Nursing Commons^™

Improving Adherence To Adjuvant Hormonal Therapy Among Disadvantaged Women Diagnosed With Breast Cancer In South Carolina: Proposal For A Multimethod Study, Tisha M. Felder, Sue Heiney, James R. Hébert, Daniela B. Friedman, Ronit Elk, Regina Franco, Lucy Gansauer, Barbara Christensen, Marvella E. Ford

Faculty Publications

Background: Current clinical guidelines recommend that hormone receptor-positive breast cancer survivors take adjuvant hormonal therapy (AHT) for 5 to 10 years, following the end of definitive treatment. However, fewer than half of patients adhere to the guidelines, and suboptimal adherence to AHT is associated with an increased risk of breast cancer mortality. Research has extensively documented sociodemographic and disease-specific factors associated with adherence to AHT, but very little evidence exists on behavioral factors (eg, knowledge, patient-provider communication) that can be modified and targeted by interventions. Objective: The goal of this study is to develop and test a theory-based, multilevel intervention …

Immune And Microrna Responses To Infection And Indole-3-Carbinol During Colitis, Rasha Raheem Alkarkoushi, Yvonne Hui, Abbas S. Tavakoli, Udai Singh, Prakash Nagarkatti, Mitzi Nagarkatti, Ioulia Chatzistamou, Marpe Bam, Traci L. Testerman

Faculty Publications

BACKGROUND: Indole-3-carbinol (I3C) and other aryl hydrocarbon receptor agonists are known to modulate the immune system and ameliorate various inflammatory and autoimmune diseases in animal models, including colitis induced by dextran sulfate sodium (DSS). MicroRNAs (miRNAs) are also gaining traction as potential therapeutic agents or diagnostic elements. Enterohepatic (EHH) species are associated with an increased risk of inflammatory bowel disease, but little is known about how these species affect the immune system or response to treatment. AIM: To determine whether infection with an EHH species alters the response to I3C and how the immune and miRNA responses of an EHH …

Family Behaviors As Unchanging Obstacles In End-Of-Life Care: 16-Year Comparative Data, Renea L. Beckstrand, Jasmine B. Jenkins, Karlen E. Luthy, Janelle L. B. Macintosh

Faculty Publications

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined.

Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time.

Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999.

Results Of the 2000 questionnaires …

Nurses' Experiences Of Organisational Learning: A Qualitative Descriptive Study, Bret Lyman, Marisa E. Biddulph, V Grace Hopper, Julie L. Brogan

Faculty Publications

Aim: To explore the validity of and expand upon a model of organisational learning in hospitals.

Background: Organisational learning is a positive change in an organisation's collective knowledge, cognition and/or action, leading to improved hospital performance. A current model offers an evidence-based, theoretical representation of organisational learning in hospitals, yet the intricacies of organisational learning in clinical practice are not fully understood. Additional guidance is needed to effectively foster and study organisational learning.

Method: Semi-structured interviews were used to gather 15 first-hand experiences of organisational learning from 14 nurses. Data were analysed via deductive thematic analysis.

Results: Organisational learning was …

American Heart Association Epi|Lifestyle Scientific Sessions: 2020 Meeting Highlights, Alexander C. Razavi, Véronique Gingras, Erin D. Michos, Ann Marie Navar, Sherry Ann Brown, Erin Delker, Kathryn Foti, Stéphanie Harrison, Yifei Lu, Jovia L. Nierenberg, Jewel Scott Phd, Rn, Fnp-C, Olive Tang, Alvin G. Thomas, Ruth Alma Turkson-Ocran, Amelia Wallace, Mingyu Zhang, Kristie J. Lancaster, Pamela L. Lutsey, Elizabeth Selvin

Faculty Publications

No abstract provided.

American Heart Association Epi|Lifestyle Scientific Sessions: 2020 Meeting Highlights, Alexander C. Razavi, Véronique Gingras, Erin D. Michos, Ann Marie Navar, Sherry Ann Brown, Erin Delker, Kathryn Foti, Stéphanie Harrison, Yifei Lu, Jovia L. Nierenberg, Jewel Scott Phd, Rn, Fnp-C, Olive Tang, Alvin G. Thomas, Ruth Alma Turkson-Ocran, Amelia Wallace, Mingyu Zhang, Kristie J. Lancaster, Pamela L. Lutsey, Elizabeth Selvin

Faculty Publications

No abstract provided.

