Nursing Commons^™

Charging Change, Kaye Barnhart Rn, Bc, Erin Joyce Bsn, Cpan

Patient Care Services / Nursing

No abstract provided.

The Lived Experience Of Parental Bereavement, Christine Denhup

Seton Hall University Dissertations and Theses (ETDs)

The purpose of this manuscript is to present a Heideggerian hermeneutic phenomenological nursing research study on the phenomenon of parental bereavement. The aim of this study is to describe the lived experience of bereaved mothers and fathers who have experienced the death of a child due to cancer. Van Manen’s (1997) method guided this qualitative inquiry. New knowledge describing the meaning of the lived experience of parental bereavement promotes a better understanding of the phenomenon from the perspective of parents, fills a significant gap in the literature, and informs nursing research, education, and practice.

Human Factors Contributing To Nursing Errors, Cheryl K. Roth

Nursing Theses and Dissertations

There has been considerable focus on reducing errors in the hospital setting over the last two centuries, but errors continue to occur at an alarming rate. Two articles are discussed that explore nursing errors. The purpose of these studies was to identify human factors that cause nursing errors and to identify the constructs of likelihood to cause error, ability to intervene, importance, and commonness relating to human factors causing errors. The first paper describes a Delphi Study which examined the likely causes of nursing error using an expert group (n=25) of Quality Assurance, Risk Management, Patient Safety, and staff nurses. …

Cost-Effectiveness Analysis Of Tunneled Central Venous Catheter Dressings In Canadian Blood Stem Cell Transplant, Melanie Keeler

Nursing Theses and Dissertations

Central venous catheters (CVC) are an integral tools used in blood stem cell transplant with registered nurses responsible for maintenance and catheter care. However, CVC practice guidelines in the literature are inconsistent or absent. Gaps in the evidence generated several research questions regarding potential variability in CVC practice across Canada and the impact that variability may have on healthcare spending and patient outcomes. A survey of Canadian practice revealed differences in CVC practice across the nation that coincide with discrepant and/or absent guidelines. Device-associated complications such as catheter-related bloodstream infection (CRBSI) are both costly and avoidable. Current cost-analyses within the …

Impact Of Text Messaging On Diabetic Foot Self-Care Behaviors Using A Single-Case Design, Stephanie Charese Hills

Nursing Theses and Dissertations

Problem: The absence of diabetic foot self-care is one of the major reasons for the approximately 60,000 avoidable lower extremity amputations annually in the U.S. Providers have limited time during clinic visits to educate their patients and increase awareness. Innovative strategies beyond the clinical setting are necessary to reinforce self-care behaviors. Objective: The purpose of this study was to use an innovative design method to examine the impact of providing diabetic foot care education to patients via text messaging and to assess the effect on patient self-care behaviors and clinical outcomes. Methods: Quantitative research using a single case study design. …

Health, Health Perceptions, Healthcare Practices, And Influencing Factors Among Korean Immigrants Living In Rural Texas, Mary Beth Winton

Nursing Theses and Dissertations

The population of Asian immigrants in the United States increased 43.3% from 2000 to 2010. During the same period, Texas experienced an increase of Korean immigrants of over 47%. Despite the increase of Korean immigrants, only a minimal number of studies explored health and healthcare needs specific to this population. Furthermore, none of the studies addressed Korean immigrants living in rural Texas. Hence, an ethnographic study was conducted to examine the health and healthcare among Korean immigrants living in rural Texas. Face-to-face interviews were conducted and transcribed. Five major themes emerged which included acculturation, health and health perceptions, healthcare, relaxation …

Lessons Learned In Caring For Patients Treated With Therapeutic Hypothermia, Catherine H. Swedberg Rn, Kelly A. Wolfenden Rn, Bsn, Cci, Jeffrey Martin Rn, Carolyn Ordway Msn, Rn, Crnp

Patient Care Services / Nursing

No abstract provided.

E Pluibus Unum: The Unification Of Four Culturally Unique Pre-Admission Testing Sites To One Network Department, Theresa Elwell Rn, Carol Saxman Msn, Rn-Bc, Kelli Brown Msn, Rn-Bc, Kelly Stivala Bsn, Rn, Capa

Patient Care Services / Nursing

No abstract provided.

