Nursing Commons^™

The Effect Of Concept Mapping On Baccalaureate Nursing Students' Knowledge Acquisition, Pamela S. Laskowski

Theses and Dissertations

This dissertation is a series of three papers on the effect of concept mapping on baccalaureate nursing students’ knowledge acquisition. The first paper is an integrative review of the literature on the use of concept mapping in nursing education. The review evidences that concept mapping has been effective in nursing education for increasing students’ critical thinking. However, it shows that no studies addressing the level of nursing knowledge gained using concept mapping were identified, indicating a need for research in the area of the use of concept mapping for nursing knowledge acquisition. The second paper is a feasibility study of …

Preoperative Activity Level And Outcomes In Older Adult Cardiac Surgery Patients: A Pilot Study, Don Howard Sorensen

Theses and Dissertations

ABSTRACTPreoperative Activity Level and Outcomes in Older ¨Adult Cardiac Surgery Patients: A Pilot StudyDon Howard Sorensen Jr.College of Nursing, BYUMaster of SciencePurpose: To assess the relationship between preoperative physical activity levels and health related quality of life on intra- and post-hospital outcomes following scheduled cardiothoracic surgery in older adults.Rationale/Background: Adults age 50 and older tend to accumulate more sedentary time and are less physically active. Sedentary behavior is linked with early morbidity and death and may predispose patients to postoperative complications. Preoperative activity levels and its relationship to surgical outcomes is an underexplored area. Insight on this topic could influence …

Does Family Communication Matter? Exploring Knowledge Of Breast Cancer Genetics In Cancer Families, Sarah Harmon Davis

Theses and Dissertations

Purpose: Knowledge of breast cancer genetics is critical for those at increased risk whomust make decisions about breast cancer screening options. The purpose of this study was toexplore cognitive and emotional variables that might influence knowledge of breast cancergenetics.Methods: This descriptive, exploratory study analyzed theory-based relationships amongvariables related to knowledge of breast cancer genetics in cancer families. Participants includedfirst-degree relatives of women with breast cancer who had received genetic counseling andtesting; participants themselves did not have breast cancer and had not received geneticcounseling or testing. Data were collected by telephone interview and survey. Variables analyzedinclude numeracy, health literacy, cancer-related distress, …

Does Family Communication Matter? Exploring Knowledge Of Breast Cancer Genetics In Cancer Families, Sarah Harmon Davis

Theses and Dissertations

Purpose: Knowledge of breast cancer genetics is critical for those at increased risk whomust make decisions about breast cancer screening options. The purpose of this study was toexplore cognitive and emotional variables that might influence knowledge of breast cancergenetics.Methods: This descriptive, exploratory study analyzed theory-based relationships amongvariables related to knowledge of breast cancer genetics in cancer families. Participants includedfirst-degree relatives of women with breast cancer who had received genetic counseling andtesting; participants themselves did not have breast cancer and had not received geneticcounseling or testing. Data were collected by telephone interview and survey. Variables analyzedinclude numeracy, health literacy, cancer-related distress, …

Adults With Cystic Fibrosis: Self-Management And Health Outcomes, Amanda Rose Lambie

Theses and Dissertations

This dissertation is comprised of three manuscripts for publication reporting on adults living with cystic fibrosis, self-management behaviors and health outcomes. Chapter I explores what is known about adults living with cystic fibrosis (CF) and the factors impacting their self-management, including the complexities of a health maintenance regime required for survival while integrating and balancing the realities of adulthood. The review of literature provides direction for future research and implications for adult-focused CF studies. Chapter II is a manuscript describing the characteristics of prognostic survival models utilized in adult CF research and provides an overview of their development, validation, predictive …

Understanding The Experiences Of Adjunct Nursing Faculty In The Curriculum Development Process: A Qualitative Case Study, Laurie Ann Colborn

