Nursing Commons^™

Assessing The Feasibility And Perceptions Of Health Services For Refugees Of Resettlement Organizations, Heidi Jean Worabo

Dissertations

Background: Since 1975 the U.S. has resettled 2.6 million refugees who had to flee from their home countries. Many refugee resettlement organizations have developed different models of innovation to promote a smooth transition between previous foreign refugee camps to U.S. communities so that refugees swiftly become economically and socially self-sufficient. Providing refugees with health benefits and resources has been foremost priority upon arrival as they try to overcome health care barriers. Yet there is a lack of literature examining the impact of these health services and how they are perceived by the program recipients. Purpose: This scholarly project aimed to …

Breast Health And Mammography Screening In Older Women, Martha A. Ibarra Phd, Msn, Anp, Rn

Dissertations

Age-related health disparities in breast cancer screening are a public health concern. From 2002 to 2006, the median age for newly diagnosed cases of breast cancer was 61 years and the median age for breast cancer mortality was 68 years of age (Surveillance Epidemiology and End Results [SEER], 2009). Mammography is the best available screening tool for breast cancer detection (Susan G. Komen Foundation, 2008). The Centers for Medicare and Medicaid Services (CMS, 2006) reported that only about half of older women who are eligible for mammograms through Medicare obtain a mammogram every two years. The literature identifies psychosocial barriers, …

Pain Management In Triage And Reducing Percentage Of Left Without Being Seen In An Overcrowded Ed, Christina Ballejos-Campos Phd

Dissertations

Although in most emergency rooms, the patient is seen first by a highly trained triage nurse, the ED physician is trained to determine if the patient can safely leave the ED prior to in-depth exam, treatment and diagnosis. The goal is to keep the left without being seen by a physician percentage low, since a high number would indicate poor quality, additionally patients who present with pain, and then leave the ED prior to being seen can pose a greater risk. This study examined the association of nurse-initiated triage pain protocol on the LWOBS percentage rate of patients who present …

Nurse Manager Transformational Leadership Practices And Patient Outcomes Among Magnet And Non-Magnet Hospitals, Bridgett Byrd Sellars Phd, Msn, Ma, Rn

Dissertations

In 2004 the Institute Of Medicine called for healthcare leaders to embrace and adopt transformational leadership practices to promote quality of care and favorable patient outcomes. Nurse managers are accountable for 24-hour operations of their departments and influence patient outcomes. The purpose of this research was to examine the relationships among nurse manager transformational leadership practices, patient outcomes and hospital types (Magnet, On The Journey, and Non-Magnet). A correlational study examined relationships between self-reported transformational leadership practices of nurse managers and patient outcomes by hospital types. The study was conducted using a purposive sample of Association of California Nurse Leader …

A Qualitative Descriptive Study Of The Work Of Nurses In Interventional Radiology, Brenda Naef Boone Phd

Dissertations

This dissertation study explored the work of nurses in interventional radiology. Interventional radiology (IR) is an emerging field of practice in health care. More and more procedures that were historically done in the operating room are being performed in IR. This has led to higher acuity patients and an increased need for specialized nursing care. The work of nurses in this area of practice is not well described and as such can lead to a lack of understanding of nursing involved in high tech low touch areas. This qualitative descriptive research study was conducted to shed light on this under …

Inpatient Glycemic Management: Glucose Control Relationship With Hospital Variables, Discharge Planning And Education, Crisamar Javellana-Anunciado Phd, Fnp-Bc, Rn

Dissertations

This dissertation study examined the relationship of glucose control with clinical outcomes, costs, discharge planning and education. Extant studies showed that hyperglycemia, in the presence or absence of a diabetes diagnosis, is prevalent in hospitalized patients. Hyperglycemia is found in one-third of all hospital admissions and is linked to poor clinical outcomes and increased healthcare costs. Furthermore, clinical evidence suggests that lack of discharge coordination associated with medical errors and readmission. This entire body of work contains three distinct sections: Two manuscripts and a grant proposal. The two manuscripts in this study were based on more current retrospective data at …

