Nursing Commons^™

Preserving Skin Integrity By Utilizing Unit-Specific Wound Care Champions For Pressure Ulcer-Prevention, Christine A. Fanelli

Evidence-Based Practice Project Reports

It is estimated that the incidence of pressure ulcers range from 0.4 to 38% in a hospital setting. Overall prevalence in the U.S. was 12.3% in 2009. A CMS analysis reported that pressure ulcers were responsible for over $2.41 billion dollars (Niederhauser et al., 2012). A large body of literature related to pressure ulcer incidence and prevalence reflects that education is not always the principal influencing factor for prevention; social and organizational barriers are just as critical when adapting clinical practice guidelines. To address these barriers, an evidence-based practice (EBP) project was implemented at a large, tertiary hospital in the …

Advancing The Future Of Nursing: A Report By The Building Academic Geriatric Nursing, Jennifer L. Bellot, Dana Carthron, Melissa O'Connor, Karen Rose, Casey Shillam, Janet Van Cleave, Amy Vogelsmeier

College of Nursing Faculty Papers & Presentations

In the United States, the number of older adults will double during the next 25 years (United States Census Bureau, 2008). This dramatic demographic shift is changing the landscape of health care practice as more people live longer with multiple chronic conditions. To better prepare nurses to care for this future population, the John A. Hartford Foundation partnered with the American Academy of Nursing in 2000 to launch the Building Academic Geriatric Nursing Capacity (BAGNC) program. Since that time, 251 scholarships and fellowships have been awarded to nurses to advance geriatric nursing education, research, and practice. In 2009, …

A New Approach To An Old Problem: Defining Nursing’S Role In Successful Transitions To Long-Term Residential Care, Kyleen Aldrich

Honors College Theses

A growing body of nursing research addresses the transitional period for older adults entering long-term residential care. However, gaps exist in our understanding of nursing’s role in the transition process. Our aim is to examine the available evidence and develop a model of nursing strategies and interventions to ease the transition to long-term care. This model describes interventions that nurses can incorporate into everyday practice.

A literature review was conducted to examine the transitional care needs and interventions for older adults with a goal of developing a model addressing transitions to long-term care.

Most nursing studies provided descriptive information about …

Effects Of Emergency Department Care Coordination Team Referrals In Older People Presenting With A Fall, Kristie J Harper, Nicholas P. Gibson, Annette D Barton, Antonio C Petta, Sara K Pearson, Antonio Celenza

Research outputs 2013

Objectives: The study aims to describe the characteristics of patients presenting to an ED with a fall and evaluate multidisciplinary Care Coordination Team (CCT) referrals on patient outcomes.

Methods: A single-centred retrospective analysis of electronic data at an adult tertiary hospital was performed using data from 2004 to 2009 of presentations for patients aged 65 years or over with a fall. The primary outcome measure was representation to hospital within 30 days, comparing patients referred to CCT and those not referred. Secondary outcomes were differences in demographic characteristics, mode of arrival, triage score and readmission.

Results: The proportion of ED …

Effectiveness Of A Pilot Gerontological Nursing Certification Preparation Support Program For Registered Nurses Working In Long Term Care, Gail B. Sprigler

Graduate Theses, Dissertations, and Capstones

Between 2000 and 2025 there will be a 30% increase in the prevalence of Alzheimer’s disease (AD) in Indiana (Alzheimer’s Association, 2010). Many individuals with AD and related dementia are cared for in long term care communities. Adequate knowledge and expertise of nurses caring for older adults, particularly those with dementia, is important for the delivery of quality care and the promotion of quality of life for residents living in long term care. This pilot project examined the benefit of a resource support program to encourage Gerontological Nursing certification for registered nurses in the long term care setting.

Impact Of Social Marketing On Nurse Practitioners' Acceptance Of Clinical Video Telehealth For Elderly Patients In Rural Mississippi, Teresa Lynn Langley

Doctoral Projects

Elderly patients 65 years and older who have chronic illness and disabilities living in rural Mississippi have increased difficulty in obtaining timely cost-effective healthcare services from nurse practitioners. The purpose of the capstone project was to utilize social marketing strategies for promoting nurse practitioners’ acceptance of clinical video telehealth (CVT) in improving healthcare access for rural elderly patients in Mississippi. Clinical video telehealth is an innovative way to provide healthcare services to populations in need by reducing barriers to healthcare, such as distances, time, and transportation, and financial resources. However, providing healthcare through the use of technology has not always …

Successful Aging In Hispanic Elders: A Narrative Inquiry, Julie Kay Carr

Boise State University Theses and Dissertations

Purpose: The purpose of this narrative study was to describe and provide an understanding of the unique cultural factors that are associated with successful aging in the elder Hispanic population.