Theses and Dissertations

This qualitative case study examines the experiences of adjunct nursing faculty within the curriculum development process at universities granting a bachelor's degree in nursing within the Philadelphia five-county region, and the state of New Jersey. Seven adjunct nursing faculty members participated in this study providing detailed input of their experiences in this process. Five themes were uncovered during analysis including: assembling a critical foundation, value added, incidental collaboration, a seat at the table, and trial by fire. These themes helped to provide a deeper understanding of the opportunities, rewards, and challenges experienced by these adjunct nursing faculty members in the …

A Qualitative Case Study On Delegation Of School Nursing Practice: School Nurses, Teachers, And Paraprofessionals Perspectives, Sharon L. Schofield

Theses and Dissertations

For the past decade, there have been many changes to school nursing with the implementation of unlicensed assistant personnel now known as paraprofessionals. This process has brought about several concerns such as mode of delegation, education, training, ability to monitor health-care needs, and organizational effects that trended downward without direction. This qualitative inquiry gave an interpretative meaning to the process of delegation in school nursing, the factors that hinder the delegation process as well as components that are needed to effectively delegate and utilize support staff (paraprofessionals) without detrimental effects to students. This study interviewed 20 participants.

Results of this …

Structural Stress And Otherness: How Do They Influence Psychological Stress?, Christine Dewilde

Theses and Dissertations

Background: The Theory of Cultural Distress offers a framework for understanding the potential outcomes in patients who do not receive care that incorporates their cultural beliefs (DeWilde & Burton, 2017).This study represents initial steps in researching the theory byexploring the layering of stressors that place the patient at risk for Cultural Distress. Methods: Utilized aCross-sectional descriptive correlational analysis of intersecting identities (Structural Stressors), ethnicity-related stressors (Otherness) and ethnic-identity (Otherness) to develop understanding of the potential effects of these variables on psychological stress. Independent variables included intersecting identities, perceived ethnic discrimination, concern for stereotype confirmation, own group conformity pressure, and …

Initiating The Loeb Criteria In Long-Term Care, Janice Khauslender

Theses and Dissertations

Urinary tract infections are one of the most commonly reported infections in long-term care. Current practices often rely on non-specific symptoms, rather than specific genitourinary symptoms, to aid in the decision to obtain a urine culture. The literature does not support this practice due to the high prevalence of asymptomatic bacteriuria among long-term care patients, which does not have adverse outcomes when untreated. Antibiotics do not eradicate asymptomatic bacteriuria and place patients at risk of adverse reactions and increased risk of multi-drug resistant organisms. This clinical improvement project applied the Loeb criteria in two long-term care facilities to reduce the …

High Fidelity Simulation Experience And Development Of Clinical Judgment: Recent Graduate Nurses’ Reflections, Martha Kay Lawrence

Theses and Dissertations

Introduction: Nurse faculty endeavor to educate future nurses who are able to effectively transition to competent practice after graduation. Shrinking clinical resources and shortages of qualified clinical faculty have contributed to the increasing utilization of high fidelity simulation (HFS) as a substitute for and enhancement of clinical practice in nursing education. The growing body of HFS research documents both student and faculty satisfaction and increased student self-confidence and self-efficacy. A significant gap in the literature is the lack of research on the translation of knowledge gained in HFS to practice. The aim of this research was to investigate recently graduated …

Perceptions Of The Nursing Faculty Shortage: A Case Study Of One College’S Adjunct Faculty’S Perception Of Doctoral Education, Donna Shaw

Theses and Dissertations

The problem addressed in this qualitative case study was the nurse faculty shortage and associated consequences of a shortage of nurses available to care for an aging population with multifaceted healthcare needs in a complex healthcare system. Because of the nurse faculty shortage, numerous qualified applicants are unable to enroll in nursing programs across the country. One of the key reasons for the nurse faculty shortage is a lack of nurse educators with doctorate degrees to fill the vacant positions. Adjunct nursing faculty were interviewed to ascertain their perceptions about the nurse faculty shortage and messages conveyed by full-time nurse …

