Nursing Commons^™

What Do You Want To Eat? A Descriptive Study Of Native Hawaiian And Pacific Islanders' Home Food Environment, Petr Ruda

Theses and Dissertations

Objectives: Home food environments are created when families stock their kitchens with food, which contributes to their dietary patterns and weight management. Native Hawaiians and Pacific Islanders (NPHIs) have a high prevalence of overweight and obesity. A description of their home food environment can help nurses understand NHPIs' dietary patterns. Our purpose was to describe NHPIs' home food environments by analyzing grocery store and restaurant receipts. Design and Sample: This descriptive study used analyzed qualitative and quantitative data from eight NHPI families, collected over an 8-week period. Measures: Grocery store and restaurant receipts were analyzed with descriptive statistics. Families' dietary …

Rural Emergency Nurses' End-Of-Life Care Obstacles Experiences: Stories From The Last Frontier, Jonathan Rohwer

Theses and Dissertations

Introduction: Rural emergency nurses face unique obstacles to providing quality end-of-life (EOL) care. Stories provided by emergency nurses embody their most difficult EOL care obstacles. Methods: A questionnaire was sent to 53 rural hospitals. Respondents were asked to share stories that epitomized the obstacles faced while providing EOL care in the rural emergency setting. Results: The lack of an ideal death (nurse personally knows the patient, issues with family members, and unknown patient wishes) was the top obstacle. Other reported obstacles were insufficient ED staff and power struggles between nurses and physicians. Discussion: Rural emergency nurses often provide EOL care …

Evaluation Of Vaccination Policies Among Utah Pediatric Clinic Employees, Tia Peterson

Theses and Dissertations

Introduction: Pediatric health care settings are high risk environments for spreading communicable and vaccine preventable diseases from health care workers to susceptible patients. Methods: All managers of pediatric clinics operating in the state of Utah were included. Participants were invited to complete a two-page questionnaire regarding their clinic vaccination policies. Results: Half (n = 23, 50%) of Utah pediatric outpatient clinics recommend employee vaccinations, although employee refusal is allowed without consequence. Of all adult vaccines, influenza was most often included as part of the employee vaccination policy. Some clinics required unvaccinated employees to wear masks in the event of illness, …

Diffusion Of Innovations Of Videoconference Technology: An Instrumental Case Study Concerning Undergraduate Degree-Seeking Nontraditional Learners, Bruce G. Campbell

Theses and Dissertations

This applied dissertation is an instrumental case study based on diffusion of innovations theory designed to gather student opinions regarding videoconference (VC) technology use in facilitating courses to undergraduate degree-seeking nursing students. The author of diffusion of innovations theory, Rogers (2003), recommended that more qualitative studies be conducted in education. Rogers and Jain (1968) recommended these studies should be conducted from the aspect of “receivers of innovation diffusion” (p.1) to provide feedback instrumental to implementation of technological innovations in academe. Further, Rogers stated that multiple data points should be used during the process of trialing an innovation. Therefore, a current …

An Evidence-Based Approach To Prepare Interdisciplinary Team Members For Implementation Of The Abcde Bundle, Jessica Murner Hamilton

Theses and Dissertations

Quality improvement projects contribute to the development of evidence-based management strategies for successful implementation of evidence-based practices in health care, thus reducing the risk of change implementation failure. This study assessed practice change implementation strategies for the awakening and breathing trial coordination, delirium assessment and management, early exercise and mobility (ABCDE) bundle. The ABCDE bundle is an evidence-based, interdisciplinary framework for managing pain, agitation, and delirium, reducing the duration of mechanical ventilation, and supporting early mobility in critically ill patients. The purpose of this study was to implement a nurse-driven initiative to design and put into place an evidence-based approach …

Best Practice For A Standardized And Safe Registered Nurse Shift Handoff, Nancy Rankin Ewing

Theses and Dissertations

One of the most important times for the delivery of patient care occurs during the change of shift handoff between professional nurses. This complex interchange of information and responsibility carries with it distinct possibilities for error that can adversely affect a patient’s hospitalization, safety, and the quality of patient care outcomes (Blouin, 2011; Hilligoss & Cohen, 2011). Communication errors, including errors during shift handoff, account for more than 70% of sentinel events that occur in the provision of healthcare in the acute care setting (Federwisch, 2007; Streeter, 2010). Poorly conducted and unstructured shift handoffs are known to result in delayed …

