Nursing Commons^™

Models Of Discharge Care In Magnet® Hospitals, Kathleen Bobay, Sarah J. Bahr, Marianne E. Weiss, Ronda G. Hughes, Linda L. Costa

College of Nursing Faculty Research and Publications

Objective: The aim of this article is to describe how the discharge preparation process is operationalized in Magnet® hospitals.

Background: Nationally, there are intensive efforts toward improving discharge transitions and reducing readmissions. Discharge preparation is a core hospital function, yet there are few reports of operational models.

Methods: This was a descriptive, Web-based survey of 32 Magnet hospitals (64 units) participating in the Readiness Evaluation and Discharge Interventions study.

Results: Most hospitals have adopted 1 or more national readmission reduction initiatives. Most unit models include several discharge preparation roles; RN case managers, and discharging RNs lead …

Effects Of Spiritual Care Education On Pediatric Nurses' Knowledge, Attitudes, And Competence, Cheryl Lynn Petersen

Dissertations (1934 -)

Holistic nursing care embraces the physical, psychological, and spiritual needs of the patient and family, thereby providing support and reducing suffering. Nurses’ spiritual care can improve the well-being and quality of life of children with cancer by assisting them to find meaning in their lives. At the end of life, spiritual care assists children in coping with their diagnosis, suffering, and losses. There are distinct deficiencies in education that lead nurses to feel unprepared to provide spiritual care to children. This study employed a prospective, longitudinal design to evaluate the potential effects of an online spiritual care educational program on …

Bridges And Barriers: Patients' Perceptions Of The Discharge Process Including Multidisciplinary Rounds On A Trauma Unit, Dawn Zakzesky, Katie Klink, Natalie S. Mcandrew, Kathryn Schroeter, Grace Johnson

College of Nursing Faculty Research and Publications

Discharge planning is a complex process and ideally begins early in the patient stay. Despite evidence about the importance of discharge readiness, there is limited literature about the patient's view during this transition. The goal of this study was to explore patient perspectives about the discharge process, including multidisciplinary rounds. Multidisciplinary rounding is a process where care providers from various specialties meet to communicate, coordinate patient care, make decisions, and manage responsibilities. The theme found was “bridges and barriers to discharge.” Participants identified timelines and tasks, communication, social support, and motivation as helpful and medical setbacks, insurance limitations, and infrequent …

Depressive Symptoms Affect Working Memory In Healthy Older Adult Hispanics, Mauricio Garnier-Villarreal, Monica Salazar-Villanea, Edward Liebmann, Esteban Montenegro-Montenegro, David K. Johnson

College of Nursing Faculty Research and Publications

Objectives: Low and middle income nations will experience an unprecedented growth of the elderly population and subsequent increase in age-related neurological disorders. Worldwide prevalence and incidence of all-types of neurological disorders with serious mental health complications will increase with life expectancy across the globe. One in ten individuals over 75 has at least moderate cognitive impairment. Prevalence of cognitive impairment doubles every 5 years thereafter. Latin America’s population of older adult’s 65 years and older is growing rapidly, yet little is known about cognitive aging among healthy older Latinos. Clinically significant depressive symptomatology is common among community-dwelling older adults and …

Depressive Symptoms And Walking In African‐Americans, Elisa R. Torres, Carolyn M. Sampselle, Harold W. Neighbors, David L. Ronis, Kimberlee A. Gretebeck

College of Nursing Faculty Research and Publications

Objective

Although increased frequency of physical activity is associated with fewer depressive symptoms in African‐Americans, most studies do not focus on a specific type of activity. Identifying the activity can provide helpful information for designing interventions that focus on depressive symptoms. The objective of this study was to examine the odds of depressive symptoms in relation to walking in African‐Americans.

Design and Sample

A secondary analysis was performed on the National Survey of American Life. The sample was made up of community‐dwelling African‐American women (n = 1,903) and men (n = 1,075) who did not meet the DSM‐IV‐TR …

Current Medical Research: Summer/Fall 2014, Richard J. Fehring

College of Nursing Faculty Research and Publications

No abstract provided.

Predictors Of Engagement In Postpartum Weight Self-Management Behaviours In The First 12 Weeks After Birth, Jennifer M. Ohlendorf, Marianne E. Weiss, Debra L. Oswald

College of Nursing Faculty Research and Publications

Aim

To explore factors that influence postpartum weight self-management behaviours. Transitions Theory and the Integrated Theory of Health Behaviour Change guided selection of variables. Transition conditions, level of patient activation and social facilitation were examined for association with postpartum weight self-management behaviours.

