Medical Specialties Commons^™

Effect Of Psychological Distress On The Emerging Cause Of Infertility, Faiza Kausar

Journal of Asian Midwives (JAM)

Background: Infertility is a growing issue of the recent era, and it represents significant crises for most couples. Psychological distress has often been suggested as a cause of unexplained infertility. Male infertility accounts for 40% of all infertility problems, while female infertility accounts for 40% of all infertility problems; others are unexplained. Previous studies have indicated that stress and depression negatively impact various infertility parameters in both partners. To determine the relationship between infertility and psychological distress and the level of different types of stress among infertile couples, and to relate the significant stressors responsible for worsening infertility or …

Early Identification Of Depression In Patients With Pediatric Epilepsy, Erin Fecske, Paul Glasier, Lines Vargas Collado, Elizabeth Rende

Posters

Describes the use of the Neurological Disorders Depression Inventory-Epilepsy-Youth (NDDI-E-Y) in adolescent patients in a comprehensive epilepsy center to identify patients who need referral for mental health care.

Care Of Adult Cancer Survivors, Kelsey Kloosterman

Doctoral Projects

As innovative cancer treatments emerge, more people are surviving cancer. Cancer survivors have multiple and unique healthcare needs due to their cancer and cancer treatments. Communication among those treating the cancer, primary care providers, and cancer survivors is necessary to coordinate care once treatment is finished. The development of a survivorship care plan that is reviewed with the cancer survivor is intended to facilitate communication among all stakeholders. This quality improvement project examined current practice in a survivorship clinic in a Midwestern health system cancer center that cares for a variety of types of cancer patients. By reviewing evidence in …

Needs Assessment For Palliative Care In Pediatric Oncology: An Integrative Literature Review, Tabitha Negrete

Grace Peterson Nursing Research Colloquium

Abstract

Background: Cancer is the leading cause of non-accidental death in childhood. Cancer is the primary disease for which pediatric palliative care services are utilized worldwide. Improvement in pediatric palliative care has been identified as an ongoing research priority. There are still significant gaps in current knowledge of pediatric palliative care because education has not been integrated into curriculum and clinical experiences.

Objectives: The purpose of this integrative literature review aims to provide a comprehensive review of current research about the need of nursing education on palliative care for long-term care in pediatric oncology.

Methods: This integrative literature review focused …

Maternal And Infant Attributes And Antecedents Of Breastfeeding, Riyan Yanes, Jessie Lakota Dinelli

Grace Peterson Nursing Research Colloquium

Abstract

Background: The Center for Disease Control (CDC) claim that breastfeeding rates are increasing in the United States. Surveys show that 81.1% of newborn infants started to breastfeed in 2013 (2016). Unfortunately, breastfeeding duration did not meet the recommended length and of the infants born in 2013, 51.8% were breastfeeding at 6 months and 30.7% at 12 months (CDC, 2016). Breastfeeding offers various health benefits to the mother and child, which is why the identification of antecedents and attributes to breastfeeding need to be addressed in order to impact mothers and infants.

Objectives: The goal of this study is to …

The Effects Of Reentry Programs On Healthcare Accessibility And Resulting Emergency Department Strain By Ex-Inmates: An Integrative Literature Review, Kaitlyn Muratori

Grace Peterson Nursing Research Colloquium

THE EFFECTS OF REENTRY PROGRAMS ON HEALTHCARE ACCESSIBILITY AND RESULTING EMERGENCY DEPARTMENT STRAIN BY EX-INMATES

Kaitlyn Muratori

Faculty Sponsor: Dr. Christina Lattner

Background: Ex-inmates are significantly more likely to use emergency rooms to seek treatment for substance abuse, mental health disorders, or poor management of chronic conditions which, if not treated on a community level, ultimately contributes to overboarding in the emergency department.

