Medicine and Health Sciences Commons^™

Nurse Value-Added And Patient Outcomes In Acute Care, Olga Yakusheva, Richard C. Lindrooth, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Objective

The aims of the study were to (1) estimate the relative nurse effectiveness, or individual nurse value-added (NVA), to patients’ clinical condition change during hospitalization; (2) examine nurse characteristics contributing to NVA; and (3) estimate the contribution of value-added nursing care to patient outcomes.

Data Sources/Study Setting

Electronic data on 1,203 staff nurses matched with 7,318 adult medical–surgical patients discharged between July 1, 2011 and December 31, 2011 from an urban Magnet-designated, 854-bed teaching hospital.

Study Design

Retrospective observational longitudinal analysis using a covariate-adjustment value-added model with nurse fixed effects.

Data Collection/Extraction Methods

Data were extracted from the study …

Chronic Conditions In Elders In Assisted Living Facilities: Associations With Daily Functioning, Self-Assessed Health, And Depressive Symptoms, Abir K. Bekhet, Jaclene A. Zauszniewski

College of Nursing Faculty Research and Publications

Background

The increasing life expectancy of older adults has prompted an increase in chronic conditions that may interfere with their daily living and impact physical and mental health.

Objectives

This study examined associations between commonly reported chronic conditions, daily functioning, self-assessed health, and depressive symptoms of elders.

Methods/Design

A secondary analysis of existing data from 314 elderly residents of 29 facilities was conducted.

Results

The most frequently reported conditions were arthritis (64%), hypertension (47%), and heart problems (35%). Elders who reported having all three of these most frequently reported conditions differed significantly from those who reported none or one of …

Gender Differences In Neighborhood Walking In Older Adults, N. A. Gallagher, P. J. Clarke, Kimberlee A. Gretebeck

College of Nursing Faculty Research and Publications

Objective: This study examined mobility, self-efficacy, outcome expectations, neighborhood (density, destinations, and design), and neighborhood walking in older men (n = 106, 60-99 years, M = 76.78, SD = 8.12) and women (n = 216, 60-99 years, M = 75.81, SD = 8.46).

Method/Results: In hierarchical regression, the variables explained 32% of the variance in neighborhood walking in men (p < .001) and 27% of the variance in women (p < .01). Self-efficacy (β = .49, p < .01), density (β= .22, p < .05), and design (β= .21, p = .05) were associated with walking in men. Significant design characteristics included sidewalks (β= .25, p < .05) and crime (β= .36, p < .01). In women, self-efficacy (β= .48, p < .001) and destinations (β= .15, p < .05) were associated with walking. Walking was associated with self-efficacy for walking despite individual barriers in women (β= .38, p < .001) and neighborhood barriers in men (β= .30, p < .05).

Conclusion: Walking interventions targeting older women should incorporate local destinations. In older …

Effect Of A Social Script Ipad Application For Children With Autism Going To Imaging, Norah L. Johnson, Octavia Bree, Erin E. Lalley, Kelly Rettler, Pam Grande, Md O. Gani, Sheikh Iqbal Ahamed

College of Nursing Faculty Research and Publications

This randomized controlled trial feasibility study tested the effectiveness of an iPad® application (app) social script intervention for children with autism spectrum disorder (ASD) going to imaging and their parent (n = 32 parent/child dyads). Parents of the children exposed to the app (n = 16) had lower state anxiety compared to the parents whose children were not exposed to the app (n = 16) (effect size 0.33). Children exposed to the app had fewer externalized challenging behaviors than the control group (effect size 0.56). The results demonstrate feasibility and efficacy of the intervention. Further study of …

An Emerging Population: The Chronically Critically Ill, Philip Jurasinski, Christine A. Schindler

College of Nursing Faculty Research and Publications

No abstract provided.

Factors Affecting Disruption In Families Of Adults With Mental Illness, M. Jane Suresky, Jaclene Zauszniewski, Abir K. Bekhet

College of Nursing Faculty Research and Publications

PURPOSE: This study examined relationships between vulnerability/risk and protective factors, and family functioning in women family members of adults with serious mental illness.

