Nursing Commons^™

Influence Of Contextual Factors And Self Efficacy On Self- Management In Parents Of Children With Cystic Fibrosis, Erin B. Booth

Theses and Dissertations

Cystic Fibrosis, a life threatening autosomal recessive genetic disease, is characterized by a defective gene resulting in the production of thick mucus that obstructs the lungs and pancreas. CF requires intensive management performed at the home. An initial pilot study was performed to describe knowledge of CF related diabetes (CFRD) in adults with CF. The findings of this study, which demonstrated that adults with CF lacked sufficient knowledge about CFRD confirmed the need to explore additional factors of self-management guided by a theoretical framework. The second study presented in this dissertation used the Individual and Family Self-Management Theory (IFSMT) to …

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 Meaning Of Nursing Education As Described By Students With Learning Disabilities, Jacqueline Lee Reep-Jarmin

Theses and Dissertations

The numbers of students with learning disabilities (LD) in post-secondary education settings is rising (National Center for Education Statistics (NCES), 2016). The Americans with Disabilities Act, Amendments Act was passed in 2008, since that time little research has been done to reflect any impact of the original ADA (1990) being amended. Research is needed about the experiences of students with learning disabilities in higher education, and more specifically nursing education. The purpose of this study was to develop an understanding of the lived experience of nursing education from the perspective of students with learning disabilities, and delineate the essence of …

Critical-Care Nurses' Suggestions To Improve End-Of-Life Care Obstacles: Minimal Change Over 17 Years, Kacie Hart Hadley

Theses and Dissertations

Background: Critical-care nurses (CCN) provide end-of life (EOL) care on a daily basis as one in five patients dies while in Intensive Care Units (ICU). CCNs overcome many obstacles to perform quality EOL care for dying patients. Objectives: The purposes of this study were to collect CCNs' current suggestions for improving EOL care and determine if EOL care obstacles have changed by comparing results to data gathered in 1998. Methods: A 72-item questionnaire regarding EOL care perceptions was mailed to a national, geographically dispersed, random sample of 2,000 members of the American Association of Critical-Care Nurses. Nurses were asked for …

Implementing A Pain Toolkit To Improve Pain Management, Kathleen R. Atkins Dnp, Mary J. Dyck Phd, Nancy L. Novotny Phd, Karen S. Delong Msn

Theses and Dissertations

Abstract

OBJECTIVES: The purpose of this study was to evaluate the effect of a pain toolkit to improve pain management.

BACKGROUND: The World Health Organization and Joint Commission state effective pain management is a basic human right.

METHODS: Patients’ ratings of pain management on a 25-bed orthopedic/neurology unit three months before and after implementation of a toolkit were compared. The toolkit included bedside report, care board, purposeful hourly rounding, pain algorithm, pain status indicator, and complex pain interventions. The data are comprised of patient responses to the following Hospital Consumer Assessment of Healthcare Providers and Systems survey questions: pain control …

Implementing Prophylactic Amiodarone In Heart Surgery To Reduce Post -Operative Atrial Fibrillation, John M. Russell Msn, Apn, Fnp-Bc, Denise Wilson Phd, Apn, Fnp, Cde

Theses and Dissertations

Purpose: The purpose of this project is to evaluate a practice change of implementing peri-operative amiodarone infusion for cardiac surgical patients at a large northern Illinois hospital to reduce the incidence of post-operative atrial fibrillation. Evidence supports use of prophylactic amiodarone as a strategy to reduce its incidence. The sequelae of untreated post-op atrial fibrillation include increased risk of embolic stroke, extended hospitalization, and increased healthcare costs.

