Nursing Commons^™

A Mixed Method Study Of The Impact And Outcomes Of Graduates Of The Csu Northern California Consortium Doctor Of Nursing Practice Program Class Of 2014, Lori Rodriguez

Faculty Publications

In 2010, in response to a demand for advanced practice nurses to meet the burgeoning needs of the state's population, the California legislature passed AB 867 which called for a pilot project to institute the Doctor of Nursing Practice program in the California State University campus system (Nava & Arambula, 2010). Two programs, one based in Southern California and the other in Northern California, opened in fall of 2012. In Northern California, Fresno State was chosen as the base campus with San Jose State University as the partner campus for the CSU Northern California Consortium of the Doctor of Nursing …

The Experience Of Information Literacy In Evidence-Based Practice (Ebp) Among Professional Nurses In The Ho Municipality Of Ghana, Dominic Dankwah Agyei, Christian Yaw Kofi, David Fiankor, Hawa Osman

Library Philosophy and Practice (e-journal)

Purpose: This study aims to find out the information literacy competence of professional nurses in the Ho Municipality of Ghana in their pursuit of Evidence-Based Practice (EBP).

Design/methodology/approach: This study used the descriptive research strategy to describe the experience of information literacy among professional nurses in the Ho Municipality of Ghana. It used the purposive sampling method to select the various health facilities and the professional nurses. A total of 138 questionnaires out of 151 questionnaires that were administered were retrieved. The responses were presented and analysed based on the objectives of the study.

Findings: The study discovered that …

A Novel Method For Assessing Medication-Related Adverse Outcomes In A Community Hospital, Christopher M. Patty

Doctoral Projects

The use of medications for hospitalized patients is universal, and unfortunately medication-related adverse outcomes are common. The accurate assessment of medication-related harm in hospitalized patients is foundational to the development of an effective hospital medication safety program. Every hospital has its own unique "fingerprint" of harm, accurate determination of the nature of medication-related harm specific to each hospital is necessary to facilitate prevention of that harm with specific and effective interventions. This project has provided a community hospital with its first systematic methodology for assessing medication-related harm. The methodology is adapted from that used in a recent national-level study.

Several …

Nurses' Perceptions Of Structural Empowerment: A Practice Review Process Pilot, Andrea M. Lee-Riggins

Doctoral Projects

Nurses are professionally and morally obliged to monitor and evaluate nursing practice via active participation in review mechanisms that are designed to promote patient safety and care delivery, thereby improving patient care quality (American Nurses Association [ANA], 1988, 2001, 2004; O'Rourke, 2006). The purpose of this Doctor of Nursing Practice (DNP) project was to develop, pilot, and evaluate a nurse practice review process with frontline nurses within Fresno Heart & Surgical Hospital (FHSH), a small specialty hospital, affiliated with Community Medical Centers (CMC) in Fresno, California. A nurse practice algorithm was subsequently developed and structural empowerment was assessed with the …

Reducing "Failure To Rescue" Occurrences: A Pilot Project Incorporating High-Fidelity Simulation During Mock Codes, To Enhance Pediatric Nurses' Clinical Knowledge And Skills, Denise Dawkins

Doctoral Projects

Thanks to advances in technology, the survival rate of infants and children with critical illnesses has improved. One consequence has been an increase in the acuity levels of hospitalized pediatric patients, which may heighten the risk of in-hospital cardiopulmonary arrest. Patient safety can be compromised by nurses who do not detect subtle clinical changes in a patient's condition, do not perform accurate interventions, or do not apply critical thinking (failure to rescue). The Institute of Medicine (10M) in 1999 estimated that approximately 100,000 people died each year as the result of poor care.

Patients and families place great trust in …

Long-Acting Reversible Contraceptive Methods, Same-Day Initiation And Early Removal, Sandra Mary Loehner

Doctoral Projects

Objective: The study was conducted to identify the early removal rate of Long-Acting Reversible Contraceptive (LARC) methods and factors associated with early removal.