DESIGN AND METHODS: Using a descriptive, correlational design, this secondary analysis examined characteristics of the family member with mental illness (e.g., diagnosis, level of care) and measures of caregiver stigma and strain, client dependence, family disruption, sense of coherence, and resourcefulness.

FINDINGS: Family disruption was greatest inwomenwho provided direct care and whose family member had major depression, followed by bipolar disorder, schizophrenia, and panic disorder. Sense of coherence and resourcefulness were associated with lower family disruption, but …

Are Rural And Urban Newly Licensed Nurses Different? A Longitudinal Study Of A Nurse Residency Programme, Marilyn Meyer Bratt, Marianne Baernholdt, Jessica E. Pruszynski

College of Nursing Faculty Research and Publications

Aim

This study aimed to compare rural and urban nurse residency programme participants’ personal and job characteristics and perceptions of decision-making, job satisfaction, job stress, nursing performance and organisational commitment over time.

Background

Nurse residency programmes are an evolving strategy to foster transition to practice for new nurses. However, there are limited data available for programme outcomes particularly for rural nurses.

Method

A longitudinal design sampled 382 urban and 86 rural newly licensed hospital nurses during a 12-month nurse residency programme. Data were collected at the start of the programme, at 6 months and the end of the programme.

Results …

“Releasing A Lot Of Poisons From My Mind”: Patients' Delusional Memories Of Intensive Care, Jill L. Guttormson

College of Nursing Faculty Research and Publications

Objectives

To describe intensive care unit (ICU) patients' delusional memories and interpretations of those memories.

Background

Delusional memories of the ICU are distressing for patients and may impact psychological recovery.

Methods

This is a secondary analysis from a study of mechanically ventilated patients' recall in relation to sedation. Subjects, recruited from one medical-surgical ICU, participated in structured interviews after extubation.

Results

Subjects (n = 35) with a mean age of 66 (SD 12.9) and on the ventilator a median of 4.5 days provided detailed descriptions of delusional memories of being shackled, caged, strangled, or being in a foreign country. …

Comparison Of Abstinence And Coital Frequency Between 2 Natural Methods Of Family Planning, Richard J. Fehring, Mary Schneider

College of Nursing Faculty Research and Publications

Introduction

The length of periodic abstinence, due to overestimation of the fertile phase of the menstrual cycle, is often a cause for dissatisfaction, discontinuation, and user error with natural family planning (NFP) methods. The objective of this research was to compare the length of required abstinence (ie, estimated fertility) and coital frequency between 2 NFP methods.

Methods

This was an analysis of data from a 12-month prospective comparison study in which participants were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group—both of which included a fertility algorithm as a double check …

Social Script Ipad Application Versus Usual Care Before Undergoing Medical Imaging: Two Case Studies Of Children With Autism, Norah L. Johnson Phd, Rn, Cpnp, Octavia Alexis Bree

College of Nursing Faculty Research and Publications

Autism spectrum disorders (ASDs) are neurodevelopmental disorders of socialization, communication, and repetitive behaviors. Children with ASD have underlying anxiety leading to challenging behaviors in unfamiliar situations. The anxiety impacts timely completion of an imaging procedure. The purpose of the case study was to describe the process of the social script intervention delivered using the iPad application on parent and child anxiety, child behaviors, and imaging procedure length between two parent and child dyads. The case study of two parent-child dyads demonstrated the process for comparing the social script intervention iPad app for preparing for imaging versus usual care. Parent anxiety …

Transition From Hospital To Home Following Pediatric Solid Organ Transplant: Qualitative Findings Of Parent Experience, Stacee M. Lerret, Marianne E. Weiss, Gail Stendahl, Shelley Chapman, Katie Neighbors, Joan Lokar, Ashley Voit, Jerome Menendez, Estella M. Alonso

