Medicine and Health Sciences Commons^™

Lateral Violence In The Emergency Department, Lesley Swafford

Nursing Theses and Capstone Projects

This study examined the types, frequency, and scopes of emergency room nurses' personal experience with disruptive behavior and its impact on staff, their patients, and the organization. Seventy registered nurses completed the Johns Hopkins Disruptive Clinician Behavior survey. Descriptive statics were used to analyze results. The most significant findings included: (a) Passive aggressive behavior was the most commonly reported form of disruptive behavior occurring on a daily basis, (b) RN's were identified as the most common instigators of disruptive behavior, (c) pressure from high census, volume, and patient flow was identified as the most common trigger of disruptive behavior occurring …

Breastfeeding Education: Improving Initiation And Duration Of Breastfeeding, Rhonda Coffey

Nursing Theses and Capstone Projects

The purpose of this research study was to examine the level of self-efficacy for new mothers attending a formal breastfeeding education compared to those that did not. Participants were asked to complete the Breast Feeding Self-Efficacy Scale - Short Form via telephone. Twenty primigravida mothers who were breastfeeding at the time of discharge agreed to participate. A Pearson correlation coefficient was calculated examining the relationship between the participant's level of self-efficacy and participation in formal breastfeeding. The Pearson correlation coefficient was positive but was not statistically significant ( r (18)= .250, p > .05) indicating no relationship between the participant's self-efficacy …

A Measure Of Perceived Fatigue Among Nurses In Western North Carolina, Karen R. Cochran

Nursing Theses and Capstone Projects

We are anticipating a heightened shortage of nurses as our aging population retires. A shortage of workers tends to lead to overtime for those still in the work force. Previous research has demonstrated a link between working long hours, fatigue, and decreased performance among nurses. Fatigue has specifically been linked to on the job injuries and poorer patient outcomes. This research study examined perceived fatigue among nurses in western North Carolina. A convenience sample of nurses from five hospitals in western North Carolina was surveyed to measure fatigue, as well as compare differences in reported fatigue across varying demographic groups. …

Simulation Collaboration: Will Screen Capture Change Attitudes?, Jeffrey Carmack

Nursing Theses and Capstone Projects

The ongoing call for interprofessional education with healthcare providers who routinely work together has largely gone unanswered. Parallel to this call, a large number of nursing programs across the United States exist in a stand-alone setting. These programs are unattached to a school of medicine. This creates barriers including a lack of access to physicians and lack of funding to hire medical staff as embedded participants. At the same time, aging nursing faculty, increasing enrollment, and decreasing clinical facility availability create an increased need to use simulation-learning environments to continue to maintain existing capacity in nursing programs. This project used …

Nursing Retention In Critical Care, Jeannine A. Eckman

Nursing Theses and Capstone Projects

The purpose of the study was to examine anticipated turnover in critical care nurses and if having previous nursing experience prior to working in critical care affects that turnover. Using the Anticipated Turnover Scale (ATS) by Hinson and Atwood, nurses that had been employed in the critical care areas five years or less were asked to participate. They were asked to complete the ATS and answer the question relating to previous nursing experience. Findings of the study indicated that the nurses with previous nursing experience before working in critical care had a higher ATS score than the nurses with no …

Knowledge Of The Risks Of Heart Disease In Uninsured And Insured Persons With Diabetes In A Rural Community In Southeastern United States, Lisa S. Howard

Nursing Theses and Capstone Projects

Diabetes and heart disease are chronic illnesses affecting many lives in the United States. Both diseases have complications, and when coupled together, the mortality rate and risk of complications increase. Heart disease is the leading cause of death in most countries across the world, and the majority of individuals diagnosed with diabetes die of a heart disease complication. Literature review reveals a plethora of research regarding the relationship between diabetes and heart disease, but limited research was found regarding health disparities with diabetes and heart disease awareness. No research was found assessing the knowledge base regarding diabetes and heart disease …

Interprofessional Simulations: Student Attitudes And Effects On Sbar Performance, Michele A. Pfaff

