Nursing Commons^™

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

How Is Health Seeking Behavior And Patient Outcomes For Latin Immigrants Affected By Language Barriers, Socioeconomic Status And Health Literacy?, Cassandra Sanchez

Nursing | Senior Theses

Background

Language barriers cause a disconnect between patients and health care workers. What further causes a disconnect is when patients have a lower level of education in addition to having a language barrier. I will be focusing on Latin immigrant individuals in the United States for my research. Many Latin immigrant patients may not have gone to school in their native countries, so their education level is lower making it harder to understand discharge information or patient teaching. When patients are unable to have that health literacy it may lead to negative patient outcomes due to not adhering to medication …

Nursing Abroad: A Comparison Of Healthcare In Italy, Sweden, And The Us, Sadie Stark

The Eleanor Mann School of Nursing Undergraduate Honors Theses

No healthcare system is perfect, nor does one system work for all populations. History and culture have dictated the mindset of people for generations. It is the ever-changing mindset of patients and providers that will continue to expand and improve international healthcare by first changing daily practices. Nursing in Italy, Sweden, and the United States look very similar but also have a number of differences. Each country’s healthcare system works for its population, but efforts for international collaboration could still prove beneficial. Whether it be universal or private, centralized or localized, a patient centered focus is the driving force behind …

Perpetuation Of Gender Discrimination In Pakistani Society: Results From A Scoping Review And Qualitative Study Conducted In Three Provinces Of Pakistan, Tazeen Saeed Ali, Shahnaz Shahid Ali, Sanober Nadeem, Zahid Memon, Sajid Bashir Soofi, Falak Madhani, Yasmin Karim, Shah Mohammad, Zulfiqar Ahmed Bhutta

School of Nursing & Midwifery

Background: Gender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender discrimination. The aim of this study is to assess the factors that influence gender discrimination in Pakistan, and its impact on women's life.
Methods: A mixed method approach was used in the study in which a systematic review was done in phase one to explore the themes on gender discrimination, and qualitative interviews were conducted in phase two to explore the perception of people regarding gender discrimination. The qualitative interviews (in-depth interviews and …

Long-Term Care In The United States: History, Financing, And Directions For Reform, George A. (Sandy) Mackenzie

Upjohn Press

This book is a concise survey of the development of U.S. long-term care and its financing, with comparisons with other rich countries. It also includes a brief comparative account of the impact of the COVID-19 pandemic in the United States and several other countries. The study finds much that is amiss with American long-term care and proposes three sets of progressively more ambitious reforms.

Urban Health: A Practical Application For Clinical Based Learning, Cynthera Mcneill, Umeika Stephens, Tara Walker

Open Textbooks

Urban Health: A Practical Application for Clinical Based Learning is an openly licensed, peer-reviewed textbook for clinical-based nursing educators covering barriers in urban health and their impact on patient health outcomes. The authors explore perspectives of urban communities, urban patients, and urban healthcare providers to offer insight into how healthcare providers can address disparities in urban healthcare, provide meaningful care with the lived experiences of urban patients in mind, and improve patient-provider communication by moving towards a more solution-driven, team-based care approach. Features include learning activities, exemplars, and case studies.

Nurse-Initiated Treatment Reduces Costs For Acute Asthma In A Pediatric Emergency Department, Michael D. Johnson Md, Ms, Minkyoung Yoo Phd, Richard E. Nelson Phd, Amanda K. Nielson Md, Lauren Allen Mas, Nanette Dudley Md, Brandon Andersen Rrt, Amanda Orme Dnp, Cpnp-Ac, Cameron Mcfarland Np-C, Michael Mundorff Mba, Mhsa

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Standardized emergency department (ED) pathways can improve care delivery to children with acute asthma, though their impact on hospitalization and costs is unclear. An Acute Asthma Care Pathway (AACP) that facilitates nurse initiation of treatment was implemented at a tertiary care pediatric ED using standard quality improvement methodology. The impact of implementation was assessed using process control methodology and multivariable time series analyses between pre- and post-implementation periods. Provision of a steroid within 30 minutes and 60 minutes of arrival increased by 21 and 22 percentage points respectively, IV magnesium sulfate administration increased by 30 percentage points, the proportion hospitalized …

Outcomes Of Asthma Quality Improvement In Pediatric Patients, Kathryn M. Murray Md, Faap

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. The Utah Pediatric Partnership to Improve Healthcare Quality (UPIQ) and Utah Department of Health (UDOH) Asthma Program Learning Collaborative is a quality improvement initiative designed to standardize asthma care in pediatric patients and improve the overall assessment and patient education process for both healthcare providers and patients. The aim of the Asthma QI Project was to improve the diagnosis and management of asthma for patients in the state of Utah by implementing a standardized approach to the identification and treatment of patients with asthma.