College of Nursing Faculty Research and Publications

Transplant providers are challenged to determine appropriate interventions for patients and families due to limited published research regarding the context of the post-discharge experience from the perspective of parents of transplanted children. The purpose of this study is to describe the parent perspective of the transition from hospital to home following their child's solid organ transplant. Within a mixed-methods design, 37 parents of pediatric heart, kidney, and liver transplant recipients from three pediatric hospitals responded to qualitative interview questions on the day of hospital discharge and three wk following hospital discharge. Insight to the discharge preparation process revealed necessary education …

Reducing The Burden Of Medication Costs To Improve Medication Adherence, Christine R. Shaw

College of Nursing Faculty Research and Publications

The high cost of medications is one reason that patients do not adhere to treatment plans. Providers can take actions to relieve the economic burden such as prescribing generic medications and offering patients information on various resources, including discount generic drug lists, discount cards, mail-order pharmacies, and prescription assistance programs.

Self-Assessed Health In Caregivers Of Persons With Autism: Associations With Depressive Symptoms, Positive Cognitions, Resourcefulness, And Well-Being, Abir K. Bekhet

College of Nursing Faculty Research and Publications

Purpose

Caregiving for children with autism spectrum disorder (ASD) can affect family caregivers' self-assessed health. The purpose of this study was to determine whether depressive symptoms, positive cognitions, resourcefulness, and well-being will differ significantly among those who rated their health as fair, good, or excellent.

Design and Methods

This study is a secondary analysis of 109 ASD caregivers who were recruited from the Interactive ASD Network.

Findings

Depression was significantly lower among those who rated their health as excellent than among those who rated their health as fair. Positive cognitions, resourcefulness, and well-being were significantly higher among those who rated …

A Comparison Of Two Formulas Of Topical Menthol On Vascular Responses And Perceived Intensity Prior To And Following A Bout Of Maximum Voluntary Muscular Contractions (Mvmcs), Robert V. Topp, Alex V. Ng, Alyson Cybulski, Katalin W. Skelton, Paula Papanek

College of Nursing Faculty Research and Publications

The purpose of this study was to compare the vascular responses in the brachial artery and perceived intensity of two different formulas of topical menthol gels prior to and following a bout of maximum voluntary muscular contractions (MVMCs).

18 adults completed the same protocol on different days using blinded topical menthol gels (Old Formula and New Formula). Heart rate, brachial artery blood flow (ml/min), vessel diameter and reported intensity of sensation were measured at baseline (T1), at 5 min after application of the gel to the upper arm (T2), and immediately following five MVMCs hand grips (T3).

The New Formula …

Patient Perceptions Of Patient-Empowering Nurse Behaviours, Patient Activation And Functional Health Status In Postsurgical Patients With Life-Threatening Long-Term Illnesses, Teresa Jerofke-Owen, Marianne E. Weiss, Olga Yakusheva

College of Nursing Faculty Research and Publications

Aim

To explore the trajectory of associations between the nursing care process of patient empowerment during postsurgical hospitalization and postdischarge patient self-management outcomes, specifically patient activation and functional health status.

Background

Patient-centred care models advocate for patient empowerment in long-term illness care. Postsurgical patients with life-threatening long-term illnesses frequently feel powerless, have unmet needs, decreased functional health status and high readmission rates; however, previous studies of patient empowerment have conceptualized empowerment as an outcome primarily in outpatient settings, with little attention paid to provider processes used to empower patients during hospitalizations.

Design

A non-experimental, prospective, correlational study.

Methods

This sample …

Psychometric Properties Of The Index Of Relocation Adjustment, Abir K. Bekhet, Jaclene Zauszniewski

College of Nursing Faculty Research and Publications

More and more American older adults are relocating to retirement communities, and they experience challenges in adjusting to new surroundings that may increase their depression and mortality. An instrument not previously tested in the United States, the Index of Relocation Adjustment (IRA), may help in early identification of poor relocation adjustment. This study examined the psychometric properties of the IRA using secondary data from a convenience sample of 104 older adults who relocated to 6 retirement communities in Northeast Ohio. Cronbach’s alpha was .86. The IRA was correlated with measures of positive cognitions (r = .48, p < .01) and relocation controllability (r = …

Strategies For Sustaining Self Used By Family Caregivers For Older Adults With Dementia, Margaret J. Bull

