Nursing Commons^™

Prevention Of Unplanned Extubations, Melissa Fradette, Donna Kamps

Nursing Posters

Background: The trend of unplanned extubations is rising. Unplanned extubations are a safety concern for patients. A ventilator bundle is in place to guide nurses and respiratory therapists for weaning and extubating patients who meet criteria; it is not always being used. This concern has been discussed at the ICU safety team, ICU NP, ICU ROE, and ICU leadership meetings.

Disinfection Of Shared Mobile Phones Carried By Registered Nurses: A Comparison Of Two Methods, Roberta Basol, Amy Hilleren-Listerud, Sherri Reischl, Terri Mccaffrey, Jean Beckel, Terri Mccaffrey, Pamela Rickbeil, Mary Schimnich, Kirsten Skillings, Mary A. Struffert

Nursing Posters

This study determined the efficacy of cleaning products on mobile phones. Previous research has demonstrated the risk for bacterial cross contamination between healthcare workers' hands, close contact equipment, and mobile communication devices. There is extensive literature on survival of organisms on inanimate objects. Mobile communication devices can act as a reservoir for bacteria associated with nosocomial infection. Additional studies show cross contamination between the healthcare workers hands, the mobile phones, and the patient.

Nursing Skin Integrity Guidelines: A New Approach To Skin Care, Kim Schuster, Amy Gorecki, Jennifer Burris

Nursing Posters

What is nursing skin integrity guidelines: a nursing driven order to provide evidence based skin integrity interventions; provides a streamlined process for immediate application of best practice interventions for identified skin impairments; the interventions can be implemented based on assessment findings and clinical judgment; and provides a guideline for consulting the WOC Nurse, including when wounds are not healing, all pressure ulcers, and ostomy needs.

Dsm V: Review Of Commonly Seen Diagnosis Found In The Inpatient Mental Health Setting, Joyce Salzer

Nursing Posters

Objectives: increased awareness of where to find some of the most commonly seen diagnosis within the DSM V and knowledge of some of the changes that have been made in diagnostic classification.

Impact Of Tranexamic Acid (Txa) On Hemoglobin Levels In Elective Total Knee Arthroplasty Patients, Gina Anderson-Malum

Nursing Posters

Over the last 2 years, the Bone and Joint Center has focused on blood utilization for total knee and total hip arthroplasty. With the use of a blood transfusion protocol, we significantly reduced blood transfusion rates and standardized the approach to care. As an expansion of this work, other ideas to further decrease blood utilization were considered. The purpose of the data collection of preoperative and postoperative Hemoglobin (HGB) levels was to evaluate the effect of Tranexamic Acid (TXA) on the average change in Hgb levels compared to Hgb levels of patients that did not receive the medication. In addition, …

Successful Mentoring Relationships, Mary Leyk, Colleen Porwoll

Nursing Posters

A poster presentation on the structure, process, and outcomes of a successful mentoring program.

Timing Of Surgical Antibiotic Prophylaxis Vs. Therapeutic Antibiotics And The Risk Of Surgical Site Infection, Sandy Gilk, Joan Hemker, Jeni Hansen

Nursing Posters

Introduction: The CDC has developed criteria that define surgical site infection (SSI) as infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure or within 90 days if prosthetic material is implanted. Objectives: Differentiate between Prophylactic Antibiotics and Therapeutic antibiotic. Understanding SCIP guidelines with use of prophylactic antibiotics. Understanding the use of Therapeutic antibiotics by physician's order, prior to surgery.

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

Nursing Theses and Capstone Projects

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

Project Title Improving Pci Door-To-Balloon Times Through Team Collaboration, Diane Rydzy Rn, Kenneth Forte Dnp, Rockman Ferrigno, Stuart Zarich

Posters

Objective: To utilize a team approach in identifying areas of improvement to reduce median door-to-balloon times (D2B) for heart attack patients

Assessment Of Mild Traumatic Brain Injury By Advanced Practice Registered Nurses, Mary Lou Garey

