Nursing Commons^™

An Integrative Review Of The Use Of The Individual And Family Self-Management Theory In Research, Wendy S. Bauer, Rachel F. Schiffman, Julie L. Ellis, Jeanne M. Erickson, Michele Polfuss, Murad H. Taani, Kathleen J. Sawin

College of Nursing Faculty Research and Publications

The extent of the application of the Individual and Family Self-Management Theory (IFSMT) in research has yet to be determined. The purpose of this analysis was to review the use of the IFSMT in published research and evaluate posited constructs and relationships. Dimensions and categories of the IFSMT and the interrelationships were generally supported in the 77 articles reviewed. A majority focused on self-management of chronic conditions in the adult population. More research on the strength, direction, and interaction of relationships is needed. Defining and exploring social constructs, including race, ethnicity, and gender, should be prioritized in future IFSMT research.

The Importance Of Feedback With An Asynchronous Online Training Program When Learning Debriefing For Meaningful Learning, Aimee A. Woda, Brandon Kyle Johnson, Jamie Hansen, Kristina Chen, Kristina Thomas Dreifuerst

College of Nursing Faculty Research and Publications

Background

Despite knowing the importance of debriefing, there is insufficient evidence to guide the best way to train and provide formative feedback to develop competent debriefers.

Method

This multi-site, experimental, repeated measures study was used to test the impact of different intervals of expert feedback on a debriefer's competence implementing debriefing after participating in an asynchronous, online, distributed modular training program.

Results

Training and early feedback facilitated rapid improvements in a debriefer's ability to implement a debriefing method correctly. Regular feedback improved competence over time.

Conclusion

A well-developed, asynchronous online training program is an effective way to train debriefers.

The Impact Of Electronic Health Record Training: How Students Utilize The Electronic Record To Inform Clinical Judgment, Sarah Marie Calonder

Dissertations (1934 -)

Nurses practice within a complex healthcare environment and must make well-informed judgments about their patients to provide safe, quality care. The electronic health record (EHR) is a piece of healthcare and informatics technology which houses important patient information that nurses utilize frequently while making clinical judgments surrounding patient care. The importance of entry-level nurse competency with the EHR and similar healthcare and informatics tools has been outlined by the American Association of Colleges of Nursing (AACN) Essentials and other nursing organizations concerned with the preparation of future nurses (AACN 2021; QSEN, 2020). Currently, there are limited established best practices for …

Changing Intimate Partner Violence Screening And Intervention: Focus Group Perspectives, Colleen M. Galambos, Teresa Jerofke-Owen, Heidi Paquette, Linda B. Piacentine, Erin C. Schubert, Mychoua Vang, Erica Arrington, Nilanjan Lodh, Kimberly S. Gecsi

College of Nursing Faculty Research and Publications

Background: Many survivors of intimate partner violence (IPV) remain unconnected to professional help. Screenings in health settings may improve connections to support services.

Purpose: The purpose of this study was to gather data to help inform an IPV screening intervention in an obstetrics/gynecology health clinic.

Methods: A qualitative analysis was employed using a summative content analysis approach of the transcripts of 2 focus groups consisting of health care providers, advocates, and survivors of IPV.

Results: Four thematic categories and additional subcategories emerged from the analysis, including (1) current process (what is done); (2) need (what is not done); (3) concerns …

Outpatient Physical Therapy Attendance By Older Adults After Emergency Department Discharge Was A Predictor For Lower 30-Day Revisits—But Demographic Factors Affected Attendance, Suzanne Ryer, Michelle Simpson, Maharaj Singh

College of Nursing Faculty Research and Publications

Objective

Given the high risk of functional loss and revisits among older adults presenting to the emergency department (ED), there is a need to understand how post-ED discharge outpatient physical therapy affects outcomes. This study sought to examine patient demographics and their association with outpatient physical therapy utilization after ED discharge and physical therapy attendance with 30-day ED revisits among older adults discharged to home.