An Examination Of Exposure And Avoidance Behavior Related To Second-Hand Cigarette Smoke Among Adolescent Girls In Canada, Jennifer Schwartz, Raquel B. Graham, Chris G. Richardson, Chizimuzo T.C. Okoli, Laura L. Struik, Joan L. Bottorff

Nursing Faculty Publications

BACKGROUND: Although rates of tobacco use and exposure to second-hand smoke (SHS) are declining in Canada, SHS exposure among non-smoking adolescents remains high. This study aimed to describe frequency, locations, and avoidance behavior related to SHS exposure among adolescent girls in British Columbia, Canada.

METHODS: Data were analyzed from 841 adolescent girls aged 13 to 15 years old who completed an internet-delivered survey as part of a cohort study examining SHS exposure and substance use. Measures assessed demographics, smoking behavior and intentions, frequency and locations of SHS exposure, and avoidance behavior related to SHS.

RESULTS: Excluding their own smoking, 27% …

Emergencies: Risk And Personal Preparedness Measures, Charleen C. Mcneill

Nursing Theses and Dissertations

Personal emergency preparedness efforts that increase the resiliency of individuals and communities and decrease the risk for poor outcomes after an emergency are increasingly of interest to health care leaders, policy makers, and governmental entities. The limited capacity for external aid to provide relief in the first 72 hours after an emergency dictates that individuals and communities become prepared to sustain themselves for this initial period. Failure to prepare for an emergency can result in a multitude of negative outcomes. Those who are economically vulnerable are particularly at risk, including a high risk for negative health outcomes. An initial review …

Validation Of The Transportation Burden Questionnaire Among Family Caregivers Of Older Adults, Bryant James Price

Dissertations

Because family caregivers provide a substantial amount of informal care to dependent loved ones, the potential burden such care may place on family members is an important area for clinical research and intervention. While the provision of transportation is recognized in the literature as a caregiving task and a component of global burden, few studies, to date, have addressed this as a distinct concern for measurement and intervention. The purpose of this study was to determine if an item set focused specifically on transportation burden would be additive to accepted global measures of burden in a volunteer sample of caregivers. …

Advantages And Limitations Of Anesthesia And Sedation Practices Used Among Acute Ischemic Stroke Patients During Endovascular Revascularization Therapy, Margaret Korzewski

Doctor of Nursing Practice (DNP) Projects

In order to safely and efficiently perform endovascular revascularization procedures among acute ischemic stroke (AIS) patients, general anesthesia or sedation is often required. However, anesthesia management during these procedures varies significantly worldwide and the procedural logistics have not been established yet. At some institutions AIS patients are intubated and paralyzed, while at other facilities, there is no routine protocol. In 2011 the University Hospital used “action nurses” (critical care float pool nurses) to provide pharmacological paralysis with sedation for intubated AIS patients under direct supervision of the neurointerventionalist. However, clinical outcomes among AIS patients undergoing endovascular procedures were poor. Exclusive …

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 …

Effects Of An Apn-Led Amiodarone Clinic On Adherence To Recommended Monitoring Guidelines, Melissa Bartoszewicz

Evidence-Based Practice Project Reports

Evidence shows that patients receiving amiodarone therapy have not adhered to monitoring guidelines set forth by the Heart Rhythm Society. Uncertainty with responsibility for monitoring has led to the development of pharmacist-managed or multidisciplinary-managed outpatient amiodarone clinics. Some limitations have been identified in the pharmacist-managed outpatient clinics that may be overcome by advanced practice nurse (APN)-managed clinics. The purpose of this EBP project was to determine what effects an APN-led amiodarone clinic would have on adherence to amiodarone monitoring guidelines. Using the PICOT format, the clinical question was developed: Does enrollment in an amiodarone clinic compared with “usual care” change …

The Effect Of Telephone Follow-Up On Pain Experienced By Patients After Knee Replacement Surgery, Laurie J. Jones

Evidence-Based Practice Project Reports

Hospital length of stays are decreasing throughout the U.S. in an effort to contain healthcare costs, but these measures can be detrimental to patients. Those who get knee replacement surgery are finding their length of stay reduced from an average of 3 to 4 days to 24 to 48 hours, which can affect pain control and interfere with rehabilitation and recovery. This affects many people, as more than 632,000 knee replacements occur each year (American Academy of Orthopedic Surgeons, 2008). The purpose of this evidence-based project was to evaluate the effect of telephone follow-up on pain experienced by knee replacement …

The Effect Of Shared Medical Appointments And Education On Hemoglobin A1c Levels, Gina L. Moore

