognized and untreated in outpatients. Though BMI, nutritional intake, anthropometric measurements have been used in clinical trials, there still remains no standard nutritional assessment. The purpose of this dissertation was to (1) identify the incidence of malnutrition in patients with compensated and decompensated liver disease utilizing defined nutritional parameters (Subjective Global Assessment, anthropometric measurements, hand grip strength, and laboratory values) and (2) correlate with …

Psychometric Properties Of Standardized Patient And Faculty Rater's Evaluations Of Pre-Licensure Nursing Student Competencies, Karen A. Macauley Phd, Dnp, Fnp-Bc, Gnp, Bc

Dissertations

The use of simulation as a teaching modality has been rooted in the military, aviation, space, and engineering for centuries (Bradley, 2006). Clinical simulation allows for training of healthcare providers that might be too costly, risky, or hazardous in the clinical setting (Bradley, 2006). A variety of simulation modalities are used including virtual learning, task trainers, mannequins, and standardized patients (SPs). External demands for improved accountability of clinical performance is requiring nursing educators to reevaluate methods of teaching and how we measure nursing competence (Nehring & Lashley, 2010). Standardized patients have been used in medical school curricula to teach and …

Nursing Students' Attitudes Toward Science In The Nursing Curricula, Jill Deanne Maroo

Dissertations

The nursing profession combines the art of caregiving with scientific concepts. Nursing students need to learn science in order to start in a nursing program. However, previous research showed that students left the nursing program, stating it included too much science (Andrew et al., 2008). Research has shown a correlation between students’ attitudes and their performance in a subject (Osborne, Simon, & Collins, 2003). However, little research exists on the overall attitude of nursing students toward science. At the time of my study there existed no large scale quantitative study on my topic. The purpose of my study was to …

The Impact Of Technology Attitudes And Skills Of Rural Health Clinic Nurses On The Level Of Adoption Of Electronic Health Records In Mississippi, Jennifer Lynn Styron

Dissertations

The evolution of health information technology continues to reform the delivery of efficient, safe, and equitable healthcare in the United States. One such example is the emergence of electronic health records (EHRs) and the discerning emphasis placed on using this technology in meaningful ways. While the integration of EHRs into daily practice impacts all healthcare professionals, nurses remain a prominent driver in the successful adoption and usage of these systems. It is therefore imperative to understand the impact of nurses’ technology attitudes and skills on the level of EHR adoption in Mississippi.

This quantitative study examined the technology attitudes and …

Toward A Model For Predicting Depression Among Veterans, Nita Aurora Magee-Cornelius

Dissertations

Major depression, identified as a leading cause of disability in the United States, is often first diagnosed by primary care providers. This disability is associated with increased morbidity, mortality, and a lower quality of life. With approximately one in every three veteran diagnosed with depression and the rate of suicide increasing in the United States military (Department of Veterans Affairs, 2009), the Patient Health Questionnaire-2 items (PHQ-2) can be instrumental in identification and monitoring of depressive symptoms. The purposes of this retrospective study were to determine the prevalence of depression, as measured by the federally mandated PHQ-2 in the VA, …

Perceptions Of Workplace Bullying Among Practicing Registered Nurses, Crystal Regina Threadgill

Dissertations

Workplace bullying (WPB) is a social and organizational problem. Within the health care arena, employees, particularly registered nurses, are at risk. WPB has several adverse effects and has been cited in the literature as closely associated with burnout and nurses leaving their positions. This quantitative study examined workplace bullying among practicing registered and its relationship with burnout and nurses’ intent to leave their current position.

The surveys utilized were the Negative Acts Questionnaires-Revised (NAQ-R), Maslach Burnout Inventory Survey, Intention to Turnover Scale and a demographic survey. Of the surveys distributed, a total of 185 were returned from one selected hospital …

A Case Study Exploring Restraint And Seclusion Use In School-Age Children On An Inpatient Psychiatric Unit, Michelle Buckman Phd

Dissertations

Perceptions of children restrained and secluded (R&S) were explored using Yin's methodology and critical theory. The literature presented reviewed proponent's and opponent's views of the R&S intervention used on inpatient psychiatric units for the containment of violent patients. Despite reports of physical and emotional injury to staff and patient during restraining and secluding children, the intervention is still in use. Using Machover's framework, a semi-structured interview and drawings were used to illicit information from a 12 year old boy about his perceptions of R&S. Then, a presentation of barriers to conducting research is made. Results of the child's perceptions included …

Determinants Of Health-Related Quality Of Life In Arab American Patients With Type 2 Diabetes, Yousef Zakarni Phd

