Nursing Commons^™

A Minimal Contact Diet And Physical Activity Intervention For White-Collar Workers, Kimberlee A. Gretebeck, Tatiana Bailey, Randall J. Gretebeck

College of Nursing Faculty Research and Publications

Minimal contact lifestyle interventions with multiple components coupled with health screening have the potential to improve worker health. The purpose of this study was to test a minimal contact multiple component lifestyle diet and exercise intervention. The multiple components that were included in this project included a worksite health screening, brief counseling session, emailed newsletter, and a pedometer. In response to the intervention, participants reported an increase in green salad, fruit, and vegetable consumption as well as an increase in self-efficacy for consuming three servings of fruits and vegetables a day. Study participants also demonstrated a significant increase in physical …

Debrief In Emergency Departments To Improve Compassion Fatigue And Promote Resiliency, Kristin Haglund, Madeline Schmidt

College of Nursing Faculty Research and Publications

The purpose of this case study was to describe compassion fatigue using one nurse's experience as an example and to present the process of Personal Reflective Debrief as an intervention to prevent compassion fatigue in emergency department (ED) nurses. Debriefing after adverse outcomes using a structured model has been used in health care as a nonthreatening and relatively low-cost way to discuss unanticipated outcomes, identify opportunities for improvement, and heal as a group. There are many methods of debrief tailored to specific timing around events, specific populations of health care workers, and amount of time for debriefing. Debrief with personal …

Pediatric Nurses' Perspectives On Medication Teaching In A Children's Hospital, Cori A. Gibson, Ashley Stelter, Kristin Haglund, Stacee M. Lerret

College of Nursing Faculty Research and Publications

Purpose

To explore inpatient pediatric nurses' current experiences and perspectives on medication teaching.

Design and Methods

A descriptive qualitative study was conducted at a Midwest pediatric hospital. Using convenience sampling, 26 nurses participated in six focus groups. Data were analyzed in an iterative group coding process.

Results

Three themes emerged. 1) Medication teaching is an opportunity. 2) Medication teaching is challenging. Nurses experienced structural and process challenges to deliver medication teaching. Structural challenges included the physical hospital environment, electronic health record, and institutional discharge workflow while process challenges included knowledge, relationships and interactions with caregivers, and available resources. 3) Medication …

The Impact Of Simulation Sequencing On Perceived Clinical Decision Making, Aimee A. Woda, Jamie Hansen, Mary Paquette, Robert V. Topp

College of Nursing Faculty Research and Publications

An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students' perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences.

A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, …

Physical Activity, Functional Ability, And Obesity In Older Adults: A Gender Difference, Kimberlee A. Gretebeck, Leann M. Sabatini, David R. Black, Randall J. Gretebeck

College of Nursing Faculty Research and Publications

Disability, institutionalization, and loss of independence may be directly caused or exacerbated by physical inactivity and obesity. The purpose of the current cross-sectional survey was to explore the impact of gender and obesity on functional ability tasks, physical activity, and psychosocial factors in older adults. Participants comprised 964 University retirees (55% female, mean age = 75.3 years, SD = 6.7 years) with a mean body mass index (BMI) of 26.1 kg/m² (SD = 4.7 kg/m²). Results revealed significant gender and BMI interaction effects. Women were less active than men and obese women were most functionally impaired, …

Risk And Protective Factors In The Lives Of Caregivers Of Persons With Autism: Caregivers’ Perspectives, Abir K. Bekhet, Denise M. Matel-Anderson

College of Nursing Faculty Research and Publications

PURPOSE

The purpose of this descriptive exploratory study is to understand the experience of being a caregiver of a person with autism spectrum disorder (ASD) in the light of the resilience theory.

METHODS

Qualitative data were collected as a part of a larger quantitative study. Ninety-three caregivers completed this qualitative study and responded to the two open-ended questions. In the parent study, subjects were recruited by convenience sampling from the Interactive ASD Network (IAN).

FINDINGS

The identified categories appeared to reflect three distinct categories consistent with the resilience theory, labeled as follows: risk factors, protective factors, and overlapping factors.

PRACTICE …

Parents’ Perspectives On Caring For Children After Solid Organ Transplant, Stacee M. Lerret, Norah L. Johnson, Kristin Haglund

College of Nursing Faculty Research and Publications

Purpose

To explore parents’ experiences of the transition from hospital to home and complex chronic illness management following their children's solid organ transplant (SOT).