Background: The number of aging Hispanic in Americans is on the rise. The Center for Disease Control recently released data showing the life expectancy for the Hispanic population is 80.6 years — a 2.5 year advantage over the non-Hispanic white population and 7.7 years over the non-Hispanic black population. With longer life spans resulting in an increased number of Hispanic older adults, we are presented with a difference that – …

Late-Life Body Mass Index And Dementia: An Integrative Literature Review, Sarah Slade, Patricia K. Ravert

Faculty Publications

Dementia and obesity are significant public health concerns. Alzheimer's disease affects 5.3 million adults, while 72.5 million adults are obese. Emerging evidence linking body mass index (BMI) and dementia suggest that, although a high BMI in midlife is associated with a greater risk for dementia, a high BMI in late life is considered protective and should not necessarily be considered a risk factor for dementia. Beginning in midlife, practitioners should trend patient BMI numbers. Major fluctuations during this time should be monitored and nutritional counseling and cognitive screenings offered to help patients maintain a healthy BMI and detect early cognitive …

Patient And Nurse Considerations In Home Health Routing With Remote Monitoring Devices, Jessica Spicer

Graduate Theses and Dissertations

We build on the current consistent vehicle routing problem literature by formulating a novel multi- objective mathematical model of the home health scheduling and routing problem that includes the option of assigning some patient visits to remote monitoring devices, with the objectives of mini- mizing total cost, achieving nurse consistency and creating balanced nurse workloads. A heuristic solution approach that approximates the efficient frontier of this multiobjective problem is pre- sented and validated, and the results of using this methodology to solve several realistic instances are included. We also analyze the assignment of patients to devices and present some managerial …

Surgical Delay For Hip Fracture Clients And The Use Of Clopidogrel: An Integrative Review, Phoebe Genevieve Waller

Senior Honors Theses

Abstract

Hip fractures in elderly patients have very high postoperative mortality rates and the number of hip fractures in the United States is expected to increase exponentially before 2030. Early surgery is essential to improve outcomes, but patients on clopidogrel (Plavix) have a high risk for increased bleeding if surgery is performed within the usual 72 hour window. This paper presents literature and research addressing the dangers of delaying surgery versus undergoing surgery before the effects of the clopidogrel are gone. Based on articles published after 2006, most researchers advocated earlier surgical intervention than previously recommended and emphasized an individualized …

Geriatric Trauma Patients In The Emergency Department: Length Of Stay, Intensity Of Care, And Post Ed Destination", Elanor Gates, Doris Warner, Meg Bourbonniere, Patricia Williams

Department of Nursing papers and presentations

Background & Purpose: Research on emergency department length of stay (EDLOS) suggests that increased LOS may result in worse patient outcomes and increased overall LOS. Additional research suggests that increased age may not only result in lower intensity of care for some patients but might also increase EDLOS. For geriatric trauma patients, intensity of care and EDLOS may be different from non-geriatric patients. Given the nature of geriatric traumatic injury, it is important to understand if improvements can be made in geriatric trauma services.

Study/Project Design: A retrospective descriptive study utilizing the hospital’s trauma registry data was completed, including patient …

Nursing Satisfaction In Caring For Elders, Sarah L. Vlachos

Honors Theses and Capstones

Despite the increasing number of Americans who are over 65 years of age, little research exists about the satisfaction of nurses who care for this population. This qualitative descriptive study investigated the factors that influence the satisfaction of such nurses, and yielded five main themes. Registered Nurses (RNs) reported providing high-quality care, developing relationships, and making a difference to be rewarding components of geriatric nursing. The nurses also discussed challenges, which included caring for elders with dementia and being unable to deliver the high-quality care they felt patients deserve. Several of these finding were consistent with existing studies that addressed …

Two Cultures Of Caring: A Comparative Study, Lisa Armstrong, Chistina Polito

Honors Theses and Capstones

There is much that the UK and the US could and should learn from each other to understand the quality of end-of-life care, through comparison of practice, analysis of care patterns and via original research (Higginson, 2005, p.170). Although comparisons between end-of-life care in the United Kingdom and United States have demonstrated similarities and disparities in many contexts, there is little evidence of research that directly compares nursing perspectives between the two Atlantic partners. This research explores nurse’s perceptions and experiences of caring for people within a hospice context and identifies themes of commonalities and disparities in theory and practice, …

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

Hospice Nurse Perceptions Of Constipation And Attitudes Towards Abdominal Massage, Elizabeth Everette