Relational Coordination: An Exploration Of Nursing Units, An Emergency Department And In-Patient Transfers, Mary Coffey

Theses and Dissertations

Emergency department (ED) crowding is a patient safety concern that has been increasing for more than a decade. Increased visits have resulted in ED crowding, longer wait times, ambulance diversions, and boarding of admitted patients (Hing & Bhuiya, 2012). Numerous factors affect ED crowding. Once various extraneous issues are resolved and a bed is available for a patient, it becomes the responsibility of nurses across unit boundaries to coordinate the patient transfer. This study applies Relational Coordination Theory (RCT) as a framework to provide nurses insight into the relational aspects of their work in the transfer of ED patients to …

Early Screening And Identification Of Preschool Children Affected By Serious Emotional Disorders, Cathy Renee Robey-Williams

Theses and Dissertations

Mental illness has surpassed physical health problems as the leading cause for morbidity and mortality in American children. National prevalence of serious emotional disorders in the 0-5 age group has ranged from 9.5% to 14.2%. Of the 15 million children affected by mental illness, less than 20- 25% receive any treatment. Nationwide, early screening, identification, and treatment of preschoolers with emotional or behavioral disorders have become a critical priority in order to reduce the increasing burden of healthcare costs for mental illness and psychiatric care. The purpose of this study was to test the feasibility of a screening process for …

The Effects Of Multiple Gratitude Interventions Among Informal Caregivers Of Persons With Dementia And Alzheimer's Disease, Cristy Degregory

Theses and Dissertations

The purpose of this group randomized intervention trial was to examine the impact of participation in three telephone-based gratitude interventions on the physical, psychological and social functioning of participants in caregiver support groups who are unpaid family caregivers of persons with dementia and Alzheimer’s disease. Fredrickson’s (2001) Broaden-and-Build Theory informed the investigation of the effect of three gratitude interventions on participants’ levels of gratitude, positive aspects of caregiving, subjective well-being, physical health and mental health. This was a randomized, wait-list controlled study involving informal caregivers involved in support groups. The research questions were: 1.) How does gratitude contribute to subjective …

Quality Improvement Project: A Comparison Of Daily Routine Chest Radiography Versus Clinically-Indicated Chest Radiography In Preventing Ventilator-Associated Pneumonia In Adult Icu Patients On Ventilators: An Evidenced Based Practice Project, Kimberly Mckenney

Theses and Dissertations

Ventilator-associated pneumonia is one of the critical complications identified by a chest x-ray (CXR). However, there is a controversy about the use of CXRs. Overuse of the CXR has also identified concern among the ICU patient population. The purpose of this evidenced-based practice project was to determine if there were differences in patient outcomes when receiving daily routine CXRs as compared to clinically-indicated CXRs. Patient outcomes measured were: ICU length of stay, complications while on the ventilator and ICU mortality, number of ventilator days, diagnostic efficacy, therapeutic efficacy, costs, and radiation exposure The author identified 30 articles in the search …

Best Practices In High Fidelity Patient Simulation To Enhance Higher Order Thinking Skills, Kathryn S. Mock

Theses and Dissertations

Undergraduate nursing education has begun to use very expensive and time intensive high fidelity simulation activities without making full use of the ability to build higher order thinking skills in students. Current research in high fidelity patient simulation has tended to be subjective and focus on critical thinking. However, reflective thinking habits of mind must be in place before full use can be made of critical thinking skills. A comprehensive search of all reflective thinking literature used in conjunction with simulated patient experiences by healthcare students was undertaken. A guideline

was created for nurse faculty to use that outlined current …

Oncology Nurses' Suggestions For Improving Obstacles In End-Of-Life Care, Rosanne Johnson Oliver

Theses and Dissertations

The purpose of this paper was to determine the most important changes needed to improve the quality of end-of-life (EOL) care to terminal cancer patients as perceived by experienced oncology nurses. The study was designed as a cross-sectional survey, sampling 1,000 Oncology Nursing Society members from the United States with experience caring for inpatient cancer patients, who could read English, and had experience in EOL care. Eligible nurses responded to an open-ended item sent to them as part of a mailed questionnaire. Nurses were asked to respond to the following question: “If you had the ability to change just one …

