Nursing Commons^™

Exemplary Practices Of Baccalaureate Degree Nursing Programs With High Pass Rates On The Nclex-Rn, Wynona (Nonie) Marie Wiggins

Student Theses and Dissertations

Baccalaureate nursing programs from the Southern Regional Educational Board whose NCLEX-RN pass rates met or exceeded the national pass rate for 2006-2008 consecutively and who had at least 60 candidates sit for the exam annually were studied to determine the practices utilized to have success on the NCLEX-RN. Fifty programs met the inclusion criteria and were invited to participate. Thirty programs accepted the invitations to participate in the study. Recorded telephone interviews with baccalaureate nursing program directors, chairs, or their designee were conducted. Most of the nursing programs were upper division traditional programs. Some also offered 2nd degree accelerated option. …

Perinatal Palliative Care: Assessment Of Practice Barriers, Clinician Perspectives And Confidence, Charlotte Wool

Nursing Theses and Dissertations

Perinatal palliative care (PPC) is an emerging model of care that provides supportive services to families anticipating fetal or neonatal demise. Clinician reported practice barriers, their perspectives of PPC and confidence in caring for patients requiring PPC are unknown. The aim of this research is to fill a gap in understanding clinician perspectives, perceived practice barriers and reported confidence to providing PPC. A cross sectional survey design using the Perinatal Palliative Care Perceptions and Barriers Scale© was administered using a Web-based tool. Recruitment was completed via email invitation and list serves. Participants included physicians (n = 66) and advance practice …

Knowledge Of The Effects Of Alcohol On Fetal Development Among Women Of Childbearing Age., Mary Bales

Undergraduate Honors Theses

While Fetal Alcohol Syndrome Disorder is a recognized problem with alcohol ingestion during the formation of facial features, Fetal Alcohol Spectrum Disorders are not as widely recognized. These disorders result from exposure to alcohol throughout pregnancy when the brain and nervous system are developing. The resulting disorders include attention deficit disorders, social disorders, inappropriate behaviors, learning disorders, and intellectual disability. The incidence of children with alcohol-related disorders is increasing as evidenced by children needing special services in the educational systems. It is unknown how much alcohol ingestion is safe during pregnancy or how genetic factors are involved in the development …

The Influence Of Time Perspective On Physical Activity Intentions And Behaviors Among Adolescents Residing In Central Appalachia., Tauna Gulley

Electronic Theses and Dissertations

Obesity and inactivity are prevalent among central Appalachian adolescents. Appalachian residents have been labeled "fatalistic," a time perspective unsupportive of health-promoting behaviors such as regular participation in physical activity. The theory of planned behavior has been used extensively to explain the physical activity behaviors of adolescents. Constructs within the theory of planned behavior include attitudes toward the behavior, subjective norms, perceived behavioral control, and intention to perform the behavior. The purpose of this study was to determine the time perspective of central Appalachian adolescents and examine the relationship between time perspective and the constructs within the theory of planned behavior. …

Horizontal Violence In The Nursing Work Environment: Beyond Oppressed Group Behavior, Therese M. Mendez

LSU New Orleans Theses and Dissertations

The United States has been experiencing a nursing shortage since the mid-1990s. The shortage is expected to deepen as the provisions of the 2010 Patient Protection and Affordable Care Act are enacted. Horizontal violence is a negative phenomenon in the nursing workplace that contributes to difficulty in recruiting and retaining nurses in hospitals. Horizontal violence has been described as a form of mistreatment, spoken or unspoken, that is threatening, humiliating, disrespectful or accusatory towards a peer. The effects of this nurse on nurse aggression can be devastating for the nurse involved and also for the patients under the nurse's care. …

Rn Transition To Practice Program In The Primary Care And School Settings: Development, Implementation, And Evaluation, Maria-Idalia O. Lens

Doctor of Nursing Practice (DNP) Projects

New graduate registered nurses (RN) are facing a difficult time finding jobs since the economy of the United States has declined. Since then the California Institute of Nursing and Health Care, along with funding from the Betty Moore Foundation, have developed RN transition programs. These programs were developed to increase skills, confidence, and experience among new RN graduates to promote their transition into the nursing workforce. The programs also were designed to retain newly licensed nurses in the nursing profession while engaging competencies that could be transferred to both acute and outpatient care settings. In addition, the programs are intended …