College of Nursing Faculty Research and Publications

The negative health consequences of caring for an older adult family member with dementia are well documented. However, not all family caregivers experience these negative health consequences. The purposes of this study were to describe strategies family caregivers use to help them continue to provide care for an older family member with dementia despite challenges and describe these family caregivers’ resilience and psychological distress. A mixed methods design was used with a narrative approach dominant and standardized scales for resilience and psychological distress used to enhance the description of the sample. Data were collected through telephone interviews with 18 family …

Psychometric Properties Of The Resourcefulness Scale Among Caregivers Of Persons With Autism Spectrum Disorder, Abir K. Bekhet, Jaclene Zauszniewski

College of Nursing Faculty Research and Publications

Caregiving for children with autism spectrum disorder (ASD) can be very costly to caregivers’ well-being. Resourcefulness interventions have shown increases in positive health outcomes. However, before delivering the intervention, there should be a reliable and a valid measure to test resourcefulness. The psychometric properties of the Resourcefulness Scale (RS) have not been examined among ASD caregivers. This study examined the psychometrics of the 28-item RS in a convenience sample of 204 ASD caregivers. A Cronbach’s alpha of .91 showed the internal consistency of the RS. Construct validity was supported by the emergence of two dimensions of resourcefulness (personal and social) …

Phd Preparation For Nurse Faculty And Nurse Scientists: Do They Have To Be The Same?, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

No abstract provided.

Feasibility Of Oral Prenatal Probiotics Against Maternal Group B Streptococcus Vaginal And Rectal Colonization, Lisa Hanson, Leona Vandevusse, Megan Duster, Simone Warrack, Nasia Safdar

College of Nursing Faculty Research and Publications

Objective

To examine the effect of an oral prenatal probiotic on group B Streptococcus (GBS) colonization and to demonstrate the feasibility of a larger randomized controlled trial.

Design

This pilot study was an open‐label, two‐group quasi‐experiment.

Setting

An urban central city nurse‐midwifery and wellness center serving a diverse population.

Participants

Ten pregnant participants received the oral probiotic (Florajen3) taken once daily, and 10 participants served as controls.

Methods

A questionnaire on dietary practices, vaginal cleansing, sexual history, and symptoms and GBS colony count samples were taken at 28‐, 32‐, and 36‐weeks gestation.

Results

Participants in the probiotic group reported no …

Cohort Efficacy Study Of Natural Family Planning Among Perimenopause Age Women, Richard Fehring, Qiyan Mu

College of Nursing Faculty Research and Publications

Objective: To determine the efficacy of using natural family planning (NFP) methods to avoid unintended pregnancy among women of perimenopause age (i.e., age 40-55 years).

Design: A secondary analysis of subset data from two prospective observational cohort studies.

Setting: A university based in-person and online NFP service program.

Participants: One hundred and sixty couples who used either a website or an in-person NFP service to learn how to avoid pregnancy from January 2001 to November 2012.

Methods: A prospective 12-month effectiveness study among 160 women (between ages 40-55) who used NFP to avoid pregnancy. The …

Palliative And End-Of-Life Care: Precepts And Ethics For The Orthopaedic Population, Cheryl L. Petersen, Susan Breakwell, Margaret Callahan

College of Nursing Faculty Research and Publications

Since the emergence of reports such as the National Consensus Project for Quality Palliative Care (2013) and the National Association of Orthopaedic Nurses Palliative Care Consensus Document (2005), there continues to be a growing recognition of the multiple adverse effects of serious illness and chronic conditions, as well as the potential benefits of receiving palliative or end-of-life care. As modern technology expands its ability to support life, ethical dilemmas may be encountered in the provision of palliative or end-of-life care. Through integration of the precepts of palliative care and consideration of the relevant ethical principles, orthopaedic nurses may best meet …

Use Of Ovulation Predictor Kits As Adjuncts When Using Fertility Awareness Methods (Fams): A Pilot Study, Rene Letva, Ula Burban, Edmond Kyrillos, Richard Fehring, Robin Mclaren, Catherine Dalzell, Elizabeth Tanguay

College of Nursing Faculty Research and Publications

Purpose: Difficult clinical signs such as confusing cervical mucus or erratic basal body temperature can make the use of fertility awareness methods (FAMs) difficult in some cases. The goal of this study was to assess the feasibility of using a cheap urinary luteinizing hormone (LH)–surge identification kit as an adjunct to identify the infertile phase after ovulation when facing these scenarios.