Relationship Between Delirium And Night-Time Interruptions In Icu, Amy R. Stuck Phd, Rn

Dissertations

Background: This dissertation examined the phenomenon of delirium in the intensive care unit (ICU) setting. Delirium is a form of cognitive disturbance with a physiologic etiology and complex, multifactorial mechanisms of causation and risk. Delirium in the ICU patient presents a significant risk for adverse outcomes including increased mortality, length of stay, falls, and restraint use. ICU delirium can lead to persistent cognitive impairment beyond discharge and frequent skilled nursing placement. Identifying delirium requires accurate diagnosis that is optimized when validated instruments are used. Sleep deprivation has been linked to adverse health consequences including delirium. Previous studies investigating the relationship …

Tobacco-Use Promotional Environment And Intrapersonal Environment: Predictors Of Smoking Intention Among Young Southern California Thai-American Adolescents, Arpakorn Magkunthod Phd, Msn, Rn

Dissertations

This study explores tobacco-use related environment, intrapersonal factors, and smoking initiation in Thai-American adolescents aged 10 to 16 living in Southern California. A purposive sample of 217 youth was recruited from seven Thai-community centers located in four counties of Southern California: The sample was fairly evenly distributed by gender with female (54.5%) and almost three quarters (70.9%) were born in the United States (70.9%). Age ranged from 10 to 16 years, with the mean age 12.71 years old (SD =1.835); 27% reported age of 11. Data were collected using the 97 item Teen Tobacco-Use Questionnaire. Findings indicated 12 participants (6.3%) …

Documentation: Delirium In The Hospitalized Older Adult, Jacqueline Fitzgerald Close Phd

Dissertations

Background: Delirium is a common, life threatening and preventable geriatric syndrome. Because this condition is frequently addressed by administering dangerous antipsychotic drugs, it is imperative that accurate systematic assessments are charted to determine the actual need for these medications. The purpose of the study was to describe medical record documentation of a systematic assessment of delirium in older adults who had been administered an antipsychotic medication. Methods: A descriptive correlational retrospective design was used for this medical record data based study. The setting was a 107 bed acute care community hospital located in southern California. Inclusion criteria were medical records …

Instituting An Oral Health Preventive Service Program, Including Fluoride Varnish, For Preschool Children Birth To Five Years In A Rural Health Clinic: A Clinical Scholarship Project, Carol Ann Berger

Dissertations

Abstract This project was designed to institute an oral health preventive program in a rural health clinic, in a dental provider shortage area, promoting oral health in preschool children birth to five years by: (a) instituting a program that supports the Missouri preventive service program in oral health, (b) promoting oral screenings and fluoride varnish twice yearly, (c) assessing the risk of caries, (d) referring to appropriate dental services and (e) educating parents or guardian about the importance of oral health and how to maintain oral health at home with children birth to five years. This project sought to answer …

Development Of An Advanced Practice Registered Nurse Primary Care Telephone Clinic, Linda G. Kaiser

Dissertations

Abstract Development of an Advanced Practice Registered Nurse Primary Care Telephone Clinic This pilot project developed and implemented a telephone clinic based on established Veterans Affairs telephone policy and procedures and determined patient acceptability of this new visit type as an alternative to face to face visits. The review of the literature produced research that indicates telephone clinics are a viable visit option for patients. Telephone visits provide access to the primary care provider while being convenient and economical for patients. Research studies demonstrate that patients are satisfied with this visit option. The pilot project was successfully implemented in a …

Oncology Nurses' Cultural Competence, Knowledge, And Attitudes Toward Cancer Pain, Ayman Alnems Phd, Msn, Rn

Dissertations

Effective pain management requires appropriate knowledge, attitudes, and assessment skills. The purposes of this study were to obtain information about the knowledge and attitudes of oncology nurses related to cancer pain and its management, to evaluate oncology nurses' cultural competence, and to investigate relationships between oncology nurses' cultural competence and their pain management knowledge and attitudes. Ferrell and McCaffery's (2008) Nurses' Knowledge and Attitude Survey Regarding Pain (NKASRP), the Cultural Competence Assessment Survey (CCA) (Doorenbos, Schim, Benkert, & Borse, 2005; Schim, Doorenbos, Miller, & Benkert, 2003), and a demographic questionnaire were used to measure oncology registered nurses' cultural competence and …