Impact Of Multiple Children On Parental Supervision Practices, Parental Developmental Competence, And Unintentional Injury Risk, Jennifer L. Taylor

Dissertations

Unintentional injury is the leading cause of childhood mortality and morbidity in the United States. The effects of injury on children, families and society encompass physical, mental, emotional, and financial consequences. The highest injury rates are among preschool age children, especially preschool children who have siblings. Child injury prevention strategies can reduce the rates of childhood unintentional injuries and minimize the burdens to children, families, and society created by these injuries. To design and implement effective child injury prevention strategies, further investigation is needed to understand the relationship between the variables influencing the occurrence of child injuries. The specific aim …

Chest Tube Dressings: A Comparison Of Different Methods, Susan Kathleen Blackburn Jones

Dissertations

This study is an experimental design with randomization comparing the use of standard gauze dressings (SGD) to transparent adhesive dressings (TAD) to cover chest tube insertion sites in post-operative patients who have undergone cardio-thoracic surgery. The study was conducted in a 400 bed, tertiary non-academic teaching hospital in the Midwestern United States. Seventy-nine patients were enrolled in the study; 39 received TAD and 40 received SGD. The non-inferiority margin was set at 15% in keeping with current recommendations (Kaul & Diamond, 2006). The TAD was found to be not inferior to the SGD with regards to the proportional differences in …

The Determinants Of A Nurse's Discretionary Decision To Respond To Situations That Place Patients At Risk For Safety Events But Requires A Response That Is Beyond The Scope Of Nursing Practice, Kathy Baker

Theses and Dissertations

A nurse’s contribution to patient safety in regards to early detection of issues in the clinical setting is undisputed (Redman, 2008). If these patient situations require a response that is beyond the scope of nursing practice, in most instances nurses are not sanctioned to intervene without physician consultation (Gaba, 2000). The evidence in the nursing literature does suggest that some nurses exercise professional discretion and are, at times, making the decision to initiate interventions independently (Benner, Hooper-Kyriakidis, & Stannard, 1999; Hutchinson, 1990; Tiffany, Cruise, & Cruise, 1988). The focus of this inquiry was to examine the determinants of a nurse’s …

Facilitating The Staff Nurse's Role In Creating A Culture Of Care On An Obstetrical Care Unit, Laura Struve Hanson

Theses and Graduate Projects

The art of caring is foundational to the nursing profession, but too often nurses prioritize care for others above care for themselves. Nurse self-care and peer care are integral in the creation of a unit culture of care. This project introduces a new nursing practice model based on Jean Watson's caring theory and Caritas Processes to guide staff nurses on an obstetrical unit in creating a culture of care for self and peers. The practice model relies on nurse courage, intentional collaboration, and creativity to uniquely integrate the Caritas Processes into professional practice. This progression fosters the emergence of holistic …

Introducing Integrative Medicine At The Bedside To Patients With Post-Traumatic Headache Pain, Melissa E. Allard

Theses and Graduate Projects

The use of integrative medicine is growing, and the nursing profession has a responsibility to meet the changing needs of patients. This paper describes a model of nursing for delivering integrative medicine practices at the bedside to persons suffering with post-traumatic headache pain related to traumatic brain injury (TBI) and is grounded in Katherine Kolcaba's Comfort Theory. A patient is best served when the holistic principles of integrative medicine are facilitated by a nurse who is centered and able to introduce these modalities with positive intention. The goal of the practice model is to provide the foundation for nursing to …

Advancing A Culture Of Safety Through The Creation Of A Unit-Based Safety Team, Lynda K. Carr

Theses and Graduate Projects

Hospitals are challenged to create a strong culture of safety within their organization to eliminate harm to patients. This paper describes a project to advance a culture of safety on a cardiovascular acute care unit at an urban hospital through the creation of a unit-based safety team. Based on the premise that patient safety is a local phenomenon, the rationale for the project is to aim interventions at the unit level where they will have the greatest impact. Four key steps in creating an effective unit-based safety team are highlighted: team member selection, team development, enacting interventions, and evaluating interventions …