Evidence-Based Practice Project Reports

Type II diabetes affects millions of people worldwide. Approximately 25.8 million or 8.3 percent of the United States (U.S.) population has type II diabetes. The number of adults in the United States developing diabetes has been projected to double by the year 2030 (World Health Organization, 2013). Diabetes is the leading cause of kidney failure and blindness, as well as the major cause of heart disease and stroke which is the 7th leading cause of death in the U.S. The purpose of this evidence-based project was to determine the effects of education during shared medical appointments with type II diabetic …

Microbial Exposure And Asthma: Applying Strachan’S Hygiene Hypothesis To Nursing Practice, Elisabeth M. Campbell

Senior Honors Theses

The incidence of asthma has risen significantly in recent decades. Asthma is a complex disease process affected by multiple factors including environmental exposure, genetics, epigenetics, and lifestyle. In 1989, the hygiene hypothesis was proposed based on Strachan’s findings suggesting increased exposure to microbes may have protective benefits against allergic rhinitis and eczema. Since that time, research in this arena has exploded as investigators seek to establish a causal link between increased microbial exposure and decreased incidence of allergic disease. The aim of this literature review is to synthesize the current research regarding Strachan’s hygiene hypothesis and identify the nursing implications …

Design And Implementation Of A Sustainable, University-Based, Emergency Medical Response Service, Octavia A. Mandel Struve

Doctor of Nursing Practice (DNP) Projects

Collegiate-based emergency medical services (EMS), designed primarily to provide pre-hospital basic life support and emergency services, are venues by which nurses and other healthcare professionals, with an understanding of community health and social network issues, can maximize health promotion objectives for university and college campus communities. These EMS systems also provide vital support to city and county emergency services and promote positive community relationships with neighboring areas. They can provide excellent opportunities for students to develop critical skills for success in the healthcare and business world. The sustainability and vibrancy of collegiate-based EMS systems are primarily related to impact, benefit …

A Novel Psychotropic Risk Assessment To Enhance Medical Management Of Patients With Behavioral And Psychological Symptoms Of Dementia, Nancy C. Trego

Doctor of Nursing Practice (DNP) Projects

There is growing evidence and concern documenting the risks of antipsychotic use, and psychotropic medication burden in general, for older adults with behavioral and psychological symptoms of dementia (BPSD). Yet nearly 25 percent of all long term care residents take antipsychotics for behavioral disturbances associated with dementia as “off-label” use, despite their modest efficacy and FDA black box warnings (CMS, 2013). Expert consensus calls for non-pharmacological strategies as the first line treatment, yet some patients with BPSD may require a combination of non-pharmacological interventions and pharmacological treatments for symptom reduction (AGS, 2011). The relief of debilitating symptoms aims to improve …

Motivational Interviewing Education For San Mateo County’S Adolescent Healthcare Providers: Focus On Healthy Diet And Physical Activity, Emilie J. Gruhl

Doctor of Nursing Practice (DNP) Projects

Motivational interviewing has been endorsed by San Mateo County as an evidence-based effective form of behavior change counseling. Eighty percent of pediatric healthcare providers in San Mateo County have been trained in motivational interviewing, however 70% of the providers use it less than 50% of the time. The goal of this project was to reeducate the adolescent providers of San Mateo County in motivational interviewing with an emphasis on individualized training and feedback, directed toward healthy diet and exercise. Results of the quality improvement project showed an average 2.5-point increase in provider confidence on a zero to ten-point scale, and …

Influence Of A Palliative Care Protocol On Nurses' Perceived Barriers To Palliative Care And Moral Distress, Christina Cavinder

Evidence-Based Practice Project Reports

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported …

A Novel Method For Assessing Medication-Related Adverse Outcomes In A Community Hospital, Christopher M. Patty

Doctoral Projects

The use of medications for hospitalized patients is universal, and unfortunately medication-related adverse outcomes are common. The accurate assessment of medication-related harm in hospitalized patients is foundational to the development of an effective hospital medication safety program. Every hospital has its own unique "fingerprint" of harm, accurate determination of the nature of medication-related harm specific to each hospital is necessary to facilitate prevention of that harm with specific and effective interventions. This project has provided a community hospital with its first systematic methodology for assessing medication-related harm. The methodology is adapted from that used in a recent national-level study.