Dissertations

HRQL is an important aspect of chronic illnesses such as diabetes and needs to be considered by healthcare providers. It is one of the most important outcomes of healthcare interventions, representing an integral public health goal in Healthy People 2000, 2010, and 2020. Arab Americans (AAs), one of the most rapidly growing minorities in United States, tend to have a high prevalence of type 2 diabetes. The purpose of this study was to describe determinants of HRQL, including social support attitude, religiosity, and select demographics for AA patients with type 2 diabetes. A descriptive correlational study using a cross sectional …

Counselor Educator Knowledge, Experience, Attitudes And Beliefs Toward Complementary And Alternative Medicine, Jennifer Mills Langeland

Dissertations

Following growing public interest and widespread use, many health professions have begun to explore the attitudes toward, knowledge of and experience with complementary and alternative medicine (CAM) of the various stakeholders within their professions. This foundational information has enabled disciplines such as medicine, nursing, psychology, and marriage and family therapy to take a closer look at how students, patients, clients, and faculty think about and utilize CAM and its relevance to their professions. Surveying the practices and attitudes of stakeholders has been an important starting point for professions undertaking the task of integrating these practices into training programs.

This study …

Developing A Clinical Nurse Leader Practice Model: An Interpretive Synthesis, Miriam Bender Phd

Dissertations

Objective: The Institute of Medicine's Future of Nursing report identifies the Clinical Nurse Leader (CNL) as an innovative and necessary new role for meeting higher healthcare quality standards. The American Association of Colleges of Nursing CNL White Paper defines core competencies necessary for practice. The literature documents preliminary evidence of improved outcomes associated with CNL integration into clinical microsystems. However, the CNL role is not yet clearly defined in terms of fundamental activities and responsibilities necessary to produce outcomes. Lack of practice clarity limits the ability to articulate, implement, and measure CNL-specific practice and outcomes. The purpose of this study …

Elevated Blood Glucose Levels In The Emergency Department: Missed Opportunity For Informing And Referring, Melissa D. Rouse Phd, Rn, Cns-Bc, Cen, Hacp, Cphq

Dissertations

The purpose of this research was to examine (1) the rates of elevated blood glucose ≥ 150 mg/dL in adults without a prior history of diabetes, receiving care for a non-diabetes related visit to the ED and (2) Emergency Department provider patterns for informing and referring discharged Emergency Department patients for follow-up of elevated random blood glucose levels. A descriptive, correlational, cross-sectional design, with purposive sample was used. Retrospective chart review was done for patients age 18 and older, treated in two EDs from March 1, 2010 through March 22, 2010. Significant relationships were found between blood glucose level and …

Relationship Of Internet-Delivered Mantram Repetition Program To Burnout, Stress Of Conscience, Spiritual Wellbeing, And Mindfulness In Healthcare Workers, Sheryl Leary Phd

Dissertations

This study evaluated the effect of the Mantram Repetition Program (MRP), an internet-delivered stress management course on burnout, stress of conscience, spiritual wellbeing, and mindfulness on a self-selected group of healthcare workers (HCWs). A quasi-experimental repeated measures design was used. Participants enrolled in a six-session MRP delivered over three months and completed baseline, post-course, and three-month post-course assessments. Measurement tools included the Maslach Burnout Inventory-General Survey (MBI-GS), the Stress of Conscience Questionnaire (SCQ), the Functional Assessment of Chronic Illness Therapy Spiritual Wellbeing Scale (FACIT-12), and the Mindfulness Awareness Attention Scale (MAAS). Statistically significant effects of the MRP showed a decrease …

The Relationship Between Parental And Adolescent Religiosity Factors And Adolescent Sexual Risk-Taking Among Older Adolescents In The Anglophone/Latin Caribbean, Karen Christoffel Flowers

Dissertations

Problem: Sexually active youth across the Anglophone/Latin Caribbean have been identified as among the most-at-risk for HIV infection. Studies conducted in the United States have identified parental and religiosity factors associated with adolescent sexual risk-taking, but these relationships remain largely unexplored in the Caribbean region.

Method: This cross-sectional study, based on survey data generated by the Seventh-day Adventist Caribbean Youth Survey, investigated the relationship between parental and adolescent religiosity factors and sexual at-risk behaviors reported by adolescents ages 16-18 years attending Seventh-day Adventist Church-operated secondary schools across the region. Pearson correlations and multiple regression analyses were used to assess the …

Opening The Black Box: Understanding Adult Inpatient Falls, Laura M. Rogers

Dissertations

Within the United States, falls are the largest category of adverse events reported in hospitals. Injuries associated with falls include increased costs, extended length of stays, increased mortality and morbidity, and liability to hospitals. The purpose of this study was to discover, describe, and systematically analyze universal and diverse care meanings and expressions of adults experiencing a fall while hospitalized. The research was conceptualized with the ethnographic theoretical framework of Culture Care Diversity and Universality (Leininger 2001, 2006). Data collection took place in a large academic medical center, over a five month period and included 24 participants: eight adult inpatients …

