Nursing Commons^™

Safety In Children With Medical Complexity: Our Canaries In The Coal Mine?, Christine A. Schindler, Elisabeth S. Pordes, Steven D. Finkenbinder, K. Jane Lee

College of Nursing Faculty Research and Publications

Purpose of review

The goal of this paper is to describe the complicated and diverse safety risks facing children with medical complexity.

Recent findings

Children with medical complexity have an increased risk of experiencing adverse health outcomes related to multiple comorbidities, the complicated nature of their care, and frequent interactions with the health care system. The safety risks experienced by children with medical complexity are in large part due to the complex nature of their care rather than the specific risks posed by the complicated nature of their illnesses.

Summary

The complicated nature of care for children with medical complexity …

Predeath Grief, Resourcefulness, And Perceived Stress Among Caregivers Of Partners With Young-Onset Dementia, Karie Ruekert Kobiske, Abir K. Bekhet, Mauricio Garnier-Villarreal, Marilyn Frenn

College of Nursing Faculty Research and Publications

More than 200,000 Americans are currently diagnosed with young-onset dementia (YOD). YOD is dementia diagnosed prior to the age of 65. Most persons of YOD are cared for by their partners. Using the theoretical framework of Resilience Theory, this cross-sectional, correlational study examined the moderating effects of personal and social resourcefulness on the relationship between predeath grief and perceived stress among 104 YOD caregiving partners (life partners/spouses) using an online survey platform. Results indicated a large positive correlation between predeath grief and caregiver perceived stress (r = .65; p < .001). Together predeath grief, personal resourcefulness and social resourcefulness explained 51.5% of the variance in perceived stress. Personal resourcefulness did not moderate the relationship. Social resourcefulness did positively moderate this relationship between predeath grief and perceived stress. These findings allow for a better understanding of the caregiving experience for a partner with YOD and creates opportunities for future research studies.

Pediatric Oncology Nurses’ Perceptions Of Prognosis-Related Communication, Amy Rose Newman, Kristin Haglund, Cheryl C. Rodgers

College of Nursing Faculty Research and Publications

Background

Disclosure of prognosis-related information is an essential aspect of communication with pediatric patients with cancer and their families. The nurse is believed to play an important role in this process, but nurse perceptions and experiences have not been well-described.

Purpose

Provide an exploration of pediatric oncology nurses’ experiences with prognosis-related communication (PRC).

Method

Mixed-methods, multiphase design. This paper highlights the qualitative portion of the study.

Findings

Three themes were identified: Importance of collaboration, impact of PRC, and delivery of prognostic information.

Discussion

Collaboration is a critical element of PRC. Nurses are often not included in the disclosure process, which …

Through The Microbial Looking Glass: Premature Labor, Preeclampsia, And Gestational Diabetes: A Scoping Review, Alexis B. Dunn, Lisa Hanson, Leona Vandevusse, Sharon Leslie

College of Nursing Faculty Research and Publications

The influence of microbial factors on adverse perinatal outcomes has become the focal point of recent investigations, with particular interest in the role of the microbiome and probiotic interventions. The purpose of this scoping review was to identify and critique the most recent evidence about these factors as they relate to pregnancies complicated by preeclampsia (PEC), preterm birth (PTB), and gestational diabetes mellitus (GDM). Four databases (PubMed, EMBASE, Web of Science, and Cochrane) were searched for articles published in English in the last 10 years with the concepts of the microbiome, probiotics, and PEC, PTB, or GDM. Forty-nine articles were …

Effect Of Implementing Discharge Readiness Assessment In Adult Medical-Surgical Units On 30-Day Return To Hospital The Readi Randomized Clinical Trial, Marianne E. Weiss, Olga Yakusheva, Kathleen L. Bobay, Linda L. Costa, Ronda G. Hughes, Susan A. Nuccio, Morris Hamilton, Sarah J. Bahr, Danielle M. Siclovan, James Bang

College of Nursing Faculty Research and Publications

Importance: The downward trend in readmissions has recently slowed. New enhancements to hospital readmission reduction efforts are needed. Structured assessment of patient readiness for discharge has been recommended as an addition to discharge preparation standards of care to assist with tailoring of risk-mitigating actions.

Objective: To determine the effect of unit-based implementation of readiness evaluation and discharge intervention protocols on readmissions and emergency department or observation visits.