Methods. Patients scheduled to see a healthcare provider at our pediatric clinic were screened for …

Addressing Culturally Congruent Care Amongst African Americans In Skilled Nursing Facility: A Systematic Review, Adekemi T. Adedipe

DNP Qualifying Manuscripts

Introduction: Healthcare disparities and mistrust of the healthcare system discourage African Americans from seeking mental health services. Healthcare providers face challenges delivering culturally appropriate care. Examining current cultural practices can inform the education needed for healthcare providers to understand cultural care and awareness. This review aimed to identify evidence available to understand the impact of a cultural training on healthcare providers in skilled nursing facilities.

Methods: APA PsycINFO, CINAHL, and PubMed, were searched for English-language studies published between January 2016 and January 2022. Healthcare cultural competency training

in any aspect of cultural care was considered. Outcomes of interest included changes …

New Horizon's Staff Decisional Conflict Flowchart, Tayler Hart, Aysha Caoili, Emily Nguyen, Fatou Kanteh, Julia Chen, Andra Onu

Nursing Leadership in Community Engagement Projects

New Horizon’s Staff Decisional Conflict Flowchart

New Horizons was founded in 1998 by Father Don, a Greek Orthodox priest who did street outreach with homeless youth outside a donut shop near Pike Place Market (New Horizons, n.d.). He discovered that youth would rather live on the backstreets of Seattle than seek shelter and help from current service providers. After conversations with the youth and young adults (YYA), Father Don started an institution that specifically targeted homeless youth and the unstable housed population. To be different and accessible to all individuals, New Horizons adopted a low barrier system designed to serve …

Contextual Coding In Qualitative Research Involving Participants With Diverse Sociocultural Backgrounds, Ahtisham Younas, Angela Cuoco, Ercole Vellone, Sergi Fàbregues, Elsa Lucia Escalante Barrios, Angela Durante

The Qualitative Report

Understanding participants’ perspectives in qualitative research is contingent on unravelling the essential meaning of their speech. When data are collected in native language and translated into English language, the underlying sociocultural meaning of participants’ speech can be missed. This paper discusses a new contextual coding approach and illustrates its application in research. The technique was used in a phenomenological study in Pakistan and a mixed methods study in Europe. Contextual coding entails a preliminary coding stage involving data reading in native language, choosing socially and culturally relevant words and phrases, and developing preliminary codes. The concluding coding stage focuses on …

Mystay – Development Of Nurse-Facilitated Condition-Specific Multimedia Resources To Facilitate Patient Participation In Postoperative Care, Jo Mcdonall, Anastasia F. Hutchinson, Natalie Heynesbergh, Bernice Redley, Richard De Steiger, Damien Khaw, Mari Botti

Patient Experience Journal

Improved postoperative outcomes and the global drive toward the provision of patient-centred care underpins efforts to enhance the nature and capacity of patient participation in acute postoperative hospital care. In this paper, we describe the design, framework and processes used to develop a modular, procedure-specific, digital health intervention platform aimed at improving the patient experience and patient participation in care following surgery. The intervention, a multimedia application MyStay, uses bedside delivery of audio-visual and text-based information to engage postoperative patients to better participate in their care. MyStay modules are developed using an iterative, multi-method approach intended to balance procedure-specific best …

Microaggression Among Registered Nurses: An Exploratory Study, Saige Addison

The Journal of Purdue Undergraduate Research

No abstract provided.

From The First Encounter: A Communication Program For High Volume, High Acuity Patient Care Locations, Shazam Bacchus

Student Scholarly Projects

Effective communication is a true value to healthcare organizations. Far too many communication sessions are detrimental to patient health outcomes. National data and hospital records are proven information to suggest communication is a major barrier to overall patient satisfaction. Organizations struggle to increase market share and patient satisfaction with a likelihood to recommend because of poor communication by physician and nurses. The use of a strategic communication tool like AIDET plus the Promise can influence the improvement of an organization’s quality of care.

This paper examines the use of AIDET plus the Promise as a strategic communication tool. High volume, …

Opioids For Dyspnea End Of Life Review, Lindsey Obarzanek, Wendy Wu, Victoria Tutag-Lehr

Library Scholarly Publications

Objective: The objective of this systematic review is to consolidate the existing evidence on opioid use, including administration, dosing and efficacy, for the relief of dyspnea at end-of-life. The overarching goal is to optimize clinical management of dyspnea by identifying patterns in opioid use, improving opioid management of dyspnea, and to prioritize future research.