Background

Retention of pregnancy weight increases risk of overweight and obesity later in life. Little is known about what women do to self-manage return to pre-pregnant weight and how providers can influence their behaviours.

Design

Prospective, longitudinal, correlational.

Methods

Data collection occurred from March through October, 2013. One hundred and twenty-four women completed surveys during postpartum hospitalization; telephone …

Losartan Treatment Attenuates Tumor-Induced Myocardial Dysfunction, Sarah C.W. Stevens, Markus Velten, Dane J. Youtz, Yvonne Clark, Runfeng Jing, Peter J. Reiser, Sabahattin Bicer, Raymond D. Devine, Donna O. Mccarthy, Loren E. Wold

College of Nursing Faculty Research and Publications

Fatigue and muscle wasting are common symptoms experienced by cancer patients. Data from animal models demonstrate that angiotensin is involved in tumor-induced muscle wasting, and that tumor growth can independently affect myocardial function, which could contribute to fatigue in cancer patients. In clinical studies, inhibitors of angiotensin converting enzyme (ACE) can prevent the development of chemotherapy-induced cardiovascular dysfunction, suggesting a mechanistic role for the renin–angiotensin–aldosterone system (RAAS). In the present study, we investigated whether an angiotensin (AT) 1-receptor antagonist could prevent the development of tumor-associated myocardial dysfunction. Methods and results: Colon26 adenocarcinoma (c26) cells were implanted into female CD2F1 mice …

The Influence Of Contraception, Abortion, And Natural Family Planning On Divorce Rates As Found In The 2006–2010 National Survey Of Family Growth, Richard J. Fehring

College of Nursing Faculty Research and Publications

The purpose of this study was to determine the influence of contraception, abortion, and natural family planning (NFP) on divorce rates of US women of reproductive age. The variables of importance of religion and frequency of church attendance were also included in the analysis. The study involved 5,530 reproductive age women in the (2006–2010) National Survey of Family Growth who indicate that they were ever married. Among the women who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who were currently divorced among the women who never used NFP (x² = 5.34, …

Undergraduate Nursing Students’ Attitudes Toward Mental Health Nursing, Vipavee Thongpriwan, Susan E. Leuck, Rhonda L. Powell, Staci Young, Suzanne Schuler, Ronda G. Hughes

College of Nursing Faculty Research and Publications

Objectives: The purpose of this study was to describe undergraduate nursing students’ attitudes toward mental health nursing and how these attitudes influenced their professional career choices in mental health nursing.

Design: A descriptive, online survey was utilized to examine students’ perceptions of mental health nursing. A total of 229 junior and senior nursing students were recruited from eight nursing colleges in Midwestern United States to participate in this survey.

Results: Students of different ages, genders, ethnicities, and nursing programs did not report significantly different perceptions of: (a) knowledge of mental illness; (b) negative stereotypes; (c) interest in mental health nursing …

Psychometric Properties Of The Family Caregiver Delirium Knowledge Questionnaire, Margaret J. Bull, Jennifer M. Sjostedt, Lesley Boaz, Debra L. Oswald

College of Nursing Faculty Research and Publications

A valid, reliable measure of family caregivers’ knowledge about delirium was not located in the literature; such an instrument is essential to assess learning needs and outcomes of education provided. The purpose of the current study was to (a) develop a family Caregiver Delirium Knowledge Questionnaire (CDKQ) based on the Symptom Interpretation Model; and (b) establish validity and reliability of the measure. The 19-item CDKQ was developed and administered to 164 family caregivers for community-dwelling older adults. Descriptive statistics were examined for all variables. Psychometric testing included confirmatory factor analysis, item-to-total correlations, and internal consistency reliability. A three-factor model provided …

Emerging Areas Of Nursing Science And Phd Education For The 21St Century: Response To Commentaries, Susan J. Henly, Donna O. Mccarthy, Jean F. Wyman, Anna C. Alt-White, Patricia W. Stone, Ann Marie Mccarthy, Nancy S. Redeker, Jacqueline Dunbar-Jacob, Marita Titler, Marita G. Titler, Yvette P. Conley, Margaret M. Heitkemper, Shirley M. Moore

College of Nursing Faculty Research and Publications

We respond to commentaries from the American Academy of Nursing, the American Association of Colleges of Nursing, and the National Institute of Nursing Research on our thoughts about integrating emerging areas of science into nursing PhD programs. We identify areas of agreement and focus our response on cross-cutting issues arising from cautions about the unique focus of nursing science and how best to proceed with incorporation of emerging areas of science into nursing PhD programs.