Objectives: The purpose of this literature review is to use current research to examine the relationship between reentry programs across the US and healthcare accessibility, as well as the resulting strain of emergency room misuse by ex-inmates. …

Eye Examination:Satisfying A Quality Care Measure In Diabetes, Meera Shekar

Dissertations

Abstract

Purpose: Diabetic retinopathy (DR), a microvascular complication occurs in patients with poorly controlled diabetes mellitus (DM). A known risk of increased visual impairment associated with DM occurs in patients when the glycosylated hemoglobin level (HbA1c) increases over 7.0%. Therefore, an annual retinal assessment as a quality care measure in diabetes management is necessary. The conducted study aimed to evaluate the documentation of an annual eye exam in all patients with DM in a private family practice clinic and to investigate any possible association between HbA1c level.

Method: This quality improvement study included a retrospective medical record review in …

An Evaluation Of Implementing Enhanced Recovery After Surgery Protocol Throughout The Perioperative Phase: A Quality Improvement Initiative To Enhance Patient Outcomes After Colorectal Surgery, Jerica Hill Dnp

Doctoral Projects

Abstract: The Enhanced Recovery After Surgery protocol (ERAS) is a multimodal collaborative approach implemented throughout the perioperative phase to enhance patient outcomes. The key mechanism for effectiveness in the ERAS protocol is the attenuation of the surgical stress response combined with treatments that support the return of functions that delay recovery in traditional methods. The purpose of this scholarly project was to evaluate the results of the ERAS Pilot program currently initiated at Baptist Memorial Hospital to improve patient outcomes undergoing major abdominal surgery. Prior to the implementation of the ERAS protocol there was no standardized method in place at …

Associations Of Demographic Factors And Tobacco Use With Progesterone And Estradiol During Pregnancy, Kristin Ashford, Emily Rayens, Amanda T. Wiggins, Mary Kay Rayens, Molly Malany Sayre, John O'Brien

Perinatal Research and Wellness Center Faculty Publications

Objective: To evaluate the association of biochemically validated prenatal tobacco use with serum progesterone and estradiol in the second trimester of pregnancy, controlling for demographic and personal factors.

Study design: This secondary analysis of a multicenter longitudinal study included 114 women with singleton pregnancies. Multiple regression analysis assessed whether prenatal tobacco use was related to hormone levels during the second trimester, controlling for covariates (age, body mass index, and race or ethnicity, with gestational age added to subsequent models).

Result: In the initial regressions, tobacco users had significantly lower progesterone level compared with nonsmokers (p = .037), while estradiol …

The Perioperative Patient Experience Of Hand And Wrist Surgical Patients: An Exploratory Study Using Patient Journey Mapping, Else F. De Ridder, Tessa Dekkers, Jarry T. Porsius, Gerald Kraan, Marijke Melles

Patient Experience Journal

Patient-centred care is becoming more important in healthcare. The success of patient-centred care can be assessed by exploring the patient experience through a patient journey map. As the number of outpatient surgeries is increasing, it is important to reveal the specific characteristics of this type of surgery. The perioperative patient experience is considered very important for outpatient surgery, because all perioperative activities are condensed in one day. To investigate this experience, we performed a case study of hand and wrist surgery. Six teams of two industrial design engineering students interviewed 40 patients in total in two private and two public …

The Ties That Bind: Cradling In Tajikistan, Lana B. Karasik, Catherine S. Tamis-Lemonda, Ori Ossmy, Karen E. Adolph

Publications and Research

A traditional childrearing practice—“gahvora” cradling—in Tajikistan and other parts of Central Asia purportedly restricts movement of infants’ body and limbs. However, the practice has been documented only informally in anecdotal reports. Thus, this study had two research questions: (1) To what extent are infants’ movements restricted in the gahvora? (2) How is time in the gahvora distributed over a 24-hour day in infants from 1–24 months of age? To answer these questions, we video-recorded 146 mothers cradling their infants and interviewed them using 24-hour time diaries to determine the distribution of time infants spent in the gahvora within a day …

Examining Symptom Trajectories That Predict Worse Outcomes In Post-Cabg Patients, Ming-Fen Tsai, Shiow-Luan Tsay, Debra K. Moser, Tsuey-Yuan Huang, Feng-Chun Tsai

Nursing Faculty Publications

Background: Coronary artery bypass grafting is one of the most common interventional revascularisation procedures used to treat coronary artery disease worldwide. With a wide variability in postoperative cardiac symptoms, identification of symptom trajectories during the 3-month postoperative recovery period may improve clinicians’ abilities to support symptom recovery.