Response To And Recovery From Endotracheal Suctioning In Preterm Infants Using Routine Versus Four-Handed Care, Sharon Cone

Theses and Dissertations

Neonatal Intensive Care Units have experienced profound advances in technology and treatment modalities over the last two decades. Infants born at the edge of viability are now surviving despite prolonged hospitalizations. These infants born preterm are prone to a high degree of stress from life sustaining and routine interventions. Much focus has been directed toward addressing noxious environmental factors such as noise, light, and infectious disease; however, little has been done to examine the stress experienced by the professional caregiver who work in these environments. Environmental press theory, which focuses on the interplay between human beings and their surroundings, is …

Caring For A Preterm Infant During The First Six Months Post Nicu Discharge: A Mother’S Perspective, Lois Phillips-Pula

Theses and Dissertations

Overview There are numerous studies in the current literature focusing on the intense emotions experienced by parents, following the birth of a preterm infant, (i.e., born prior to 37 weeks gestational age [GA]). Research findings have helped us understand the fear and anxiety they feel while attempting to navigate the neonatal intensive care unit (NICU) environment. What happens in those early weeks and months at home after discharge, however, is surprisingly absent from the literature. It is well known that preterm infants are readmitted to the hospital during the first few months after discharge at a rate of 10% - …

A Bridge To One World: An Indigenous Wisdom-Based Approach To Designing A Transcultural Patient Family Advisory Council, Julie Lundberg

Theses and Graduate Projects

As health care organizations face increasing challenges to accommodate diverse patient populations amid growing concerns of persistent health disparities, there is urgent need to better understand and listen to diverse, unique patient experiences. This paper describes the design and implementation of a transcultural Patient Family Advisory Council (PFAC) as a concrete step towards ensuring that the voices of culturally diverse patients and families are effectively engaged to improve the patient experience at a large, Midwestern healthcare organization. Storytelling, ritual and dialogue provide a wisdom-based approach to the design of a Bridge to One World practice model grounded in Leininger's Culture …

Care Of Self: How Reiki Is Used By Nurses To Reduce Stress On An Acute Care Unit, Leann Olson

Theses and Graduate Projects

As the nursing shortage escalates and patient acuity levels continue to rise, nurses can expect to experience increased stress and burnout. Indeed, studies show that job dissatisfaction among nurses today is widespread. Finding ways to reduce the stress, improve job satisfaction, and retention is important not only for nurses, nursing units, and organizations, but also for patients. This paper describes a nursing practice model that was developed to reduce stress and burnout among nurses in an acute care unit of a large urban hospital. The model uses the energy therapy of Reiki and is guided by Martha Rogers' Science of …

Creating A Healing Environment In The Intensive Care Unit, Elissa Egbers

Theses and Graduate Projects

The intensive care unit (ICU) can be a very stressful environment. Patients are critically ill and require constant monitoring. Indeed, high tech care in the ICU environment includes multiple factors that may impair the patient's ability to sleep and rest. The purpose of this paper is to describe a practice model that is conducive to patient healing in an intensive care unit in a large urban hospital. This practice model is significant to patients, families, and nursing staff and is based on Florence Nightingale's Environmental Model of Nursing and her thirteen canons. This paper describes the potential implementation of the …

Living With Hiv: Views Through The Blog, Linda Eastham

Theses and Dissertations

The purpose of this qualitative descriptive study was to develop a greater clarity of how HIV infected individuals live and work within the sphere of HIV infection as represented through unsolicited, personal narratives posted on blogs. Existing, single author, personal blogs were identified via a search engine. Blogs were defined as the blog author's postings and all responses, whether written by the blog author or a reader respondent. Inclusion and exclusion criteria were developed to respect indicators of bloggers' intentions for privacy, e.g., blogs which required a password were excluded. A total of 14 blogs met inclusion criteria. Actions to …

Healthcare Acquired Infection Risk And Toothbrush Contamination In The Icu., Michelle Frazelle

Theses and Dissertations

Healthcare acquired infections (HAIs) are a complex and multi-factorial problem associated with high morbidity, mortality, and cost. Toothbrushes (TBs) may be at risk for contamination with potential pathogenic microorganisms (PPMs) from the patient care environment or autoinnoculation from the patient. We focused on three PPMs: multiply resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), and Acinetobacter. Specific aims were to (1) describe environmental factors associated with TB contamination in the ICU; (2) describe the relationship between TB contamination and oral colonization in critically ill adults.

