Nursing Commons^™

Use Of A Remote Patient Home Telemonitoring System (Engage Practice Solutions) In A Rural Health System To Decrease Rural Patients’ Utilization Of Acute Healthcare Services: A Quality Improvement Project, Christopher Baker

Doctor of Nursing Practice (DNP) Manuscripts

Individuals in rural areas of the U.S. have less healthcare access in large part due to access barriers, and include travel and wait time, distance to a provider, cost, transportation, and social and cultural components. Rural individuals have been found to be in poorer health and have higher rates of being uninsured and having chronic disease. These disparities lead to rural individuals requiring more expensive acute care once they are at the point of receiving care. A significant burden is placed on the individual and health system. The rates of emergency department (ED) use in rural areas increased 70% from …

Child-Rearing By Imprisoned Women: Sadness, Anxiety, And Feelings Of Guilt, Umi Hani, Agus Setiawan, Poppy Fitriyani

Jurnal Keperawatan Indonesia

The number of imprisoned women continues to increase. Imprisonment of women affects them as perpetrators of crime and those who have relationships with and ties to them, such as children. This phenomenological study aims to explore the experience of imprisoned women in Jakarta in playing the role of mother. In-depth interviews were conducted to explore the experiences of seven imprisoned women. Through a thematic content analysis, we identified specific key- words, the results revealing the sadness, anxiety, and feelings of guilt experienced by imprisoned mothers in relation to their child-rearing. Imprisoned mothers also experience difficulties in meeting their children's needs, …

Maternal Factors In Stunting Among Vulnerable Children, Stefanus Mendes Kiik, Muhammad Saleh Nuwa

Jurnal Keperawatan Indonesia

Children with stunting in Indonesia and other low-middle countries remains a serious problem. This study aimed to identify the association between maternal education, maternal age, maternal height, preceding birth interval, and ANC clinic visits, and stunting among vulnerable children in Kupang Regency, Indonesia. A cross-sectional study was con- ducted of two villages in Kupang Regency. The study sample comprised female ex-refugees from Timor Leste who had children aged 24–59 months. The subjects were chosen using consecutive sampling, with a total number of 154. Data were collected from both primary and secondary sources. There was a significant relationship between maternal education …

The Effectiveness Of Spiritual Intervention In Overcoming Anxiety And Depression Problems In Gynecological Cancer Patients, Lina Anisa Nasution, Yati Afiyanti, Wiwit Kurniawati

Jurnal Keperawatan Indonesia

Anxiety and depression are psychological distress that often occurs in gynecological cancer patients. However, there are few studies related to interventions to overcome these problems. The purpose of this study was to determine the effect of a spiritual intervention on anxiety and depression in such cancer patients. The research design was quasi-experimental, employing pretest and posttest on the intervention and the control groups. The total number of respondents was 108 patients, consisting of 54 in each group. The instrument used in the study was the Hospital Anxiety and Depression Scale (HADS). The spiritual intervention consisted of four sessions, namely an …

The Smoking Behavior Of Health Workers In Asia: A Literature Review, Arif Rahman, Titih Huriah

Jurnal Keperawatan Indonesia

Health workers are role models in preventing smoking behavior, yet many are smokers themselves. This study reviews and analyzes the smoking behavior of health workers in Asian countries, based on databases such as PubMed, EBSCO, and Google Scholar in 2013–2018. It is shown that the prevalence of smoking amongst health workers was 4.6–44%, with the nursing profession showing a higher level than other health professions and with a higher ratio of male to female smokers. Health workers are aware of the dangers of smoking, including the effects of cardiovascular disease, respiratory disease, oral cancer, atherosclerosis, hypertension, fetal disorders, and infertility. …

Spiritual Behavior And Stress In Adolescents: An Initial Study, Sumiyati Tarniyah, Laili Nur Hidayati