Aims: To identify distinct trajectories of cardiac symptoms seen over time in a cohort of patients during the 3-month post-coronary artery bypass grafting period, and determine clinical characteristics associated with different symptom trajectories postoperatively.

Methods: A prospective trial used the cardiac symptom survey to determine patient symptoms at baseline prior to surgery, and …

Problems Experienced In The Second And Third Months After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven

Journal of Patient-Centered Research and Reviews

The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing …

Trajectory Of Thirst Intensity And Distress From Admission To 4-Week Follow Up At Home In Patients With Heart Failure, Nana Waldréus, Misook L. Chung, Martje H. L. Van Der Wal, Tiny Jaarsma

Nursing Faculty Publications

Background: Patients with heart failure (HF) can suffer from increased thirst intensity and distress. Trajectories of thirst intensity and distress from hospital to home are unclear. The aim of this study was to describe thirst intensity and distress trajectories in patients from the time of hospital admission to 4 weeks after discharge, and describe trajectories of thirst intensity and distress by patients’ characteristics (gender, age, body mass index [BMI], plasma urea, anxiety, and depression).

Patients and methods: In this observational study, data were collected from patients with HF (n=30) at hospital admission, discharge, and at 2 and 4 weeks after …

Exome Sequencing Identifies Gene Variants And Networks Associated With Extreme Respiratory Outcomes Following Preterm Birth, Aaron Hamvas, Rui Feng, Yingtao Bi, Fan Wang, Soumyaroop Bhattacharya, Jared Mereness, Madhurima Kaushal, C Michael Cotten, Philip L Ballard, Thomas J Mariani

Faculty, Staff and Student Publications

BACKGROUND: Previous studies have identified genetic variants associated with bronchopulmonary dysplasia (BPD) in extremely preterm infants. However, findings with genome-wide significance have been rare, and not replicated. We hypothesized that whole exome sequencing (WES) of premature subjects with extremely divergent phenotypic outcomes could facilitate the identification of genetic variants or gene networks contributing disease risk.

RESULTS: The Prematurity and Respiratory Outcomes Program (PROP) recruited a cohort of > 765 extremely preterm infants for the identification of markers of respiratory morbidity. We completed WES on 146 PROP subjects (85 affected, 61 unaffected) representing extreme phenotypes of early respiratory morbidity. We tested for …

Laryngeal Mask Airway: A Postoperative Sore Throat Clinical Practice Guideline, Logan Williams

Doctoral Projects

One of the most common and preventable complications experienced by patients undergoing general anesthesia is a postoperative sore throat (POST). Up to 70% of patients who receive a laryngeal mask airway (LMA) during anesthesia suffer from POST. Despite its regular occurrence and designation as a minor complication, POST has proven to be a distressing complication for patients afflicted. Consequently, a perceived minor complication can, in fact, play a major role in a patient’s perception of their care, the skill of their anesthesia provider, and their overall satisfaction with their experience.

Evidence shows that inflation of LMA cuffs beyond the recommended …

Improving Communication Between Child Life Services And Nursing On An Inpatient Pediatric Unit, Sherryann St. Pierre, Elizabeth Shaughnessy, Bethany Kay, Barbara Bush Children's Hospital, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks

Operations Transformation

IMPROVING COMMUNICATION BETWEEN CHILD LIFE SERVICES AND NURSING ON AN INPATIENT HOSPITAL UNIT

Effective communication between patient caregivers has been shown to reduce stress and trauma related to hospitalization and subsequent improved outcomes. An HCAHP score for a 30 bed acute inpatient pediatric unit illustrated the confusion faced by children as a result of nursing and care life specialists not working together as a team.

A root cause analysis identified a number of issues as to why patients were not benefitting fully from child life services. Several counter measures were instituted with the goals of improving the HCAHP score and …

Strategies To Improve Timeliness For Cleaning Inpatient Rooms Following Patient Discharge, Lora Dixon, Mark Parker, Ruth Hanselman, Suneela Nayak, Amy Sparks

Operations Transformation

STRATEGIES TO IMPROVE THE TIME FRAME FOR CLEANING INPATIENT ROOMS BY ENVIRONMENTAL SERVICES

In an inpatient rehab hospital, it was noted that Environmental Services (EVS) was delayed in cleaning rooms between patient discharges and admissions. This resulted in the frequent use of a “stat clean” order that allows only 50% of the normal cleaning time , forcing patients to wait and impacting patient flow.