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to evaluate the knowledge about assessing mild traumatic brain injured patient by the advanced practice registered nurse (APRN) as reflected in the Centers for Disease Control (CDC) Acute Concussion Evaluation (ACE) Tool Kit. A descriptive cross-sectional survey research design was used to assess knowledge about the evidenced based assessment of APRNs practicing in an urgent care setting as established by the CDC for the evaluation of acute concussion. Specifically the history and physical assessment practices of the APRNs for the mild traumatic brain injured patient (MTBI) were evaluated in relationship to the CDC / …

Attitudes And Beliefs Of Registered Nurses About The Process Of Changing To An Electronic Medical Record In A Community Hospital: A Mixed Method Investigation, Roberta Jo Myers

Doctor of Nursing Practice Scholarly Projects

The change from paper charting systems to electronic medical records (EMR) is a daunting task. Many hospitals today are undergoing this process. Kotter’s Change Model informs us that the process must be guided by sound principles and lead by an engaged, focused team of dedicated employees. The studied hospital is a small hospital in rural Ohio that initiated this change in late 2012. Their computer charting initiative launched the EPIC program for EMR use throughout the facility. Nursing staff was challenged to learn and eventually become proficient in its use. Because nurses are the largest care provider group in any …

Advanced Practice Care Model In A Midwestern Allergy Clinic, Bernie Theobald

Theses and Graduate Projects

Health care organizations are creating innovative patient care models to deal with the rapidly changing healthcare environment. Implementation of the Affordable Care Act has led to reduced revenue for healthcare organizations and placed an impetus on quality. For healthcare providers to continue to practice, they must change their model of care. An allergy clinic in a large Midwestern healthcare organization created a care model which capitalizes on the unique skillset that nurses possess. Nurses in the care model contact the patient before their visit, assess patient needs, and follow-up with the patient in a post- consult nurse visit. The care …

Heart Nursing Care Model, Jennifer M. Harden

Theses and Graduate Projects

The role of the hematology ambulatory registered nurse (HARN) is currently disorganized at a large Midwestern clinic. Cumently the HARN is responsible for telephone care, lab results, prescription refills, patient education, submitting forms, and helping patients with miscellaneous items. The HARN is pulled in several directions throughout the day. With healthcare reimbursement changing, there is a growing need for HARNs to be utilized to one's fullest potential and licensure. The purpose of this project is to create a new model of nursing care, which will further enhance the HARN role. Jean Watson's Philosophy and Science of Caring provides a framework …

Paramedic Students' Perceived Self-Efficacy At Airway Management, Holly Herron

Doctor of Nursing Practice Scholarly Projects

The out of hospital (OOH) environment is chaotic, unpredictable and unforgiving. Paramedics are the primary providers of life-saving, OOH airway management, which includes respiratory assessment, bag-valve-mask ventilation (BVM), and endotracheal intubation (ETI). OOH ETI is the most difficult skill for which to obtain and retain clinical competence. Preventable patient care errors and deaths related to OOH ETI are a healthcare concern. Clinical experience remains limited for paramedic students in the acquisition of adequate ETI experience.

The purpose of this study was to assess the perceived self-efficacy (PSE) of paramedic students in ETI. Bandura's self-efficacy theory was the theoretical framework for …

Prevention, Recognition, And Treatment Of Pediatric Obesity In The Ambulatory Care Setting, Susan Farrus-Brown

Doctor of Nursing Practice Scholarly Projects

The World Health Organization (WHO) in 1995 described obesity as a chronic disease and one of the most important public health threats and in 2000 reported obesity as a “global epidemic.” The numbers of obese children are increasing in society; moreover, the onset of obesity is occurring at even a younger age than in the past. The prevalence of pediatric obesity is staggering and interventions need to be developed to decrease the risk for chronic and related psychological diseases.

The objective of this project was to provide education on utilization of a tool kit to increase the nurse practitioner (NP) …

The Utility Of The U.S. Diabetes Conversation Map As An Intervention To Promote Diabetes Self-Management Adherence, Lisa Gale Jones

Theses and Dissertations--Nursing

Diabetes has reached epidemic levels, to the currently estimated 29 million individuals who are living with diabetes. Those with diabetes must manage their disease through a combination of medication, physical activity recommendations, and nutritional guidelines. The consequences of non-adherence to recommendations include cardiovascular disease, kidney failure, vision loss, or ultimately, death. Despite the risks of non-adherence, individuals often do not adhere to recommended treatment. Researchers have attempted to identify strategies to promote diabetes self-management adherence, thereby decreasing complications related to the disease.