Methods

In this retrospective cohort study, we analyzed data from 1395 older adults (65 years old and older) who had a referral to outpatient physical therapy upon discharge from 15 EDs between January 2021 and …

Integrated Mental Health Care In Specialty Clinics For Children With A Diagnosis Of Asthma Or Diabetes: A Mixed Methods Study, Joan P. Totka, Maria Peña, Joshua A. Steinberg, Peter M. Wolfgram

College of Nursing Faculty Research and Publications

Introduction

Using patient-reported outcome measures (PROM) in a shared-space mental health-integrated specialty clinic, we explored the feasibility, acceptance, and experience of youth with asthma and diabetes, their families, and the healthcare team.

Method

Using mixed methods, we examined feasibility, acceptability, and experience of PROM inclusion in caring for youth with asthma (n = 7) and diabetes (n = 11), their families (n = 18), and healthcare providers (n= 13). Completion and receipt of PROM (feasibility), postvisit surveys (acceptance), and structured interviews (experience) between June 2019 and February 2020.

Results

Targeted PROM met feasibility goals (80%) …

To Address The Nursing Faculty Shortage, Start With The Salary Gap, Jacqueline Christianson, Christine A. Schindler, Lisa M. Grabert

College of Nursing Faculty Research and Publications

Nurses must advocate with policymakers for meaningful change.

There is a national shortage of nursing faculty to educate the future nurse workforce. The biggest barrier to recruiting and retaining nursing faculty is the salary gap between the faculty and clinical nursing roles. Many full-time nursing faculty earn a lower salary than the new graduate nurses they educate. According to our recent research (American Nurse, July 2024), NPs who have a comparable education level to nursing faculty take an average $43,000 pay cut if they leave clinical practice to teach full-time. Even the salaries of PhD-prepared faculty often lag …

Validating At-Home Urinary Hormone Measurements In Postpartum And Perimenopause Fertility Transitions, Thomas Bouchard, Patricia K. Doyle-Baker, Paul J. Yong, Richard Fehring, Mary Schneider

College of Nursing Faculty Research and Publications

Background: Measuring quantitative menstrual cycle hormones at home may help women better understand their postpartum and perimenopause fertility transitions, but these quantitative fertility monitors require validation.

Materials and Methods: This study included 16 North American women, aged 28–51, during either the postpartum (n = 8, cycles = 18) or perimenopause (n = 8, cycles = 35) fertility transitions testing daily firstmorning urine testing with both the Mira Monitor and ClearBlue Fertility Monitor (CBFM) along with menstrual cycle parameter tracking. The main outcome measures were a rise in estrone-3-glucuronide (E₁3G) and luteinizing hormone (LH) urine hormone values from the …

Evaluating Nurse Conscientious Objection: Application Of A Novel Framework, Maya Zumstein-Shaha, Lucia D. Wocial, Vicki D. Lachman, Norah Louise Johnson, Cynda Hylton Rushton, Pamela J. Grace

College of Nursing Faculty Research and Publications

Certain moral beliefs and/or values about what is good or harmful can cause nurses and other healthcare professionals to object to participating in some clinical actions. Such objections are also called conscientious objections. Invocation of a conscientious objection (CO) can produce complexities in patient care and health care delivery and must be mindfully evaluated for its soundness. In this manuscript, a recently developed framework, The Ethical Evaluation of a Nurse’s Conscientious Objection (EENCO), is applied to expose hidden elements and nuances in a proposed or actual CO by nurses or other healthcare professionals, thereby illuminating strategies that can lessen associated …

Assessing Family Caregiver Readiness For Hospital Discharge Of Patients With Serious Or Life-Limiting Illness Using Electronic Health Record And Self-Reported Data, Joan M. Griffin, Diane E. Holland, Catherine E. Vanderboom, Brystana G. Kaufman, Allison M. Gustavson, Jeanine Ransom, Jay Mandrekar, Ann Marie Dose, Cory Ingram, Zhi Ven Fong, Ellen Wild, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Objective

To assess how patient and caregiver factors influence caregiver readiness for hospital discharge in palliative care patients.

Study Setting and Design

This transitional care study uses cross-sectional data from a randomized controlled trial conducted from 2018 to 2023 testing an intervention for caregivers of hospitalized adult patients with a serious or life-limiting illness who received a palliative care consult prior to transitioning out of the hospital.