Home Exercise Therapy For The Treatment Of Knee Osteoarthritis, Kezia Nixon

Theses and Dissertations

Knee pain is the chief complaint of most osteoarthritis patients, and encourages them to seek medical attention. Unfortunately, pharmacological approaches to the treatment of knee osteoarthritis have been found to be inadequate. Given the prevalence and chronicity of osteoarthritic knee pain, there is an obvious need for treatments that can be provided for the course of the disease, with minimal adverse side effects. Exercise therapy has been found to significantly improve both pain and function among individuals with knee osteoarthritis. The primary objective of this quality improvement project was to investigate the effectiveness of a home-based therapeutic exercise program on …

Assessment Of An Educational Intervention To Increase Knowledge And Intention To Take Hpv Vaccine And Cervical Cancer Screening In Nigeria, Chigozie Anastacia Nkwonta

Theses and Dissertations

Nigeria has some of the highest rates of cervical cancer morbidity and mortality in sub-Saharan Africa. Both the human papillomavirus vaccine (HPV) and cervical screening are effective prevention strategies against both HPV infection and cervical cancer. Lack of awareness, limited knowledge, limited decision-making agency, lack of spousal support and stigma are barriers to uptake of these preventive measures. Given patriarchal structures and norms through which men control family resources and dominate decisions, male involvement in initiatives aimed at improving sexual and reproductive health is necessary. Community-based health education is an effective intervention to improve knowledge and reduce stigma. The aim …

Online Risks, Sexual Behaviors, And Mobile Technology Use In Early Adolescent Children: Parental Awareness, Protective Practices, And Mediation, Kendra Allison

Theses and Dissertations

Mobile technologies (e.g., smartphones and associated social media accessed through downloadable mobile applications) have changed the social landscape of adolescent communication. Intertwined with this communication are risks, many of which are sexual. Evidence suggests online risks associated with mobile technology use can be mitigated by (a) parental awareness of online activities; (b) protective practices regarding content and contacts; and (c) mediation aimed at regulating access and use. Prior research on mobile technology use and associated risks in adolescent children focused on exposure to pornography, sexting, online victimization, and associated negative health outcomes. Parental awareness, protective practices, and mediation have also …

Efficiency Of Ambulatory Blood Pressure Monitoring Vs. 5-Day Serial Monitoring In A Military Treatment Facility, Kadijatu Kakay

Theses and Dissertations

The purpose of this process improvement project is to determine efficiency of ambulatory blood pressure monitoring (ABPM) vs. 5-day blood pressure checks in a military treatment facility. The sample consists of male and female active duty soldiers ages 18 to 54 years without a previous diagnosis of hypertension (HTN). The soldiers were assigned to a unit that is physically and mentally challenging, has demanding training opportunities and duty requirements, and are rapidly deployable in support of peacekeeping, humanitarian and combat missions.

The data collection method included a retrospective chart review of 128 charts randomly selected between June 2016 and May …

Implementation Of A Depression Screening Tool For Cardiovascular Patients In The Primary Care Setting, Amber Nicole Ballentine

Theses and Dissertations

Background: Patients with cardiovascular disease (CVD) have a two-fold increased risk of depression as compared to patients without CVD. According to the American Heart Association (AHA, 2016), there is no gold-standard procedure for screening for depression in cardiovascular patients. Screening for depression varies greatly across specialties and practices, often leaving a gap for detection and treatment of depression in cardiac patients. There are many depression screening tools available; however, the AHA recommends use of the patient health questionnaire (PHQ) screening tool. The PHQ-2 and PHQ-9 questionnaires are the most brief, sensitive, and specific depression screening tool for patients with …

Nicu Nurses' Suggestions For Improving Obstacles In End-Of-Life Care, Rebecca Faye Isaacson