Data Sources: The Society of Thoracic Surgeons (STS) Adult Cardiac Surgical Database is a validated research tool used to collect comprehensive data on its member surgeons. A pre/post intervention case-controlled retrospective study design …

Comparison Of Iron Supplementation And Albendazole On Anemia In Ghanaian Children, Megan M. Zitting

Theses and Dissertations

Half a billion school aged children suffer from anemia, with the majority of anemia caused by iron deficiency. Researchers have shown a strong correlation between low hemoglobin levels and presence of intestinal parasites in children with anemia. Childhood anemia has profound negative effects on physical growth, maturation, and cognitive development leading to poorer educational achievement. Using hemoglobin as a measure of anemia, this quasi-experimental study investigated impact of either iron supplementation or an antiparasitic medication on hemoglobin levels in two groups of children in a rural region of Eastern Ghana. Surprisingly, after a 6-month intervention period, hemoglobin levels in both …

Pediatric Icu Nurses' Suggestions Forimproving End-Of-Life Care, Jeremy Ratliff

Theses and Dissertations

Of the 34,000 children who die annually, over 28,000 are four years old or younger. Nurses working in pediatric intensive care units (PICU) provide end of life (EOL) care before, during, and after death of these children. The purpose of this study was to determine thesuggestions PICU nurses have for improving EOL care for dying pediatric patients and their families. A sample of 1047 PICU nurses, who were members of the American Association of Critical-Care Nurses (AACN), were sent a 70-item questionnaire. One open ended item asked nurses to offer a suggestion for improving EOL care for dying PICU patients. …

Exploring The Effect Of An Interdisciplinary Teamwork Intervention In Acute Rehabilitation, Julie K. Cope

Theses and Dissertations

Purpose: The purpose of this study was to explore the efficacy of an interdisciplinary intervention on interdisciplinary teamwork and patient functional outcomes in an acute inpatient rehabilitation unit at a mid-sized regional hospital. Design: Pilot mixed-methods pre-post intervention study. Methods: Interdisciplinary teamwork and patient functional outcomes were measured before and after a teamwork intervention. Interdisciplinary teamwork was measured with the Healthcare Team Vitality Instrument (HTVI) and a qualitative staff questionnaire developed by a content expert. Patient functional outcomes were measured by aggregated Functional Independence Measure (FIM®) scores. Findings: Post-intervention FIM® gain scores increased significantly (p = .008). Staff questionnaire revealed …

Multi-Symptom Management In Hospice Patients During End-Of-Life Transition, Ashley N. B. Sirianni

Theses and Dissertations

The purpose of this quality improvement project is to compare the provider’s perception following an educational model of using single symptom management versus multi-symptom management during the end-of-life transition in adult patients for improved quality of life outcomes. The appraised evidence indicates that it is critical to have anticipatory medications at the patient’s residence to manage multiple symptoms rather than focusing exclusively on a single symptom management such as pain management. In February 2016, the author conducted an educational model among hospice providers for increasing knowledge and awareness of multi-symptom management. Thirty (n = 30) Clinical Nursing Directors, Licensed Practical …

Breast Cancer Risk Assessment: Evaluation Of Screening Tools For Genetics Referral, Maren Lothyan Zaro

Theses and Dissertations

Purpose: This study assessed effectiveness of five tools recommended by the US Preventive Services Task Force (USPSTF), designed to help primary care clinicians determine which unaffected patients to refer to genetics specialists for breast cancer risk assessment based on concerning family history. Design: This descriptive secondary analysis included 85 women aged 40-74. All participants had a first-degree female relative previously diagnosed with breast cancer who also had uninformative negative BRCA1/2 tests. Methods: Each pedigree was evaluated using the five tools including the Family History Screen-7 (FHS-7), Pedigree Assessment Tool (PAT), Manchester Scoring System, Referral Screening Tool (RST), and Ontario-Family History …

Critical Care Nurses' Perceptions Of End-Of-Life Care: Comparative 17-Year Data, Nicole Lamoreaux

Theses and Dissertations

BACKGROUND: Nurses working in intensive care units (ICUs) frequently care for patients and their families at the end-of-life (EOL). Providing high quality EOL care is important for both patients and families, yet ICU nurses face many obstacles that hinder EOL care. Researchers have identified various ICU nurse-perceived obstacles, but no studies have been found addressing the progress that has been made over the last 17 years.
OBJECTIVE: To determine the most common and current obstacles in EOL care as perceived by ICU nurses and then to evaluate whether or not meaningful changes have occurred since data were first gathered in …