Methods: The study used a block-allocation, crossover, 2-arm methodology (LH kit/FAM vs FAM only). Comparison of the 2 arms was done with regard to the accuracy of identification (yes/no) of the luteal phase in each cycle as confirmed by …

Do You Use Your Professional Code Of Ethics?, Kathryn Schroeter

College of Nursing Faculty Research and Publications

No abstract provided.

Factors Associated With The Emotional Distress Of Women Family Members Of Adults With Serious Mental Illness, Jaclene Zauszniewski, Abir K. Bekhet

College of Nursing Faculty Research and Publications

Women family members of adults with serious mental illness are at great risk for emotional distress. This study examined associations between characteristics of 60 women (age, race, and education), their relatives with mental illness (age, diagnosis, and years since diagnosis), and the family situation (relationship, living arrangements, and care provided) and symptoms of emotional distress. Depressive symptoms were greater among those with younger, non-sibling relatives. Anxiety was greater among Caucasians and those with a recently diagnosed family member, particularly bipolar disorder. Anger was associated with providing direct care. The findings are informative for tailoring interventions to minimize emotional distress in …

Supporting Labor Progress Toward Physiologic Birth, Lisa Hanson, Leona Vandevusse

College of Nursing Faculty Research and Publications

No abstract provided.

Labor Down Or Bear Down: A Strategy To Translate Second-Stage Labor Evidence To Perinatal Practice, Kathryn Osborne, Lisa Hanson

College of Nursing Faculty Research and Publications

Scientific evidence supports spontaneous physiologic approaches to second-stage labor care; however, most women in US hospitals continue to receive direction from nurses and birth attendants to use prolonged Valsalva bearing-down efforts as soon as the cervix is completely dilated. Delaying maternal bearing-down efforts during second-stage labor until a woman feels an urge to push (laboring down) results in optimal use of maternal energy, has no detrimental maternal effects, and results in improved fetal oxygenation. Although most commonly used with women who are undergoing epidural anesthesia, laboring down is just one component of physiologic second-stage labor care that can be used …

Compassion Fatigue: An Unwanted Reflection Of Your Reality, Kathryn Schroeter

College of Nursing Faculty Research and Publications

No abstract provided.

Validation Of Patient And Nurse Short Forms Of The Readiness For Hospital Discharge Scale And Their Relationship To Return To The Hospital, Marianne E. Weiss, Linda L. Costa, Kathleen Bobay, Olga Yakusheva

College of Nursing Faculty Research and Publications

Objective: To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits.

Data Sources/Study Setting: A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011. Study Design Prospective longitudinal design, multinomial logistic regression analysis.

Data Collection/Extraction Methods: Nurses and patients independently completed an eight-item Readiness for Hospital Discharge Scale on the day of discharge. Patient characteristics, readmissions, and ED visits were electronically abstracted.

Principal Findings: Nurse assessment of low discharge readiness was associated with a six- to …

Individual Characteristics And Relocation Factors Affecting Adjustment Among Relocated American And Egyptian Older Adults, Abir K. Bekhet, Jaclene A. Zauszniewski

College of Nursing Faculty Research and Publications

Worldwide, the population of elders is increasing significantly. Relocation can be a positive or a negative experience, depending on many factors, including culture. The purpose of this study is to compare individual characteristics (age, gender, marital status, education, perceived health status, activities of daily living), relocation factors (movement preparation, time passed since relocation, closeness of prior home to the present, and whether relocation was from home or another facility), and adjustment in relocated American and Egyptian elders. This secondary analysis study merged data from two cross-sectional descriptive studies of a 104 elders relocated to retirement communities in Northeast Ohio and …