Data Sources and Analytical Sample

Caregiver readiness was measured with the Family Readiness for Hospital Discharge Scale (n = 231). Caregiver demographic, intra- and interpersonal factors were self-reported. Patient demographic, comorbidity score, …

Sex Work Patterns Among Transgender And Gender Diverse People: A Latent Class Analysis, Madeline Stenersen, Anjum Umrani, Irelan Fricke, Jessica L. Zemlak

College of Nursing Faculty Research and Publications

Sex work is a diverse profession encompassing a broad range of people, and services. Though overrepresented in sex work communities, transgender and gender diverse (TGD) individuals are underrepresented in sex work literature. Further, sex work literature continues to underrepresent the heterogeneity evident in the sex work community and the practices that occur within it. The present study utilized data from the 2015 United States Transgender Survey (USTS) to conduct a latent class analysis (LCA) to identify patterns of different types of sex work among TGD adults (N = 2,153) and understand the demographic characteristics associated with engagement in different types …

“Ringleader Who Has No Power”: A Qualitative Study Of Parent Uncertainty During A Nicu Admission Unrelated To Prematurity, Erin Rholl, Steven R. Leuthner, Kathryn J. Malin, Joanne Lagatta, Krisjon R. Olson

College of Nursing Faculty Research and Publications

Background

Parents of preterm infants experience stress related to uncertainty which impacts parent health outcomes. Less is known about the experience of parents whose infants are admitted for reasons other than prematurity. In this study we sought to describe (1) the experience of parents whose infants are admitted to a level IV NICU for reasons unrelated to prematurity in relation to uncertainty and (2) the effect of social and structural determinants on parent experience with uncertainty.

Methods

This single center qualitative study utilized interviews, questionnaires, and chart review at 2 time points: 2 weeks after admission and 3 months after …

Evaluation Of A Quality Cpr Coach Simulation-Based Competency Training: From Learning Outcomes To Patient Outcomes, Katie L. Mcdermott, Kari L. Rajzer-Wakeham, Jennifer M. Andres, Christine A. Schindler

College of Nursing Faculty Research and Publications

Background

Variability in cardiopulmonary resuscitation (CPR) quality and skill decay result in suboptimal application of CPR, which impacts patient outcomes following an arrest. Quality CPR Coach is a supplementary code team role that provides real time, verbal feedback directly to chest compressors to cognitively offload the team leader and ensure high-quality, goal-directed CPR delivery.

Methods

Design, implementation, and evaluation of a simulation-based Quality CPR Coach competency curriculum. Multi-modal assessment and evaluation methods were used.

Results

Statistically significant increase in confidence, perceived ability to verbalize Coach responsibilities, and knowledge. Participants demonstrated accurate Coach role performance across progressively scaffolded simulated compression event …

Resilience As Accusation: A Critical Examination Of Individual Resilience Training For Burnout Mitigation, Jacqueline Christianson, Bonnie Sommers-Olson, Jessica Leiberg, Dana Kaminstein

College of Nursing Faculty Research and Publications

Burnout, a syndrome of work-related exhaustion and cynicism, is prevalent among nurses and is associated with workplace stressors. Resilience training programs are a prevalent method of burnout mitigation employed by healthcare institutions that aim to improve or alter how individuals respond to chronic stressors. Through the lens of General Systems Theory, we describe resilience training as a method of individualizing a systemic problem by problematizing a response to chronic stress exposure. Resilience training may furthermore serve as a mechanism which allows subversion of institutional responsibility for nurses’ well-being in the workplace. We describe several suggestions for nurses to resist being …

Rapid Implementation Of Open-Access Pandemic Education For Global Frontline Healthcare Workers, Jacqueline Christianson, Erica Frank, Stacen Keating, Susan Boyer, Miriam Chickering

College of Nursing Faculty Research and Publications

Background

The recent global pandemic posed extraordinary challenges for healthcare systems. Frontline healthcare workers required focused, immediate, practical, evidence-based instruction on optimal patient care modalities as knowledge evolved around disease management.

Objective

This course was designed to provide knowledge to protect healthcare workers; combat disease spread; and improve patient outcomes.