Measuring Learning And Engagement During Debriefing: A New Instrument, Shelly Jensen Reed

Faculty Publications

Background: Debriefing is considered to be where the bulk of learning takes place. Examination of debriefing is needed to help determine if facilitation methods effectively contribute to the learning process. More instruments are needed to evaluate all key debriefing elements, and no tools exist that evaluate participant engagement in the learning process.

Method: Kolb’s experiential learning theory was used to inform tool development. The focus of the new instrument is behaviors that indicate engagement with the learning process as the learner moves through Kolb’s learning cycle. A qualitative study of debriefing facilitators was performed, and a behaviorally anchored instrument was …

Hereditary Cancer Syndrome Recognition And Testing: Beyond Brca, Deborah O. Himes, Hanford B. Shuman

Faculty Publications

Hereditary cancer syndromes, resulting from mutations of tumor suppressor genes, can significantly increase the risk for breast cancer. Although hereditary breast and ovarian cancer syndrome caused by BRCA1/2mutations is well-known, less well-known hereditary cancer syndromes also exist. This article focuses on 3 other syndromes, including Li-Fraumeni, Cowden, and Peutz-Jeghers. This article will help prepare nurse practitioners to recognize key clinical features of these syndromes and understand testing criteria. Additionally, this article discusses barriers to diagnosing hereditary cancer syndromes and the role of primary care nurse practitioners in ordering genetic tests and making genetic referrals for optimal patient care.

Patient With Questions About Cancer Risk, Deborah O. Himes, Jennie Vagher

Faculty Publications

Primary care nurse practitioners routinely care for patients with personal or family histories of cancer. Approximately 5% to 10% of all cancers are related to hereditary cancer syndromes (HCSs), which cause an increased risk for developing more cancers and cancers at earlier ages than the general population. Nurse practitioners in primary care must become comfortable with identifying patients at risk for HCSs. Ordering genetic tests can be a challenge because the number of genetic tests available is growing at a rapid pace. This case highlights a woman who survived breast cancer at age 25 and basal cell carcinoma at age …

A Smartphone App For Self-Management Of Heart Failure In Older African Americans: Feasibility And Usability Study, Sue P. Heiney, Sara B. Donevant, Swann Arp Adams, Pearman D. Parker, Hongtu Chen, Sue Levkoff

Faculty Publications

Background: Mobile health (mHealth) apps are dramatically changing how patients and providers manage and monitor chronic health conditions, especially in the area of self-monitoring. African Americans have higher mortality rates from heart failure than other racial groups in the United States. Therefore, self-management of heart failure may improve health outcomes for African American patients.

Objective: The aim of the present study was to determine the feasibility of using an mHealth app, and explore the outcomes of quality of life, including self-care maintenance, management, and confidence, among African American patients managing their condition after discharge with a diagnosis of heart failure. …

Social Adversity, Sleep Characteristics, And Elevated Blood Pressure Among Young Adult Black Females, Jewel Scott Phd, Rn, Fnp-C, Susan Silva, Leigh Ann Simmons

Faculty Publications

Purpose: We examined whether sleep characteristics and adverse social exposures were associated with elevated blood pressure (BP) in young adult black women. Methods: This is a cross-sectional analysis of existing data from 581 black females who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Adverse social exposures included child abuse, discrimination, perceived stress, social isolation, and subjective social status. Self-reported sleep characteristics were measures of duration, latency, continuity, and snoring. Logistic regression was used to evaluate the influence of social exposures and sleep characteristics on BP. Results: Among the women (mean age=29.1 years), 32.4% had …

Social Adversity, Sleep Characteristics, And Elevated Blood Pressure Among Young Adult Black Females, Jewel Scott Phd, Rn, Fnp-C, Susan Silva, Leigh Ann Simmons

Faculty Publications

Purpose: We examined whether sleep characteristics and adverse social exposures were associated with elevated blood pressure (BP) in young adult black women. Methods: This is a cross-sectional analysis of existing data from 581 black females who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Adverse social exposures included child abuse, discrimination, perceived stress, social isolation, and subjective social status. Self-reported sleep characteristics were measures of duration, latency, continuity, and snoring. Logistic regression was used to evaluate the influence of social exposures and sleep characteristics on BP. Results: Among the women (mean age=29.1 years), 32.4% had …

Academic Electronic Health Record Implementation: Tips For Success, Patricia K. Ravert, Kristen Whipple, Stacie Hunsaker

Faculty Publications

Many nursing programs use simulation experiences to augment or replace clinical experiences. Use of an electronic health record (EHR) in the educational setting extends the realism. A task force reviewed EHR programs, selected an EHR, and created an implementation plan with successful rollout over 2 years.