Nursing Theses and Capstone Projects

Constipation is a prevalent symptom in the hospice population, negatively effecting quality of life for patients. Constipation is frequently overlooked, undiagnosed, and untreated by healthcare providers. The role of the hospice nurse is ideal for managing the symptom of constipation with traditional and alternative therapies. Literature review reveals very limited research on constipation and hospice patients, and alternative therapies for constipation. No research was found regarding nurse attitudes towards alternative therapies, such as abdominal massage for constipation. This research study tested the following hypothesis: Hospice nurses perceive constipation as significantly impacting the quality of life for the hospice patient, and …

Care Of The Dying Patient: How Comfortable Are Nursing Students Toward The Care Of Dying Patients At The Completion Of The Associate Nursing Degree Program?, Phyllis Bray

Nursing Theses and Capstone Projects

People are living longer today due to lifestyle changes and treatment of illnesses. End of life nursing care has become a field of nursing practice that requires focus on meeting the needs of the patient and family. Nurses are central figures in advocating for interventions that minimize burden and distress and enhance quality of life for their patients. Given these extremely important responsibilities, new nurses must be adequately prepared to provide sensitive, quality of care for patients at the end of life. This quantitative study aimed to assess how comfortable nursing students feel toward the care of dying patients at …

Knowledge Of And Attitude Toward Pain Control Among Hospice Nurses In A Southeastern State In The Us, Brandy C. Leroy

Nursing Theses and Capstone Projects

The hospice philosophy is based on pain and symptom management, comfort measures, and enhancement of quality of life at end-of-life (EOL). Pain management at EOL requires advanced knowledge and understanding by the healthcare team caring for these patients. A primary concern for the nurse caring for a patient at EOL is to achieve adequate pain control, provide comfort measures and maximize the patient's quality of life. This descriptive correlation study examined the hospice RN's knowledge and attitude of pain control at end-of-life. Forty-nine nurses employed at a hospice facility in a Southeastern state in the US were surveyed. Findings of …

The Use Of Peppermint Oil To Reduce The Nausea Of The Palliative Care And Hospice Patient, Mary Seale

Nursing Theses and Capstone Projects

A descriptive study was initiated to investigate the use of peppermint oil to reduce the nausea of the palliative care and hospice patient. Two local palliative care and hospice programs were used as sites for the study. Patients eighteen and older complaining of nausea were invited to participate in the study. The study was conducted for one and a half months. A total of eight patients consented to participate in the study with a mean age of seventy one years. The Bieri Scale, a visual-numeric analog, was used as the measurement instrument for the patients to evaluate their nausea. Results …

Value Of A Graduate Gerontology Certificate Versus A Masters Degree, Janet S. Hahn

Academic Leadership Academy

The WMU Center for Gerontology was established in 2010 and builds on a strong tradition of gerontology education offered at WMU from the late 1970s to 2004. The undergraduate minor has been revised and is again offered. The previous graduate certificate in gerontology has not yet been reestablished.

This project sought to determine the relative value of a graduate certificate in gerontology vs. a masters degree in gerontology.

Adult Children's Perceptions Of Critical Caregiving Conversations With Their Aging Parents: A Pilot Study, Wendy S. Cregg

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this qualitative pilot study was to describe adult children's perceptions of critical caregiving conversations between themselves and their aging parents; barriers to these conversations; factors that facilitate these conversations; and the support from health care providers that adult children believe would help facilitate critical caregiving conversations between themselves and their aging parents. The overall purpose was to increase understanding of family communication processes that promote health as families age. Focus group interviews using a semi-structured interview guide were conducted with 16 adult children with caregiving experience of their aging parents. Data analysis was conducted utilizing Leininger's phases …

Developing Positive Attitudes Toward Geriatric Nursing Among Millennials And Generations Xers, Barbara A. Heise, Vickie Johnsen, Deborah O. Himes, Debra Wing

Faculty Publications

Despite the increase of the older adult population, there exists a shortage of health care professionals trained to help this population remain independent as long as possible. Ageism, common among younger adults, affects the capacity building of health care for older adults. Research has indicated that increased knowledge about older adults, as well as exposure to the elderly, may alter nursing students' attitudes regarding careers in gerontological nursing. However, questions remain as to what are the most effective ways to provide gerontological content in nursing programs and enhance attitudes toward older adults. With the understanding that younger adults see a …

Multisite Recruitment And Data Collection Among Older Adults : Exploring Methods To Conserve Human And Financial Resources., Valerie Lander Mccarthy, Karen Cassidy

Faculty and Staff Scholarship

The purpose of this article is to describe strategies that were effective in recruitment and data collection among older adults in 3 quantitative studies while decreasing costs in terms of time and money. Factors effective in reducing use of investigators' time and expenses included limiting exclusion of data because of abnormal Mini-Cog scores by careful initial screening and avoiding repeated reminders or follow-up, collecting data in small groups, collapsing consent, dementia screening, and data collection into single sessions, as well as accommodating for sensory and literacy deficits. The cross-sectional, descriptive studies were conducted among community-dwelling older adults attending senior citizen …

A Primer For Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. To ensure that providers behave appropriately, the federal and state governments have established an extensive set of regulations that nursing homes must comply with if they are to be reimbursed for patients insured by Medicaid. Consumers exert considerable influence here by focusing on regulations and enforcement of non-compliance.