Nursing Theses and Capstone Projects

National healthcare organizations recommend innovative educational initiatives and fundamental changes in the way healthcare providers are educated. Educational strategies that incorporate collaboration have been shown to impact professional behaviors and competency. Improved student attitudes toward collaboration and increased understanding of professional roles are impacted by exposure to simulation and interprofessional education. The purpose of the Interprofessional Simulation Project was to determine whether the type of clinical simulation experience (traditional versus interprofessional) influences nursing students' knowledge and performance of skilled communication. Additionally, the project investigated attitudes toward collaboration in an educational setting. A quantitative pretest and posttest design was utilized to …

An Assessment Of Nurses' Knowledge And Attitudes Toward End Of Life Care Pain Management, Amy Davis

Nursing Theses and Capstone Projects

This study was completed to help determine if nurses had a true understanding of how to provide pain management to patients in their care who were at the end of their life. A review of literature was completed and it revealed that nurses have a fear of opioid overdose and respiratory depression in their patients when providing proper pain management. It also revealed that patients have a fear of dying in pain at the end of their life especially if they have been diagnosed with a terminal illness. The study also revealed that when patients die in pain it actually …

Patient Education In The Emergency Department, Bryan K. Devinney

Nursing Theses and Capstone Projects

Patient education is a core component to the practice of nursing in many countries, including the United States. Emergency department nurses are often overwhelmed with the number of patients they must care for in short amounts of time. The patients are often in varying stages of evaluation and treatment, and the nurse may be involved in one-on-one interventions with these patients. This can leave little time for patient education, especially if the nurse does not feel like the patient education is meaningful or useful. Various factors can influence the ability and desire of the emergency department nurse to provide proper …

Evaluating The Relationship Between Preadmission Assessment Examination Scores And First-Time Nclex-Rn Success, Elizabeth Pyatte Payne

Nursing Theses and Capstone Projects

The relationship between preadmission assessment composite and reading scores and first-time National Council Licensure Examination for Registered Nurses (NCLEX-RN) success was evaluated in this study. Following an extensive literature review, the researcher hypothesized that students who score at or above the national average on the Test of Essential Academic Skills (TEAS) composite score and/or reading score are more likely to be successful on the first attempt of the NCLEX-RN examination. Utilizing archived student records from a rural community college in western North Carolina, a convenience sample of 59 graduates from May 2012 and 2013 was used. Findings of this study …

Lateral Violence Experienced By Nurses In The Workplace, Alicia Hill

Nursing Theses and Capstone Projects

Lateral violence in the workplace is not uncommon. Not only is it costly to the healthcare facility, it is detrimental to the nurse's physical and mental health. Lateral violence also affects the quality of patient care and increases the risk of poor health outcomes. The purpose of this study was to determine if there is a relationship between caring behaviors in nurse managers and the amount of lateral violence experienced by nurses on the unit. Using a modified version of the Workplace Aggression Research Questionnaire (WAR-Q) and Watson's Caritas Leaders Score (WCLS) surveys were electronically sent to nurses at a …

Job Satisfaction And Retention Of Registered Nurses At A Small Rural Hospital In Southeastern United States, Rachael M. Drake

Nursing Theses and Capstone Projects

This research project embarked upon an investigation related to the retention of nurses at a small hospital in the Southeastern United States. The research question that guided this study asked, `what were the factors affecting nurse satisfaction at this health care facility? Many variables were explored as answers sought through surveys and documented reviews emerged. From a sample of 65 (n=65) respondents to a survey it was discovered that salary, vacation, opportunities to work straight days, compensation for working weekends, weekends off, nursing peers, physician the nurse works with, opportunities to interact professionally with other disciplines, recognition of work from …

Non-Pharmacological Interventions Project: Treatment For Dementia, Mandy Richards

Nursing Theses and Capstone Projects

In response to the Office of Inspector General's research report on atypical antipsychotic off label treatment of elderly dementia residents in long-term care, the Centers for Medicare and Medicaid Services developed a non-pharmacological intervention known as the Hand In Hand training tool. This projects focus was on training the direct care nursing staff with the Hand In Hand tool and evaluating for decrease in behavior and psychological symptoms in their patients. A retrospective chart review was utilized for the Minimum Data Sets tool Brief Interview of Mental Status (BIMS) and Mood interview. Pre training and post training scores were analyzed …