California School Nurses' Knowledge, Attitude, And Intention To Participate In Sexuality Education, Maria G. Matza Phd, Msn, Rnc

Dissertations

A critical need exists to provide adolescents with sexual health education as demonstrated by our nation's position in having the highest adolescent pregnancy rates among all the developed nations. The critical need is further pronounced by California's changing demographic profile of young Latinos who are projected to be the majority in 2042 and continue to demonstrate higher pregnancy and birth rates than other racial and ethnic groups. Currently, there is limited evidence to confirm if California's students are receiving sexual and reproductive health as required by law, nor is there evidence to link school nurses as teachers or consultants in …

Factors And Health Promoting Behaviors That Influence Maternal And Infant Outcomes In Older Pregnant Thai Women, Supawadee Thaewpia Phd, Msn, Rn

Dissertations

This dissertation summarizes research conducted in partial fulfillment of the program requirements for the Doctor of Philosophy in Nursing degree from the Hahn school of Nursing and Health Sciences, University of San Diego. The results of the dissertation research are organized as three discrete papers. Article one is entitled; "Reliability and Validity of Thai Translations of Instruments Measuring Psychosocial Factors and Health Promoting Behaviors among Older Pregnant Thai Women." This article describes the dissertation research study in which the selected instruments were piloted at an antenatal clinic in Thailand. The article determines the instruments' ability to examine perceived benefits, perceived …

The Impact Of Guided Imagery On Sleep Quality In Mothers Of Preterm Infants, Linda M. Schaffer Phd, Mn, Rn

Dissertations

Background: Mothers who have given birth to preterm infants are at an increased risk for impaired sleep. Evidence based interventions are needed to assist mothers in improving their sleep quality as few are available. Purpose: Guided by the transactional framework of Lazarus and Folkman (1984), the purpose of this study was to: describe maternal and infant factors which influence sleep quality, examine the relationships between depression, anxiety, stress, social support, to sleep quality, and describe the influence of a R-GI intervention on sleep quality among a sample of mothers whose preterm babies were admitted to NICU. Methods: This prospective, descriptive, …

Enzyme Therapy In Oncology Care: A Clinical Scholarship Project, Julie Penick

Dissertations

Studies worldwide indicate that oral enzyme therapy (OET) can prevent or reduce the side effects associated with standard oncology care. Yet use of OET is not common in the United States. The ultimate aim of the proposed project is to improve the quality of life of women with breast cancer who are on standard chemotherapy protocols. Achieving this goal can be facilitated by implementation of the proposed feasibility project designed to: (a) enhance the knowledge of oncology care providers and women with breast cancer on use of OET in conjunction with standard oncology care, (b) assess the attitudes of oncology …

In Search Of Resilience And Positive Health Outcomes In Low-Income Adolescents With Asthma, Darla Kim Dewolff

Dissertations

Asthma is a chronic lung disease of epidemic proportions affecting 24.6 million Americans, including 7.0 million children. In particular, 22% of high school students indicated a doctor or a nurse had told them that they had asthma, with 10.8% with current asthma. The disease disproportionately afflicts minority children from low-income areas. Adolescents with asthma, who live in such areas, are at particular risk for increased morbidity and mortality. The purpose of this study was to examine the degree to which the phenomenon of resilience, observed in other physical health and psycho-social contexts, may be found in adolescents with asthma exposed …

Coping Mechanisms Among Lebanese First-Time College Students, Rita Doumit

Dissertations

No abstract provided.

The Emotional Intelligence Profiles And Cognitive Measures Of Nurse Anesthesia Students In The Southeastern United States, Shawn Bryant Collins

Dissertations

Problem. The purpose of this cross-sectional correlational study was to explore the relationship between emotional intelligence and personal and academic factors of nurse anesthesia students at three points in a program: matriculation, at one year of study, and in the last semester of study and the relationship of these to clinical scores and national certification examination (NCE) scores.