Vaccination Status And Attitudes Of Urban School Employees In Utah, Kim Estella Thompson

Theses and Dissertations

Individuals who work with children are at risk for exposure to vaccine-preventable diseases. School settings can quickly become outbreak centers for communicable infection since school employees are in direct contact with children in confined areas for many hours each day. Therefore, it is important for school employees to be fully vaccinated. There are many reasons school employees may be inadequately vaccinated. One common myth is that adults believe vaccines are only for children. Another reason for inadequate vaccination rates among school employees is that many adults believe vaccinations received during childhood are still effective. Healthcare providers (HCPs) constitute the first …

Distress In Women With Ovarian Cancer, Judith Dellaripa

Theses and Dissertations

Clinicians and researchers know that women experience distress related to the diagnosis of and treatment for ovarian cancer. A review of the literature revealed that while there is interest in the topic, distress is inconsistently defined and measured. Women have been reported to have a variety of distress experiences including the challenges of late diagnosis and the treatment regimen, communication difficulties with healthcare providers, and concern about the effect of their diagnosis on their loved ones. Without information directly from women, assumptions predominate about what the experience is like and what they would find helpful from support persons. Women’s perceptions …

A School-Based Intervention’S Impact On Children’S Knowledge And Self-Efficacy Related To Physical Activity And Nutrition: A Pilot Study, Katherine Turley Jenkins

Theses and Dissertations

Childhood obesity has become epidemic in the United States. One of the best places to combat this problem is within the school system. The purpose of this study was to examine changes in exercise self-efficacy, science interest, and science knowledge of children who participated in a school-based anatomy and healthy lifestyle intervention called Anatomy Academy. In this pilot study, 212 study participants were recruited from 5th and 6th grade children enrolled in one of three charter schools who participated in our 7-week intervention, Anatomy Academy. Children completed four questionnaires pre and post intervention: (1) a science knowledge questionnaire, (2) a …

The Impact Of The Ohana Mana Challenge On Native Hawaiian And Pacific Islander Children, Kristin Kay Van Tassell

Theses and Dissertations

In this four-week, family-focused pilot intervention study, researchers studied the impact of culturally relevant nutrition and activity sessions on eleven children from eight Native Hawaiian and Pacific Islander (NHPI) families. Mixed methods were used in analysis. In their favorite meal drawings, children included more fruits and vegetables at week four than week one, which was consistent with their self-reported intake of healthy foods that were new to them. From week one to four, mean total scores increased on the nutrition and exercise knowledge exercise questionnaire and the physical activity self-efficacy tool; however, the mean total score decreased on healthy diet …

Relationship Of Mitochondrial Enzymes To Fatigue Intensity And Health-Related Quality Of Life In Men With Prostate Cancer Receiving External Beam Radiation Therapy, Kristin Filler

Theses and Dissertations

Introduction: Cancer-related fatigue is often described by patients as a lack of energy, mental or physical tiredness, diminished endurance, and prolonged recovery after activity. Etiologic mechanisms underlying CRF are not well understood. Methods: A literature review was conducted to examine studies that had investigated the association of mitochondrial dysfunction with fatigue. The major conclusion from this review was that alterations in energy metabolism may contribute to fatigue. Therefore, the dissertation study focused on laboratory techniques for measuring mitochondrial oxidative phosphorylation enzymes (complexes I-V) and a mitochondrial-specific oxidative stress marker (superoxide dismutase 2 [SOD2]). The primary aim of the dissertation research …

Factors Contributing To Infant Feeding Practices With Latina Mothers, Diana Cartagena

Theses and Dissertations

Background: An estimated 9.7% of U.S. infants and toddlers are considered overweight. Hispanic infants persistently show higher prevalence rates for being overweight compared to black and white infants. Little is known about factors promoting excessive infant weight gain in Latinos. Purpose: Primary aim of this study was to describe multidimensional factors and maternal feeding practices that may correlate with infant overfeeding in Latina mothers. A secondary aim was to determine whether there was an association between these factors and infant weight gain. Subjects: Sixty-two low-income immigrant Latina mothers and their infants ages 4-12 months receiving assistance through the Special Supplemental …

