Nursing Commons^™

Community Healthcare Workers (Chw) High-Risk Stabilization Study: Does The Ability Of Chws At Mobile Covid Clinics To Link Patients With Uncontrolled Diabetes To A Physician Improve Short Term Outcomes?, Mo Hadaya, Venkateswar Venkataraman, Jaimy D. Jabon, Kenneth W. Stagliano, Richard T. Jermyn

Rowan-Virtua Research Day

Uncontrolled diabetes may cause preventable but significant effects. One major preventative measure is early screening; there are hopes that community healthcare workers can increase awareness and screening availability, especially in underserved populations. We hosted and recorded logs of patients at mobile COVID health clinics, educating those with uncontrolled diabetes and connecting them to healthcare. We then looked to see if any patients had improvements in blood glucose to non-diabetic levels. 378 patients were logged, but only 138 were in events that had a significant amount of repeat visits. Twenty-five of them had blood sugar indicative of uncontrolled diabetes. Out of …

Enhanced Recovery After Surgery (Eras) Protocol For Bariatric Surgery, Krista Bunch

Doctor of Nursing Practice Projects

Bariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). …

Coping Strategies And Stress Of The Undergraduate Nursing Student In The Clinical Setting: An Evidence Based Practice Quantitative Study, Ashley Calverley

Electronic Theses and Dissertations

The assessment of perceived stress and coping behaviors related to first-semester clinical might benefit students in nursing education. The assessment of most common coping behaviors and perceived stress related to the clinical setting is essential due to difference in personalities, learning abilities, and coping behaviors among nursing students today. Previous research has suggested the initial clinical period results in adverse outcomes, such as poor academic performance, elevated burnout levels, and diminished personal well-being. These factors are detrimental to academic success in nursing programs. Evidence supports that helping students develop positive stress/coping abilities will aid in adapting in both the academic …

Oral Sucrose And The Relation To Neonatal Pain Perception, Meagan L. Burns

MSN Capstone Projects

Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Treede, 2018). The phenomenon of pain is a personal and unique experience that many of the world’s population has experienced in some form or fashion throughout their lifetime. Neonates are exposed to many painful procedures and/or situations due to various medical ailments that may require a neonatal intensive care unit (NICU) admission. Infants have a special place in the hearts of adults all over the world, and any interventions that would increase the likelihood of diminishing or removing perceived pain in this population are likely …

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Implementing The Use Of The Emergency Severity Index Triage Tool In Urgent Care, Sakeena Spencer

Doctor of Nursing Practice Projects

Background: The urgent care sector has quickly grown in the last decade. Patients who visit healthcare facilities seeking treatment for exacerbations of chronic conditions or episodic illnesses such as asthma without scheduled appointments receive healthcare services from Urgent Care Centers (UCC) or Emergency Departments (E.D.s). Upon visiting the UCC, these patients report life-threatening symptoms; hence require immediate medical attention. UCC healthcare workers should distinguish between non-acute and acute patients to prioritize providing healthcare to patients, ensuring they are not at risk for fatal outcomes. Using the Emergency Severity Index (ESI) triage tool while delivering healthcare services to these patients has …

Improving Same Day Surgery Patient Outcomes Through A Nurse Practitioner Led Telephone Follow-Up Call, Jessica Cooke, Kamila Zasowska

Doctor of Nursing Practice Final Manuscripts

Background: On average, patients experience one to seven problems post-hospital discharge leading to increased unplanned emergency room visits, hospital readmission, and worse outcomes. The average cost of a single hospital admission is $15,477, an emergency room visit $1,389, and treatment for a surgical site infection $10,443-$25,546. Additionally, the Center for Medicare and Medicaid Services (CMS) imposes fines on hospital systems with high readmission rates. Currently, the Southern California hospital this project was implemented at has a 15.5% hospital-wide unplanned 30-day readmission rate with a national average of 15.2%.