Design and Methods

Qualitative component of a larger mixed methods longitudinal study. Parents of SOT recipients were interviewed three times following hospital discharge from five major pediatric transplant hospitals in the United States.

Results

Analysis of parent interviews (N = 48) resulted in three themes that characterized the phases of transition to home and complex chronic illness care. Three themes, corresponding to the three time periods of data collection, included “getting back to normal” at 3 …

Effectiveness Of An Online Natural Family Planning Program For Breastfeeding Women, Richard J. Fehring, Mary Schneider, Thomas Bouchard

College of Nursing Faculty Research and Publications

Objective To analyze the effectiveness of an online, nurse-managed natural family planning (NFP) program among breastfeeding women and subgroups of these women. Design Longitudinal comparative cohort study. Setting A university-based online NFP education program and menstrual cycle charting system. Participants Women (N = 816) with a mean age of 30.3 years (standard deviation = 4.5) who registered to use the online NFP system and indicated they were breastfeeding. Methods Participants tracked their fertile times with an electronic hormone fertility monitor (EHFM), cervical mucus monitoring, or both. All unintended pregnancies were evaluated by professional nurses. Results The correct use pregnancy rates …

Positive Thinking Training Intervention For Caregivers Of Persons With Autism: Establishing Fidelity, Abir K. Bekhet

College of Nursing Faculty Research and Publications

More than 3.5 million in the US are diagnosed with autism spectrum disorder (ASD) and caregivers experience stress that adversely affects their well-being. Positive thinking training (PTT) intervention can minimize that stress. However, before testing the effectiveness of PTT, its fidelity must be established. This pilot intervention trial examined fidelity of an online PTT intervention for ASD caregivers with a random assignment of 73 caregivers to either the online PTT intervention or to the control group. Quantitative data [Positive Thinking Skills Scale (PTSS)] and qualitative data (online weekly homework) were collected. The mean scores for the PTSS improved for the …

Trauma Exposure Among Women In The Pacific Rim, Elizabeth Reeves, Pilar De Bernal, Susan G. Silva, Diva Jaramillo, Tulia Uribe, Agnes Tiwari, Gladys Eugenia Canaval, Maria Eugenia Mendoza Flores, Ruth Ann Belknap, Janice Carrol Humphreys

College of Nursing Faculty Research and Publications

Purpose

Healthcare professionals who provide services in the immediate or long‐term aftermath of traumatic events need to understand the nature and frequency of traumatic events in the lives of women. However, research on trauma exposure in women has only recently begun to assess events other than intimate partner and sexual violence and has not supported direct statistical comparison of cross‐national and cross‐cultural data. The purpose of this descriptive, correlational study was to describe and compare trauma exposure prevalence and type in community‐based samples of women in the United States, Colombia, and Hong Kong.

Design

Women were recruited through posted notices …

Onset Of Mild Cognitive Impairment In Parkinson Disease, David K. Johnson, Zachary Langford, Mauricio Garnier-Villarreal, John C. Morris, James E. Galvin

College of Nursing Faculty Research and Publications

Objective: Characterize the onset and timing of cognitive decline in Parkinson disease (PD) from the first recognizable stage of cognitively symptomatic PD-mild cognitive impairment (PD-MCI) to PD dementia (PDD). Thirty-nine participants progressed from PD to PDD and 25 remained cognitively normal.

Methods: Bayesian-estimated disease-state models described the onset of an individual’s cognitive decline across 12 subtests with a change point.

Results: Subtests measuring working memory, visuospatial processing ability, and crystalized memory changed significantly 3 to 5 years before their first nonzero Clinical Dementia Rating and progressively worsened from PD to PD-MCI to PDD. Crystalized memory deficits were …

How Postpartum Women With Depressive Symptoms Manage Sleep Disruption And Fatigue, Jennifer J. Doering, Dauphne A. Sims, Donald D. Miller

College of Nursing Faculty Research and Publications

Postpartum sleep and fatigue have bidirectional relationships with depressive symptoms and challenge women's everyday functioning. The everyday process of managing postpartum sleep and fatigue in the context of depressive symptoms remains unexplored. We conducted a grounded theory study with a sample of 19 women who screened positive on the Postpartum Depression Screening Scale (PDSS™) Short Form at 3 weeks postpartum. Women completed semi‐structured in‐home interviews and the full PDSS and Modified Fatigue Symptoms Checklist at 1, 3, and 6 months postpartum. The sample was on average 27 years old, with 2.8 children, and 63% were African‐American. They described a basic …

Evaluation Of A Primary Care Weight Loss Program, Callie Chiroff, Christine Shaw, Kristin Haglund, Susan Breakwell

College of Nursing Faculty Research and Publications

Nurse practitioners at a primary care clinic established a weight loss program to address high obesity rates among their African American patients. Interviews and a retrospective chart review were used to evaluate the weight loss program. Number of appointments was the only significant predictor of weight loss, and there was a strong positive correlation between total number of appointments and weight loss. The overall view of the program was positive. This description and evaluation of the program may be useful to nurse practitioners seeking to develop an individualized effective weight loss intervention for African Americans within a primary care setting.