Methods

A team of global healthcare workers responded by rapidly creating a competency-based online course. To promote transcultural applicability, the course was developed by an international team of more than 45 educators from over 20 countries. Course delivery included a built-in language translation tool, routine updates, and several innovative course …

Health Equity And Children With Medical Complexity/Children And Youth With Special Health Care Needs: A Scoping Review, Elizabeth A. Flasch

College of Nursing Faculty Research and Publications

Children with medical complexity (CMC) and children and youth with special health care needs (CYSHCN), compared with the general population, engage with the health care system at increased rates, at multiple life stages, and for a myriad of reasons (Berry et al., 2015). Operational definitions of CMC and CYSHCN are very limited, with the terms conflated and differentiated across the literature. Because of the lack of standardized definitions and general conflation of the two terms across the literature, CMC and CYSHCN will be used interchangeably for this review. Allshouse et al. (2018) defined CMC as a subset of CYSHCN “as …

Nurse Perspectives On Labor Union Participation Prior To Implementation Of A Collective Bargaining Agreement: A Qualitative Study, Jacqueline Christianson, Bonnie Sommers-Olson, Cathleen Fox, Norah L. Johnson

College of Nursing Faculty Research and Publications

Background: Patient advocacy is a duty for professional nurses; however, not all nurses are empowered to advocate for meeting patients’ needs. Participation in labor unions may serve as a venue for nurses with limited institutional decision-making authority to advocate for patient needs; however, unionization can be a time-intensive and fraught process.

Purpose: This study examined how nurses participating in a new union in an urban United States hospital described their reasons for participating in a labor union during collective bargaining.

Methods: Content analysis of participant's interviews that took place between January and March 2023, after the nurses voted to unionize …

Factors Associated With Health Decision-Making Autonomy On Own Healthcare Among Tanzanian Women: A 2022–2023 Demographic Health Survey Study, Tausi Seleman Haruna, Henry Ofori Duah, Rebecca Lee

College of Nursing Faculty Research and Publications

Background

Women’s health decision-making autonomy is fundamental for the health and well-being of women and their children. It empowers women to make health decisions and exercise their rights and choices surrounding their health. Like most parts of Africa, women’s autonomy in Tanzania remains contentious, with an estimated 19% prevalence of health decision-making autonomy in 2015. Given the impact of women’s health decision-making autonomy on women’s health outcomes and the fact that women’s health decision-making autonomy is an ongoing process affected by advancements in technology, economic growth, and social and cultural shifts, understanding the sociodemographic correlates of women’s autonomy is imperative. …

Critical Care Advanced Practice Providers As Partners In Advancing Pediatric Intensive Care Unit Nursing Knowledge: A Needs Assessment., Mary Seidl, Meghan Roller, Whitney Seul, Laura Rose, Christine A. Schindler

College of Nursing Faculty Research and Publications

Background

Critical care advanced practice providers (APPs) are frontline providers in many pediatric intensive care units (PICUs). From 2020 to 2022, there was a significant downward shift in nursing experience level in the PICU at the authors’ institution. APPs may help provide additional in situ education.

Methods

Data were collected using role-specific needs assessment of PICU nursing staff and providers, assessing concept related to knowledge and job stress.

Results

Findings overwhelmingly demonstrated desire for more APP-led education. Overall, 27% of nurse respondents strongly agreed that current knowledge was adequate to provide safe and best care for their patients, and 47% …

The Nursing Human Capital Value Model, Olga Yakusheva, Kathryn A. Lee, Marianne Weiss

College of Nursing Faculty Research and Publications

Nursing's economic value is presently framed within the dominant “outcomes-over-cost” value framework. Within this context, organizations employing nurses often use nursing budget reductions as a cost-minimization strategy, with the intent of retaining high quality outcomes. However, persistent issues such as nurse understaffing, burnout, and turnover threaten healthcare systems' capacity to deliver the quality, equitable, affordable patient care that the public requires. In this paper, we propose a new conceptual model and definition of nursing's economic value. The model development is guided by the convergence of three classic economic frameworks: human capital theory, production theory, and value theory. Grounded in these …

Metacognition Across The Curriculum, Amber Young-Brice

College of Nursing Faculty Research and Publications

For nursing students to succeed, they must reflect on their learning, think critically, and develop skills to adequately retrieve pertinent information relevant to patient care (Waryold et al., 2021). We often hear, “Just tell me what I need to know,” and witness students struggling to think deeply, reflect on if they are making the right decisions for the right reasons, and gain self-awareness of what they know and what they do not know. What can we do about this?