Background: Opioids are commonly used in the management of dyspnea at end of life; yet specific administration guidelines are limited. A greater understanding of the effectiveness of opioids in relieving end-of-life dyspnea with consideration of study design, patients, and opioids, including dyspnea evaluation tools …

The Development And Implementation Of Evidence-Based Preanesthesia Assessment Tools For Lvad Patients Undergoing Non-Cardiac Procedures, Tracey Rooney, Casey Weimer, Eileen Giardino, Kerry Shanklin, Pete Pelletier, Audrey Rosenblatt

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Abstract

A university-affiliated tertiary medical center with a newly developed Advanced Heart Failure and Mechanical Circulatory Support program identified the need to implement a more systematic approach to the preanesthesia assessment process for patients with a Left Ventricular Assist Device (LVAD) undergoing noncardiac procedures and standardized guidelines to determine the best blood pressure monitoring system for patients with an LVAD during these noncardiac procedures. A multidisciplinary panel of clinical experts developed an LVAD Preanesthesia Toolkit using standard recommendations identified via evidence-based literature and expert opinion. The Toolkit included an LVAD Preanesthesia Assessment (VaPA) tool and an LVAD Blood Pressure Monitoring …

Mindfulness-Based Interventions For Survivors Of Lung Cancer And Their Partners: A Systematic Review, Karen Kane Mcdonnell, Otis L. Owens, Fattona Umari

Faculty Publications

Background

Survivors of lung cancer and their partners often have complex unresolved physical, psychosocial, and behavioral needs that can negatively affect the survivors’ and partners’ well-being. This systematic review aimed to (1) examine the content and delivery of mindfulness-based interventions (MBIs) and (2) summarize and synthesize the current evidence for effectiveness of MBIs targeting survivors of lung cancer and/or one selected partner (dyads).

Method

Six databases were searched for interventional studies published in English between 1980 and June 2020 using three terms (lung neoplasms, mindfulness, caregivers). For outcome measures, the interventions focused on behavioral change (meditation, yoga, stretching, breathing), symptom …

Altop (Alternatives To Opioids), Fall 2022, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

In this issue:

• New Principal Investigator (PI) ALTOP Grant
• 2021-2022 Graduating Class
• ANEW HRSA 2022-2023 Awardees
• Students Quality Improvement Projects
• April 9th, 2022, Preceptor Workshop Photos
• New Clinical Partner: The Bridgeport Rescue Mission/ Sage Health Care
• Save the Date: Annual DNP Colloquium

Evidence-Based Practice Liaisons: Supporting Ebp Across The Health System, Tami A. Hartzell, Susan Stell

Nursing Research and EBP Day 2022

No abstract provided.

An Evaluation Of Covid-19 Vaccination Rates Of The Patients At The Kentucky Racing Health Services Center, Aditya Mehta, Dedra Hayden

The Cardinal Edge

COVID-19 vaccines have been widely available to the U.S. public since early 2021. However, vaccination rates still vary considerably across geographical areas and different populations. The objective of this study was to research overall vaccination rates against COVID-19 for Latinx patients at the Kentucky Racing Health Services Center (KRHSC). Vaccination and booster data was collected from June to December 2021 for all unique patients visiting the center. It was initially hypothesized that these rates of vaccination and booster doses for the KRHSC patients would be lower than the data reported by Kentucky and Jefferson County. After a retrospective review, the …

Association Between Suicidal Attempts In Connection To Discrimination Among Trans Genders, Asghar Ali, Saad Ahmed Khan, Shah Zeb, Zahir Munir, Tazeen Saeed Ali

School of Nursing & Midwifery

Suicide has become a serious public health challenge across the world with around 800,000 people dying by suicide each year. Amongst these a majority of the people (79%) belongs to low and middle-income countries.
Objective:The study aimed to identify the association between suicidal attempts in connection to discrimination among transgender.
Methods: An analytical cross-sectional study was conducted. Data were collected from a registered NGO (Gender Interactive Alliance) from February to May, 2020, using a universal and purposive sampling technique.DatawasanalyzedonSPSS(version21.0).Meanandstandarddeviationwas calculated for frequency distribution, while Chi-square was used for categorical variables.
Results: Overall, 250 transgender were approached through a registered …

The Lived Experiences Of Middle Eastern Immigrant Women During Their Cancer Survivorship Journey: A Phenomenological Study, Enam Alsrayheen, Khaldoun Aldiabat, Catherine Aquino-Russell