Building Research Infrastructure In Magnet® Hospitals: Current Status And Future Directions, Meg Johantgen, Marianne E. Weiss, Vicki Lundmark, Robin Newhouse, Karen Haller, Lynn Unruh, Maria Shirey

College of Nursing Faculty Research and Publications

OBJECTIVE: The aim of this study was to describe the infrastructures supporting research in Magnet® hospitals.

BACKGROUND: Hospitals undertaking the journey toward Magnet designation must build research and evidence-based practice (EBP) infrastructures that support the infusion of research and EBP into clinical practice.

METHODS: An electronic survey was developed and distributed to the chief nursing officer or Magnet coordinator of all Magnet hospitals between June 10, 2015, and July 8, 2015.

RESULTS: Of the 418 Magnet hospitals invited, 249 responses (60%) were received. Resources dedicated to nursing research were difficult to isolate from those for EBP. Supporting clinical nurses’ time …

Pain Management Efficacy Study Between Continuous And Single-Administration Bupivacaine Following Lumbar Spinal Fusion, Jay Tumulak, Steve Johnston, Patty Adams

College of Nursing Faculty Research and Publications

Poorly managed postoperative pain decreases patient satisfaction, impedes early patient mobilization, lengthens inpatient hospital stay, and increases healthcare costs. Multimodal analgesia with local anesthetics is considered most effective for postoperative pain management. This study compared patients undergoing lumbar fusion who received plain bupivacaine from May 2011 until August 2012 with those who received liposomal bupivacaine from September 2012 until May 2013. The aim was to determine which preparation reduced postoperative opioid use the most. All lumbar spinal fusion surgeries in the periods indicated were included in the study. Ninety-three patient charts were reviewed: 47 for the plain bupivacaine group and …

Development Of A Self‐Management Theory‐Guided Discharge Intervention For Parents Of Hospitalized Children, Kathleen Sawin, Marianne E. Weiss, Norah L. Johnson, Karen Gralton, Shelly Malin, Carol Klingbeil, Stacee M. Lerret, Jamie J. Thompson, Kim Zimmanck, Molly Kaul, Rachel Schiffman

College of Nursing Faculty Research and Publications

Background

Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self‐management of their child's care at home after discharge.

Problem

No theory‐based discharge intervention exists to guide pediatric nurses' preparation of parents for discharge.

Purpose

To develop a theory‐based conversation guide to optimize nurses' preparation of parents for discharge and self‐management of their child at home following hospitalization.

Methods

Two frameworks and one method influenced the development of the intervention: the Individual and Family Self‐Management Theory, Tanner's Model of Clinical Judgment, and the Teach‐Back method. A team of nurse …

Maternal Weight After Childbirth Versus Aging-Related Weight Changes, Olga Yakusheva, Kandice A. Kapinos, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background

Pregnancy weight gain is believed to contribute to female overweight and obesity. However, most studies do not account for the changes in body weight expected to occur as women age. We examined the long-term weight trajectory of childbearing women relative to weight progression that could be expected in the absence of pregnancy.

Methods

From the hospital records of 32,187 women with two births in Wisconsin during 2006 to 2013, we extracted the maternal weight at pregravid, delivery, and subsequent pregravid. We predicted the corresponding aging-progressed weights using a weight-for-age equation adjusted for sociodemographic variables. Nonparametric mixed effects models estimated …

Interleukin-1 Receptor Antagonist Polymorphism And Birth Timing: Pathway Analysis Among African American Women, Shannon L. Gillespie, Jeremy L. Neal, Lisa Christian, Laura A. Szalacha, Donna O. Mccarthy, Pamela J. Salsberry

College of Nursing Faculty Research and Publications

Background: Timing of birth is a major determinant of newborn health. African American women are at increased risk for early birth, particularly via the inflammatory pathway. Variants of the IL1RN gene, which encode the interleukin-1 receptor antagonist (IL-1Ra) protein, are implicated in early birth. The biological pathways linking these variables remain unclear. Evidence also suggests that inflammatory pathways differ by race; however, studies among African American women are lacking.