Study Design: A non-experimental descriptive design based upon retrospective chart review of electronic medical records (EMR) was used. There was a total of 96 subjects, ages 15-47 years who had a LARC method inserted within a 12-month time period and subsequent removal within 6-months of insertion date. Subjects were grouped according to same-day insertion versus non-same-day insertion.

Results: Seventy percent of study subjects with early removal had their LARC method inserted under a same-day protocol. Most subjects …

Electronic Medical Record In The Simulation Hospital: Does It Improve Accuracy In Charting Vital Signs, Intake, And Output?, Carel M. Mountain

Doctoral Projects

The introduction of electronic health records has created a shift in the way nursing care is delivered (McBride, Delaney, & Tietze, 2012; Furukawa, Raghu, & Shao, 2010). A factor which heavily influences a nurse’s ability to navigate and utilize EMR is adequate education in the use of computerized documentation (McBride, et al., 2012). There is an increased risk for error at the bedside without the correct knowledge and skills regarding EMR documentation (Kelly, Brandon, & Docherty, 2011). This skill should be introduced during the pre-licensure education of the nurse.

Two groups of associate degree nursing students attending a small community …

Self-Reported Neurogenic Bowel And Bladder Management In Acute Hospitalized Chronic Spinal Cord Injured Patients: Its Role In Clinical Practice, Mary Lupe Jimenez

Doctoral Projects

Patients with spinal cord injuries and disorders (SCI/D) are at risk for mismanaged bowel care during acute hospitalization, which can lead to numerous medical complications ranging from loss of personal dignity and privacy to many serious medical conditions, some of which are life threatening. Additionally, mismanagement of bowel care during acute hospitalization may lead to costly extended hospital stays. The project was to describe bowel and bladder care for SCI/D patients during acute hospitalization using a self-reported questionnaire submitted by approximately 46.6% of SCI/D patients from the Veterans' Affairs Central California Health Care System. The self-report questionnaire was designed by …

Chronic Non-Cancer Pain In The Ed: Are Nurses Sbirt-Ready?, Dorothy James Moore

Doctoral Projects

Emergency department (ED) Registered Nurse (RN) understanding of chronic pain management is critically important. By some estimates, 30% of all opioid pain medications in the United States (US) are prescribed from EDs. At the same time, prescription drug abuse is America’s fastest growing drug problem. While RNs have significant contact time with chronic pain patients who may also be drug abusers, RNs often use the stigmatizing label, “drug-seeking” for certain key patient behaviors and may not feel confident intervening constructively with these patients. This project reviews literature pertaining to SBIRT use for substance abuse in the ED and surveys ED …

Impact Of Cue-Based Feeding Protocol On Premature Infants' Outcomes And Hospital Length Of Stay, Diana Michele Easley Cormier

Doctoral Projects

The project was an oral feeding practice change from traditional, gestational-age/volume-driven feeding progression to developmentally-based, infant-driven feeding progression. The infant-driven (cue-based) feeding protocol was implemented with goals to improve premature infants' feeding outcomes, and decreased the infant's length of hospitalization. The project was designed to implement a cue-based feeding protocol for oral feeding initiation and progression, within the neonatal intensive care unit (NICU) at Community Regional Medical Center (CRMC), and then retrospectively evaluate the impact of the cue-based feeding protocol on feeding outcomes. In order to realize full implementation of a NICU feeding practice change, multiple components, such as electronic …

The Experience Of Latino Parents Of Hospitalized Children During Family Centered Rounds, Lisa Ann Walker-Vischer

Doctoral Projects

Problem: Hospitalization of a child is stressful. The parental role is altered and parents have a primary need to receive timely information. Family centered rounds (FCR) provide a mechanism to exchange information and facilitates shared decision making with the medical team while parents advocate for their child's needs. FCR has been linked to increased satisfaction and improved outcomes. A recent study suggests that Latino parents have a suboptimal experience related to language barriers and a lack of empowerment. The purpose of this study is to describe the experience of Latino parents of hospitalized children during FCR in a public safety …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