Caregivers Of Older Adults: Burden, Perception Of Strain, And Health, Juana Ferrerosa Phd, Msn, Rn, Phn

Dissertations

Background: By the year 2030, the older population in the United States is projected to double from 35 to 70 million. Consequently, increasing the number of informal caregivers required to care for an aging population. Research suggests that levels of caregiver strain and their ability to cope can impact the health of caregivers. Tsai's (2003) Middle-Range Theory of Caregiver Stress guided this study and was modified to present an innovative approach which used perceived caregiver strain as a specific stressor in the Control Process of the model; it provided a basis for examining caregiver strain and its effect on the …

Early Identification Of At-Risk Lpn-To-Rn Students, Lisa K. Hawthorne Phd, Msn, Rn, Phn, Cne,

Dissertations

Nurse education programs are implementing standardized assessments without evaluating their effectiveness. Graduates of associate degree nursing programs continue to be unsuccessful with licensure examinations, despite standardized testing and stronger admission criteria. This problem is also prevalent for LPN-to-RN education programs due to a lack of research on this group of graduates, who by all accounts should be successful in nursing education based on their work experience and prior nursing education. Findings of this quantitative, non-experimental descriptive correlational study are presented to determine the effectiveness of standardized testing from Assessment Technologies Institute (ATI) as it relates to identifying at-risk LPN-RN students …

A Descriptive Study Of The Leadership Role Of Community Health Ambassadors On Diabetes-Related Health Behaviors, Barbara Pullen-Smith

Dissertations

Diabetes is a chronic disease that bears a disproportionate burden among African American populations. The lack of access to affordable, culturally appropriate health care is a key barrier to effective diabetes prevention or disease management for racial/ethnic minority populations. Living in public housing communities, with concentrated poverty, exacerbates the burden of diabetes and reduces access to screening and early detection services to prevent the onset of diabetes. The purpose of the study was to describe the leadership role of lay health advisors, known as Community Health Ambassadors (CHAs), on diabetes-related health behaviors of African Americans living in a public housing …

Effect Of Doping On Β-Tricalcium Phosphate Bioresorbable Bulk Material And Thin Film Coatings, Suhaila Abdalla

Dissertations

Magnesium has emerged as a revolutionary biodegradable metal for use as an orthopedic material, it has several advantages over the permanent metallic materials currently in use, including eliminating the effects of stress shielding, improving biocompatibility and degradation properties, thus removing the requirement of a second surgery for implant removal. Due to the rapid degradation of magnesium, it is necessary to control the corrosion rates of the materials to match the rates of bone healing. This dissertation reports on the effect of doping on the properties of β-tricalcium phosphate (β-TCP). It also reports on its application as a thin film coating …

A Mathematical Modeling Framework For Phlebotomist Scheduling And Blood Draw Assignments In Laboratory Medicine, Laquanda T. Leaven

Dissertations

Laboratory services in healthcare delivery systems play a vital role in inpatient care. Studies have shown that laboratory data affects approximately 65% of the most critical decisions on admission, discharge, and medication. Laboratory testing accounts for approximately 10% of hospital billing. Reducing laboratory costs would contribute to reducing total healthcare cost, which is one of the major goals for the U.S. healthcare delivery system. This research focuses on improving the performance of the hospital laboratory in a large hospital system. The intention of this study is to identify and then optimize the most critical stage to improve the entire laboratory …

Exploring The Relationship Between Adventist Hospital Board Chair Leadership Behaviors And Effectiveness, Anthony M. Stahl

Dissertations

Problem and Purpose. There is a lack of empirical research regarding the leadership behaviors that predict an effective community hospital board chair. Researchers indicate that an effective organization normally has a well-led board. However, the chair role has been largely neglected in the research of board functions and operations. With many hospitals facing reorganization or closing, it is important to understand and identify effective chair behaviors. Thus, the purpose of this study was to determine the relationship between hospital chair leadership behaviors and effectiveness, and the relationship of effective chairs to effective hospitals.