Purpose: The purpose of this evidence-based practice project was to implement a …

"Pain Is What The Patient Says It Is": A Secondary Analysis Of Nurses’ Reflections On The Term Pain Catastrophizing, Riana Longo

Electronic Thesis and Dissertation Repository

Background: Pain catastrophizing is a widely used concept; however, many have argued that it delegitimizes and decontextualizes patients’ pain experiences. Previous studies identified that patients and clinicians think the term is stigmatizing; however, nurses’ perceptions are underrepresented. Nurses offer a unique perspective that is critical to explore to foster positive change and improve patient outcomes. Objectives: This thesis aims to summarize the current literature on pain catastrophizing perspectives from clinicians and patients, analyze nurses’ perspectives, and uncover any underlying issues with the term itself. Methods: This thesis consisted of a two-stage design. The first study is a scoping review that …

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Pediatric Sepsis-Development Of A Clinical Pathway For The Pediatric Emergency Department, Roslyn Lampkin-Smiley

Student Scholarly Projects

Globally, various researchers have suggested that sepsis is one of the most prominent causes of infant fatalities. Since 2004, countless guidelines have been developed to assist in the early identification and management of sepsis. The PICOT question that guided this project was: Does the implementation of a pediatric sepsis clinical pathway, compared with the standard protocol in emergency departments, decrease delays in treatment times of patients presenting with sepsis? Researchers have suggested that early recognition and interventions for septic patients can result in decreased mortality rates. A pediatric sepsis clinical pathway was implemented during this project. The pathway alerted staff …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Healthcare Policy Analysis: Next Of Kin Contact Information On Driver's Licensse And Its Use In Emergency Notification, Suzanne Sheaffer

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

In Pennsylvania, there has been a rise in unclaimed decedents within Third-Class and Fifth-Class county coroner offices. Decreasing the number of unclaimed decedents in Third-Class and Fifth-Class Pennsylvania coroners offices is the goal for this healthcare policy analysis project. Using the Bardach’s eight step policy analysis problem solving technique, the data and the project outcomes will be presented to Pennsylvania Department of Transportation (PennDOT). Data collection began with a questionnaire sent to all 67 counties to determine who had access to the Pennsylvania driver’s license database entitled Pennsylvania Justice Network (JNET). Fourteen of 67 counties have partial access and …

Chronic Pain, Sleep Disruption, And Work Performance In The Military, Jeffrey Ransom

Dissertations

Abstract

Background and Significance: Managing pain is a challenge for many organizations, including the U.S. military. The added complication of managing sleep disruption compounds the issue. Examining pain and sleep disruption in the context of work performance within the military is critical to understanding the impact of these conditions on our nation’s fighting forces.

Purpose: Examine the associations of chronic pain and sleep disruption in the context of work performance among active duty military service members.

Research Aims: 1) Describe sociodemographic characteristics, military service characteristics, clinical characteristics, and work performance of active duty service members, 2) Examine relationships between these …

Safe Care For Seizure Patients On An Epilepsy Monitoring Unit, Deborah Bachand, Lauri Wilson, Rachel Caiola, Lynne Keller, Megan Selvitelli, Mary Jo Farley, Jennifer O'Neill, Sara Shrock, Hannah Plummer, Sally Prokey, Amy Sparks, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

Operations Transformation

Seizure patients admitted to an Epilepsy Monitoring Unit located within an academic tertiary medical center have a high potential to impact patient safety. As a result, a unit based team identified a need for a higher level of training for both their staff and float companions to ensure safe and standardized care for this group of patients.

The goal of this quality improvement project was to create an educational tool that would assist 100% of staff in better recognizing and responding to seizures. Baseline metrics and root cause analysis demonstrated a lack of consistent information being taught, a poorly identified …

The Association Between Physiologic Sources Of Pain And Sleep Quality In Older Adults And People With Dementia, Crystal-Rae Evans

Theses and Dissertations

The association between physiologic sources of pain and sleep quality in older adults and people with dementia was examined in this dissertation. Previous research illustrates multiple factors contribute to sleep quality outcomes. Musculoskeletal pain, respiratory distress, gastrointestinal discomfort, and genitourinary pain were examined in relation to sleep quality in older adults and people with dementia. No theory currently exists to guide this nursing research, therefore an illustration of pain and sleep quality in older adults and people with dementia was utilized. Descriptive data analysis and logistic regression were used to address the study aims. The findings from this research illustrate …