Design, Setting, and Participants: The Readiness Evaluation and Discharge Interventions (READI) cluster randomized clinical trial conducted in medical-surgical units of 33 Magnet hospitals between September 15, 2014, and March 31, 2017, included all …

Health Policy Engagement Among Graduate Nursing Students In The United States, Pamela B. De Cordova, Mary Beth Wilson Steck, Amber Vermeesch, Natacha Pierre, Audra Rankin, Jennifer M. Ohlendorf, Sherry Lawrence, Anne Derouin

College of Nursing Faculty Research and Publications

Aim

The aim was to understand how health policy education is currently being delivered in the United States’ graduate nursing programs.

Methods

This exploratory cross‐sectional design used an anonymous online survey to target graduate nursing students attending American Association of College of Nursing (AACN) member institutions.

Results

Over 75% of the sample (n = 140) reported taking a dedicated health policy course and 71.5% ( n = 131) of the sample responded that a health policy course was required and an equal distribution among master’s and doctoral students. There was no significant difference between type of graduate degree sought …

A New Leadership Development Model For Nursing Education, Jane M. Miles, Elaine S. Scott

College of Nursing Faculty Research and Publications

Background

Leadership competency is required throughout nursing. Students have difficulty understanding leadership as integral to education and practice. A consistent framework for nursing leadership education, strong scholarship and an evidence base are limited.

Purpose

To establish an integrated leadership development model for prelicensure nursing students that recognizes leadership as a fundamental skill for nursing practice and promotes development of nursing leadership education scholarship.

Method

Summarizing definitions of nursing leadership, conceptualizing leadership development capacity through reviewing trends, and synthesizing existing leadership theories through directed content analysis.

Discussion

Nine leadership skills form the organizing structure for the Nursing Leadership Development Model. Leadership …

Integrating Research And Quality Improvement Using Teamstepps: A Health Team Communication Project To Improve Hospital Discharge, Joseph Beiler, Kristi Opper, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Purpose/Objectives:

The purpose of this article is to describe an innovative approach to the integration of quality improvement and research processes. A project with the objective of improving health team communication about hospital discharge provides an exemplar case.

Description of the Project/Program:

The TeamSTEPPS 10-step action planning guide provided the structure for planning, developing, and evaluating a redesign of interprofessional health team communication to improve hospital discharge led by 2 clinical nurse specialists. The redesign involved development of processes for team bedside rounding, registered nurse bedside shift reports, and briefing tools to support the rounding processes.

Outcome:

Using the TeamSTEPPS …

The Impact Of Maternal Bmi, Gestational Weight Gain, And Breastfeeding On Early Childhood Weight: Analysis Of A Statewide Wic Dataset, Jennifer M. Ohlendorf, Karen Marie Robinson, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

Early childhood obesity is a persistent health concern with more frequent and significant impact on low-income families. Maternal weight factors impact offspring weight status, but evidence on whether breastfeeding protects against this impact is mixed. This analysis examined a model to predict early childhood obesity risk, simultaneously accounting for maternal pre-pregnancy body mass index (BMI), gestational weight gain, and breastfeeding. The team analyzed 27,016 unique maternal-child dyadic records collected via the Supplemental Nutrition Program for Wisconsin Women, Infants, and Children (WIC) between 2009 and 2011. Generalized Linear Modeling, specifically logistic regression, was used to predict a child's risk …

Effects Of Positive Thinking On Dementia Caregivers’ Burden And Care-Recipients’ Behavioral Problems, Abir K. Bekhet, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

Most dementia care is provided at home by family members. This caregiving places an additional burden on the family members, which can negatively impact their physical and psychological well-being. The caregivers’ burden can also contribute to behavioral problems in the care-recipients. The purpose of this study was to examine the mediating/moderating effects of positive thinking (PT) on the relationship between caregivers’ burden (embarrassment/anger, patient’s dependency, and self-criticism) and their care-recipients’ behavioral problems (memory, depression, and disruption) in a sample of 100 dementia caregivers. Results indicated that caregivers’ embarrassment, self-criticism, and perception of patient dependency predicts depression in care-recipients, and these …

Restrictive Ventilatory Patterns In Residents Of Continuing Care Retirement Communities, Christine R. Kovach, Murad H. Taani, Crystal-Rae Waltons, Sheryl Kelber, Irwin Margolis