Describing The End Of Life Knowledge, Beliefs, And Preferences Of Alaska Native And American Indian Peoples, Colleen Marie Kelley

Theses and Dissertations

This dissertation is comprised of three manuscripts that will be submitted for publication, describing the end of life knowledge, beliefs, and preferences of Alaska Native and American Indian Peoples. The first manuscript is a literature review that examines what is known about the understanding about the end of life knowledge, beliefs, and preferences of Alaska Native and American Indian Peoples. The second manuscript offers results of an exploratory descriptive study designed to describe the end of life knowledge of hospice care services, beliefs about dying, and preferences for end of life care of Alaska Native and American Indian Peoples. Finally, …

Stories Of Becoming And Being An Associate Degree Nurse Educator: A Narrative Inquiry Study Examining How Participants' Ways Of Knowing Evolved Through Their Experiences, Bonnie Jill Ross

Theses and Dissertations

This study explored the stories of the experiences of three associate degree nurse educators and how they evolved in the way they viewed their world as they transitioned in their role from nurse expert to experienced nurse educator. As associate degree nursing education is the most commonly reported initial nursing education of registered nurses in the United States, and, because of the highly affordable and accessible means for educating the next generation of nurses, the purpose of this study was to address the projected nurse and nursing faculty shortage. Through narrative inquiry, this study has provided a means to inform …

Immunization Status Of Nicu Graduates At A Tertiary Care Children's Hospital, Leslie Jane Huggins

Theses and Dissertations

The objectives of this study were to determine the current rates of immunization and identify variables associated with immunizations of NICU graduates who were 60 days of age or older at time of discharge. This is a descriptive pilot study utilizing retrospective paper chart review. The relationships between immunization status and study variables were examined using logistic regression. Of 43 infants discharged at least 60 days of age or older from the NICU, 74.4% were up to date for immunizations in accordance with AAP recommendations. Additional variables were not significant. Immunization needs to be a priority in order to give …

Analyzing The Leadership Skills Of Nurses Through Mentoring Relationships, Barbara Jean Siwula

Theses and Dissertations

Mentoring relationships have the ability to create healthier working environments for nurses by encouraging better communication, teaching necessary leadership skills, and creating unity among nurses. In the same respect, mentoring relationships can instill negative habits, creating a cycle of ineffective leadership. Therefore, it is vital mentoring relationships be analyzed to ensure that nurses are being taught effective leadership skills that will lead to a healthy workplace environment. The purpose of this study is to analyze the leadership skills of nurses though mentoring relationships. Data collection consisted of a mixed methods study completed by student, certified and registered nurses from various …

Recruitment And Retention Of Hispanic Nursing Students: Through The Lens Of Associate Degree Nursing Program Administrators And Hispanic Nursing Students, Debra Jean Handlos Devoe

Theses and Dissertations

The Hispanic population in the United States is changing and will constitute 30% of the population in 2050; however, the Hispanic registered nurse population is less than 3%. Cultural differences between patients and nurses may cause harm and a mistrust that can affect patient outcomes. A mixed methods convergent research study was done by an electronic survey, non-electronic surveys, telephone interviews, and focus groups to compare the perceptions of nursing program administrators at seven community colleges in a Mid-Atlantic state, in the United States, and the perceptions of 15 Hispanic nursing students regarding the challenges, barriers, and obstacles of Hispanic …

Effects Of Sepsis Protocols On Health Outcomes Of Adult Patients With Sepsis, Monika U. Mróz

Theses and Dissertations

Sepsis is a condition that arises from the host’s own exaggerated response to an infection, directed towards pathogens, but causing multiple organ failure. Sepsis is one of the most common causes of death, and a considerable absorber of healthcare resources. This frequently fatal condition, despite progress in technology and improving knowledge of pathophysiology, is still poorly understood, carries high mortality and morbidity rates, and survivors are often left with permanent disabilities and poor health outcomes.