Jurnal Keperawatan Indonesia

Spirituality is often associated with mental health, including stress. Older people tend to have high rates of involvement in spirituality rather than young people. This study aimed to identify the relationship between spiritual behavior and the stress levels of 152 high school students, using a descriptive correlation research design. The data collection techniques involved a spiritual dimension scale questionnaire and the Depression Anxiety Stress Scale 42 (DASS 42). The data were analyzed using Spearman's rho correlation test. The results show that the spiritual behavior distribution was mostly in the moderate category (53.3%), and stress level distribution was primarily in the …

The Healthcare Needs Of Families Caring For Patients With Pulmonary Tuberculosis, Astuti Yuni Nursasi, Nadya Tiara Sabila, Muhamad Jauhar

Jurnal Keperawatan Indonesia

Tuberculosis (TB) is a global public health problem. Families need to meet healthcare needs during the treatment of TB sufferers. This study aims to identify healthcare needs of families caring for patients with the disease. The cross-sectional study involved 83 families caring for TB patients. The research was conducted at a Primary Healthcare Center in an urban area in West Java. The results revealed that 60.2% of caregivers were 18–40 years old, 60.2% were female, 51.8% were senior high school educated, 43.4% were housewives, 86.7% had an income under the regional minimum wage, and 55.4% had cared for the TB …

Hypertension Self-Care Management During Covid-19 Pandemic Crisis In The Meranao Tribe: A Phenomenological Inquiry, Jonaid M. Sadang, Sittie Inshirah P. Macaronsing, Narima M. Alawi, Normala M. Taib, Hamdoni K. Pangandaman

Jurnal Keperawatan Indonesia

The COVID-19 crisis has been a challenging and stressful event for individuals with known underlying health problems, not to mention their higher risk of contracting the disease. This phenomenological inquiry was conducted to explore the common self-care practices of the Meranao tribe in the Province of Lanao del Sur, Philippines, concerning their management of hypertension amidst the ongoing pandemic health crisis. This study employed a descriptive-phenomenological approach. Ten known hypertensive adults participated in the study selected using purposive sampling. Data collection employed focus group discussion (FGD) and then analyzed using Colaizzi's approach. Four themes were derived which explained the common …

Postdischarge 24/7 Hotline Service For Neurology And Neurosurgery Patients And 1-Year Impact On Readmission Rates, Unplanned Emergency Department Visits, And Patient Satisfaction, Shafqat Bibi, Rida Mitha, Kiran Bano, Farida Datoo, Nadia Karim, Muhammad Shahzad Shamim

School of Nursing & Midwifery

Objective: Telephone triage is a system in which trained nurses use standardized protocols to evaluate symptoms over the phone and determine the appropriate course of action.
Materials and methods: We implemented a protocol for systematic follow up phone calls and telephonic triage to families of neurology and neurosurgery patients after discharge, primarily to improve care transition and to assess its impact on the ratio of visits in the emergency department, readmissions, and overall satisfaction of patients and families. The intervention comprised the implementation of nurse led telephone triage and postdischarge follow up phone calls. After implementing hotline services in mind …

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

Evaluating Va Nurse Acceptance Of Virtual Healthcare Technology During The Coronavirus Outbreak, Francesca Bryan-Couch

Doctor of Nursing Practice Scholarly Projects

At a regional Veterans Administration (VA) hospital, nurses performing case management were unable to perform face-to-face visits with patients due to coronavirus. Care coordination and discharge planning efforts occurred through telephonic case management to preserve personal protective equipment and reduce transmission rates through social distancing. Trust and rapport between patients and nurses were reduced without personal contact. Peplau’s theory of interpersonal relations described six nurse roles and three phases of relationship development required to create therapeutic nurse-patient relationships. Connectedness was a key concept considered to be the path to a successful meaningful therapeutic nurse-patient relationship (Hrabe, 2005).