College of Nursing Faculty Research and Publications

Restrictive ventilatory patterns (RVPs) in older adults may contribute to morbidity and decreased quality of life. The purpose of this study was to begin to understand (a) the number of older adults residing in Continuing Care Retirement Communities with RVPs, (b) factors associated with RVP, and (c) whether RVP is associated with ambulation level. This descriptive study was conducted at three sites. RVP was evident in 34 of the 65 participants (52%), and 33 (97%) of these were either moderate or severely restricted. Dementia, dyspnea, kyphosis, and lower muscle strength were significant predictors of RVP. Eighty percent of the nonambulatory …

Patient Safety Incentives For Residents: A Slippery Slope Or Reinforcement Of Desirable Behavior?, Kathryn Rapala

College of Nursing Faculty Research and Publications

In a study of error reporting in the care of Medicare beneficiaries, the US Department of Health and Human Services Office of Inspector General found that only 14% of patient safety events were reported.¹ A multicenter study found that 44.6% of residents were uncomfortable reporting diagnostic errors, possibly related to fear of repercussions and issues with the reporting system, among other factors.² A key question at the intersection of graduate medical education and patient safety is how to encourage resident and fellow error reporting.

The intervention described in the article, “Improving Resident and Fellow Engagement in Patient Safety …

Depression, Positive Thinking, Personal And Social Resourcefulness Among Caregivers Of Persons With Autism Spectrum Disorders, Abir K. Bekhet, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

No abstract provided.

Promoting Team-Based Exercise Among African American Breast Cancer Survivors, Linda B. Piacentine, Karen Marie Robinson, Leslie J. Waltke, Judy A. Tjoe, Alexander V. Ng

College of Nursing Faculty Research and Publications

Physical activity benefits the health and well-being of breast cancer survivors (BCS). Yet, many African American survivors do not routinely exercise and have increased risk of poor outcomes. The purpose of this mixed-method study was to identify motivational factors compelling African American BCS to participate in a 14-week team walking program and to intend to continue exercise after the intervention concluded. Focus groups were held with participants (n = 12) before and after training. Content analysis discovered themes before the intervention: Not wanting to go at it alone, exercise not a life or treatment priority, cancer treatment affected activity, …

Comprehensive Evaluation Of Interventions: Eight Vital Parameters, Jaclene A. Zauszniewski, Abir K. Bekhet, Kayla Herbell

College of Nursing Faculty Research and Publications

Background It is critically important to determine the effectiveness of an intervention before it can be translated into clinical practice. However, the future implementation and sustainability of the intervention may be diminished if other intervention parameters are not assessed. This requires obtaining feedback from intervention recipients so interventions will be perceived as appealing, relevant, meaningful and beneficial to them; otherwise recipients may be unlikely to perform them over time, resulting in unsuccessful health outcomes.

Aim To propose the addition of two intervention parameters to the existing six-parameter model and provide examples from recent research of how each parameter can be …

Dissociation Between Cervical Mucus And Urinary Hormones During The Postpartum Return Of Fertility In Breastfeeding Women, Thomas Bouchard, Len Blackwell, Simon Brown, Richard J. Fehring, Suzanne Parenteau-Carreau

College of Nursing Faculty Research and Publications

Identifying the return of fertility with cervical mucus observations is challenging during the postpartum period. Use of urinary measurements of estrogen and progesterone can assist in understanding the return to fertility during this period. The purposes of this study were to describe the postpartum return of fertility by an analysis of total estrogen (TE) and pregnanediol glucuronide (PDG) profiles and to correlate these profiles with cervical mucus observations. Twenty-six participants collected urine samples during the postpartum period and recorded mucus scores. TE and PDG hormones were analyzed and compared with mucus scores. During amenorrhea, mucus reflected TE changes in only …

A Framework For Integrating Oncology Palliative Care In Doctor Of Nursing Practice (Dnp) Education, Laura Fennimore, Dorothy Wholihan, Susan Breakwell, Rose Virani, Betty Ferrell

College of Nursing Faculty Research and Publications

Doctor of Nursing Practice (DNP) faculty play a critical role in preparing students to meet the complex needs of the nation as the number of cancer rates and survivors rise (National Cancer Institute, 2018) and as an unprecedented number of older Americans enter into the healthcare system with complicated comorbidities (Whitehead, 2016). Palliative care has dramatically expanded over the past decade and has been increasingly accepted as a standard of care for people with cancer and other serious, chronic, or life-limiting illnesses. Advanced practice registered nurses (APRNs) are recognized as important providers of palliative care (Walling et al., 2017). A …

The State Of The Science Of Natural Family Planning Fifty Years After Humane Vitae: A Report From Nfp Scientists’ Meeting Held At The Us Conference Of Catholic Bishops, April 4, 2018, Michael D. Manhart, Richard J. Fehring