A root cause analysis demonstrated lack of communication between the rehab hospital and the contracted cleaning services. A number of counter measures were initiated with the goal that cleaning would be started within 20 minutes of …

Improving Safe Handoffs & Transitions From The Ed To Adult Inpatient: A Response To The Ahrq Hospital Patient Safety Culture Survey, Natalie Talbot, Joanne Chapman, Rhonda Diphilippo, Gail Savage, Michele Higgins, Nancijean Goudey, Lori Sweatt, Erin Graydon Baker, Joseph East, Stephen Tyzik, Suneela Nayak, Mark Parker, Ruth Hanselman, Amy Sparks

Operations Transformation

SAFE TRANSITIONS AND PATIENT HANDOFFS IN A LARGE ACUTE CARE HOSPITAL

It is well documented in the literature that ineffective patient handoffs and transitions continues to be an area that can lead to adverse patient safety events so it is an urgent opportunity for a performance improvement plan. At an academic tertiary care medical center, the lowest scoring domain from the FY2017 AHRQ Patient Safety Culture Survey was patient handoffs and transitions.

A team was established consisting of staff from the Emergency Department and a medical/surgical unit to develop a plan for implementing improvement interventions. Their goal was to attain …

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 …

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 …

Translational Evaluation Of Acid/Base And Electrolyte Alterations In Rodent Model Of Focal Ischemia, Sarah R. Martha, Lisa A. Collier, Stephanie M. Davis, Hilary A. Seifert, Christopher C. Leonardo, Craig T. Ajmo, Elspeth A. Foran, Justin F. Fraser, Keith R. Pennypacker

Neurology Faculty Publications

BACKGROUND AND PURPOSE: Acid/base and electrolytes could provide clinically valuable information about cerebral infarct core and penumbra. We evaluated associations between acid/base and electrolyte changes and outcomes in 2 rat models of stroke, permanent, and transient middle cerebral artery occlusion.

METHODS: Three-month old Sprague-Dawley rats underwent permanent or transient middle cerebral artery occlusion. Pre- and post-middle cerebral artery occlusion venous samples for permanent and transient models provided pH, carbon dioxide, oxygen, glucose, and electrolyte values of ionized calcium, potassium, and sodium. Multiple regression determined predictors of infarct volume from these values, and Kaplan-Meier curve analyzed morality between permanent and transient …

Implementation Of A Sustainable Peer Mentor Program In Student Registered Nurse Anesthetists (Srnas)”, Kristin Cox

Doctoral Projects

Evidence has shown that Student Registered Nurse Anesthetist’s (SRNAs) stress is perceived as above average and is correlated with substandard patient care during clinical courses (Chipas et al., 2012). Some studies have indicated SRNAs experience low self-efficacy during clinical, which could lead to difficulty in thinking clearly or responding to clinical situations (Imus, Burns, & Weglarz, 2017). Peer mentoring has shown to result in stress reduction and improvement in self-efficacy in students (Barker et al., 2012; Giordana & Wedin, 2010). Despite the current evidence, a nurse anesthesia program in the southeastern United States did not have an organized peer mentor …

Continuous Epidural Analgesia For Postoperative Pain Management: A Policy Analysis, Madison Nowell

Doctoral Projects

Postoperative pain management is a necessary component of the care of every surgical patient. Epidural analgesia is a widely used method to provide excellent postoperative pain relief and enhance postoperative recovery (Sawhney, 2012). Epidural analgesia is associated with fewer side effects than alternative pain management techniques; however, when epidural catheters are managed improperly, or pain is inadequately assessed, epidural analgesia fails to provide adequate pain relief (Deni et al., 2016). More than 80% of surgical patients experience moderate to severe postoperative pain, and 28 to 50% of these patients have a pain score greater than 6 out of 10 at …

Clinical Outcomes Of Women With Adenocarcinoma In Situ Of The Cervix Treated By Conization: An Integrated Literature Review, Jennifer Keeley

Grace Peterson Nursing Research Colloquium

Abstract

Background: The incidence of cervical adenocarcinoma in situ is on the rise. Its detection, diagnosis, and management is both challenging and controversial. For these reasons, hysterectomy has historically been the treatment of choice, but many women with adenocarcinoma in situ are of reproductive age and have not completed childbearing so more conservative treatment is often desired.