Objectives: We assessed whether an IL1RN variant was associated with timing of birth among African American women and whether this relationship was mediated by lower anti-inflammatory IL-1Ra production or …

Bivalirudin Versus Unfractionated Heparin During Peripheral Vascular Interventions, Daniel Ortiz, Maharaj Singh, Arshad Jahangir, Suhail Allaqaband, Jayant Khitha, Tanvir Bajwa, Mark W. Mewissen

College of Nursing Faculty Research and Publications

Objectives This study aimed to compare the association of access site complications and the use of unfractionated heparin versus bivalirudin during subinguinal peripheral vascular intervention.

Background Compared to unfractionated heparin, bivalirudin has been associated with fewer bleeding complications in patients undergoing percutaneous coronary intervention but more ischemic events. The safety and efficacy of direct thrombin inhibitors in peripheral vascular interventions is not well defined.

Methods We compared the incidence of in-hospital access site complications and discharge status among patients in the multicenter, prospective Vascular Quality Initiative registry who underwent peripheral vascular intervention between August 2007 and January 2014 using bivalirudin …

Fertility Care Services, Richard J. Fehring

College of Nursing Faculty Research and Publications

The Catholic Church calls married couples to responsible parenthood; this includes both openness to new human life and the avoidance of pregnancy when serious reasons present themselves. Natural methods of family planning respect the dignity of the person and the integrity of the sexual act. They treat fertility as a natural process rather than a disease. Natural family planning (NFP) works with a woman’s menstrual cycle; it uses awareness of fertile and infertile times to achieve or avoid pregnancy and allows married couples, through their awareness, to respect and maintain both the unitive and the procreative aspects of the sexual …

Development And Psychometric Evaluation Of The Nurses Professional Values Scale-3, Darlene Weis, Mary Jane Schank

College of Nursing Faculty Research and Publications

Background and Purpose: The Nurses Professional Values Scale-3 (NPVS-3) is an instrument derived from the American Nurses Association Code designed to measure nurses' professional values. The purpose of this study was to examine its psychometric properties. Methods: A random sample of 1,139 baccalaureate nursing students, graduate nursing students, and practicing nurses participated. The 28-item Likert-scale instrument was subjected to exploratory and confirmatory factor analysis. Principal components analysis with varimax rotation and Kaiser normalization resulted in a 3-factor solution. Results: Findings supported internal consistency reliability of 3 factors with alpha coefficients from .80 to .91 and total scale coefficient of .94. …

Rankings Matter: Nurse Graduates From Higher-Ranked Institutions Have Higher Productivity, Olga Yakusheva, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background

Increasing demand for baccalaureate-prepared nurses has led to rapid growth in the number of baccalaureate-granting programs, and to concerns about educational quality and potential effects on productivity of the graduating nursing workforce. We examined the association of individual productivity of a baccalaureate-prepared nurse with the ranking of the degree-granting institution.

Methods

For a sample of 691 nurses from general medical-surgical units at a large magnet urban hospital between 6/1/2011–12/31/2011, we conducted multivariate regression analysis of nurse productivity on the ranking of the degree-granting institution, adjusted for age, hospital tenure, gender, and unit-specific effects. Nurse productivity was coded as “top”/“average”/“bottom” …

Nursing Students’ Perception Of The Stigma Of Mental Illness, Abir K. Bekhet, Carolyn J. Murrock, Qiyan Mu, Harpreet Singh-Gill

College of Nursing Faculty Research and Publications

Background: Mental health disorders are highly prevalent in the U.S. Nursing students’ perceptions regarding the stigma of mental illness will impact the quality of care delivered and the patients’ outcomes.

Method: Data was collected from 64 sophomore students. Five open ended questions were distributed to the students during the first class. All the surveys were collected by a volunteer student and were placed in the instructor’s mailbox in a sealed envelope.

Results: The results revealed three categories: students ‘perceptions of the causes of mental illness stigmatization, their own perception of mental illness, and their perception on how to break the …

Online Positive Thinking Training Intervention For Caregivers Of Individuals With Asd: Necessity, Acceptability And Feasibility, Abir K. Bekhet

College of Nursing Faculty Research and Publications

Background: More than 3.5 million people in the United States are diagnosed with autism spectrum disorder (ASD). Caring for children with ASD can be stressful and can be detrimental to the well-being of the caregivers (CGs). However, the adverse effects of caregiving on the well-being of CGs may be avoided with appropriate interventions. CGs of persons with ASD might benefit from a positive thinking training (PTT) intervention to help them cope with the stress of caregiving. However, the necessity, acceptability and feasibility for PTT in ASD CGs have not been studied.