College of Nursing Faculty Research and Publications

A one-day meeting of physicians, professional nurses, and scientists actively involved in Natural Family Planning (NFP) research was held to review the state of the science of NFP and consider future priorities. The meeting had four objectives: (i) determine the gaps in research evidence for secure methods of NFP among women of all reproductive categories, (ii) determine the gaps in the research and development of new technology for providing NFP services, (iii) determine the gaps in the research that determine the benefits and challenges with use of NFP among married couples, and (iv) provide prioritized ideas for future research needs …

Validation Of Stroke Network Of Wisconsin Scale At Aurora Health Care System, Kessarin Panichpisal, Maharaj Singh, Adil Chohan, Paul Vilar, Reji P. Babygirija, Mary Hook, Sharon Matyas, Nathaniel Kojis, Rehan Sajjad, Thomas Wolfe, Amin Kassam, Richard Rovin

College of Nursing Faculty Research and Publications

Background

The Stroke Network of Wisconsin (SNOW) scale, previously called the Pomona scale, was developed to predict large-vessel occlusions (LVOs) in patients with acute ischemic stroke (AIS). The original study showed a high accuracy of this scale. We sought to externally validate the SNOW scale in an independent cohort.

Methods

We retrospectively reviewed and calculated the SNOW scale, the Vision Aphasia and Neglect Scale (VAN), the Cincinnati Prehospital Stroke Severity (CPSS), the Los Angeles Motor Scale (LAMS), and the Prehospital Acute Stroke Severity Scale (PASS) for all patients who were presented within 24 hours after onset at AHCS (14 hospitals) …

The Catholic Medical Association And Humanae Vitae: On The Fiftieth Anniversary Of The Encyclical, Kathleen Raviele, Richard J. Fehring, Janet Smith

College of Nursing Faculty Research and Publications

No abstract provided.

Comparing Interprofessional Socialization In Mixed Discipline And Nursing Student Only Cohorts, Kara Groom

Dissertations (1934 -)

A main cause of patient safety incidents are avoidable failures in communication between health professionals. In response, healthcare has entered an era of interprofessionalism in education and patient care. A challenge to substantiating the value of interprofessional education (IPE) has been a limited number of studies that assess the effectiveness of IPE interventions compared to education interventions in which professions were learning separately from one another. This research project helps fill this gap and measures the differences in student interprofessional socialization (IS) between an IPE cohort and a usual care group of one-discipline learners. The purpose was to compare IS …

Evaluation Of Clinical Growth And Nursing Student Motivation In The Traditional Clinical Learning Environment, Jessica Barkimer

Dissertations (1934 -)

Evaluation of students in the traditional clinical learning environment is difficult. There remains a lack of standard guidelines to evaluate students using valid and reliable instruments as well as inconsistent processes with lack of interrater reliability standards between educators. A need exists for fair and consistent evaluation of nursing students. When the clinical educator uses a standard evaluation process and understands students’ motivation for learning, adaptations in teaching strategies and education on self-regulatory strategies can be implemented to enhance learning and measure clinical growth. This research study used a prospective, correlational, pre-test/post-test design to examine the relationship between student motivation …

Home Health Care Effect In Post-Discharge Return To Hospital, Danielle M. Siclovan

Dissertations (1934 -)

Background: Home Health Care (HHC), the most commonly used bridge strategy for transitioning from hospital to home-based care, is expected to contribute to ongoing readmission avoidance efforts. However, evidence suggests HHC patients are readmitted more frequently than patients without HHC. Determining the effectiveness of HHC as a readmission reduction strategy requires a comparison sample of patients with similar characteristics referred and not referred to HHC. Methods: For this matched-sample comparative study, the available sample (n=18,774) included 3,629 patients referred to HHC and 15,145 non-HHC patients, from which 2,718 pairs matched 1:1 were obtained using exact and Mahalanobis distance matching. Unadjusted …

Qualitative Exploration Of The Perceptions Of Nursing Undergraduates Regarding Family Care At End-Of-Life, Penny A. Alt-Gehrman

Dissertations (1934 -)

Background/Purpose: Family care at end-of-life is delivered by nurses and includes communication and explanations, providing emotional support for the family, creating an environment in which death occurs with dignity, providing privacy, facilitating visitation, and honoring and meeting cultural and personal family values (Beckstrand et al., 2011; Bloomer et al., 2013; Cronin et al., 2015; Heidari & Norouzadeh, 2014). There appears to be a gap in the empirical evidence and literature on this topic. Regarding the knowledge and comfort of student nurses, and subsequently nurses, in family care at the end-of-life, there is disparity. To determine what must be taught to …