Initial presentation of sepsis is often nonspecific, making diagnosis difficult, and causing lifesaving treatment delays. Sepsis guidelines are derived from emerging evidence-based research. While there …

Mysleep101©: An Educational Mobile Medical Application For Sleep Health In Primary Care, Sonya Cook

Theses and Dissertations

Insufficient sleep has emerged over the past few decades as a public health concern. As little as 1 to 2 hours of sleep loss can produce extreme fatigue and physiological drives similar to thirst and/or hunger which increases the risk of motor vehicle accidents, work related mistakes and injuries. Sleep restriction whether voluntary or involuntary has produced a culture of chronic sleep deprivation that can be seen throughout the population. Chronic lack of quality sleep has been shown to adversely affect cardiovascular health, cognitive function, memory, immune responses and hormonal regulation among other homeostatic functions. Sleep disorders represent the cause …

Nursing Attitudes Towards Suicidal Patients In The Emergency Department: Assessment Interview Training, Belinda Beaver

Theses and Dissertations

This project sought evidence for the effectiveness of pedagogy in professional nursing continuing education and its effect on emergency department nurse attitudes towards patients seeking crisis intervention for suicide. Approximately 12 million emergency department (ED) visits annually were for patients suffering with mental illness and/or suicidal ideation. Emergency department staffs were often not adequately prepared to manage these problems. The purpose of this project was to examine the impact of an educational initiative on nurses’ attitudes about patients expressing suicidal ideation in the emergency departments 2 rural southeastern towns.

The project question was; in two different rural community emergency departments …

Exploring The Factors Of Persistence For African American Senior Nursing Students, Yolanda Nelson

Theses and Dissertations

African American nursing students experience commonalities within their college experience. Often these students may be faced with challenges, barriers, and/or struggles that may place a hindrance on their success in meeting their educational goals. This qualitative study used a phenomenological approach to explore African American female nursing students perceptions of faculty-student relationships and its implications for persistence. Four African American female nursing students and two nursing faculty agreed to participate in this study. This research study offers an examination of past and present research regarding the history of African American nursing students, health disparity, social justice and diversity within the …

Nurses Utilizing The V.O.I.C.E.S. Hiv Prevention Intervention In The Black Church Community, Jason Richard

Theses and Dissertations

The Human Immunodeficiency Virus (HIV) epidemic is a significant problem in the United States, especially in the “Bible Belt” Deep South where the epidemic is hitting this region the hardest. The HIV epidemic in the state of South Carolina is very real, significant, and quite alarming. In fact, the Center for Disease Control and Prevention (CDC) labels South Carolina as an HIV “hot spot.” All racial and ethnic groups are susceptible and impacted by HIV. However, evidence shows that African Americans – especially young adults 18-35, bear the brunt of the burden to the extent that the “new face” of …

Unexpected And Interrupted Transitions Among Newly Licensed Registered Nurses: Perspectives Of Nurse Managers And Preceptors, Sheri S. Webster

Theses and Dissertations

Successful retention of newly licensed registered nurses (NLRNs) into practice is critical to ensure the nursing workforce required to meet current and future health care demands. NLRN turnover rates result in loss of revenue due to high orientation costs and further hinder the development of a stable workforce. For nurse educators and administrators to effectively address early attrition among NLRNs, they must have a clear understanding of the factors that contribute to NLRNs leaving employment. The aim of this qualitative descriptive research was to explore NLRN transition to professional practice from the experiences and perspectives of nurse managers and preceptors …

Vaccination Policies Of Utah Family Practice Clinics, Levi R. Kohler

Theses and Dissertations

The purpose of this study was to collect information regarding healthcare worker (HCW) vaccination policies in Utah family practice clinics. Data sources: The study was conducted in Utah family practice clinics in the most densely populated counties in the state and was a cross-sectional descriptive design. Data were collected from 155 family practice clinic managers. Analyses included frequencies and percentages for quantitative items and a content analysis for open-ended items. Conclusions: HCWs are employed in environments where infectious diseases can be easily spread from person to person, thus, vaccinations can be instrumental in protecting the health of HCWs and patients …

Evaluation Of Vaccination Policies Among Outpatient Oncology Clinics In Utah: A Pilot Study, Sarah Louise Stocksdale