Objective: To examine the necessity, acceptability and feasibility of …

Answering Wicked Questions: Dealing With Opposing Truths As A Nursing Associate Professor, Robert V. Topp, Patricia E. Hershberger, Marilyn Bratt

College of Nursing Faculty Research and Publications

Nursing associate professors frequently are confronted with increasing responsibilities and fewer resources. These challenges commonly contribute to declines in job satisfaction and may result in departing academe. This article addresses these challenges by providing answers to four common “wicked questions” experienced by nursing associate professors: (a) How do I decline a request from a supervisor to take on additional responsibilities while continuing to support the mission of the school and advance my own scholarly productivity? (b) How do I handle the workload of multiple doctoral students with a variety of content areas that are different from my own and maintain …

Cesarean Deliveries And Maternal Weight Retention, Kandice A. Kapinos, Olga Yakusheva, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background

Cesarean delivery accounts for nearly one-third of all births in the U.S. and contributes to an additional $38 billion in healthcare costs each year. Although Cesarean delivery has a long record of improving maternal and neonatal mortality and morbidity, increased utilization over time has yielded public health concerns and calls for reductions. Observational evidence suggests Cesarean delivery is associated with increased maternal postpartum weight, which may have significant implications for the obesity epidemic. Previous literature, however, typically does not address selection biases stemming from correlations of pre-pregnancy weight and reproductive health with Cesarean delivery.

Methods

We used fetal malpresentation …

Examining The Relationship Between Clinical Judgment And Nursing Actions In Prelicensure Students, Andrea Stuedemann Fedko, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Faculty frequently use the Lasater Clinical Judgment Rubric (LCJR) to identify students’ clinical judgment; however, it is unclear whether LCJR scores relate to appropriate nursing action. In a pilot study consisting of senior-level nursing students (N = 22), participants were scored on the LCJR and anticipated nursing actions, and results were analyzed using simple linear regression. There was a statistically significant correlation (r = 0.364) between clinical judgment and nursing action. Results suggest that total LCJR scores may be an indicator of the completion of indicated nursing action.

Discharge Teaching, Readiness For Discharge, And Post-Discharge Outcomes In Parents Of Hospitalized Children, Marianne E. Weiss, Kathleen Sawin, Karen Gralton, Norah L. Johnson, Carol Klingbeil, Stacee M. Lerret, Shelly Malin, Olga Yakusheva, Rachel Schiffman

College of Nursing Faculty Research and Publications

Purpose

This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).

Design/methods

In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3 weeks post-discharge …

Effectiveness Of A Natural Family Planning Service Program, Richard J. Fehring, Mary Schneider

College of Nursing Faculty Research and Publications

Purpose: The aims of this study were to determine and compare extended use-effectiveness of an online nurse-managed fertility education service program among women (and subgroups of women) seeking to avoid pregnancy.

Study Design and Methods: This was a 24-month prospective study of a university-based online Web site with 663 nonbreastfeeding women using an online charting system to avoid pregnancy. Participants tracked their fertility online with either cervical mucus monitoring, electronic hormonal fertility monitoring, or both fertility indicators. Unintended pregnancies were validated by professional nurses.

Results: Participants had a mean age of 30.4 years (SD = 6.3) and mean 1.7 children …

Preparing Family Caregivers To Recognize Delirium Symptoms In Older Adults After Elective Hip Or Knee Arthroplasty, Margaret J. Bull, Lesley Boaz, Mehdi Maadooliat, Mary E. Hagle, Lynn Gettrust, Maureen T. Greene, Sue Baird Holmes, Jane S. Saczynski

College of Nursing Faculty Research and Publications

Objectives

To test the feasibility of a telephone-based intervention that prepares family caregivers to recognize delirium symptoms and how to communicate their observations to healthcare providers.

Design

Mixed-method, pre–post quasi-experimental design.

Setting

A Midwest Veterans Affairs Medical Center and a nonprofit health system.

Participants

Forty-one family caregiver-older adult dyads provided consent; 34 completed the intervention.

Intervention

Four telephone-based education modules using vignettes were completed during the 3 weeks before the older adult's hospital admission for elective hip or knee replacement. Each module required 20 to 30 minutes.

Measurements

Interviews were conducted before the intervention and 2 weeks and 2 months …