An Emancipatory Approach To Cultural Competency: The Application Of Critical Race, Postcolonial, And Intersectionality Theories, Linda M. Wesp, Victoria Scheer, Ashley Ruiz, Kimberly Walker, Jennifer Weitzel, Leslie Shaw, Peninnah M. Kako, Lucy Mkandawire-Valhmu

College of Nursing Faculty Research and Publications

Nurses teach, work, and conduct research in an increasingly hostile sociopolitical climate where health inequities persist among marginalized communities. Current approaches to cultural competency do not adequately equip nurses to address these complex factors and risk perpetuating stereotypes and discrimination. A theory-driven emancipatory approach to cultural competency will instead lead to lasting change and uphold the core nursing value of commitment to social justice. This article explicates key tenets of critical race, postcolonial feminist, and intersectionality theories and then applies them, using an emancipatory approach to cultural competency that can reshape nursing education, research, and practice.

Aligning Evidence-Based Practice With Translational Research: Opportunities For Clinical Practice Research, Marianne E. Weiss, Kathleen L. Bobay, Meg Johantgen, Maria Shirey

College of Nursing Faculty Research and Publications

Magnet(R) and other organizations investing resources in evidence-based practice (EBP) are ideal laboratories for translational nursing research. Translational research, the study of implementation of evidence into practice, provides a unique opportunity to leverage local EBP work for maximum impact. Aligning EBP projects with rigorous translational research can efficiently meet both EBP and research requirements for Magnet designation or redesignation, inform clinical practice, and place organizations at the leading edge of practice-based knowledge development for the nursing discipline.

The Power Of Play: A Pediatric Role In Enhancing Development In Young Children, Michael Yogman, Andrew Garner, Jeffrey Hutchinson, Kathy Hirsh-Pasek, Roberta Michnick Golinkoff, Virginia Keane, Rebecca Baum, Thresia Gambon, Arthur Lavin, Gerri Mattson, Lawrence Wissow, Sahron Berry, Amy Starin, Edward Christopherson, Abigail Schlesinger, Karen S. Smith, David L. Hill, Nusheen Ameenuddin, Yolanda Reid Ghassiakos, Corinn Cross, Rhea Boyd, Robert Mendelson, Megan A. Moreno, Wendy Sue Swanson, Justin Smith, Kristopher Kaliebe, Jennifer Pomeranz, Brian Wilcox, Thomas Mcpheron

College of Nursing Faculty Research and Publications

Children need to develop a variety of skill sets to optimize their development and manage toxic stress. Research demonstrates that developmentally appropriate play with parents and peers is a singular opportunity to promote the social-emotional, cognitive, language, and self-regulation skills that build executive function and a prosocial brain. Furthermore, play supports the formation of the safe, stable, and nurturing relationships with all caregivers that children need to thrive.

Response To ‘Aspih Standards For Simulation-Based Education: Process Of Consultation, Design And Implementation’, Kristina Dreifuerst, Teresa Gore, Bette Mariani

College of Nursing Faculty Research and Publications

No abstract provided.

Patients’ Perspectives On Engaging In Their Healthcare While Hospitalized, Teresa Jerofke-Owen, Jennifer Jean Dahlman

College of Nursing Faculty Research and Publications

Aims and objectives

To examine patients’ experiences and preferences for engaging in their healthcare while hospitalised.

Background

Promoting patient engagement or involvement in healthcare has become an important component of contemporary, consumer‐oriented approaches to quality care. Previous research on patient engagement highlights that preferences for engagement are not assessed while hospitalised, leading to patient role confusion and frustration.

Methods

Semistructured interviews were conducted with patients from January–March 2017 to examine their experiences and preferences for engaging in their care while hospitalised on medical‐surgical units in the United States. Inductive thematic analysis was used to uncover the themes from the interview …

Moral Distress In Critical Care Nursing: The State Of The Science, Natalie S. Mcandrew, Jane Leske, Kathryn Schroeter

College of Nursing Faculty Research and Publications

Background:

Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions.

Objectives:

An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions.

Review Methods:

This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies.

Results:

Synthesis of the scientific literature revealed inconsistencies in measurement, conflicting findings of moral distress and nurse demographics, problems …