Reflecting On Diagnosis: The Metacognitive Diagnostic Reasoning Model©, Sarah L. Beebe, Angela M. Mcnelis, Majeda El-Banna, Kristina Thomas Dreifuerst

College of Nursing Faculty Research and Publications

Background:

Diagnostic reasoning is a complex cognitive process that requires intuitive, heuristic processing from knowledge and experience, as well as deliberate and reflective thinking. Evidence on interventions to improve diagnostic reasoning is inconsistent, in part because different terms and models are used to guide research.

Purpose:

To present a model of the factors of diagnostic reasoning in Advanced Practice Registered Nurses (APRNs), based on a review of the literature supporting the Metacognitive Diagnostic Reasoning (MDR) Model^©.

Methodology:

A review of the literature through systematic database search, historical articles, texts, and documents was conducted from inception through August 2023 …

Intensive Postpartum Antihypertensive Treatment (Ipat) And Healthy Lifestyle Education: Study Protocol For A Pilot Randomized Controlled Trial For Patients With Hypertensive Disorders Of Pregnancy, Anna Palatnik, Nadine Sunji, Zaira Peterson, Jennifer M. Ohlendorf, Amy Y. Pan, Jacquelyn Kulinski

College of Nursing Faculty Research and Publications

Background

Hypertensive disorders of pregnancy (HDP) complicate about 10% of pregnancies and lead to postpartum hospital readmissions and cardiovascular complications. Following HDP, vascular dysfunction could persist and accelerate the trajectory of cardiovascular disease risk. The benefits of intensive blood pressure (BP) control following HDP have not been adequately investigated. Therefore, no standard guidelines exist to guide the management of mild-to-moderate hypertension in the postpartum period, leading to a wide variation in clinical practice. The present study will investigate the effect of intensive BP control and healthy lifestyle education on maternal cardiovascular health (CVH) and vascular function following HDP.

Methods

The …

Student Use Of Electronic Health Records To Inform Decision-Making: A Pilot Study, Sarah Marie Calonder, Aimee A. Woda

College of Nursing Faculty Research and Publications

Background

As health care continues to evolve, the electronic medical record (EHR) has emerged as an important decision-making tool. To ensure that nursing students work toward competency with the EHR, this study sought to gather information regarding how students use the EHR.

Method

Students in a direct-entry, prelicensure program were observed using the EHR during a simulation-based experience (SBE). Focus groups gathered qualitative student perceptions of EHR use.

Results

Minimal use of the EHR during SBE was identified. Students reported using the EHR for information gathering, validating findings, and nursing tasks.

Conclusion

This study highlights the need for more robust …

Health Outcomes In Children With Prenatal Opioid Exposure With And Without Neonatal Abstinence Syndrome In The First Seven Years Of Life: An Observational Cohort Study, Joshua Lambert, Sara Arter, Henry Ofori Duah, Teenu Xavier, Jon E. Sprague

College of Nursing Faculty Research and Publications

Introduction Prenatal opioid exposure (POE) is a major public health consequence of the opioid epidemic. Long-term health outcomes associated with POE remain unclear, especially for children with POE without a diagnosis of neonatal abstinence syndrome (NAS). Here, we aimed to describe the health outcomes of children with POE and with POE and NAS compared to unexposed children during the first 7 years of life. Design In this retrospective observational cohort study, children born between 2015 and 2022 were identified from the Maternal and Infant Data Hub (MIDH), a data repository that continuously integrates maternal, neonatal, and pediatric records from two …

Reframing Burnout: Measuring “Altruistic Execution” To Understand Nurse Burnout, Jacqueline Christianson, Abir K. Bekhet, Jill L. Guttormson, Maharaj Singh, Norah L. Johnson

College of Nursing Faculty Research and Publications

Background:

Many nurses join the profession because they have altruistic intentions, but some nurses experience barriers to acting on altruistic intentions which may be a source of job dissatisfaction or burnout.