Understanding Mothers Of Late Preterm Infants, Brenda Baker

Theses and Dissertations

The experience of becoming a mother is a personal and social experience influenced by individual characteristics, friends and family, and the infant. The journey to become a mother encompasses concepts of maternal competence and responsiveness. The purpose of this study was to examine maternal competence and responsiveness to the infant in mothers of late preterm infants compared to mothers of full term infants. The conceptual model for this work was based on the work of Reva Rubin describing maternal identity and role development. Maternal competence and responsiveness are components of maternal role and are influenced by social support, maternal self-esteem, …

Caring, Interaction, And Active Teaching Strategies: Factors That Contribute To The Success Of The Associate Degree Nursing Student, Penelope Sue Logsdon

Dissertations

This exploratory study examined successful associate degree nursing students’ perceptions regarding the importance of caring by the nursing faculty, nursing faculty/student interaction, and faculty use of active teaching strategies. Participants completed a researcher developed survey instrument that measured both the importance and frequency of the caring, interaction, and active teaching strategies. The survey instrument measured six demographic factors and 30 statements regarding caring, interaction, and active teaching. Participants rated the statements for both importance and frequency on a four-point Likert scale. Five community and technical college associate degree nursing programs participated in the research with a total of 270 successful …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

• Greetings
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• AccPhD Scholars Find First Year Exciting, Challenging
• Event Salutes AccPhD Donors
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• Faculty Publications
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• Endowed Faculty Positions

Are Nursing Students’ Clinical Skills Competency And Self-Confidence Levels Improved Via Video Ipods? A Randomized Controlled Pilot Study, Margaret M. Hansen Edd, Msn, Rn

Nursing and Health Professions Faculty Research and Publications

Background: Mobile technologies allow students the opportunity to enhance learning while away from the traditional classroom setting. However, educational outcome research is lacking in the use of mobile health (m-health) applications in healthcare professional practice development.

Objectives: The aim of this pilot study was to discover whether male and female urinary catheter insertion videos delivered via iPods increases students’ skills competency and self-confidence levels.

Methods: A prospective replicated study including second year, semester two, undergraduate nursing student participants (NSP) (N=16) was conducted: nine control participants (no video iPods) and seven intervention participants (video iPods). Nursing students attending a mandatory skills …

Nursing Students' Lived Experiences Surrounding Medication Administration, Sally Nan Morgan Phd

Dissertations

Medication errors are abounding and the complexity of medication administration creates an environment where health care providers are at risk for making errors. This environment includes nursing students learning medication administration. Coupled with a rigid, protocol-driven pedagogy, nursing students may be placed in a learning experience counterproductive to accuracy. Previous studies have focused on causes and perceptions of medication errors looking for the delineation between safe and unsafe practice. In doing so, past research may have narrowed the path of discovery needed to diminish medication errors. In addition, research regarding the lived experience of nursing students while they are learning …

Effects Of Voluntary Public Reporting On The Nurse Sensitive Measures Of Falls And Falls With Injury In Hospitals: A Massachusetts Perspective, Patricia Noga

Graduate Doctoral Dissertations

Background: Interest and efforts in the health care industry to be transparent by collecting and publicly reporting performance measures about healthcare quality and cost has increased in recent years. The National Quality Forum (NQF) endorsed a set of 15 national quality measures for nursing-sensitive care that could be used for public accountability and quality improvement, including measures of patient falls and falls with injury. Patient falls have been among the largest category of reported incidents in hospitals, and are a serious concern for healthcare leaders and healthcare team members. In 2006, Massachusetts hospitals began voluntarily publicly reporting the nurse sensitive …