Emerging Areas Of Science: Recommendations For Nursing Science Education From The Council For The Advancement Of Nursing Science Idea Festival, Susan J. Henly, Donna O. Mccarthy, Jean F. Wyman, Margaret M. Heitkemper, Nancy S. Redeker, Marita Titler, Ann Marie Mccarthy, Patricia W. Stone, Shirley M. Moore, Anna C. Alt-White, Yvette P. Conley

College of Nursing Faculty Research and Publications

The Council for the Advancement of Nursing Science aims to “facilitate and recognize life-long nursing science career development” as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee (IFAC) to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2005 National Research Council report Advancing …

Integrating Emerging Areas Of Nursing Science Into Phd Programs, Susan J. Henly, Donna O. Mccarthy, Jean F. Wyman, Patricia W. Stone, Nancy S. Redeker, Ann Marie Mccarthy, Jacqueline Dunbar-Jacob, Marita Titler, Shirley M. Moore, Margaret M. Heitkemper, Yvette P. Conley

College of Nursing Faculty Research and Publications

The Council for the Advancement of Nursing Science aims to “facilitate and recognize life-long nursing science career development” as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2010 American Association of Colleges of Nursing …

Educating Future Nursing Scientists: Recommendations For Integrating Omics Content In Phd Programs, Margaret M. Heitkemper, Donna O. Mccarthy, Cindy M. Anderson, Elizabeth J. Corwin, Sandra Daack-Hirsch, Susan G. Dorsey, Katherine E. Gregory, Maureen W. Groer, Susan J. Henly, Timothy Landers, Debra E. Lyon, Jacquelyn Y. Taylor, Joachim Voss

College of Nursing Faculty Research and Publications

Preparing the next generation of nursing scientists to conduct high-impact, competitive, sustainable, innovative, and interdisciplinary programs of research requires that the curricula for PhD programs keep pace with emerging areas of knowledge and health care/biomedical science. A field of inquiry that holds great potential to influence our understanding of the underlying biology and mechanisms of health and disease is omics. For the purpose of this article, omics refers to genomics, transcriptomics, proteomics, epigenomics, exposomics, microbiomics, and metabolomics. Traditionally, most PhD programs in schools of nursing do not incorporate this content into their core curricula. As part of the Council for …

Weight Loss Intervention Efficacy Among Black Women, Callie Chiroff, Kristin Haglund

College of Nursing Faculty Research and Publications

Obesity is a complex disease state that has challenged the health of Americans and has become a main concentration in health care. The highest rates of obesity are observed among black women. The purpose of this evidence-based review was to find evidence that specifically examined black women to determine if participation in weight loss interventions led to successful weight loss compared with usual care and control groups. Twelve experimental studies and 4 systematic reviews revealed that interventions contributed to successful weight loss among black women with obesity. However, maintenance of weight loss is an ongoing challenge.

A Survey Of Concerns In End-Of-Life Care: Perspective From Pakistan, Ariba Khan, Maharaj Singh, Sarah Saeed, Arif Siddiqui, Zeba Aziz, Michael Malone

College of Nursing Faculty Research and Publications

Personalized health care that incorporates advance care planning and aligns treatment with patient-centered goals can improve the quality of life of dying individuals and reduce stress, anxiety, and depression in surviving relatives. Although several prognostication indices that address all-cause mortality have been developed for use in elderly inpatients, none have been integrated into the electronic health record (EHR) to automatically identify high-risk individuals and used during interdisciplinary team rounds to identify vulnerable hospitalized adults.3 At Aurora Health Care in Milwaukee, Wisconsin, an automated alert for serious medical illnesses has been programmed into the EHR. Built on previous findings,the alert …

Can The Electronic Health Record Identify Vulnerable Older Adults In Need Of A Palliative Care Assessment In The Hospital Setting?, James D. Hocker, Ariba Khan, Maharaj Singh, Mary Hook, Michelle Simpson, Aaron Malsch, Marsha Vollbrecht, Michael Malone

College of Nursing Faculty Research and Publications

Personalized health care that incorporates advance care planning and aligns treatment with patient-centered goals can improve the quality of life of dying individuals and reduce stress, anxiety, and depression in surviving relatives.1, 2 Although several prognostication indices that address all-cause mortality have been developed for use in elderly inpatients, none have been integrated into the electronic health record (EHR) to automatically identify high-risk individuals and used during interdisciplinary team rounds to identify vulnerable hospitalized adults.3 At Aurora Health Care in Milwaukee, Wisconsin, an automated alert for serious medical illnesses has been programmed into the EHR. Built on previous findings,4 the …

Anesthesia Preoperative Clinic Referral For Elevated Hba1c Reduces Complication Rate In Diabetic Patients Undergoing Total Joint Arthroplasty, Peter J. Kallio, Jenea Nolan, Amy C. Olsen, Susan Breakwell, Richard Topp, Paul S. Pagel

College of Nursing Faculty Research and Publications

Background: Diabetes mellitus (DM) is risk factor for complications after orthopedic surgery.