Objective:

The purpose of this study was to evaluate construct validity, internal consistency, and convergence reliability of the Nursing Altruistic Execution Scale (NAES), a novel instrument assessing the perceived ability to help others through work.

Methods:

The NAES was developed based upon a literature review examining altruistic behavior as a motivator for nursing work, with expert feedback for instrument refinement. Participants completed the NAES, Copenhagen Burnout Inventory Work-Related Burnout …

Essentials Of Genomics In Nursing Undergraduate Education: A Discussion Paper, Sarah L. Dewell, Kathleen A. Muglia, Letitia Y. Graves, Rachel Joseph, Kara L. Mangold, Laura Grayson Roselli, Anne L. Ersig, Trina K. Walker

College of Nursing Faculty Research and Publications

Aim

To map the 2021 American Association of Colleges of Nursing Essentials to the American Nurses Association Essentials of Genomic Nursing for all nurses and provide resources for nursing faculty to support the seamless integration of genomics into existing undergraduate curricula.

Background

Since the completion of the Human Genome Project in 2003, rapid advancements in genomic science leading to practical applications of genomics have revolutionized all areas of healthcare. Nursing is built on foundational life sciences, including genomics. As the largest segment of the healthcare workforce, who spend the most time with patients and families, nurses play a critical role …

Student Voice: Perceptions Of Sense Of Belonging And Involvement Among Underrepresented Prelicensure Nursing Students, Maria Peña

Dissertations (1934 -)

ABSTRACT STUDENT VOICE: PERCEPTIONS OF SENSE OF BELONGING AND INVOLVEMENT AMONG MINORITIZED PRELICENSURE NURSING STUDENTS Maria Y. Peña, MSN, RN, CNE Marquette University Efforts like holistic review admissions by nursing programs to create a more ethnically diverse student body have led to increased enrollment of students with underrepresented ethnic and cultural social identities. However, these students continue to experience higher attrition rates compared to their White, middle-class peers. Although both sense of belonging and student involvement are positively correlated with academic success, limited research explores these constructs together from the perceptions of students with underrepresented ethnic and cultural social identities …

Impact Of Social Risk Screening On Discharge Care Processes And Postdischarge Outcomes A Pragmatic Mixed-Methods Clinical Trial During The Covid-19 Pandemic, Andrea S. Wallace, Alycia A. Bristol, Erin Phinney Johnson, Catherine E. Elmore, Sonja E. Raaum, Angela Presson, Kaleb Eppich, Mackenzie Elliott, Sumin Park, Benjamin S. Brooke, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background: 

Social risk screening during inpatient care is required in new CMS regulations, yet its impact on inpatient care and patient outcomes is unknown.

Objectives: 

To evaluate whether implementing a social risk screening protocol improves discharge processes, patient-reported outcomes, and 30-day service use.

Research Design: 

Pragmatic mixed-methods clinical trial.

Subjects: 

Overall, 4130 patient discharges (2383 preimplementation and 1747 postimplementation) from general medicine and surgical services at a 528-bed academic medical center in the Intermountain United States and 15 attending physicians.

Measures: 

Documented family interaction, late discharge, patient-reported readiness for hospital discharge and postdischarge coping difficulties, readmission and emergency department visits …

Reimagining Supportive Approaches At The Intersection Of Mandatory Reporting Policies For The Mother–Infant Dyad Affected By Substance Use, Kelly Mcglothen-Bell, Diana Cartagena, Kathryn J. Malin, Dorothy Vittner, Jacqueline M. Mcgrath, Rebecca Koerner, Ashlee J. Vance, Allison Crawford

College of Nursing Faculty Research and Publications

Background: As rates of substance use during pregnancy persist, the health and optimal development of infants with prenatal substance exposure remain a key priority. Nurses are tasked with identifying and reporting suspected cases of child maltreatment, including abuse and neglect, which is often assumed to be synonymous with substance use during pregnancy. While policies aimed at protecting infants from child abuse and neglect are well intentioned, literature regarding the short- and long-term social and legal implications of mandatory reporting policies is emerging.

Purpose: In this article, we explore the intersections between the condition of substance use in pregnancy and policies …