Exploring Barriers To Organ Donation In The African American Communities Of California, D. R. Law, Susan Mcniesh

Faculty Publications

There are a disproportionate number of African-Americans on transplant waiting lists across the country. The outcomes of a transplant are greatly improved when the donor and the recipient are from the same ethnic group. Sadly, the demand for cadaver organs in the African-American community exceeds the supply. Researchers in the past have sought to identify barriers to organ and tissue donation. To date, the studies have been conducted in the eastern and southern regions of the United States. This study examines whether the previously identified barriers are applicable in the African-American communities of California. A revised version of the Bone …

Differences In Substance-Related Risk Behavior Between Dual And Triple Diagnosed Severely Mentally Ill Adults, Michelle Hampton, Linda Chafetz, Carmen Portillo

Faculty Publications

No abstract provided.

Constructivism Applied To Psychiatric–Mental Health Nursing: An Alternative To Supplement Traditional Clinical Education, Michelle Hampton

Faculty Publications

With the popularity of accelerated pre‐licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism‐based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric–mental health nursing course. Students participated in a 10‐week, multistage project that examined life histories, treatment resources, and evidence‐based practice, as applied to a single …

Differences In Substance-Related Risk Behavior Between Dual And Triple Diagnosed Severely Mentally Ill Adults, Michelle Hampton, Linda Chafetz, Carmen Portillo

Faculty Publications

The purpose of this study was to determine whether differences exist between adults with dual and triple diagnoses with regard to substance-related risk behaviors. This secondary analysis was a cross-sectional study. There were 252 subjects with dual and triple diagnoses recruited from residential crisis programs in San Francisco. Using descriptive and logistic regression analyses, subjects in the two groups were compared with regard to demographic data, types of substances, and routes of administration used in the previous 30 days to determine risk for exposure and/or transmission of human immunodeficiency virus/hepatitis C virus. When compared to the dual diagnosis group, subjects …

Integrating A Professional Apprenticeship Model With Clinical Simulation For Psychiatric Nursing Students, M. C. Crider, Susan Mcniesh

Faculty Publications

In this article, we present a theory-based application of clinical simulation in psychiatric-mental health nursing education. As described by Benner, Sutphen, Leonard, and Day, a three-pronged apprenticeship that integrates intellectual, practical, and ethical aspects of the professional role is critical in the development of practical reasoning in nursing education and training. Clinical encounters are often fraught with ambiguity and uncertainty. Therefore, educating for a practice discipline requires experiential and situated learning. Using the three-pronged experiential model in simulated psychiatric-mental health nursing practice supports the development of critical nursing skills, ethics, and theoretical concepts. A clinical scenario is presented that demonstrates …

The Lived Experience Of Students In An Accelerated Nursing Program: Intersecting Factors That Influence Experiential Learning, Susan Mcniesh

Faculty Publications

The goal of this interpretive research study was to articulate the lived experience of students in an accelerated master’s of nursing entry program learning the practice of nursing within a clinical setting. Specific questions included: How did previous life experiences, education, and career choices influence the experience of second-degree students? What were the potential effects on learning of condensing and accelerating the curriculum as is requisite in second-degree programs? Data from small group and individual interviews were collected and analyzed using interpretive phenomenological methods. Akin to the experience of tourists or new immigrants, students were confronted with new physical demands, …

The Composite First Person Narrative: Texture, Structure, And Meaning In Writing Phenomenological Descriptions, M. S. Wertz, M. Nosek, Susan Mcniesh, E. Marlow

Faculty Publications

This paper illustrates the use of composite first person narrative interpretive methods, as described by Todres, across a range of phenomena. This methodology introduces texture into the presently understood structures of phenomena and thereby creates new understandings of the phenomenon, bringing about a form of understanding that is relationally alive that contributes to improved caring practices. The method is influenced by the work of Gendlin, Heidegger, van Manen, Gadamer, and Merleau-Ponty. The method’s applicability to different research topics is demonstrated through the composite narratives of nursing students learning nursing practice in an accelerated and condensed program, obese female adolescents attempting …