Patient Discomfort In The Icu: Ett Movement Effects, Virginia Hamilton

Theses and Dissertations

Critically ill patients who require MV are at risk for a number of complications, including the development of ventilator-associated events (VAE) and agitation that may require the use of sedation. Patients experience anxiety and discomfort during mechanical ventilation from a variety of sources including unfamiliar breathing assistance and an inability to communicate anxiety and pain verbally, but a primary cause of discomfort identified by these patients is the simply the presence of the endotracheal tube (ETT). Discomfort often leads to agitation and may be exacerbated by ETT movement. Management of agitation typically involves the use of sedative therapy and has …

An Analysis Of The Cause, Effect & Control Of Hyperlipidemia From A Nursing Perspective, Melissa Rodgers

Theses and Dissertations

Two of the top four causes of death worldwide, heart disease and stroke, are related to hyperlipidemia, elevated cholesterol levels; these two illnesses account for approximately seventeen million deaths each year (World Health Organization, 2014). In order to combat the prevalence of these illnesses, the National Cholesterol Educational Panel has issued guidelines regarding cholesterol management. Extensive research has been published concerning cholesterol management. However, a gap remains between evidenced-based practice and community awareness of this phenomenon. This manuscript compiles research from peer reviewed nursing journals and acclaimed government and national organizations to express the cause, effect, and control of hyperlipidemia …

In Children And Elderly Patients, What Are The Effects Of General Anesthesia On Neurological Health Compared With Procedural Sedation?, Taylor G. Caldwell

Theses and Dissertations

Anesthesia has been a necessity in the field of health care since it was discovered in the early to middle 1800s. Before anesthesia, many procedures and surgeries that are now considered an easy fix were life-threatening and patients often chose the inevitable death over the pain of surgery. The idea was stumbled upon when "laughing gas," nitrous oxide, was inhaled and credited in "produc[ing] a state of intoxication during which people became highly amused and insensitive to pain" (Palo Alto, 2013, para. 2). Anesthesia has come an unbelievably long way since the first surgery under anesthesia was performed by Dr. …

Preventing And Treating Complications Of Sickle Cell Disease In Pediatric Patients, Keandra S. Ferguson

Theses and Dissertations

Preventing and Treating Complications of Sickle Cell Disease in Pediatric Patients Sickle cell anemia, also known as sickle cell disease, affects over 90,000 people in the United States alone with those of African descent being at greater risk (Dobson & Byrne, 2014). Worldwide, it affects over 30 million people (Khoury, Musallam, Mroueh, & Abboud, 2011). It is usually detected during first year of life. After that, it is a lifelong disease (Hollins et al., 2012). Patients with sickle cell disease in the United States are expected to live until they are approximately 48 years old (BMJ Group, 2011). It is …

An Analysis Of Interpreter-Mediated Healthcare Interactions, Robin Dawson Estrada

Theses and Dissertations

The content and quality of communication between nurse practitioners and patients in primary care encounters contributes to diagnostic decision making, the provision of culturally appropriate interventions, and ultimately may impact health outcomes. In caring for patients with limited English proficiency, the addition of language discordance increases the complexity of the interaction and communication processes and the potential for disparate health outcomes. Most prior research on interpreter-mediated healthcare interactions has focused on accuracy, cost, satisfaction, and role enactment, but there is a lack of systematic research examining the actual interaction processes within the context of primary care clinic visits.

The aim …

Best Practices In The Management Of Pediatric Obesity In Primary Care Clinics, Lori Moseley

Theses and Dissertations

Obesity prevalence among children and adolescents has nearly tripled since 1980. Children and adolescents are at risk for developing the comorbidities seen in obese and overweight adults such as hypertension, type 2 diabetes, and sleep apnea. Traditional treatment for obese and overweight children involved counseling children and their families. Current recommendations include a comprehensive staged approach to weight management that includes prevention plus structured weight management, comprehensive multidisciplinary intervention and tertiary care intervention. Unfortunately structured weight management programs have not been widely available, leaving the primary provider with limited options.