States also seek to align providers’ interests with those of other interested parties through controls and incentives built into state reimbursement systems, including with respect to facility cost and quality, access to care, payment equity, service capacity, and budgetary …

Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota For State Policymakers, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. State governments design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control.

Often, participation in the process of developing Medicaid payment policy is limited to state agency officials and providers of care and, occasionally, union representatives and state legislative staff. Invited less frequently to reimbursement policy discussions are consumer representatives. Lack of consumer involvement in the development of state rate setting systems has the potential to result in the …

Feasibility And Impact Of Telemonitor-Based Depression Care Management For Geriatric Homecare Patients, Thomas Sheeran, Terry Rabinowitz, Jennifer Lotterman, Catherine F. Reilly, Suzanne Brown Rn, Patricia Donehower, Elizabeth Ellsworth, Judith L. Amour, Martha L. Bruce

Social Work Faculty Publications

Objective: The objective of this study was to test the feasibility, acceptability, and preliminary clinical outcomes of a method to leverage existing home healthcare telemonitoring technology to deliver depression care management (DCM) to both Spanish- and English-speaking elderly homebound recipients of homecare services.

Materials and Methods: Three stand-alone, nonprofit community homecare agencies located in New York, Vermont, and Miami participated in this study. Evidence-based DCM was adapted to the telemonitor platform by programming questions and educational information on depression symptoms, antidepressant adherence, and side effects. Recruited patients participated for a minimum of 3 weeks. Telehealth nurses were trained on DCM …

Successful Aging And The Epidemiology Of Hiv, David E. Vance, Teena Mcguinness, Karen Musgrove, Nancy Ann Orel, Pariya L. Fazeli

Gerontology Faculty Publications

By 2015, it is estimated that nearly half of those living with HIV in the US will be 50 years of age and older. This dramatic change in the demographics of this clinical population represents unique challenges for patients, health care providers, and society-at-large. Fortunately, because of highly active antiretroviral therapy (HAART) and healthy lifestyle choices, it is now possible for many infected with HIV to age successfully with this disease; however, this depends upon one’s definition of successful aging. It is proposed that successful aging is composed of eight factors: length of life, biological health, cognitive efficiency, mental health, …

Developing Interprofessional Collaboration: An Action Research Approach To Change In Residential Care, Denise F. O Leary

Theses

This thesis presents a study which aimed to develop interprofessional teams to drive organisational change at residential care facilities in order to gain insight into the processes involved, as well as the factors influencing them. It is unrealistic to create a team and expect team members to immediately act in a collaborative way to address team goals, yet the development process has been largely overlooked in the literature. This thesis addresses this gap. Healthcare providers at three residential care facilities for older people were invited to become involved in the study and teams were successfully set up at two facilities. …

Feasibility Of Implementing A Web-Based Dementia Feeding Skills Training Module For Nursing Home Staff, Melissa Batchelor Aselage

MUSC Theses and Dissertations

Background: For an event that occurs three times daily and offers the most opportunity for socialization, mealtimes warrant careful hand feeding implementation by NH staff. PWD may exhibit aversive feeding behaviors that are misinterpreted. This vital misinterpretation can lead to malnutrition in the PWD and increase the risk of mortality. Objective: The goal of this two-month study was to test clinical feasibility and collect pilot data for an intervention to train nursing home (NH) staff via a web-based dementia feeding skills training module with group coaching. The goal of training was to alleviate mealtime difficulties in persons with dementia (PWD) …

Artificial Nutrition, Advance Directives And End Of Life In Nursing Homes, Cheryl Ann Monturo

Nursing Faculty Publications

No abstract provided.

The Relationship Of Financial Performance, Quality Indicators, And The Role Of Nurse Executives In Virginia Nursing Homes, Jeany V. Murphy

Health Services Research Dissertations

Problem statement. The dynamic nature of the healthcare industry has triggered changes in nurse executive functions. The job has expanded into entrepreneurial roles to be able to provide the most cost effective services while maintaining good quality outcomes for the residents. The new responsibility requires a different set of knowledge and competencies that is usually achieved through advanced education. It is not known whether nurse executives in long term care in Virginia possess the skills to influence both the financial and quality outcomes of the facility.

Methods. This descriptive research study examined the relationship of the nurse executives' technical, human, …