Disruptive Innovation: Impact For Practice, Policy, And Academia, Heather V. Nelson-Brantley, K. David Bailey, Joyce Batcheller, Laura Caramanica, Bret Lyman, Francine Snow

Faculty Publications

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US States, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.

Using Simulation To Develop Clinical Teaching Competencies In Nurse Educators, Julie Fitzwater

Faculty Publications

This report describes a research study to measure the effect of simulation on clinical educators’ knowledge and skills about effective formative feedback for prelicensure nursing students.

Subject Population: Clinical nurse educators who teach prelicensure nursing students in clinical education were recruited.

Research Design: Pre-test and post-test design with a simulation workshop for educators as the intervention. This was a pilot study.

Theoretical Frameworks: The theoretical frameworks guiding the research study include Meleis’ Transitions theory and the NLN Jeffries Simulation theory. Transitions theory addresses the situational transition when a nurse clinician takes on the new role of nurse educator. Simulation theory …

The Effect Of Dyad Rounding On Collaboration And Patient Experience, Amy Christensen, Korby Miller, Jason Neff, Rusty A. Moore, Sharee Hirschi, Katreena Collette Merrill

Faculty Publications

Communication among the healthcare team is essential to providing high-quality patient care. In the hospital, nurses care for multiple patients during their shift. Physicians or advanced practice clinicians (APCs) visit hospitalized patients daily to update orders, complete assessments, and contribute to care plans. One method to ensure that healthcare providers communicate effectively is interdisciplinary, or dyad, rounding in the hospital. This consists of purposeful rounding on each patient by the nurse and the physician or APC together to review the patient's status and update the care plan. When healthcare providers and nurses round together, it improves communication, patients are more …

Using Information Practices Of Nurses To Reform Information Literacy Instruction In Baccalaureate Nursing Programs, Anne R. Diekema, Betsy S. Hopkins, Brandon Patterson, Nena Schvaneveldt

Faculty Publications

Objective - Seeking information is a key element of evidence based practice and successful healthcare delivery. Significant literature exists on both the information seeking behaviour of professional nurses and information literacy teaching methods, but scarce evidence connects nurses’ information behaviour and environments with their education. This study sought to use data from nursing alumni to answer the following research questions: What are the current information practices of professional bachelor’s-prepared nurses? How do recently-graduated nurses suggest that their education could have better prepared them to find and evaluate information in the workplace?

Methods - The researchers conducted a descriptive study using …

Development And Psychometric Properties Of A Prostate Cancer Knowledge Scale For African American Men, Otis L. Owens, Abbas Tavakoli Drph, Theda Rose, Nikki R. Wooten

Faculty Publications

African American men have the highest prostate cancer-related mortality nationally. In response to this disparity, targeted interventions are emerging to enhance African American men's prostate cancer (PrCA) knowledge to ensure they are equipped to make informed decisions about PrCA screening with health-care providers. African American men's PrCA knowledge has been measured inconsistently over time with limited psychometric evidence. The factor structure of this construct in African American men is relatively unknown. This study describes the development and psychometric evaluation of an 18-item Prostate Cancer Knowledge Scale among 352 African American men. Exploratory factor analysis (EFA) was conducted using weighted least …

Reliability Of The American Community Survey Estimates Of Risk-Adjusted Readmission Rankings For Hospitals Before And After Peer Group Stratification, Nathaniel Bell, Ana Lòpez-De Fede, Bo Cai

Faculty Publications

Importance Since the transition to the American Community Survey, data uncertainty has complicated its use for policy making and research, despite the ongoing need to identify disparities in health care outcomes. The US Centers for Medicare & Medicaid Services’ new, stratified payment adjustment method for its Hospital Readmissions Reduction Program may be able to reduce the reliance on data linkages to socioeconomic survey estimates.

Objective To determine whether there are differences in the reliability of socioeconomically risk-adjusted hospital readmission rates among hospitals that serve a disproportionate share of low-income populations after stratifying hospitals into peer group–based classification groups.