To evaluate current …

Efficacy Of Diabetes Self-Management Education Administered Via Telehealth For Adults With Uncontrolled Diabetes, Tanner Free

Evidence-Based Practice Project Reports

Patient’s with a diagnosis of diabetes require significant lifestyle modification and education. The need for patient education has led to the development of diabetes self-management education (DSME) classes. Unfortunately, utilization of DSME classes is only 5% among Medicare beneficiaries and 6.8% among privately insured patients (Centers for Disease Control [CDC], 2018). The purpose of this evidence-based practice (EBP) project was to implement DSME via telehealth and assist with goal formation to help patients with uncontrolled diabetes achieve glycemic control by increasing access to crucial education. The intervention consisted of bi-weekly calls for a period of 3 months. Participant data were …

Implementing Telemental Health To Improve Access To Mental Healthcare In Rural Vermont, Julia Mcdougal Ronconi

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Mental health access in rural areas is a national problem. Of strategies to increase access, telemental health has the highest level of evidence.

PURPOSE: This project aimed to implement a telemental health program in rural Vermont to: (a) increase the number of rural-dwelling patients who enter treatment for anxiety and depression, (b) evaluate the effectiveness of telemental health for depression, anxiety, and overall functioning, and (c) evaluate patient satisfaction with the accessibility, quality, and affordability of the service.

METHODS: Adult psychiatric diagnostic evaluation, medication management and psychotherapeutic interventions were delivered via telemental health. The service was marketed to Health …

Depression Symptoms And Covid-19, Kaylee Armendariz

The Eleanor Mann School of Nursing DNP Capstone Projects

The COVID-19 pandemic presents new challenges in behavioral healthcare. Americans may face anxiety surrounding the virus, economic strain, isolation, and grief, putting them at increased risk for depression symptoms. This Doctor of Nursing Practice (DNP) quality improvement project aimed to increase depression screening rates and utilized data from a Federally Qualified Health Center (FQHC) to identify population groups at higher risk for depression symptoms during the COVID-19 pandemic. Using the Patient Health Questionnaire (PHQ) depression screening tool, a statistical analysis determined if being tested for COVID-19 or testing positive for COVID-19 had an impact on depression symptoms. Additionally, this project …

Implementation Of A Postdischarge Virtual Visit And Nurse Follow-Up Protocol To Decrease 30-Day Readmission Rates For Patients With Pulmonary Arterial Hypertension, Kimberly Thompson

The Eleanor Mann School of Nursing DNP Capstone Projects

Pulmonary arterial hypertension (PAH) is a rare, chronic disease with no cure. Patients with this disease have high mortality and morbidity, experience frequent hospitalizations, readmissions, and psychosocial burdens, and require a high degree of self-care management skills (Doyle-Cox et al., 2016; Lattimer et al., 2016; McDevitt & Walter, 2019). More than half of PAH patients are hospitalized within the first year following diagnosis, and about 20% are readmitted to the hospital within thirty days of discharge (Bhattacharya et al., 2019: Tonelli, 2020). These patients also have a high symptom burden, and these symptoms significantly affect their physical and mental quality …

Mothers’ Breastfeeding Practices And Self-Efficacy, Agrina Agrina, Febriana Sabrian, Oswati Hasanah, Erika Erika, Yesi Hasneli

Jurnal Keperawatan Indonesia

This study examined breastfeeding practices and self-efficacy among mothers residing in rural areas. A cross-sectional study was conducted for 104 mothers via purposeful sampling in a Posyandu (maternal and child health service) in Kampar district, one of the rural areas in Riau, Indonesia. The Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) was used in the questionnaires to collect data. Chi-square test was used for bivariate analysis. Majority of the respondents (71.2%) were 20–35 years old; 69.3% of the respondents’ level of education were low (such as junior and senior high school levels). Approximately 91.3% of them were housewives. Exclusive breastfeeding prevalence …

Phenomenological Study On The Experience Of Male Nurses In Caring For Female Patients, Anik Maryunani, Rr. Tutik Sri Hariyati, Enie Novieastari

Jurnal Keperawatan Indonesia

Nurses provide care equally and do not discriminate between men and women. However, male nurses face challenges and obstacles, especially when they take care of female patients. This study aimed to explore the experiences of male nurses who look after female patients by using a descriptive qualitative design with a phenomenological approach. Ten male nurse participants aged 26–43 years and having an experience of caring for female patients for at least 2 years were included in this study. Seven themes were identified: the discomfort of female patients and male nurses; patient’s trust and privacy; the identification of factors affected by …