Method. An ex-post-facto cross-sectional study design was used to gather data at three critical times in nurse anesthesia (NA) programs to explore the relationships between emotional intelligence scores, preadmission demographics, clinical scores, and NCE scores.

Results. Data from 216 nurse anesthesia students …

Acute-To-Home Care Nursing Handoffs: Distributed Cognition Across Patterns Of Knowledge, Rosemary Kennedy

Dissertations

Timely, explicit, and effective communication of patient information during care transitions is fundamental to safe care. Studies show that handoffs or transfers of patient care from one provider to another are susceptible to communication failures (Riesenberg et al., 2009a). Most studies on communication failures focus on communication between providers within the same setting of care. Few studies, if any, focus on communication between care settings in different locations. However, research has identified gaps in care during critical transitions and identified poor communication and incomplete transfer of information as the root cause (Naylor et al., 2004). This qualitative dissertation consists of …

Risk Perception, Psychological Well-Being, And Health-Promoting Behaviors In Persons Informed Of A Coronary Artery Calcium Score, Jennie Elizabeth Johnson

Dissertations

Background: Cardiovascular disease (CVD) remains the leading cause of adult deaths because individuals continue to engage in behaviors that exacerbate CVD. New technologies such as coronary artery calcium (CAC) screening detect atherosclerosis before clinical disease is manifested. Awareness of an abnormal finding should enhance motivation for change.

Objective: To examine how awareness of a CAC score affects risk perception and health-promoting behaviors in persons at high risk for CVD.

Methods: This study used a descriptive prospective design with 174 high risk adults (3 or more major risk factors) recruited at a radiology center offering CAC scans in a Chicago suburb. …

The Development Of Trust In The Nurse-Patient Relationship With Hospitalized Mexican American Patients, Sharon M. Jones

Dissertations

The Hispanic population in the United States is growing and this population experiences health care disparities compared to non-Hispanic Whites. Mexican Americans are the largest sub-group of Hispanics and providing nursing care that is patient-centered and culturally competent is important when caring for this population. Trust is an important component of patient-centered care and culturally competent care as well as a major element , (confianza) in the Hispanic culture. Although nursing researchers have identified the need for trust in culturally competent care with Mexican American patients, none have explored how trust develops between the nurse and the Mexican American patient. …

Impact Of Multiple Children On Parental Supervision Practices, Parental Developmental Competence, And Unintentional Injury Risk, Jennifer L. Taylor

Dissertations

Unintentional injury is the leading cause of childhood mortality and morbidity in the United States. The effects of injury on children, families and society encompass physical, mental, emotional, and financial consequences. The highest injury rates are among preschool age children, especially preschool children who have siblings. Child injury prevention strategies can reduce the rates of childhood unintentional injuries and minimize the burdens to children, families, and society created by these injuries. To design and implement effective child injury prevention strategies, further investigation is needed to understand the relationship between the variables influencing the occurrence of child injuries. The specific aim …

Chest Tube Dressings: A Comparison Of Different Methods, Susan Kathleen Blackburn Jones

Dissertations

This study is an experimental design with randomization comparing the use of standard gauze dressings (SGD) to transparent adhesive dressings (TAD) to cover chest tube insertion sites in post-operative patients who have undergone cardio-thoracic surgery. The study was conducted in a 400 bed, tertiary non-academic teaching hospital in the Midwestern United States. Seventy-nine patients were enrolled in the study; 39 received TAD and 40 received SGD. The non-inferiority margin was set at 15% in keeping with current recommendations (Kaul & Diamond, 2006). The TAD was found to be not inferior to the SGD with regards to the proportional differences in …

Caring, Interaction, And Active Teaching Strategies: Factors That Contribute To The Success Of The Associate Degree Nursing Student, Penelope Sue Logsdon