The Qualitative Report

The number of Middle Eastern immigrant women (MEIW) living in Canada has significantly increased. However, this group of women is underrepresented in health research and there is a gap in knowledge of their cancer survivorship experiences in Canada. This phenomenological qualitative approach was employed to uncover the meaning of the lived experiences of MEIW during their cancer survivorship journey (CSJ). Data were collected through unstructured interviews and one written description from three MEIW. The participants' perspectives of cancer risk factors were believed to be the cause of their cancer, and their CSJ was fear-inducing and anxiety-provoking. There appears to be …

The Purple Heart And Suicidal Behaviors In Post-9/11 U.S. Army Combat Veterans With A Traumatic Brain Injury: A Mixed Methods Study, Jayna Moceri-Brooks

Electronic Theses and Dissertations

Military suicide rates remain high, despite years of targeted efforts to prevent suicide. Specifically, Army Combat Veterans who sustained a traumatic brain injury (TBI) while deployed in support of the Global War on Terrorism are at the highest risk for suicide. This dissertation highlights possible causes for suicidal behaviors within this unique group and provides specific military suicide prevention recommendations. The dissertation is organized into three publishable manuscripts: The first manuscript (Chapter 1) is a mixed-methods dissertation research proposal written according to the National Institute of Health proposal guidelines. The second manuscript (Chapter 2) is an integrative review of the …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Educating Providers Without Prescriptive Authority About Psychopharmacology Basics: Bridging The Interdisciplinary Work Among Psychotropic Prescribers And Psychologists, Olivia Ceja

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this evidence-based change in practice is to increase the fund of knowledge among psychologists, licensed clinical social workers, and talk therapists in outpatient psychiatric settings by educating clinicians about psychopharmacologic basics and the role and work of a psychiatric nurse practitioner during group supervision meetings. This can help bridge the gap of psychopharmacologic knowledge between mental health providers with and without prescriptive authority.

Problem: Evidence shows that psychologists with non-prescribing capabilities are not often trained or educated about the very medications that their clients are often taking. Currently, psychotropic medication education is not a standard aspect …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Teamwork That Affects Outcomes: A Method To Enhance Team Ownership, Brian Carlson, Richelle Graham, Brad Stinson, Jordan Larocca

Patient Experience Journal

Healthcare is the ultimate team sport, and this case study explores how to build teamwork across teams. The ability for nursing, environmental services and food and nutrition services to work collaboratively to benefit patients is paramount to a patients experience and outcomes. The case study describes how the work was done to build teams and then improved outcomes in both patient and employee experiences. The learnings are applicable to any team setting not just those described in this case study.

Experience Framework

This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework ( …

Global Child And Family-Centered Care Fellowship, Education And Mentorship For Pediatric Healthcare Professionals: A Literature Review, Ashley Zheng, Bobbijo Pansier

Patient Experience Journal

Child- and family-centered care (FCC) is increasingly accepted and implemented to optimize the healthcare experience for patients, their families, and healthcare professionals. Standish Foundation for Children, a 501(c)(3) non-profit, has designed and piloted a fellowship to educate pediatric healthcare professionals in FCC & psychosocial care via an inquiry and mentorship model in Tbilisis, Georgia. This review aimed to evaluate and synthesize existing literature on psychosocial and FCC mentorship for pediatric healthcare professionals in four parts: ongoing need, effects on healthcare professionals, effects on children and their families and/or caregivers, and in cross-country healthcare settings. Reviewers searched open-source databases for articles …

Evidence-Based Best Practice Toolkit For Social Determinants Of Health: A Program Evaluation Review, Bryleigh Berry

Student Scholarly Projects

Despite an increase in healthcare expenditure, racial and ethnic disparities remain a substantial concern among adult primary care patients in the United States. This is largely due to the focus on medical intervention and disregard for the underlying factors that contribute significantly to health outcomes such as economic stability, educational access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. The PICOT question that guided this program evaluation review project is: In adult clients seeking care at a primary care clinic (P), how does a SDOH toolkit based on the CDC framework (I) compared …

Implementation Evaluation Of A Leadership Development Intervention For Improved Family Experience In A Private Paediatric Care Hospital, Pakistan, Muneera A. Rasheed, Ayesha Hussain, Amin Hashwani, Johannes T. Kedzierski, Babar S. Hasan

Department of Paediatrics and Child Health

Background: A study from a tertiary care center in Pakistan demonstrated that a leadership development intervention led to improved family experience of care outcomes. The objective of the current paper is to assess the implementation of this intervention and identify barriers and facilitators to inform sustainability and scalability.
Methods: A working group designed the intervention using a theory-of-change model to strengthen leadership development to achieve greater employee engagement. The interventions included: i) purpose and vision through purpose-driven leadership skills trainings; ii) engaging managers via on-the-job mentorship programme for managers, iii) employee voice i.e., facilitation of upward communication to hear the …