Pursuing The Need For Physical Activity In Recurrent Cva Patients During Hospitalization: A Case Report, Stepanus Maman Hermawan, Hany Wihardja

Jurnal Keperawatan Indonesia

Cerebrovascular accident (CVA) is a neurological deficit condition caused by an acute focal injury of the central nervous system by cerebral infarction or intracerebral hemorrhage. CVA patients who do not reduce risk factors after the first attack have an 8.7 times higher risk of CVA recurrence. The effect of a recurrent CVA is six times greater than the risk of a first CVA in the general population of the same age and sex, and nearly half of them remain alive but are physically disabled. This case report illustrates the process of recurrent CVA and disability experienced by a 69-year-old Malay …

School Students’ Perception On Risky Behavior And Their Utilization Of Health Care Services, Muhammad Kamil Che Hasan, Noor Faizah Tutasting Rawi, Mohd Said Nurumal, Siti Hazariah Abdul Hamid

Jurnal Keperawatan Indonesia

The Malaysia Ministry of Health reported adolescents’ low utilization of healthcare services, although they need this ser- vice as a consequence of their involvement in risky behavior. This cross-sectional study aimed to determine adolescents’ perception on risk taking behavior and their utilization of health care services. A modified self-administered questionnaire was used to collect data from 250 secondary school students aged 13 and 14 years in one of the selected schools in Malacca, Malaysia. Data were analyzed using SPSS 20. Fast food consumption, loitering after school, physical fighting, smoking, and non-use of helmets were the most reported risky behaviors among …

A Secondary Analysis Of Peer Support And Family Acceptance Among Homosexual Living With Hiv And Antiretroviral Therapy: Quality Of Life Perspectives, Ina Martiana, Agung Waluyo, Sri Yona, Edianto Edianto

Jurnal Keperawatan Indonesia

Men who have sex with men (MSM) comprise a population at risk for HIV infection. Assessing the Quality of Life (QOL) in MSM might be different than other populations. This study showed a secondary analysis from our previous research. It was needed to understand whether peer support and family acceptance had an impact on QOL of MSM living with HIV and ART (Antiretroviral Therapy). A total of 175 respondents were involved in this cross-sectional study that was carried out with purposive sampling. The questionnaires were translated to Bahasa and tested for validity and reliability. Data questionnaires completed were analyzed. Results …

Factors Related To Doctors’ And Nurses’ Perceptions Of Evidence-Based Practice And Healthcare Information Access Through Information And Communications Technology, Melati Fajarini, Sri Rahayu, Ebaa M. Felemban, Agus Setiawan

Jurnal Keperawatan Indonesia

Evidence-based practice (EBP) that is supported by the availability of the best literature can improve the quality of health services. Information and communication technology (ICT) usage may provide the evidence in timely-manner. However, literature on the factors related to EBP and ICT of doctors and nurses in Indonesia is scant. This study aimed to describe the factors related to the doctors’ and nurses’ EBP perception and ICT. This survey was conducted in November 2017– January 2018 at one general hospital, five private hospitals, eleven public health centers, and five private clinics. A total of 85 doctors and 271 nurses selected …

Relationship Between Nurses’ Readiness And Institutional Readiness In Developing Nursing Career Paths In Public Health Centers, Tuti Afriani, Rr. Tutik Sri Hariyati, Dyah Fitri Wulandari

Jurnal Keperawatan Indonesia

Nursing career paths in public health centers have not been well established compared with nurses in hospitals. It is because the nursing career path has a different organizing system, which then becomes an obstacle in implementing the career path for nurses in primary health care. Therefore, this study aimed to identify the relationship between institutional and nurses’ readiness in implementing nursing career paths within public health centers. A cross-sectional study design with questionnaire as instrument was used in this research. A consecutive sampling technique was used to select 93 nurses from 13 public health centers. Furthermore, to identify the objective …

Patient Characteristics Related To Phlebitis In The East Coast Of Peninsular Malaysia Hospital, Azlina Daud, Fatimah Mohamad