Method. This study used an ex post …

Are Women Aware? : Factors Related To Women's Knowledge Of Risk And Preventive Factors In Breast Cancer, Sandra M. Walther

Dissertations

Problem. Women have a one-in-eight chance of being diagnosed with breast cancer in their lifetime. In the past decade, there has only been a decrease of less than 1% in breast cancer morbidity and mortality rates. Breast cancer continues to be a feared disease that ravages even its survivors, and grips many with fear. Furthermore, breast cancer remains the highest cost of care among cancers. In 1990 the overall cost of care for breast cancer was $4.2 billion. In 2010, the total cost of breast cancer care rose to almost $17 billion, and by 2020 the cost trends show …

Using The Theory Of Planned Behavior As A Predictor Of Radiologic Technologists' Use Of Patient Radiation Protection Best Practices: A Regional Study, Brenda L. Boyd

Dissertations

Problem. A growing concern exists that patients are receiving an increase in radiation exposure while undergoing medical imaging exams. According to a March 2009 report by the National Council on Radiation Protection and Measurements (NCRP), the U.S. population's total exposure to ionizing radiation has nearly doubled over the past two decades. With the introduction of new digital radiology equipment, patient dose is on the rise. Possible reasons for a radiologic technologist's behavior include: influence by availability or lack of equipment, policies, social pressure, attitudes, and a safety culture. Little research has been done in this area, specifically with applying a …

Assessment Of Neck And Shoulder Muscle Coactivations And The Effect On The Musculoskeletal System, Regina Derria Pope-Ford

Dissertations

Musculoskeletal disorders (MSDs) constitute one of the most important occupational health issues in healthcare workers who are susceptible to upper extremity disorders. Yet MSDs in the healthcare professions have not been studied extensively beyond the lower back. The focus population for this research is the field of dentistry where neck and shoulder disorders have been documented to have a high prevalence. Though quantitative data has been collected, many prior studies have focused on self-reported information. The goal of this research is to provide insight into the inter-relationship of muscles in the upper extremities. One way to accomplish this is to …

Synthesis And Assembly Of Dihydroindolizines On Gold Surfaces For Light Induced Work Function Alterations, Matthew Alan Bartucci

Dissertations

Taking advantage of surfaces' response to interfacial dipoles, a class of photochromophores (dihydroindolizine) is demonstrated to alter the work function of the underlying substrate (170 meV). This same molecule also provides spectroscopic signatures for correlating the change in molecular structure to the induced change in the surfaces' electronic properties. Polarization modulation infrared reflection absorption spectroscopy (PM-IRRAS) allows analysis of the characteristic dihydroindolizine C=C (1559 cm-1) and pyridinium (1643 cm-1) stretch as a function of photoexcitation. Structural assignments of this photochromophore are corroborated to density function theory calculations. Conformational changes in the monolayers appear in parallel with work function changes and …

Risk Perception In Cardiovascular Disease, Michelle Ellen Block

Dissertations

Cardiovascular disease (CVD) remains among the leading causes of death in the United States despite widespread knowledge about risk factors as well as effective primary prevention strategies. Risk perception is a complex phenomenon that plays an important role in how persons view disease and ultimately how they make health behavior choices. This study is supported by the knowledge that few studies have examined how persons perceive cardiovascular risk or the variables thought to contribute to the formation of risk perception.

Purpose: The purpose of this study was to examine how accurately persons perceive personal risk for cardiovascular disease and identify …

Effects Of Electrical Stimulation And Testosterone In Translational Models Of Peripheral Nerve Injury, Gina Monaco

Dissertations

As functional recovery following peripheral nerve injury is dependent upon successful regeneration and target reconnection, combinatorial treatments that enhance different regeneration events may be required for recovery from severe injuries. The neurotherapeutic effects of electrical stimulation (ES) and gonadal steroids have been demonstrated independently and in combination in extratemporal and intratemporal facial nerve injuries. The goals of the first aim were to develop a reliable intracranial facial nerve crush model and to investigate the therapeutic potential of combining ES with testosterone propionate (TP) in this most proximal injury model. Adult male rats were divided into intracranial sham-operated, intracranial crush, and …

Beyond Retention: Exploring Mental Health Benefits Of Living Learning Programs, Christopher Zaddach

Dissertations

The transition to a university setting can be a particularly challenging and stressful experience for a significant proportion of first-year students who may struggle to cope with dramatic changes in academic and social demands. Despite available resources and services, universities continue to report significant attrition rates and increases in severity and intensity of mental health issues among first-year students. Living learning communities (LLCs) have long been recognized as programming options with the ability to support students' academic and social adjustment. The current study aimed to expand the literature on LLCs by examining the possible mental health benefits of living learning …

Emergency Nurses' Knowledge, Attitudes And Preventive Practices Regarding Firearms And Firearm Injury Prevention For Children, Dorothy Ann Gomez

Dissertations

In 2010, there were 134 deaths attributed to unintentional firearm injuries of children under 19 year and 3,019 nonfatal injuries (CDC, 2011). Nurses are expected to identify potential dangers in the community and protect those at risk. It was found that there is limited research on the effectiveness of current firearm injury prevention practices of nurses. The study was designed to examine the knowledge, attitudes and practice characteristics of Emergency Nurses toward firearm prevention practices. A convenience sample of 189 emergency nurses completed a voluntary, anonymous survey on practices regarding childhood gun safety. Seventy-one percent of respondents agreed that firearm …