Nursing Commons^™

Sleep-Related Problems, Sleep-Related Distress, And Sleep-Related Functional Status Among Adult Inpatients Receiving Palliative Care, Lisa C. Sievers

Theses and Dissertations

Palliative care patients may be at a higher risk for sleep-related problems and their negative effects compared to the general population, yet limited sleep research has been done with this population. The purpose of this dissertation was to determine prevalence rates for excessive sleepiness, insomnia, restless legs syndrome (RLS), and high risk for sleep apnea (HRSA); examine relationships between the aforementioned sleep-related problems, sleep-related distress (SD), and sleep-related functional status (SFS); and to determine which sleep-related problem measures along with age and gender predicted SD and SFS among a sample of adult palliative care inpatients. Secondary aims were to understand …

Evaluating The Clinical Utility Of A Novel Electroencephalography System For Assessing Perioperative Neurocognition In Older Surgical Patients, Lloyd H. Barnwell Iii

Theses and Dissertations

Postoperative delirium (POD) is a public health and research priority (American Society of Anesthesiologists, 2019). POD is a risk factor for long-term neurocognitive decline, and the rate of decline is directly proportional to the severity of POD (Vasunilashorn et al., 2018). Baseline cognitive function is a strong, independent predictor for POD (Culley et al., 2017). The International Perioperative Neurotoxicity Working Group recommends baseline cognitive function be assessed for older patients prior to surgery and anesthesia (Berger, et al., 2018). Perioperative cognitive screening tools trialed in anesthesia are not routinely incorporated into clinical practice related to validity, reliability, or practicality problems …

Incidence And Predictor Variables Of Pressure Injuries In Patients Undergoing Ventricular Assist Device And Total Artificial Heart Surgeries: An Eight-Year Retrospective Review, Christopher T. Brindle

Theses and Dissertations

BACKGROUND

Cardiac surgery patients have some of the highest reported incidence and prevalence of pressure injuries (PI). A growing subset of cardiac surgery include patients with end-stage heart failure who undergo ventricular assist device (VAD) or total artificial heart (TAH) surgery. The risk of PI and their natural history of development in this population are unknown and the specific risk factors for PI development remain unexplored.

OBJECTIVES

To perform a systematic review of the literature to identify the incidence and risk factors of PI development in patients undergoing VAD-TAH surgery and thereby inform study design and variables in an eight-year …

Adaptation And Validation Of The Situation Awareness Global Assessment Technique For Student Registered Nurse Anesthetists, Deniz Dishman

Theses and Dissertations

Anesthesia is a health care specialty fraught with high workload demands, stressful work environments, increased production pressure, work areas with many distractions, an increasing use of advanced technology, and the constant need to prioritize work actions. Effective clinical judgment in this dynamic environment necessitates that the provider demonstrate the ability to project what may occur secondary to actual or potential condition changes. These key elements operationalize situation awareness (SA).

High level SA is an important characteristic for the successful development of student registered nurse anesthetists (SRNAs). With Endsley’s “Theory of Situation Awareness” as the foundation, the goal of this study …

Perceived Impact Of Ambient Operating Room Noise By Certified Registered Nurse Anesthetists, Marianne S. Cosgrove

Theses and Dissertations

It is widely acknowledged that elevated levels of noise are commonplace in the healthcare environment, particularly in high acuity areas such as the operating room (OR). Excessive ambient noise may pose a threat to patient safety by adversely impacting provider performance and interfering with communication among perioperative care team members. With respect to the certified registered nurse anesthetist (CRNA), increased ambient OR noise may engender distractibility, diminish situation awareness and cause untoward health effects, thereby increasing the possibility for the occurrence of error and patient injury.

This research project analytically examines the perceived impact of ambient noise in the operating …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

The Impact Of Maternal Diabetes On Fetal And Infant Outcomes: A Secondary Analysis Of Peridata.Net® From 2013 To 2017, Christina Lynn Dzioba

Theses and Dissertations

ABSTRACT

THE IMPACT OF MATERNAL DIABETES ON FETAL AND INFANT OUTCOMES:

A SECONDARY ANALYSIS OF PERIDATA.NET® FROM 2013 TO 2017

Christina Dzioba, MS, ARNP, WHNP-BC, C-EFM

Background: Diabetes is a leading cause of morbidity and mortality for most of the developed world and is known to contribute to adverse maternal, fetal, and infant outcomes. The purpose of this study was to examine the relationship of maternal diabetes to fetal and infant outcomes for infants born in a small heterogeneous urban community with significant disparities in infant mortality using data in the PeriData.Net® database.