Objectives: We tested the hypothesis that anesthesia preoperative clinic (APC) referral for elevated glycosylated hemoglobin (HbA1c) reduces complication rate after total joint arthroplasty (TJA).

Patients and Methods: Patients (n = 203) with and without DM were chosen from 1,237 patients undergoing TJA during 2006 - 12. Patients evaluated in the APC had surgery in 2006 - 8 regardless of HbA1c (uncontrolled). Those evaluated between in subsequent two-year intervals were referred to primary care for HbA1c ≥ 10% and ≥ 8%, respectively, to improve DM control before surgery. Complications …

“Not Being Able To Talk Was Horrid”: A Descriptive, Correlational Study Of Communication During Mechanical Ventilation, Jill L. Guttormson, Karin Lindstrom Bremmer, Rachel M. Jones

College of Nursing Faculty Research and Publications

Objectives: The purpose of this study was to describe the patient experience of communication during mechanical ventilation.

Research methodology: This descriptive study is a secondary analysis of data collected to study the relationship between sedation and the MV patients’ recall of the ICU. Interviews, conducted after extubation, included the Intensive Care Experience Questionnaire. Data were analysed with Spearman correlation coefficients (r_s) and content analysis.

Setting: Participants were recruited from a medical-surgical intensive care unit in the Midwest United States.

Results: Participants (n = 31) with a mean age of 65 ± 11.9 were on the …

“Wet Suction Technique (West)”: A Novel Way To Enhance The Quality Of Eus-Fna Aspirate. Results Of A Prospective, Single-Blind, Randomized, Controlled Trial Using A 22-Gauge Needle For Eus-Fna Of Solid Lesions, Rajeev Attam, Mustafa A. Arain, Staphen J. Bloechl, Guru Trikudanathan, Satish Munigala, Yan Bakman, Maharaj Singh, Timothy Wallace, Joseph B. Henderson, Nalini M. Guda

College of Nursing Faculty Research and Publications

Background Contemporary EUS-guided FNA techniques involve the use of a needle, with an air column within the lumen, with or without suction. We describe a novel technique with an aim to improve the quality of the aspirate. Objective To compare a novel “wet suction” technique (WEST) with the conventional FNA technique (CFNAT) of EUS-guided FNA using a 22-gauge FNA needle. Design Prospective, single-blind, and randomized trial. Setting Two large tertiary-care hospitals. Patients All consecutive adult patients presenting for EUS with possible FNA of solid lesions were offered the chance to participate in the study. Methods All lesions were sampled with …

Getting Started With Debriefing For Meaningful Learning, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Debriefing for Meaningful Learning© (DML) is a method of debriefing that can be used in simulation environments and other clinical settings to foster student's reflective thinking and learning. It has been used successfully with prelicensure nursing students, graduate nursing students, and interdisciplinary health care students throughout the nursing curriculum with positive learning outcomes. This method can be challenging to learn because it uses Socratic questioning and principles of active learning to uncover thinking associated with actions, but once learned, DML can be a model for reflective thinking that students can use to develop clinical reasoning and become reflective practitioners. Moreover, …

Ubiquinol Reduces Muscle Wasting But Not Fatigue In Tumor-Bearing Mice, Yvonne Clark, Loren E. Wold, Laura A. Szalacha, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Purpose: Fatigue is the most common and distressing symptom reported by cancer patients during and after treatment. Tumor growth increases oxidative stress and cytokine production, which causes skeletal muscle wasting and cardiac dysfunction. The purpose of this study was to determine whether treatment with the antioxidant ubiquinol improves muscle mass, cardiac function, and behavioral measures of fatigue in tumor-bearing mice.

Method: Adult female mice were inoculated with colon26 tumor cells. Half the control and tumor-bearing mice were administered ubiquinol (500 mg/kg/day) in their drinking water. Voluntary wheel running (i.e., voluntary running activity [VRA]) and grip strength were measured at Days …

Trauma Nurses: Making A Difference, Kathryn Schroeter

College of Nursing Faculty Research and Publications

No abstract provided.