Theses and Dissertations

Background: In Utah, all major hospital facilities have employee vaccination policies. However, the presence of health care worker vaccination policies in the Utah outpatient oncology setting was unknown. Objectives: The objectives were to identify Utah oncology outpatient employee vaccination policies and to identify what consequences, if any, were present for unvaccinated employees. Methods: This was a cross-sectional, descriptive study design in which clinic managers from outpatient oncology clinics in Utah were asked, via questionnaire, to describe the clinic's employee vaccination policy and the consequences for refusing the policy. Findings: Most vaccination policies applied to employees primarily assigned to work in …

Does Simulation Improve Nursing Student Knowledge, Skills, And Attitudes In Identifying Delirium Superimposed On Dementia?, Sheryl A. Kelly

Theses and Dissertations

This dissertation is comprised of three manuscripts, to be submitted for publication, exploring the use of simulation in geriatric nursing education. The first manuscript is a literature review. Although, a number of articles exist on the use of simulation in nursing education, there is a paucity of research using simulation emphasizing the care of patients with dementia and delirium as a pedagogical strategy or those using a stringent research design.

The second manuscript provides an overview of two conceptual frameworks (National League for Nursing (NLN)/Jeffries Simulation Framework and situated cognition learning framework) and recommends merging them to guide researchers as …

Examining The Relationship Between Anemia, Cognitive Function, And Socioeconomic Status In School-Aged Ecuadorian Children, Angela Chamberlain

Theses and Dissertations

Background and Objectives: It is estimated that over 40% of children in Ecuador are anemic. Anemia in children can influence physical and cognitive development and have lasting effects on adulthood productivity and quality of life. The objectives of this study were to: (1) evaluate the relationship of anemia and cognitive function, and (2) determine the influence of demographic factors on cognitive function. Population and Setting: The sample consisted of 175 school-aged children between 5 to 11 years old attending a school in a poverty stricken area of Guayaquil, Ecuador. Methods: A descriptive correlational cross sectional design was used to study …

Rural Emergency Nurses' Suggestions For Improving End-Of-Life Care Obstacles, Kelly Elizabeth Smith

Theses and Dissertations

Introduction: In 2010, of the 129 million visits to the emergency department (ED), 240,000 resulted in the patient dying or being pronounced dead on arrival. This number is likely to continue to increase as a significant portion of the American population ages and seeks care in the ED. Though care in the ED is focused on saving lives, death cannot always be prevented. Consequently, nurses face many barriers to providing quality end-of-life (EOL) care in the ED when death occurs. The purpose of this study was to identify suggestions emergency nurses have to improve EOL care specifically in rural ED's. …

Nicu Nurses' Perceptions Of Obstacles And Supportive Behaviors In End-Of-Life Care, Ann Rogerson

Theses and Dissertations

Background: Losing an infant is difficult for parents to face. To improve EOL care for dying neonates and their families, NICU nurses need to overcome obstacles and implement supportive behaviors. Understanding the size of obstacles and supportive behaviors will better enable NICU nurses to provide quality EOL care. Objectives: To determine the largest obstacles and supportive behaviors in NICU EOL care. Methods: A descriptive quantitative study of a random national sample of 1058 NICU nurses who were members of NANN (National Association of Neonatal Nurses). The National Survey of NICU Nurses' Perceptions of End-of-Life Care questionnaire was mailed twice yielding …

The Experience Of Siblings Of Youth With Type 1 Diabetes, Stephanie Miller

Theses and Dissertations

Background. Type 1 diabetes requires intensive management, including blood glucose monitoring, carbohydrate counting and dietary modification, and administering insulin. When a child is diagnosed with type 1 diabetes, family dynamics are often altered as family schedules revolve around care for the child with diabetes. In addition, siblings face unique challenges as they become involved in the care of the child with type 1 diabetes. Therefore, it is important to understand experiences of siblings of youth with type 1 diabetes. Aims and Objectives. To identify experiences of siblings of children with type 1 diabetes from their own perspectives. Sample. As part …