Several …

Nurses' Perceptions Of Structural Empowerment: A Practice Review Process Pilot, Andrea M. Lee-Riggins

Doctoral Projects

Nurses are professionally and morally obliged to monitor and evaluate nursing practice via active participation in review mechanisms that are designed to promote patient safety and care delivery, thereby improving patient care quality (American Nurses Association [ANA], 1988, 2001, 2004; O'Rourke, 2006). The purpose of this Doctor of Nursing Practice (DNP) project was to develop, pilot, and evaluate a nurse practice review process with frontline nurses within Fresno Heart & Surgical Hospital (FHSH), a small specialty hospital, affiliated with Community Medical Centers (CMC) in Fresno, California. A nurse practice algorithm was subsequently developed and structural empowerment was assessed with the …

Primary Care At Home: Nurse Practitioners' Perceptions And Practices, Tonya Bragg-Underwood

Doctor of Nursing Practice Technical Reports

Background: Primary care at home is not a new idea, but rather a reinvention of an old and almost forgotten practice. Today, only 1% of primary care visits are provided in a home setting; despite the increasing aging homebound population in the United States. Current primary care at home research relates improved patient outcomes with primary care at home visits. Primary care at home is reemerging in the United States, but currently is not generating many positive reviews. There is a gap in the current primary care at home literature regarding nurse practitioner home visit practices and perceptions. Methods: A …

Pediatric Asthma Telemonitoring: Literature, Theory, And Application To Practice, Erin Christine Shankel

DNP Projects

Asthma is one of the most prevalent and costly chronic diseases faced by Americans today. It is marked by inflammation and hyperresponsiveness of the airways which fluctuates, often unpredictably, in response to triggers. As such, it causes particular challenges symptom management, especially on the part of the patient who is tasked with dealing with these frequent fluctuations for months at a time between regularly scheduled health care appointments. This is further complicated when the patient is a child, and symptoms must be interpreted and managed second-hand by a caregiver. Uncertainty about how to manage symptoms, as well as minimization of …

The Effect Of Patient Education On Anxiety Levels In Patients Receiving Chemotherapy For The First Time, Sarah Garcia

Evidence-Based Practice Project Reports

Cancer affects approximately 1.5 million people every year throughout the United States.Comprehensive care that includes psychosocial aspects is important to help patients effectively adapt to their diagnosis and treatment plan. Improper prevention and management of anxiety can lead to poor psychosocial outcomes, dissatisfaction with care, and decreased adherence to treatment. Current evidence suggests that education is effective at helping reduce anxiety in patients receiving chemotherapy for the first time. The purpose of this evidenced based practice project was to determine if nurse-led patient education regarding chemotherapy side effects, side-effect management, and orientation to the infusion center was effective at decreasing …

Effects Of An Osteoporosis Educational Intervention: Knowledge And Self-Efficacy Of Prevention In Young Adult Collegiate Females, Valerie A. Bollenbacher

Evidence-Based Practice Project Reports

Osteoporosis is a silent and potentially debilitating chronic illness. In 2012, the CDC reported that 4.5 million women over the age of 50 were diagnosed with osteoporosis in the United States. Within the next 20 years, 41 million women worldwide are projected to have osteoporosis. The annual financial burden of osteoporosis is estimated to be 19 billion dollars. The objective of this evidence-based practice project was to answer the clinical question: In young adult collegiate females, how does an osteoporosis educational intervention compared to current education effect osteoporosis knowledge and self-efficacy of osteoporosis prevention over a one-month time period? The …

The Use Of Stress Reduction Techniques In Nursing Education, Jennifer S. Bauer

Evidence-Based Practice Project Reports

Stress is a complex phenomenon that has significant effects on students which may disturb their physiological, psychological, and spiritual health and well-being. Nursing students have been identified to be at high risk for stress during their education. Stress can arise from new clinical experiences, academic load, and personal stressors (Jones & Johnston, 2006). This increase in stress can lead to the student’s inability to assimilate and learn within the classroom and clinical settings. A review of the literature provided evidence that reported a positive relationship between guided imagery and a decrease in stress and anxiety. This evidence-based practice (EBP) project …

The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

Effects Of A Parish Based Heart Healthy Education Program, Kristin A. Kilinski

Evidence-Based Practice Project Reports

Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Some risk factors for cardiovascular disease can be modified which include: diet; physical activity; smoking; hypertension; diabetes; and weight. Various national programs, such as “Go Red for Women” and “Let’s Move,” have been implemented to address this growing epidemic. Community programs are needed as an adjunct to these national initiatives. Thus, a parish based cardiovascular disease educational program would provide for a unique socially and spiritually supportive environment for education at the community level. Research findings indicate that parish based educational programs are effective in increasing …