Effect Of Perceived Stress On Cytokine Production In Healthy College Students, Vorachai Sribanditmongkol, Jeremy L. Neal, Laura A. Szalacha, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Chronic psychological stress impairs antibody synthesis following influenza vaccination. Chronic stress also increases circulating levels of proinflammatory cytokines and glucocorticoids in elders and caregivers, which can impair antibody synthesis. The purpose of this study was to determine whether psychological stress increases ex vivo cytokine production or decreases glucocorticoid sensitivity (GCS) of peripheral blood leukocytes from healthy college students. A convenience sample of Reserve Officer Training Corps (ROTC) students completed the Perceived Stress Scale (PSS). Whole blood was incubated in the presence of influenza vaccine and dexamethasone to evaluate production of interleukin-6 (IL-6), interleukin-1-beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interferon-gamma …

Comparison Of Nurse Staffing Based On Changes In Unit-Level Workload Associated With Patient Churn, Ronda G. Hughes, Kathleen Bobay, Nicholas A. Jolly, Chrysmarie Suby

College of Nursing Faculty Research and Publications

Aim

This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers.

Background

Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit. Failure to account for patient churn in staffing allocation impacts nurse workload and may result in adverse patient outcomes.

Method(s)

Secondary data analysis of unit-level data from 32 hospitals, where nursing units are grouped into three unit-type categories: intensive care, intermediate care, …

Cannabinoid Hyperemesis Syndrome, Lynn Heise

College of Nursing Faculty Research and Publications

Legalization of marijuana use will increase the number of people who will become long-term users. A prior medical record review study in Australia, in 2004, identified 19 chronic marijuana users who entered the emergency department with recurrent vomiting associated with abdominal pain. Routine treatment of the nausea and vomiting, associated with the chronic marijuana abuse, with antiemetics is ineffective in patients with cannabinoid hyperemesis syndrome. Narcotics do not relieve the abdominal pain but may cause worsening rebound pain. The best treatment of cannabinoid hyperemesis syndrome was found to be abstinence from the recreational use of marijuana. It is important for …

Diffusion Of Inclusion: Measuring Willingness, Janet A. Levey

Dissertations (1934 -)

The purpose of the study was to: (1) examine psychometric properties of the Willingness to Adopt Inclusive Teaching Strategies (ITSinNE) instrument and (2) measure factors influencing a nurse educator's willingness to adopt inclusive teaching strategies based in universal design for instruction (UDI). Universal design for instruction (UDI) is one approach to facilitate multiple ways of learning and evaluation in various learning environments for all learners; however, it is not well known or researched in nursing education. Diffusion of innovation theory (Rogers, 2003) and universal design for instruction (McGuire & Scott, 2006) provided the theoretical framework for the study. A cross-sectional …

Innovative Approach To Measure Delirium In Hospitalized Older Adults Using The Electronic Health Record, Ariba Khan, Michelle Simpson, Maharaj Singh, Mary Hook, Yan Geng, Michael Malone

College of Nursing Faculty Research and Publications

The Acute Care for the Elderly (ACE) Tracker is an innovative clinical decision support tool generated from the electronic health record (EHR). The EHR delirium marker is derived from variables noted on the ACE Tracker: nursing documentation in the EHR, use of physical restraints, and pharmacological treatment for delirium (use of quetiapine, haloperidol, olanzapine, or risperidone). The combining of these data elements is consistent with a previous study. The EHR delirium marker was intended to be used by the healthcare team during interdisciplinary team meetings and remote consultation by the “e-Geriatrician.” The purpose of this investigation was to examine the …

Fluoxetine Prevents The Development Of Depressive-Like Behavior In A Mouse Model Of Cancer Related Fatigue, Diana M. Norden, Raymond Devine, Sabahattin Bicer, Runfeng Jing, Peter J. Reiser, Loren E. Wold, Jonathan P. Godbout, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Cancer patients frequently suffer from fatigue, a complex syndrome associated with tiredness and depressed mood. Cancer-related fatigue (CRF) can be present at the time of diagnosis, escalates during treatment, and can persist for years after treatment. CRF negatively influences quality of life, limits functional independence, and is associated with decreased survival in patients with incurable disease. We have previously shown that increased pro-inflammatory cytokine expression in the brain contributes to depressive- and fatigue-like behaviors in a mouse model of CRF. Inflammatory cytokines increase the activity of indoleamine 2,3-dioxygenase (IDO) and kynurenine 3-monooxygenase (KMO), which competitively reduce serotonin synthesis. Reduced serotonin …