Utilizing Early Simulation To Increase Clinical Confidence In Novice Nursing Students, Dana R. Martin

Nursing Theses and Capstone Projects

The purpose of this project was to determine if early simulation would increase the clinical confidence of novice nursing students. A convenience sample of 20 junior nursing students in their first semester of a baccalaureate nursing program within a small, rural university participated in the project prior to their first clinical experience. The students were administered the Confidence Scale as a pre-test prior to the early simulation experience which consisted of a scenario comparable to what the students would experience in the clinical setting. After the simulation, the primary investigator facilitated a debriefing exercise and then administered the Confidence Scale …

The Effect Of Virtual-Learning On The Cultural Awareness Of Nursing Students, Nicole Waters

Nursing Theses and Capstone Projects

This Capstone Project examined the effect of virtual-learning on the cultural awareness of nursing students. A convenience sample of 125 students enrolled in the advanced health assessment course in the Registered Nurse to Bachelor in Science in Nursing (RN to BSN) Program were included in the sample for this project. Of the 125 students, 53 completed pre-test surveys were submitted, resulting in a response rate of 42%, and 43 completed post-test surveys were submitted, resulting in a response rate of 34%. Descriptive statistics and measures of central tendencies were used to compare the overall mean score for the responses of …

Nurse Manager Role Perception In An Acute Care Facility, H. Gale Waters

Nursing Theses and Capstone Projects

The Nurse Manager role is a crucial part of the healthcare delivery system in an acute care facility, particularly in the current wave of healthcare reform. These are unprecedented times for nursing leadership as they develop and move in a new direction. The role of Nurse Manager is complex with numerous studies including: past roles, characteristics, innovation, outcome, education, and advancement. This study observed the role through the point of view of the Nurse Manager. The Nurse Managers participated in a survey in which they ranked themselves on a one to five scale, with one being a novice in the …

Adaptation Of Kenyan-Born Registered Nurses Into The American Healthcare System, Emily Tangwar

Nursing Theses and Capstone Projects

Kenyan-born nurses (KBNs) continue to be an important part of the nursing workforce in the United States of America (USA). They bring their skills, knowledge, and experience to their new areas of nursing practice. Even though it may be challenging to adapt, Kenyan Nurse's skills, knowledge, and experiences may be enhanced by successfully integrating them in the American healthcare system. Some of these challenges include socio-cultural difference; structure of healthcare systems; technology; language such as abbreviations, expressions, and phrases; and new environment. This study will be conducted using a quantitative research method and purposeful survey of 20 KBNs using Cross …

Perceptions From Graduates Of Professional Athletic Training Programs Involved In Peer-Assisted Learning, Dana K. Bates

Faculty Publications - Department of Kinesiology

Context: Research has not explored how peer-assisted learning (PAL) impacts graduates once they are practicing as athletic trainers. Peer-assisted learning has been used in a variety of health education settings but there is a lack of data on its effects on the performance of graduates.

Objective: To investigate professional graduates’ perceptions of PAL pedagogy in their athletic training education and the impact of that experience on their first job.

Design: Qualitative study using a phenomenological approach.

Setting: One-on-one phone interviews with athletic training graduates.

Patients or Other Participants: Participants were from 8 accredited athletic training programs that varied in terms …

The Effects Of Oral Pain Medication Being Administered In Phase I As Compared To Oral Pain Medications Administered In Phase Ii, Dana Jones

Nursing Theses and Capstone Projects

Healthcare and the provision of care are ever-changing as governing bodies over-see and regulate the way institutions provide care for patients. Pain assessment, reassessment, and pain management are a focus nationally and healthcare providers are held accountable for how pain is managed for patients. One piece to this broad topic is the use of oral pain medications, more specifically in the ambulatory surgical patient. The purpose of this project was to compare the length of stay, reported pain scores, and total amount of IV medications administered between patients who receive the first dose of oral pain medications in Phase I …