Specific Aims:

1. describe the factors that prohibit individuals from adhering from diabetes self-management behaviors as well as the …

Factors That Relate To Registered Nurses' Readiness For Interprofessional Learning In The Context Of Continuing Professional Development, Collette Williams

Dissertations

Today’s health-care professionals practice in a highly technological, multidisciplinary environment. In order to provide safe, effective, and high-quality patient care, collaboration is required among all professionals. Traditionally each profession has operated independently in regard to continued professional development. The purpose of this study was to assess practicing registered nurses’ readiness toward interprofessional learning in order to align learning with current practice.

Method. An ex post facto study design was used to gather data to examine if there is a relationship between variables of demographics and readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) assesses the readiness for …

Implementation Of A Depression Screening Protocol Specific To Implantable Cardioverter Defibrillator Patients; A Quality Improvement Project, Kendra M. Kratzwald

DNP Projects

Background: Depression in patients with implantable cardioverter defibrillators (ICD) is a problem that has not been well addressed by providers. In 2012 the American Heart Association (AHA) released a scientific statement that recommended structured and routine depression screening of these patients. The AHA statement also recommended further research on depression screening instruments and their use with this population. Aims: 1.) To develop and implement an evidenced based depression screening protocol appropriate for patients with an ICD seen in an outpatient setting. 2.) Evaluate provider knowledge about depression screening (? Is this what you mean) and depression screening practices before and …

Anesthesia Safety: Filter Needle Use With Glass Ampules, Debran L. Harmon

UNF Graduate Theses and Dissertations

Glass particle contamination of medication occurs when opening ampules which may cause patient harm. The use of filter needles reduces this risk. Many anesthesia providers use ampules daily, but do not use filter needles when aspirating medications from ampules. In addition, filter needles may not be readily available at the anesthesia medication preparation site. Not using filter needles or having them available for use can increase the risk of patient harm by glass particle contamination. The purpose of this project was to increase anesthesia provider’s knowledge thereby improving compliance with evidence-based standards when preparing medications from ampules. The goal is …

De Concentv Amisso Qvaerendo: An Investigation Into The Relative Benefits Of Three Different Types Of Ambient Music On The Observed Agitated Behaviour And Quality Of Life Of Dementia Sufferers In Residential Aged Care Facilities, Peter Wilkinson

Theses: Doctorates and Masters

There is an increasing body of research evidence to support the use of music as a therapeutic modality in reducing the agitated behaviour frequently associated with late-stage dementia. Although much of this evidence suggests that music interventions are most effective when they are “individualized”, this type of intervention is often difficult to implement in large, busy, aged care facilities where residents may be located together in communal areas during the day. The challenge therefore is to try and identify a particular musical genre which, when played as “ambient” or “background” music, demonstrates a consistent capacity to reduce agitated behaviour in …

Same-Day Discharge Of Transradial Elective Coronary Intervention, Diane Rydzy Rn, Stuart Zarich

Posters

To increase the percentage of same day discharges of elective radial interventional cases.

Intraosseous Vascular Access For Alert Patients, Stacie Hunsaker

Faculty Publications

Nurses are often faced with the challenge of starting an IV line in a patient who is dehydrated, has suffered trauma, or is in shock. Even the efforts of the most skilled clinician may fail, while valuable time is lost. Intraosseous access is a rapid, safe, and effective route for delivering fluids and medications, and is recommended by numerous professional and specialty organizations for both pediatric and adult patients. Yet many clinicians remain unaware of the procedure. This article outlines the procedure and devices used, describes support for use in the literature, and discusses various considerations and nursing implications.

Promoting Human Health Through Manned Space Flight, Deidra Fortenberry Carter

Von Braun Symposium Student Posters

No abstract provided.