Dissertations

This exploratory study examined successful associate degree nursing students’ perceptions regarding the importance of caring by the nursing faculty, nursing faculty/student interaction, and faculty use of active teaching strategies. Participants completed a researcher developed survey instrument that measured both the importance and frequency of the caring, interaction, and active teaching strategies. The survey instrument measured six demographic factors and 30 statements regarding caring, interaction, and active teaching. Participants rated the statements for both importance and frequency on a four-point Likert scale. Five community and technical college associate degree nursing programs participated in the research with a total of 270 successful …

Nursing Students' Lived Experiences Surrounding Medication Administration, Sally Nan Morgan Phd

Dissertations

Medication errors are abounding and the complexity of medication administration creates an environment where health care providers are at risk for making errors. This environment includes nursing students learning medication administration. Coupled with a rigid, protocol-driven pedagogy, nursing students may be placed in a learning experience counterproductive to accuracy. Previous studies have focused on causes and perceptions of medication errors looking for the delineation between safe and unsafe practice. In doing so, past research may have narrowed the path of discovery needed to diminish medication errors. In addition, research regarding the lived experience of nursing students while they are learning …

Call-Shift Fatigue And Use Of Countermeasures And Strategies By Certified Registered Nurse Anesthetists, Ramona M. Domen Phd, Crna

Dissertations

Purpose: The purpose of this study was to examine whether Certified Registered Nurse Anesthetists (CRNAs) experience fatigue during call and to assess their use of fatigue avoidance strategies (practices that prevent fatigue) and fatigue countermeasures (practices that decrease fatigue) to mitigate its effects. Method: Using a cross sectional descriptive survey design, data were collected from a randomly selected sample of 323 practicing CRNAs who worked call shifts. Data analysis: Data were analyzed using descriptive and multivariate statistics. Results: The sample was fairly evenly distributed with slightly more female respondents, 55% (n = 179). Fifty four percent worked a weekday call …

Women's Cognitive Appraisals Of Their Birth Experience As Predictive And Maintaining Factors Of Postpartum Posttraumatic Stress Symptom Severity, Lauren Carr Spooner

Dissertations

Empirical support has accumulated for evidence of posttraumatic stress symptoms following approximately 30% of childbirth experiences (Olde, van der Hart, Kleber, & van Son, 2006). Researchers have suggested that there is a complex relationship among predisposing, precipitating, and maintaining factors that impact postpartum PTSD (Slade, 2006). Anxiety, perception of support, and negative cognitions are such factors that have been shown to significantly correlate with PTSD symptoms (Foa & Rothbaum, 1998; Olde et al., 2006; Soet, Brack, & Dilorio, 2003), but have not been studied together in relation to PTSD associated with traumatic birth. The current study controlled for trait anxiety …

Health Literacy And Health Promotion Behaviors Among Samoans, Katherine Tong Phd, Msn, Cfnp, Phn

Dissertations

Limited health literacy is associated with failure to engage in health promotion behaviors. Few studies examine this relationship among Samoans. This study used a cross-sectional correlational design to determine health literacy levels and their relationship to health promoting behaviors in a southern California Samoan population. Health literacy (Short form Test of Functional Health Literacy in Adults) and health promotion behaviors (Health Promotion Lifestyle Profile II) were measured in a convenience sample of 87 Samoans in southern California. Data analysis employed chi-square, t-test, and one- way ANOVA. Significant associations were found for health literacy and demographic characteristics of employment and marital …

Associations Among Perceived Benefits, Barriers, Cues, And Physical Activity In Thai Primary Students, Sireewat Ar-Yuwat Phd, Mph, Rn

Dissertations

The purpose of this study is to examine the relationships between perceived benefits, perceived barriers, and cues to action and levels of physical activity in Thai fourth grade students. The Health Belief Model was used as the theoretical framework of the study to investigate students' beliefs related to physical activity. The participants in this cross-sectional study were fourth grade students selected by a simple random sampling method. A sample of 123 students was recruited from primary schools in Muang district, Phitsanulok province. The sample schools were selected by stratified random sampling. For data collection, the study utilized two instruments: the …