Jurnal Keperawatan Indonesia

The insertion of peripheral intravenous catheters (PIVCs) is common for treatment among hospitalized patients. However, this procedure usually fails before the end of therapy because of several complications, including phlebitis. Therefore, this study aimed to determine the incidence and associated factors of phlebitis among patients with PIVC. A prospective cohort study was conducted in one of the hospitals located in East Coast Malaysia. The presence of phlebitis was assessed using the visual infusion phlebitis score checklist. The patients were followed until PIVC removal. A total of 321 data were collected among patients who received a new PIVC in the medical, …

Pediatric Wound Care: Establishing A Consensus Group To Develop Clinical Practice Guidelines, Ryan Krasnosky, Geran Barton, Linda Highfield, Sheila Martinez, Stephen Linder, Edward Buchanan, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. Wound care practices for neonatal and pediatric patients have created a lack of standardized evidence-based guidelines for treatments in clinical practices. Unfortunately, published clinical guidelines for the evaluation and management of wounds in pediatric populations is limited. Consensus groups are used to develop clinical guidelines which define key aspects of the quality of health care, particularly appropriate indications for interventions. The aim of this initiative was to conduct the first two steps of the guideline development process, and to report on the findings from the expert consensus group for pediatric wound care.

Methods. The goal was to recruit a …

Implementation Of Telephone-Based Medication Adherence Conferences To Improve Health Outcomes Of Heart Failure Patients, Diana Marie Broadway

The Eleanor Mann School of Nursing DNP Capstone Projects

Cardiovascular disease (CVD) has been a significant health problem worldwide and is the leading cause of death globally. Heart failure (HF) is a chronic progressive form of CVD that affects millions of adults in the United States. The treatment for heart failure is very complex and requires an ongoing regimen of medications. In heart failure, many patients report nonadherence to their medication regimens, which leads to a magnitude of preventable deaths annually. With frequent medication nonadherence of the HF patients, there must be an intervention used to combat this problem. The use of telephone-based interventions (TBI) can modify nonadherent medication-taking …

Association Of The Magnitude Of Nurses With The Use Of Health Information Exchanges: Analyzing The National Health Insurance Claim Data Of Hospitals And Clinics In Korea, Young-Taek Park, Yeon Sook Kim, Yun-Jung Heo, Jae-Ho Lee, Hyejung Chang

Nursing Faculty Publications

Background

Many features of health care organizations (HCOs) have been identified to be associated with health information exchange (HIE), but subcategories of organizational factors focusing on nurse workforces still need to be identified. The objective of this study is to investigate the association of number of nurses with HIE use in Korea.

Methods

This study had a retrospective study design and used health insurance claim data from June 1, 2016 to June 30, 2018. The unit of analysis was the HCO, and any health insurance claims having HIE were counted by HCO. There were a total of 1490 HCOs having …

Improving Senior Level Nursing Students’ Application Of Assessing And Managing Pain Through A Virtual Game Simulation, Miranda Yelverton

Doctor of Nursing Practice Projects

Senior nursing students in the last semester of a community college nursing program take the Health Education Systems Incorporated (HESI) Exit Exam to evaluate their ability to pass National Council Licensure Examination for Registered Nurses (NCLEX-RN). The objective of this project was to implement a virtual game simulation on pain assessment and management to improve scores related to the concepts of pain comparing two different cohorts. Senior nursing students were offered the virtual game simulation and could voluntarily report attempts and results through a Google ™ Form.

Staff Perceptions Of The Health Call Center Workplace Environment, Eric Lee Escobedo-Wu

Regis University Student Publications (comprehensive collection)

The complexities of the Health Call Center (HCC) amidst of a pandemic has caused an uptick in nurses and staff experiencing physical, emotional, and mental fatigue. An increase in sick calls during peak call days and times, breakroom discussion related to workload and competing patient and clinical priorities, and the consistent need to care for patients and caregivers, while maintaining familial and fiscal responsibilities and priorities contribute to the exhaustion of the nurses. The purpose of this Quality Improvement (QI) project was to use a structured survey tool and open-ended questions to identify HCC nurses’ perceptions of stressors and burnout …