The Relationship Between Sleep Quality And Motor Function In Hospitalized Older Adult Survivors Of Critical Illness, Maya N. Elías

USF Tampa Graduate Theses and Dissertations

The primary, descriptive aim of this dissertation was to describe the nighttime sleep quality of previously mechanically ventilated older adult patients within 24-48 hours of transfer out of the intensive care unit (ICU) to a medical-surgical floor. The secondary, exploratory aim was to examine the relationships between post-ICU sleep efficiency (SE) and wake after sleep onset (WASO) with grip strength in previously mechanically ventilated older adult patients within 24-48 hours of transfer out of the ICU.

The study included 30 adults ages 65 and older (11 women, 19 men; age 71.37 ± 5.35, range 65-86 years), who were functionally independent …

The Effects Of Emerging Technology On Healthcare And The Difficulties Of Integration, Skyler J. Pavlish-Carpenter

Honors Undergraduate Theses

Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all.

Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare.

Methods: …

The Correlation Of Size Of Core Network And Frequency Of Contacts With Agitation And Positive Affect In Elderly With Dementia, Amal Ali Al Ghassani

Theses and Dissertations

In the country of Oman, care needs of older adults are primarily provided by family members in the home. The study was guided by socioemotional selectivity theory, the environmental vulnerability hypothesis, and the need-driven dementia-compromised behavior theories. The central premise was that the size of the person’s activities of daily living (ADL) core network and frequency of contact with the ADL core network would predict agitation and affect. A smaller core network with a higher frequency of contact may be better at identifying and treating the person’s unmet needs. A secondary premise was that the emotional closeness of the core …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Influence Of Expectations Of Aging On Older Women’S Use Of Dietary Supplements Using The Health Promotion Theory, Barbara Emily Hekel

Theses and Dissertations

The use of vitamins, minerals and herbal supplements by older adults is increasing and changing. There are concerns about supplement quality, safety, and vitamin D overuse. Little is known about supplement use by nursing home residents and about factors that influence older women to use supplements. The current study describes the supplement use of 247 nursing home residents and 110 independent living women 65 years or older in the Midwestern United States. A secondary analysis of 247 medication administration records describes the prevalence of vitamin, mineral, and herbal supplement use of nursing home residents. Using the health promotion theory, the …

The Association Of Nurses’ Assessment And Certainty To Pain Management And Outcomes For Nursing Home Residents In Jordan, Mohammad Jamil Rababa

Theses and Dissertations

Despite advances in dementia care Pain in people with dementia is still under recognized, underestimated, and undertreated because of poor assessment, poor treatment, and factors relating to nurses’ critical thinking and decision-making skills. Unrelieved pain leads to many serious negative health outcomes in people with dementia. The purpose of the study was to examine temporally based relationships between change in behavior, the nurses’ level of certainty regarding pain, assessment scope and outcomes of pain and agitation. Relationship between severity of dementia, comorbid burden, ability to verbally self-report symptoms and patient outcomes of pain and agitation was also investigated.

A Convenient …

First Results From Application Of An Absorbable Synthetic Membrane To Superficial And Deep Second Degree Burn Wounds, Sigrid A. Blome-Eberwein Md, Hamed Amani Md, Daniel D. Lozano Md, Deborah Boorse Rn, Cnp, Patrick Pagella Rn, Cnp

Sigrid A Blome-Eberwein MD

No abstract provided.