Impact Of Nurse Managers' Leadership Styles On Staff Nurses' Intent To Turnover, Joseph Warren L. Perez

Nursing Theses and Capstone Projects

Nurse Managers have the unenviable responsibility of ensuring that nursing staff are engaged and perform their duties to the best of their abilities. Maintaining an environment conducive to maximizing nurses' potentials resulting in retention may be a by-product of an effective leadership style. The purpose of this study was to determine whether nurse managers' leadership styles have an impact on nurses' intent to turnover. Nurse Managers with more than one year of management experience were asked to complete the Multifactor Leadership Questionnaire (MLQ-5X). The 45-item questionnaire rates the participant's leadership style based on the answers provided. Results were then compared …

South Carolina School Nurses' Knowledge, Opinions, Perceptions, And Practice Measures Regarding Childhood Obesity, Logan Camp

Nursing Theses and Capstone Projects

Childhood obesity has become a significant national health issue due to rising incidences and associated chronic medical conditions. School nurses across the United States of America are in prime positions to address childhood obesity as they have access to large numbers of children and adolescents in school settings. A review of current literature demonstrated that school nurses were overall knowledgeable concerning childhood obesity, but encountered numerous barriers in enacting weight-related assessments and treatment programs. The purpose of this research study was to determine the knowledge, opinions, perceptions, and practice measures of South Carolina school nurses regarding childhood obesity. The "School …

Nursing Knowledge And Attitudes Toward Pain Management, Joycelyn A. Craig

Nursing Theses and Capstone Projects

In many clinical settings, nurses have a vital role in pain assessment and titration of opioid doses. Surveys of nurses have revealed knowledge deficits in these areas that are thought to contribute to under-treatment of pain. The present study surveys nurses' knowledge and attitudes about assessment and treatment of pain and confirms that nurses continue to undertreat pain. As shown in previous studies, nurses may be more influenced by the patient's behavior than the patient's self-report of pain, especially in relation to decisions about opioid administration. Nurses are less likely to manage a previously safe but ineffective dose of opioid …

Larckit: A Toolkit To Increase Prescribing Of Long Acting Contraceptives To Adolescent And Young Women In A Public Health Setting, Eva M. Fried

Doctor of Nursing Practice Program Projects

In an urban, publicly funded women’s health and family planning clinic, 56% of pregnancies were reported to be unintended. The clinic director decided to address this problem by focusing on providers’ contraceptive prescribing habits; especially contraceptive prescribing for women aged 15-25. The purpose of the evidence-based practice improvement (EBPI) project was to increase provider disclosure about longer-acting reversible contraception (intrauterine and implantable methods known as “LARC” methods). The goal of the EBPI project was to increase the percentage of contraceptive prescriptions that are LARC methods for women aged 15-25 years. The clinical question guiding the EBPI project was “Among healthcare …

Maintaining The Vision In The Intensive Care Unit, Camille Leadingham

Doctor of Nursing Practice Program Projects

Background: Intensive care patients receiving mechanical ventilation have an increased chance for eye complications due to the inability to operate their own protective mechanisms resulting in dry eye.

Purpose: Develop and test an eye care protocol utilizing the evidence to prevent dry eye.

Method: In phase 1 retrospective data was collected on sedated and mechanically ventilated patients in the ICU (n=30) to determine baseline eye care practices and outcomes. Then the DEPP was developed based on the evidence. Finally data were collected prospectively (n=30) in the same patient population.