Theses and Dissertations

Background: Approximately 25,000 pediatric deaths occur in hospitals in the United States each year with over 50% of these deaths occurring in Newborn Intensive Care Units (NICU). NICU nurses are frequently involved in end-of-life (EOL) care and face unique obstacles. Objective: The objective of this study was to obtain NICU nurses suggestions for improving obstacles in EOL care in NICUs. Methods: Suggestions were obtained through mailed survey research in qualitative study design. Returned surveys yielded 121 nurse respondents who gave a total of 138 suggestions.Results: A total of 10 cohesive themes were identified: (1) environmental design issues, (2) improved communication …

Validation Of Activity Trackers In A Laboratory Setting With Young Adults, Brandon Leslie Lewis

Theses and Dissertations

Background: Objectively tracking sedentary behavior (SB) and physical activity (PA) is becoming increasingly important as research continues to show the negative effects with increasing SB and decreasing PA. Objectives: The purpose of this study was to evaluate three commercial activity trackers with young adults regarding how they accurately measure SB and PA behaviors in a laboratory setting. Methods: 50 college-aged participants wore three wrist-based activity trackers (Fitbit Surge, Apple Watch, and Basis Peak) and two ActiGraph accelerometer devices during a series of SB and PA behaviors for five-minute intervals in a laboratory setting. The activity trackers were evaluated against direct …

Implementation Of Provider And Workflow Strategies To Increase Adherence To Tqip Guidelines In Traumatic Brain Injury, Regina Thompson

Theses and Dissertations

Traumatic brain injury (TBI) is a leading cause of death and permanent disability worldwide. The American College of Surgeon’s Trauma Quality Improvement Program (TQIP) has developed a set of recommendations for the management of trauma-related injuries, including TBI. The objective of this evidenced-based practice project was to implement provider- and workflow-based strategies to improve adherence to TQIP recommended guidelines for the placement of intracranial pressure (ICP) monitors. The primary outcome measured was number of ICP monitors placed post-intervention.

The author reviewed available literature and found six articles pertaining to guideline implementations. Analysis of the literature was performed utilizing Melynk and …

Environmental Links To Ectopic Kidney Diseases, Firas Alhasson

Theses and Dissertations

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in the western culture and worldwide. Its morbidity has been raising and it has become a burden on the public health. NAFLD is associated with other metabolic diseases such as Diabetic Mellitus and hypertension. NAFLD is a wide spectrum of symptoms, from an accumulation of fat in the liver (cirrhosis) to production of scar tissue (Fibrosis). The liver along with other distal organs such as the kidney and cardiovascular system can be damaged as ectopic manifestations of NAFLD. Contamination of drinking water with Cyanobacterium toxin (Microcystin) and water disinfection …

The Effect Of A Compassion Fatigue Awareness And Self-Care Skills Educational Program On Retention Among Certified Nursing Assistants Working In A Veterans Nursing Home, Michele M. Dreher

Theses and Dissertations

Background: Compassion fatigue is defined as the emotional and physical exhaustion that can affect helping professionals and caregivers over time. Certified nursing assistants (CNAs) are at high-risk for compassion fatigue due to their daily exposure to those who are suffering from a myriad of chronic medical and behavioral illnesses along with repeated workplace stressors. If not addressed early, compassion fatigue can adversely impact a CNA’s wellbeing and quality of resident care. Compassion fatigue is associated with high absenteeism, high turnover, and low retention rates. Despite these challenges, there is no published research on the effects of a workplace compassion …

Forensic Patient Flow: An Imbalance Between Capacity And Demand, Versie J. Bellamy

Theses and Dissertations

Background: The United States (U.S.) has an ever-growing incarcerated population. The sheer volume of this population coupled with inefficient patient flow through the judicial and health care systems, create a large imbalance between the high demand for services and the capacity to deliver them. The delay in criminal defendants accessing mental health services is impacted by the lack of patient flow, which creates barriers to entering and exiting the forensic hospital system. The increasing demand for inpatient forensic services, coupled with a static supply of resources, warrants further intervention by treatment and service providers. Identifying and removing barriers to patient …

An Evidence-Based Evaluation Tool To Assist Healthcare Providers In Their Assessment Of Effective Mhealth Applications For The Management Of Chronic Health Conditions, Sara Belle Donevant