Gender Differences In Perceptions And Self-Reported Driving Behaviors Among Teenagers., Gavin C. Barr Jr. Md, Kathleen E. Kane Md, Robert D. Barraco Md, Timarie Rayburg, Lauren Demers, Chadd K. Kraus Do, Mph, Marna R. Greenberg Do, Mph, Facep, Valerie Rupp Rn, Bsn, Kimberly Hamilton, Bryan G. Kane Md

Robert D Barraco MD, MPH

BACKGROUND: The Centers for Disease Control reports that motor vehicle crashes (MVCs) are the leading cause of injury and death among U.S. teenagers, and disproportionately affect males. Among preventable causes of MVCs involving teenage drivers, distracted driving continues to be a serious public health problem. OBJECTIVES: To describe gender differences in teenage drivers' self-perceptions of safe driving behaviors, and self-reported risk behaviors and distractions while driving. METHODS: We prospectively surveyed teenage drivers from four high schools in Pennsylvania and New Jersey. Gender comparisons were made between self-reported perceptions and self-reported driving behaviors. Descriptive statistics and chi-squared testing were used in …

Surgical Management Of Diabetic Charcot Foot And Ankle Deformities, John Stapleton, Zacharia Facaros, Vasilios Polyzois, Thomas Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.

Charcot Foot: New Treatments, Better Outcomes, Thomas Zgonis, T. Roukis, John Stapleton, D. Cromack

John J Stapleton DPM, FACFAS

No abstract provided.

Management Of Foot And Ankle Trauma, Zacharia Facaros, John Stapleton, Vasilios Polyzois, Thomas Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.

Plastic Surgical Techniques For The Foot And Ankle, John Stapleton, Crystal Ramanujam

John J Stapleton DPM, FACFAS

No abstract provided.

The Experiences Of Black American Older Adults Managing Pain: A Nursing Ethnography, Sheria Grice Robinson

Wayne State University Dissertations

Introduction: Pain can negatively affect quality of life for Black elders. They are less likely to report pain concerns and have voiced pain needs adequately met. To better understand the pain management experiences and concerns of Black elders, an ethnographic study was completed within an urban, low-income, elder housing facility. Methods: 106 participants completed a questionnaire comprised of a demographic tool, the PROMIS Global Health Scale (PROMIS), the Brief Pain Inventory (BPI), and the Psychological Stress Measure (PSM-9). Additionally, participant observation, informal interviews, and 20 formal recorded interviews with individuals identified as having pain were completed. Qualitative and frequency analysis …

Sleep, Depressive Symptoms And Cognition In Older Adults And Caregivers Of Persons With Dementia, Glenna Shemida Brewster

USF Tampa Graduate Theses and Dissertations

Caregivers of persons with dementia, who are often older adults, report sleep disturbance, high rates of depressive symptoms and may be at risk for impaired cognition. This dissertation examined sleep, depressive symptoms, and cognition in older adults and caregivers of persons with dementia. The aims of the review of literature were to understand, in community dwelling adults 60 years and older, the relationships among sleep parameters (sleep onset latency, wake after sleep onset, sleep efficiency, total sleep time, and general sleep complaints), and the domains of cognition (Executive Function, Attention, Episodic Memory, Working Memory, Processing Speed), and global cognition. Based …

Quantitative And Qualitative Findings And Implications Of An Intercultural Sensitivity Assessment Among Employees At A Large Health System, Jarret R. Patton Md, Jay Baglia Phd, Lynn M. Deitrick Rn, Phd, Anthony Nerino, Eric J. Gertner Md, Mph, Judith Sabino Mph, Mary Kay Grim, Debbie Salas-Lopez Md, Mph

Debbie Salas-Lopez MD, MPH, FACP

Tuesday, November 10, 2009: 2:45 PM Jarret R. Patton, MD , Department of Pediatrics, Lehigh Valley Health Network, Allentown, PA Jay Baglia, PhD , Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA Lynn M. Deitrick, RN, PhD , Department of Community Health, Health Studies and Education, Lehigh Valley Health Network, Allentown, PA Anthony Nerino, MA , Department of Community Health, Health Studies and Education, Lehigh Valley Health Network, Allentown, PA Eric J. Gertner, MD, MPH , Department of Medicine, Lehigh Valley Health Network, Allentown, PA Judith N. Sabino, MPH , Cultural Awareness, Lehigh Valley Health Network, Allentown, PA …