Design, Setting, …

Does Family Communication Matter? Exploring Knowledge Of Breast Cancer Genetics In Cancer Families, Deborah O. Himes Phd, Aprn-Bc, Sarah H. Davis, Jane H. Lassetter, Neil E. Peterson, Margaret F. Clayton, Wendy Birmingham Phd, Anita Y. Kinney

Faculty Publications

Knowledge of breast cancer genetics is critical for those at increased hereditary risk who must make decisions about breast cancer screening options. This descriptive study explored theory-based relationships among cognitive and emotional variables related to knowledge of breast cancer genetics in cancer families. Participants included first-degree relatives of women with breast cancer who had received genetic counseling and testing. Study participants themselves did not have breast cancer and had not received genetic counseling or testing. Data were collected by telephone interviews and surveys. Variables analyzed included numeracy, health literacy, cancer-related distress, age, education, and the reported amount of information shared …

Cryolipolysis: A Guide For Primary Care Practitioners, Miryam Harper, Jane H. Lassetter

Faculty Publications

A desire for the ideal body image has influenced the development of a nonsurgical body-shaping procedure known as cryolipolysis. The purpose of this clinical feature is to inform nurse practitioners about the risks and benefits of cryolipolysis so they can educate their patients. Cryolipolysis is a safe, effective method of reducing small areas of unwanted fat. Adverse effects are minimal and include pain, redness, bruising, and swelling. Results are seen within 12 weeks, but long-term effects are unknown. There are contraindications, and it is relatively expensive; however, it may be a safer option than invasive surgery.

Development And Initial Psychometric Evaluation Of The Computer-Based Prostate Cancer Screening Decision Aid Acceptance Scale For African-American Men, Otis L. Owens, Nikki R. Wooten, Abbas S. Tavakoli

Faculty Publications

BACKGROUND:

To reliably evaluate the acceptance and use of computer-based prostate cancer decision aids (CBDAs) for African-American men, culturally relevant measures are needed. This study describes the development and initial psychometric evaluation of the 24-item Computer-Based Prostate Cancer Screening Decision Aid Acceptance Scale among 357 African-American men.

METHODS:

Exploratory factor analysis (EFA) with maximum likelihood estimation and polychoric correlations followed by Promax and Varimax rotations. RESULTS: EFA yielded three factors: Technology Use Expectancy and Intention (16 items), Technology Use Anxiety (5 items), and Technology Use Self-Efficacy (3 items) with good to excellent internal consistency reliability at .95, .90, and .85, …

Highlights From The American Heart Association's Epi|Lifestyle 2019 Scientific Sessions, Alvaro Alonso, Madison D. Anderson, Michael P. Bancks, Sherry Ann Brown, Melissa C. Caughey, Alex R. Chang, Erin Delker, Kathryn Foti, Véronique Gingras, Michael G. Nanna, Alexander C. Razavi, Jewel Scott Phd, Rn, Fnp-C, Elizabeth Selvin, Catherine Tcheandjieu, Alvin G. Thomas, Ruth Alma N. Turkson-Ocran, Allison Webel, Deborah R. Young, Bailey M. Debarmore

Faculty Publications

No abstract provided.

Highlights From The American Heart Association's Epi|Lifestyle 2019 Scientific Sessions, Alvaro Alonso, Madison D. Anderson, Michael P. Bancks, Sherry Ann Brown, Melissa C. Caughey, Alex R. Chang, Erin Delker, Kathryn Foti, Véronique Gingras, Michael G. Nanna, Alexander C. Razavi, Jewel Scott Phd, Rn, Fnp-C, Elizabeth Selvin, Catherine Tcheandjieu, Alvin G. Thomas, Ruth Alma N. Turkson-Ocran, Allison Webel, Deborah R. Young, Bailey M. Debarmore

Faculty Publications

No abstract provided.

Antimicrobial Stewardship: Staff Nurse Knowledge And Attitudes, Katreena Collette Merrill, Sandra Forsyth Hanson, Sharon Sumner, Todd Vento, John Veillette, Brandono Webb

Faculty Publications

Background: Registered nurses are uniquely qualified to augment antimicrobial stewardship (AS) processes. However, the role of nursing in AS needs further development. More information is needed regarding gaps in registered nurse knowledge, attitudes toward AS, and how infection preventionists can help.

Methods: An online descriptive survey was deployed to a convenience sample of approximately 2,000 nurses at the bedside. The survey included 15 questions addressing: (1) overall knowledge of AS; (2) antimicrobial delivery; (3) knowledge and attitudes regarding antimicrobial use; (4) antimicrobial resistance; and (5) antimicrobial resources and education.