The purpose of this project was to analyze the literature …

Best Practice For Antipsychotic Medication Management In Community Dwelling Older Adults With Schizophrenia, Estelle Marie Brown

Theses and Dissertations

Schizophrenia, aging, and medication factors combine to present a very complex clinical presentation in caring for the elderly population with schizophrenia. The aging body displays a slowing of physiological processes, which alters the pharmacokinetics and pharmacodynamics of medications prescribed. Multiple comorbid health factors and the medications recommended for treatment may become detrimental to the overall body health, causing more problems for the older individual. This evidence based practice project reviewed literature and evidence to focus on the question, "In community dwelling older adults with schizophrenia, what is best practice for antipsychotic medication management?" The literature search resulted in classifying 16 …

Symptoms, Cytokines, And Quality Of Life Of Patients With Chronic Graft-Versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation, Debra Kelly

Theses and Dissertations

Introduction: Chronic graft-versus-host disease (cGVHD) is a serious complication following allo-HSCT characterized by immune dysregulation, organ dysfunction, risk for infection, and distressing symptoms. Complications may include scleroderma, hepatic dysfunction and bronchiolitis obliterans. Advances in allo-HSCT for many hematologic dyscrasias (e.g. acute and chronic leukemias, aplastic anemia, and myelodysplastic syndrome) have improved survival which has generated a renewed focus on survivorship issues. Distressing symptoms are noted as negatively impacting quality of life (QoL). The relationship between inflammation and behavioral responses may impact symptoms. Examining patterns and levels of inflammation with symptoms is relevant. Objective: The aims of this study were to …

Exploring Factors That Influence The Choice To Retire From Driving In Older Adults, Debra J. Jenkins

Theses and Dissertations

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A Measure Of Nephrology Nurse Perceptions Toward Advance Care Planning: Validation Of The Nephrn Perceptions Toward Advance Care Planning Instrument, Mary S. Haras

Theses and Dissertations

This dissertation is a report of a three-phase quantitative research study that included the development and testing of an instrument to examine the perceptions of nephrology nurses toward advance care planning for persons with chronic kidney disease. Phase 1 began with the identification of the dimensions of advance care planning and creation of an item pool for the instrument. The instrument was distributed to five content experts for evaluation and comments of inclusiveness to measure perceptions toward advance care planning. In Phase 2 the item pool was pilot tested in a convenience sample of 50 nephrology nurses. Exploratory factor analysis …

Personal Characteristics And Learning Preference In End-Of-Life Decision Making Of Chronically Ill Community Dwelling Elders, Leigh Ann Bonney

Theses and Dissertations

Leigh Ann Bonney, RN, MSN; Susan Kossman, RN, PhD; MyoungJin Kim, PhD; Wendy Woith, PhD, Caroline Mallory, PhD

Illinois State University, Mennonite College of Nursing

Personal Characteristics and Learning Preference in End-of-Life Decision Making of

Chronically Ill Community Dwelling Elders

Purpose and Background: Clear decision-making (DM) about end-of-life [EOL] contributes to a good death This requires knowledge of life-sustaining treatment with lack of knowledge contributing to feelings of decisional conflict Decision aids can increase knowledge, but elders' preferred learning methods are unknown. Identifying characteristics associated with preferred learning method and decisional conflict can help nurses tailor information to assist in …

Predictors Of Cooperative And Externalizing Behaviors In Siblings Of Children With Disabilities, Christine Rae Platt

Theses and Dissertations

Objective: To examine whether caregiver burden, parenting style, and sibling relationships in families raising a child with a disability (CWD) predict cooperative and externalizing behaviors in typically-developing sibling (TDS). Methods: This correlational study included 189 families raising both a CWD and a TDS. Mothers and fathers completed self-report questionnaires on caregiver burden, sibling relationships, parenting style, and TDS cooperative and externalizing behaviors. Results: Authoritative parenting was positively associated with cooperative behaviors, whereas authoritarian parenting was positively associated with externalizing behaviors. Hierarchical regression revealed caregiver burden was a significant predictor of cooperative and externalizing behaviors; however, when parenting style was added …