Learning Formative Skills Of Nursing Practice In An Accelerated Program, Susan Mcniesh, P. Benner, C. Chesla

Faculty Publications

The purpose of this qualitative research study was to describe how students in an accelerated master’s degree entry program experientially learned the practice of nursing. One research question examined in this study was: What formative experiences did students identify as helping them develop and differentiate their clinical practice? Data from clinical observations and a combination of small group and individual interviews were collected and analyzed using interpretive phenomenological methods. Students identified formative skills learned through the independent care of a patient as pivotal in their identity and agency development. By experiencing the responsibility and action from within the body and …

Skin Blood Flow Response To 2-Hour Repositioning In The Long-Term Care Residents: A Pilot Study, Vivian K. Wong

Faculty Publications

PURPOSE: The purpose of this noninvasive pilot study was to examine the changes in transcutaneous oxygen (tcO2), skin temperature, and hyperemic response in the heels, sacrum, and trochanters in a 2-hour loading-unloading condition in nursing home residents who are positioned in supine and lateral positions. DESIGN: A 1-group, prospective, repeated-measures design was used. SUBJECTS AND SETTING: Nine subjects (5 males, 4 females) with a mean age of 85.3 ± 10.86 years (mean ± SD) who required help in turning and positioning at a skilled nursing facility participated in the study. METHODS: Oxygen and temperature sensors were placed on the heels, …

Changes In Temperature Of Heel Skin Under Pressure In Hip Surgery Patients, Vivian K. Wong, N. A. Stotts, H. W. Hopf, G. A. Dowling, E. S. Froelicher

Faculty Publications

OBJECTIVE: The aim of the study was to examine the effect of external pressure of the bed surface on heel skin temperature in adults in the first 3 days after hip surgery. DESIGN: A quasi-experimental study in a prospective, within-subjects, repeated-measures design. SETTING: This study was performed at 2 acute-care hospitals. PARTICIPANTS: Eighteen subjects (9 men and 9 women) with a mean age of 58.3 (±16.1) years were recruited after hip surgery at the 2 hospitals. METHODS: Temperature sensors were placed on the plantar surface of each foot, close to the heels. Measures were taken when the heels were (1) …

Exploring The Impact Of Race On Mental Health Service Utilization Among African Americans And Whites With Severe Mental Illness, Michelle Hampton, Linda Chafetz, Mary White

Faculty Publications

BACKGROUND: Disparities among African Americans and Whites with severe mental illness have been identified in numerous studies. Yet it remains unknown if disparities are associated with race or other vulnerabilities common to this population. OBJECTIVES: This study used the Behavioral Model for Vulnerable Populations to examine mental health service utilization among 155 African Americans and Whites with severe mental illness for 12 months after discharge from a residential crisis program. DESIGN: This cross-sectional study was a secondary analysis of data from a randomized trial. RESULTS: Race did not emerge as a significant predictor of mental health service utilization. Factors associated …

Current Substance Use Behavior Among Severely Mentally Ill Individuals Diagnosed With Hiv And Hcv, Michelle Hampton, Linda Chafetz, Carmen Portillo

Faculty Publications

BACKGROUND: Infection with HIV and HCV is higher among severely mentally ill (SMI) individuals than the general population. The literature addressing prevention focuses primarily on sexual risk, though substance-related risk is significant. Insufficient data is available about substance use behavior in this population to formulate effective secondary prevention interventions. METHODS: This cross-sectional study was a secondary analysis of a RCT. Subjects reporting a diagnosis of HIV/HCV (reporters) were compared to non-reporters. Data were extracted from interviews that included the Addiction Severity Index (ASI). Data were analyzed using logistic regression. RESULTS: Of 275 subjects, 64(23.3%) reported a HIV/HCV diagnosis. Compared to …