Results: From Phase 1 to Phase 2, eye crust cases diminished …

Improvement Of Standardized Documentation Of Patients With Copd In An Acute Care Setting, Kimberly Biery

Doctor of Nursing Practice Program Projects

The purpose of this project was to improve patient clinical outcomes of average length of stay, mortality rate, and readmission within 30 days by increasing health care provider order set usage and documentation as it relates to patients with a primary diagnosis of Chronic Obstructive Pulmonary Disease (COPD). Epic ™ computer based clinical documentation by healthcare providers at The Christ Hospital (TCH) was inconsistent. The PICOT question developed was: in the COPD population of an acute care hospital, how does standardized electronic COPD process measure documentation and order set usage compared to no COPD process measure documentation and order set …

Self-Care Of Heart Failure In A House Call Program, Becky Bryant

Doctor of Nursing Practice Program Projects

The incidence and prevalence of persons living with heart failure (HF) is growing in the United States. Heart failure is the most common admission in hospitals among Medicare recipients aged 65 years or older. Self-care of heart failure (SCHF) has been reported to decrease HF hospital admission rates. Elderly patients who are homebound do not have access to typical HF education and follow-up care. The purpose of this evidence-based practice (EBP) project was to implement a SCHF program intervention by nurse practitioners (NPs) with homebound elderly HF patients receiving home visits in a house call program. There were 18 sample …

Differential Eye Movements In Mild Traumatic Brain Injury Vs. Normal Controls, Joanna R. Wares, David X. Cifu, Kathy W. Hoke, Paul A. Wetzel, George Gitchel, William Carne

Department of Math & Statistics Faculty Publications

Objective measures to diagnose and to monitor improvement of symptoms following mild traumatic brain injury (mTBI) are lacking. Computerized eye tracking has been advocated as a rapid, user friendly and field ready technique to meet this need. Eye tracking data collected via a head mounted, video-based binocular eye tracker was used to examine saccades, fixations and smooth pursuit movement in 60 military Service Members with post concussive syndrome (PCS) and 26 asymptomatic control subjects in an effort to determine if eye movement differences could be found and quantified. The diagnosis of mTBI was confirmed by the study physiatrist’s history, physical …

Engineering Collaborations In Medical Modeling And Simulation, Frederic D. Mckenzie, Salim Chemlal, Tom Hubbard, Robert E. Kelly, Roderick C. Borgie, David A. Besachio, Michel Audette

Computational Modeling & Simulation Engineering Faculty Publications

Fifty years ago computer science was just beginning to see common acceptance as a growing discipline and very few universities had a computer science department although other departments were utilizing computers and software to enhance their methodologies. We believe modeling and simulation (M&S) is on a similar path. Many other disciplines utilize M&S to enhance their methodologies but we also believe that M&S fundamentals can be essential in making better decisions by utilizing the appropriate model for the problem at hand, expanding the solution space through simulation, and understanding it through visualization and proper analyses. After our students learn these …

Influence Of Tendon Tears On Ultrasound Echo Intensity In Response To Loading, Kayt E. Frisch, David Marcu, Geoffrey S. Baer, Darryl G. Thelen, Ray Vanderby

Faculty Publications - Biomedical, Mechanical, and Civil Engineering

Acoustoelastic (AE) ultrasound image analysis is a promising non-invasive approach that uses load-dependent echo intensity changes to characterize stiffness of tendinous tissue. The purpose of this study was to investigate whether AE can detect localized changes in tendon stiffness due to partial and full-thickness tendon tears. Ovine infraspinatus tendons with different levels of damage (Intact, 33%, 66% and full thickness cuts initiated on the articular and bursal sides) were cyclically loaded in a mechanical testing system while cine ultrasound images were recorded. The load-induced changes in echo intensity on the bursal and articular side of the tendon were determined. Consistent …

The Effect Of Lower Leg Casting On Energy Cost During Independent Ambulation: Considerations For Clinical Practice, Cindy Laporte, Daie Johnson, Kiersten Koen, Lena Hardy, Valda Montgomery

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to investigate the effects of dominant leg, lower leg casting on energy cost during independent ambulation. The Physiological Cost Index, predicted VO2max, and gait speed values of a Quarter-Mile Walk Test, with and without lower leg casting, were utilized to determine energy cost. Methods: Thirty-five subjects who were 23 to 32 years old (mean age 25.37 ± 2.02) performed the Quarter-Mile Walk Test at their comfortable walking speed on two occasions, one with and one without lower leg casting. Resting heart rate, walking heart rate, and time to complete the test were recorded. …