Results: Three hundred sixteen staff nurses from 3 hospitals (15.8%) responded …

Educating Patients About Opioid Disposal: A Key Role For Perianesthesia Nurses, Katreena C. Merrill, Valynn Christina Haslam, Karlen E. (Beth) Luthy, Craig Nuttall

Faculty Publications

Purpose: To examine opioid prescription practices, patient use of opioids after laparoscopic cholecystectomy, and patient knowledge about disposal of unused medication.

Design: Mixed methods design with a chart review and structured phone interview.

Methods: Thirty-four patients were interviewed by phone and asked how many opioids were prescribed, how many excess pills they had 6 to 10 days postoperatively, and if they knew how to dispose of them.

Findings: Average number of excess pills ranged from 0 to 42 (mean = 14; SD = 11.7). Nearly half of patients (47%) perceived the prescribed quantity as “too many.” Seventy-one percent of patients …

Exercises For Older Adults With Knee And Hip Pain, Neil E. Peterson, Kay D. Osterloh, M. Nichole Graff

Faculty Publications

Half of all older adults report knee and/or hip pain. Obesity and sedentary lifestyle contribute to the incidence and prevalence of painful knee and hip conditions. Weight loss should be a priority in overweight or obese patients. Improving joint function over time requires a balance of rest and usage. Practitioners should assess joint disorders and recommend exercises for reducing knee and hip pain with patients when appropriate. Instruction should include a combination of 1) stretching and flexibility, 2) strength training, and 3) endurance conditioning exercises. Even small improvements in exercise can make meaningful improvements in pain, movement, endurance, and quality …

Impact Of Donor Milk On Short- And Long-Term Growth Of Very Low Birth Weight Infants, Rebecca Hoban, Michael E. Schoeny, Anita Esquerra-Zwiers, Tanyaporn K. Kaenkumchorn, Gina Casini, Grace Tobin, Alan H. Siegel, Kousiki Patra, Matthew Hamilton, Jennifer Wicks, Paula Meier, Aloka L. Patel

Faculty Publications

Mother’s own milk (MOM) reduces the risk of morbidities in very low birth weight (VLBW) infants. When MOM is unavailable, donor breastmilk (DM) is used, with unclear impact on short- and long-term growth. This retrospective analysis compared anthropometric data at six time points from birth to 20–24 months corrected age in VLBW infants who received MOM supplements of preterm formula (n = 160) versus fortified DM (n = 161) during neonatal intensive care unit (NICU) hospitalization. The cohort was 46% female; mean birth weight and gestational age (GA) were 998 g and 27.3 weeks. Multilevel linear growth models assessed changes …

Unplanned Hospitalization Among Individuals With Cancer In The Year After Diagnosis, Robin Whitney, Janice Bell, Daniel Tancredi, Patrick Romano, Richard Bold, Ted Wun, Jill Joseph

Faculty Publications

PURPOSE: Reducing acute care use is an important strategy for improving value in cancer care. However, little information is available to describe and compare population-level hospital use across cancer types. Our aim was to estimate unplanned hospitalization rates and to describe the reasons for hospitalization in a population-based cohort recently diagnosed with cancer. MATERIALS AND METHODS: California Cancer Registry data linked with administrative inpatient data were used to examine unplanned hospitalization among individuals diagnosed with cancer between 2009 and 2012 (n = 412,850). Hospitalizations for maintenance chemotherapy, radiotherapy, or planned surgery were excluded. Multistate models were used to estimate age-adjusted …

Reduction In Hospitals' Readmission Rates: Role Of Hospital-Based Skilled Nursing Facilities, Shivani Gupta, Ferhat D. Zengul, Ganisher Davlyatov, Robert Weech-Maldonado

Faculty Publications

Hospital readmission within 30 days of discharge is an important quality measure given that it represents a potentially preventable adverse outcome. Approximately, 20% of Medicare beneficiaries are readmitted within 30 days of discharge. Many strategies such as the hospital readmission reduction program have been proposed and implemented to reduce readmission rates. Prior research has shown that coordination of care could play a significant role in lowering readmissions. Although having a hospital-based skilled nursing facility (HBSNF) in a hospital could help in improving care for patients needing short-term skilled nursing or rehabilitation services, little is known about HBSNFs’ association with hospitals’ …