Methods: Women with diabetes were case matched …

The Association Between Physiologic Sources Of Pain And Sleep Quality In Older Adults And People With Dementia, Crystal-Rae Evans

Theses and Dissertations

The association between physiologic sources of pain and sleep quality in older adults and people with dementia was examined in this dissertation. Previous research illustrates multiple factors contribute to sleep quality outcomes. Musculoskeletal pain, respiratory distress, gastrointestinal discomfort, and genitourinary pain were examined in relation to sleep quality in older adults and people with dementia. No theory currently exists to guide this nursing research, therefore an illustration of pain and sleep quality in older adults and people with dementia was utilized. Descriptive data analysis and logistic regression were used to address the study aims. The findings from this research illustrate …

Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv

Theses and Dissertations

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home

patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.

Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity …

Influence Of Muscle Strength On Mobility In Critically Ill Adult Patients On Mechanical Ventilation, Audrey R. Roberson

Theses and Dissertations

Patients in the intensive care unit (ICU) setting are prone to develop muscle weakness and the causes are multi-factorial. Muscle strength in adult, critically ill patients on mechanical ventilation decreases with immobility. The influence of muscle strength on different muscle groups and its influence on progressive mobility in the adult, critically ill patient on mechanical ventilation has not been examined. Identifying muscle strength in this patient population can benefit overall muscle health and minimize muscle deconditioning through a progressive mobility plan. The objective of this dissertation was to describe muscle strength in different muscle groups and to describe the influence …

The Correlation Of Size Of Core Network And Frequency Of Contacts With Agitation And Positive Affect In Elderly With Dementia, Amal Ali Al Ghassani

Theses and Dissertations

In the country of Oman, care needs of older adults are primarily provided by family members in the home. The study was guided by socioemotional selectivity theory, the environmental vulnerability hypothesis, and the need-driven dementia-compromised behavior theories. The central premise was that the size of the person’s activities of daily living (ADL) core network and frequency of contact with the ADL core network would predict agitation and affect. A smaller core network with a higher frequency of contact may be better at identifying and treating the person’s unmet needs. A secondary premise was that the emotional closeness of the core …

Influence Of Expectations Of Aging On Older Women’S Use Of Dietary Supplements Using The Health Promotion Theory, Barbara Emily Hekel

Theses and Dissertations

The use of vitamins, minerals and herbal supplements by older adults is increasing and changing. There are concerns about supplement quality, safety, and vitamin D overuse. Little is known about supplement use by nursing home residents and about factors that influence older women to use supplements. The current study describes the supplement use of 247 nursing home residents and 110 independent living women 65 years or older in the Midwestern United States. A secondary analysis of 247 medication administration records describes the prevalence of vitamin, mineral, and herbal supplement use of nursing home residents. Using the health promotion theory, the …

Maternal Abo Blood Phenotype And Factors Associated With Preeclampsia Subtype, Adriane Burgess

Theses and Dissertations

Preeclampsia affects 3-8% of all pregnancies and is a global issue that significantly effects the short and long-term health of women and neonates. The pathophysiology of preeclampsia remains unclear and there seems to be two distinct subtypes, early and late onset. Each subtype may have a unique pathophysiology and set of risk factors. Preeclampsia is linked to long-term risk of cardiovascular disease in previously affected women. Subsequently, risk factors shared between preeclampsia and cardiovascular disease should be explored. The main aim of this study was to determine the strength of association between maternal ABO blood type and preeclampsia subtype. This …

An Evaluation Of Critical Resources In Nurse Anesthesia Educational Programs, Lois E. Stewart

Theses and Dissertations

Advanced practice nurses fill a vital need in the U.S. by increasing access to needed healthcare. Certified Registered Nurse Anesthetists (CRNAs) are one type of advanced practice nurse with a long history of safe and effective peri-anesthetic care. Nurse anesthetists have a rich tradition of providing anesthetic care for rural and underserved communities, and are a primary provider of anesthesia for active and retired military personnel. CRNAs comprise over one-half of the actively practicing U.S. anesthesia workforce currently, and are able to function in any anesthetic care model. Nurse anesthesia educational programs (NAEPs) are the single source for new graduate …

The Association Of Nurses’ Assessment And Certainty To Pain Management And Outcomes For Nursing Home Residents In Jordan, Mohammad Jamil Rababa

Theses and Dissertations

Despite advances in dementia care Pain in people with dementia is still under recognized, underestimated, and undertreated because of poor assessment, poor treatment, and factors relating to nurses’ critical thinking and decision-making skills. Unrelieved pain leads to many serious negative health outcomes in people with dementia. The purpose of the study was to examine temporally based relationships between change in behavior, the nurses’ level of certainty regarding pain, assessment scope and outcomes of pain and agitation. Relationship between severity of dementia, comorbid burden, ability to verbally self-report symptoms and patient outcomes of pain and agitation was also investigated.

A Convenient …