Call-Shift Fatigue And Use Of Countermeasures And Strategies By Certified Registered Nurse Anesthetists, Ramona M. Domen Phd, Crna

Dissertations

Purpose: The purpose of this study was to examine whether Certified Registered Nurse Anesthetists (CRNAs) experience fatigue during call and to assess their use of fatigue avoidance strategies (practices that prevent fatigue) and fatigue countermeasures (practices that decrease fatigue) to mitigate its effects. Method: Using a cross sectional descriptive survey design, data were collected from a randomly selected sample of 323 practicing CRNAs who worked call shifts. Data analysis: Data were analyzed using descriptive and multivariate statistics. Results: The sample was fairly evenly distributed with slightly more female respondents, 55% (n = 179). Fifty four percent worked a weekday call …

Military Sexual Trauma Exposure And Heart Rate Variability Outcomes In Female Veterans, Elizabeth Ann Davis Lee

Theses and Dissertations (ETD)

Area of Investigation and Hypothesis: Decreased heart rate variability (HRV) has been used as a predictor of cardiac and all-cause mortality. Studies have documented decreased HRV in a variety of conditions, including posttraumatic stress disorder (PTSD), depression, age, coronary artery disease (CAD), diabetes mellitus (DM), and tobacco use but improvement with beta blocker (BB) treatment. No prior study evaluated the relationship between military sexual trauma (MST) exposure and HRV outcomes. The hypothesis of this study was that female veterans exposed to MST would have lower time domain HRV measures than a reference cohort reporting non-exposure. Methods and Procedures: Electronic medical …

The Effect Of Safety Climate, Teamwork, And Sustainable Motivation On Nurse Job Satisfaction And Intent To Stay, M'Lynda Owens

Nursing Theses and Dissertations

Nursing is a hazardous occupation, and occupational safety in healthcare, particularly hospitals, is gaining attention. The Institute of Medicine (2003) ranked hospitals in the top five industries for occupational injuries and illness. This study explored the relationship between sustained motivation in nurses as depicted by their perceptions of workplace safety climate, teamwork climate, and autonomy and their job satisfaction and intent to stay at their current jobs. Sustained motivation was manifested as the ability of the nurses to consistently and persistently attend to routine activities such as actions to ensure safety. Over one-third (36%) of the variance in sustained motivation …

Prehabilitation Before Total Knee Arthroplasty Increases Strength And Function In Older Adults With Severe Osteoarthritis, Ann M. Swank, Joseph B. Kachelman, Wendy Bibeau, Peter M. Quesada, John Nyland, Arthur Malkani, Robert V. Topp

College of Nursing Faculty Research and Publications

Preparing for the stress of total knee arthroplasty (TKA) surgery by exercise training (prehabilitation) may improve strength and function before surgery and, if effective, has the potential to contribute to postoperative recovery. Subjects with severe osteoarthritis (OA), pain intractable to medicine and scheduled for TKA were randomized into a usual care (UC) group (n = 36) or usual care and exercise (UC + EX) group (n = 35). The UC group maintained normal daily activities before their TKA. The UC + EX group performed a comprehensive prehabilitation program that included resistance training using bands, flexibility, and step training at least …

The Effect Of Acceptance Training On Psychological And Physical Health Outcomes In Elders With Chronic Conditions, Patricia Mcdonald, Jaclene Zauszniewski, Abir K. Bekhet, Laura Dehelian, Diana L. Morris

College of Nursing Faculty Research and Publications

This pilot trial investigated the short and long-term effects of Acceptance Training (ACT) intervention on acceptance, perceived health, functional status, anxiety, and depression in elders with chronic conditions living in retirement communities (RCs). The ACT intervention combined Rational Emotive Behavior Therapy with music, relaxation, and guided imagery during six weekly 2-hour sessions. Face-to-face interviews were conducted with 16 African-American and 46 White elders across four data collection points in six randomly selected RCs using well-established measures of perceived health, functional status, anxiety, and depression, and a measure of acceptance of chronic conditions adapted from a previous measure of acceptance of …