Perceptions Among Students In Online Health Related Courses - A Pilot Study, Kathy Sullivan

Master's Projects

Given the proliferation of online courses in university education, continuous evaluation is imperative to ensure quality. This study utilized a quantitative descriptive design using a questionnaire to explore the perceived adequacy and acceptance of distance learning in undergraduate health related courses. Questions were designed to elicit students' reactions to teaching methods, course content, and how the format influenced their learning. Overall, acceptance of online courses is high. Most of the students were willing to take another online course in the future. Respondents felt that online courses offer more flexibility, encourage both independent and critical thinking skills, and that the course …

Self Perceptions Of Clinical Performance Of Accelerated First Degree And Accelerated Second-Degree Graduates, Neelam N. Murthi

Master's Projects

Currently in the United States, motivated by nursing shortages, numerous ways have been created to recruit nurses in nursing schools. Accelerated nursing programs are increasing rapidly. Colleges and Schools of Nursing around the nation are accepting students seeking their first degree, as well as those with a second degree. This study compared perceptions of clinical performance of accelerated first-degree and accelerated second-degree bachelor of nursing graduates. The intention was to identify whether, after graduation, the two groups held different self-perceptions of performance in the clinical environment. This was to determine if one group has better self-perception of performance than the …

Postpartum Patients Reports Of Satisfaction With A Welcome Meal After A Vaginal Delivery, Jessica R. Pinilla

Master's Projects

Objective: The purpose of this research study was to assess patient perspectives regarding a special Welcome Meal. The focus was on patients' feeling welcomed and important because prior research has shown that when a patient's expectations are exceeded, patient satisfaction increases. This study suggests that receiving a Welcome Meal may improve their experience on a postpartum unit. Design: Prior to discharge, each patient on the maternity unit was served a special Welcome Meal. A questionnaire was given to patients that consisted of six questions. The six questions incorporated six themes found in research literature on improving patient satisfaction. These themes …

Perceptions Of Nursing Students Regarding Evidence-Based Practice, Sheleen Tolentino

Master's Projects

The purpose of this descriptive quantitative study was to explore the nursing students' perceptions of their attitude and knowledge regarding evidence-based practice (EBP). The Research Awareness Questionnaire (RAQ), previously used only with healthcare professionals was slightly modified and piloted with senior nursing students (N=22). Eighty-two percent (n=18) of the participants believe that EBP is part of their role. Only 41% (n=9) were confident to undertake research. On the actual knowledge measures, 96% (n=21) could define qualitative research, and 86 % (n=19) correctly defined quantitative research. Suggestions for revising the RAQ are discussed. With modifications, this instrument could be utilized by …

What Is The Perception Of Preparedness Amongst Accelerated Bsn Students Compared To Traditional Bsn Students?, Sheetal Raman-Love

Master's Projects

With today's economic uncertainty, and nursing shortages, many have decided to join the health care industry in hopes of finding financial stability and job security. The impaction of nursing schools throughout the United States has led to the proliferation of accelerated nursing programs. These programs are designed for motivated students who are able to utilize their prior educational experience enabling them to accelerate and complete their BSN degree in a short period of time (Wu, C.Y., & Connelly, C.E., 1992). This study focused on the examination of the length of time in nursing school and the potential influence it may …

Faculty Perceptions Of Interactions Between Students And Registered Nurses In The Clinical Learning Envirorunent, Laurie M. Rosa

Master's Projects

Perceptions of the relationships between nurses and staff were evaluated from a faculty perspective to uncover the ways that the faculty react, respond, and help to support students. During interviews with faculty, access to practice and clinical unit atmosphere emerged as themes. Faculty described nurses granting access to practice by mentoring students and involving them in the entire care of the patient, or nurses who limited students' access to practice through unprofessional behavior, or "cutting corners." Unit atmosphere influenced learning both positively and negatively depending on inclusion of students, morale, and welcoming behaviors of staff. Faculty acted as guides and …