Theses and Dissertations

Mobile health (mHealth) apps are considered a viable option to improve chronic disease management. Healthcare providers are now recommending mHealth apps for patient use to assist in managing chronic diseases. However, healthcare providers may have difficulty locating effective, evidence-based mHealth apps for patients as there are currently over 325,000 available health apps (Research2Guidance, 2017). Limited evaluation tools are available to assist healthcare providers in this process. Therefore, our goal was to develop an online mHealth evaluation tool to assist healthcare providers in the selection of evidence-based mHealth apps.

After creating a comprehensive pool of mHealth features, healthcare providers provided feedback …

Chemotherapy Knowledge And Health Literacy Among Women With Breast Cancer, Pearman Detreville Parker

Theses and Dissertations

Chemotherapy education is imperative for patients to gain the knowledge to manage side effects, adhere to prescribed cycles, and recognize the severity of symptoms that require immediate provider contact. Two vital factors – the readability of teaching materials and the patient’s health literacy – must be considered during chemotherapy education. However, materials are often not assessed for readability. Further, the influence of a patient’s health literacy level and demographic factors on chemotherapy knowledge has not yet been investigated. The specific aims are to: (1) critique the readability and format of chemotherapy education materials; (2) explore how women with breast cancer …

Utilization Of The Usda Supertracker System In High Schools: A Quality Improvement Project, Twanda D. Addison

Theses and Dissertations

Obesity is a major chronic care condition proven to affect more than 12 million children and adolescents, age 2 to 19; categorizing approximately 17% of America’s youth as obese or overweight. As a result, Congress established federal mandates targeting obesity by enforcing nutritional policies for cafeteria and competitive foods to enhance learning environments. Establishing federal nutritional guidelines in education allows more than 31 million children to receive meals at a free or low cost in more than 96,000 public and nonprofit private schools. As such, the purpose of this quality improvement project is to compare individual food choices with the …

Initiating A Peer Support Program For Parents Of Children With Autism Spectrum Disorder In Richland And Lexington Counties, Danielle P. Simmons

Theses and Dissertations

Objective: To initiate a parenting support program for parents of children with Autism Spectrum Disorder (ASD) in Richland and Lexington Counties. Background: Parents of children with ASD have increased stress and a poorer sense of well-being relative to parents of children with typical development. This parent population in Richland and Lexington Counties identified lack of support as a major stressor. The parenting support model initiated (e.g. Parent to Parent program) is an evidence-based intervention used to provide peer support to parents of children with ASD. The training of veteran parents is essential in the development and initiation of a Parent …

Implementing A Surgical Pathway To Reduce Operating Room Cancellation Rates, Demerise Ott Minor

Theses and Dissertations

Improving operating room efficiency is a high priority as health care cost become more challenging. In order to reduce surgical cancellation rates, a process improvement plan was implemented using a preoperative surgical pathway to optimize a patient’s health prior to scheduling the surgical procedure. The surgical risk assessment tool risk stratifies the patient based on the urgency of the procedure, the type of procedure, and the patients overall medical disease state. The Surgical Risk Tool determines patients with surgical risk scores of 9 or greater require medical and/or cardiac clearance in addition to hemoglobin A1C of 8 or less and …

Using Ultrasound Guided Peripheral Intravenous Catheters In Difficult Access Patients, Courtney Prince

Theses and Dissertations

The purpose of this quality improvement project is to compare the use of ultrasound to guide placement of peripheral intravenous (USGPIV) catheters versus standard techniques in difficult access patients, as measured by the number of attempts required to obtain venous access and total cost related to means of obtaining peripheral venous access between a nurse driven USGPIV and VAT team consults or physician assistance. The appraised evidence indicates USGPIV increases the number of successful PIV placements, prevents non-essential central lines and excessive needle sticks, and reduces patients and healthcare professionals frustrations (An et al., 2016, Au et al., 2012, Dargin, …

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 …