Objectives: The purpose of the integrative literature review was to determine the efficacy and safety of conization as conservative treatment for women with cervical adenocarcinoma in situ wishing to preserve fertility, and to determine if one method of conization, cold knife cone or …

Educational Prevention Program Of Surgical Site Infections (Ssi), Carena Leung

Master's Projects and Capstones

Surgical site infections (SSI) cause negative health care effects to patients and hospitals. SSI is one of the most common types of healthcare-associated infections (HAI) accounting for 31% among hospitalized patients (Centers for Disease Control and Prevention [CDC], 2012). It is associated with prolonged length of stays (LOS), higher morbidity and mortality, and increased healthcare costs. The purpose of this quality improvement project is to decrease SSI rates by enhancing patient education and engagement in preoperative care and hygiene before surgery. In a metropolitan pediatric hospital, a microsystem analysis of the preoperative unit was conducted before generating the SSI Prevention …

Partnering With Pediatric Patients And Families In High Reliability To Identify And Reduce Preventable Safety Events, Julie Kirby, Courtney Cannon, Lynn Darrah, Yolanda Milliman-Richard

Patient Experience Journal

Frameworks for designing highly reliable behaviors and tools to reduce preventable harm are the result of the continued effort to improve patient safety in healthcare. Evidence shows that there has been limited research on engaging patients and families in the development of safety and reliability efforts to achieve zero harm. Our aim was to develop a tool that engages patients and families in an effort to reduce preventable harm in a pediatric academic medical center.

Fatigue-Related Symptom Clusters And Their Relationship With Depression, And Functional Status In Older Adults Hospice Patients With Cancer., Suzan Fouad Abduljawad

USF Tampa Graduate Theses and Dissertations

The hospice care population with cancer are often older adults who report many cancer-related symptoms experienced often in clusters. Most prevalent of these symptoms is fatigue and often it co-occurs with depressive symptoms and poor physical functioning. This dissertation examined fatigue, symptom clusters, depression, physical activity, and functional status in older adults with cancer. The aims of the literature review were to understand the relationship among physical functioning, cancer fatigue, fatigue-related symptom clusters, and their relationship with functional status In older adults. The literature related to these associations is insufficient and inconclusive. The methods section aimed to investigate the reliability …

Journey Interrupted: A Phenomenological Exploration Of Miscarriage, Marit A. Watson, Vanessa D. Jewell, Sarah L. Smith

The Open Journal of Occupational Therapy

Background: Miscarriage is a significant life event that impacts occupational performance, identity, and competence and that influences perceptions of motherhood. Because of the lack of social rituals often attributed to the death of a loved one, miscarriages may result in disenfranchised grief, which impedes coping.

Methods: This phenomenological study explored the impact of miscarriage on relationships, perceptions of motherhood, and the meaning of occupation in the context of grief. Data was collected through semi-structured interviews (N = 4) and completion of a brief demographic questionnaire. The interviews were digitally recorded, transcribed verbatim, and reviewed to ensure accuracy. Using inductive thematic …

Noninvasive Hemodynamic Monitoring In Emergency Trauma Patients, Ryan Boyd

Nurse Anesthesia Student Capstones

Noninvasive hemodynamic monitoring has evolved steadily over the past few decades in response to healthcare providers' preference for less invasive monitoring methods for their patients. Invasive monitoring has its place in the critically ill patient population as witnessed in intensive care units throughout the country. Even in this environment, providers are opting less for the pulmonary artery catheter which has been the gold standard for invasive cardiac output monitoring in the past. Providers are now utilizing less invasive monitoring techniques which offer fewer potential complications to the patient while providing rapid access to critically important hemodynamic data. Examination of different …