The Advanced Practice Nurse And Patient-Centered Medical Home: Maintaining Patient Focus, Meeting The Institute For Healthcare Improvement Triple Aim Through The Electronic Health Record, Aileen Teresa Twomey

Seton Hall University DNP Final Projects

The Federal Government enacted the Heath Information Technology for Economic and Clinical Health Act (HITECH) in 2009, which incentivized providers to use electronic health records (EHR) for meaningful use (MU); the Patient-Centered Medical Home (PCMH) stems from the Act. Research by the National Council on Quality Assurance (NCQA) shows that primary care practices have a positive influence on the health of patients, families and communities. These positive influences are related to their ability to deliver first-contact access, and to develop long-term therapeutic relationships that focus on the person rather than the disease, improving patient health outcomes and reducing health care …

Femoroacetabular Impingement: A Guide To Diagnosis In Primary Care, Alec Rimmasch Jr., Patricia K. Ravert

Faculty Publications

Femoroacetabular impingement (FAI) has been a diagnosis for approximately a decade in the medical field. Although FAI was once considered uncommon, it is now documented as 1 of the most common hip disorders. FAI is a variance or overgrowth within the femoral head neck space, acetabular ring, labrum, or cartilage. Patients with FAI frequently present in a general practice setting and endure months of pain and physical therapy before a correct diagnosis is ascertained. Understanding FAI and appropriate treatment and diagnostic procedures will facilitate early diagnosis in the primary care setting, providing the best chance for patient recovery.

Study Abroad Programs: Using Alumni And Graduate Students As Affiliate Faculty, Sheri Palmer, Debra Wing, Leslie Miles, Sondra Heaston, Karen H. De La Cruz

Faculty Publications

To expand student appreciation of global health and diversity, many schools of nursing offer study abroad programs. However, this type of labor-intensive program can be difficult in light of faculty shortages and constrained resources. The authors discuss how these issues were addressed using alumni and graduate students as affiliate teachers in 3 clinical study abroad settings.

Underutilization Of Primary Care Providers In Treating Opiate Addiction, Jennifer Jenkinson, Patricia K. Ravert

Faculty Publications

There are inadequate numbers of care providers or treatment programs to treat opioid abuse. Although many primary care nurse practitioners care for patients who are dependent on or abuse opioids, they are not allowed to prescribe the schedule 3 medications to treat them. This option is available to primary care physicians with additional training. This article discusses the effectiveness of opioid substitution therapy in a primary care setting, the patient populations, patient satisfaction, and barriers preventing primary care providers from providing treatment to opioid patients. Nurse practitioners can help overcome some of these barriers and improve access to this underserved …

Nln/Jeffries Simulation Framework: State Of The Science Summary, Patricia K. Ravert, Julie Mcafoees

Faculty Publications

In summer 2011, a research task force from the International Association of Clinical Simulation and Learning (INACSL), in consultation with Dr. Pamela Jeffries, invited international nursing researchers and educators to participate in a project to evaluate state-of-the-science and existing research regarding the simulation model/framework (Jeffries, 2005, Jeffries, 2007). The model/framework was developed to define simulation education variables and provide an organized guide. The 21 researchers and educators worked on one of five teams, one for each of the five existing major model/framework constructs (Teacher, Student, Educational Practices, Outcomes, and Simulation Design Characteristics).

Commencement Program 2013, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2013 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | The Speakers

23 | The University Honorees

45 | The School Honorees

64 | The Programs

• School of Medicine, 65
• School of Pharmacy, 83
• School of Dentistry, 90
• School of Behavioral Health and School of Religion, 107
• School of Nursing, 120
• School of Pubic Health, 129
• School of Allied Health Professions - Physical Therapy, 145 …

Cultural Aspects Of Latino Early Childhood Obesity, Lauren Clark, Susan L. Johnson, Mary E. O'Connor, Jane H. Lassetter

Faculty Publications

The problem of Latino childhood obesity is well known, and experts agree that the sooner it is addressed in a child’s life, the better. Strong evidence from nationwide studies suggests that obesity begins in infancy for Mexican Americans. National data demonstrate the dramatic increase in weight-for-recumbent length above the 95th percentile (using the NCHS growth chart) among Mexican American children between National Health and Nutrition Examination Survey (NHANES) and the Third National Health and Nutrition Examination Survey (NHANES III) (Ogden et al., 2006). High rates of childhood obesity affect the long-term health potential of children, since childhood obesity tracks into …