Nursing Commons^™

Identification Of Posttraumatic Stress Disorder Symptoms In Post-Icu Patients, Heather Warlan Phd, Rn, Ccrn

Dissertations

Background: Patients receiving critical care are experiencing post-traumatic stress syndrome (PTSS) as a result of life-saving interventions received in the intensive care unit (ICU). PTSS is associated with poor patient outcomes and decreased quality of life compared to post-ICU patients without PTSS. Personal and clinical characteristics that place patients at higher risk for PTSS are still being examined. It is also unknown to what extent patients are being screened for ICU-induced PTSS. Objectives: This body of work aims to examine the risk factors associated with ICU-related PTSS and describe the screening experiences of patients who recently received care in an …

Delirium Rate And Risk Factors In Palliative Care Outpatients And Caregiver Coping Strategies, Sarah Deur Livermore Phd, Fnp

Dissertations

Background: Delirium causes suffering and in terminal illness undermines important goals to die at home. Improved knowledge about delirium among palliative outpatients can lead to improved patient outcomes through early identification and treatment in the home. Conversely, a missed diagnosis leads to costly hospital admissions, and is the most common reason to seek long-term care placement (Breitbart & Alici, 2008). Medicare stresses the importance by listing it as a common cause of falls among non-reimbursed hospital events. Prior evaluation of outpatient delirium rate was 14% among demented community dwelling elders (Steis, Evans, et al., 2012a). It is hypothesized that frail, …

Education For Pediatric Oncology Nurses On Fertility Preservation Of Pediatric Oncology Patients, Elyse Breit

HIM 1990-2015

Although the survival rate of childhood cancer is high, nearly two thirds of these survivors experience negative long-term secondary side effects from cancer treatments. Infertility is one such side effect that can have a prominent impact on quality of life as the patient ages. It is important for nurses working with pediatric oncology patients to provide the patient and family with education about risk for infertility and fertility preservation (FP) in order to allow families to make decisions about FP before cancer treatment starts. However, pediatric oncology nurses report being uneducated about FP guidelines and are hesitant to broach this …

Interventions For Childhood Obesity: Evaluating Technological Applications Targeting Physical Activity Level And Diet, Jessica Dipietro

HIM 1990-2015

Overweight and obese children have increased risks for multiple preventable diseases and conditions which can impair their physiological health and significantly increases the overall cost of their healthcare. Free mobile applications and technology for weight loss, dietary tracking, and physical activity may be quite useful for monitoring nutritional intake and exercise to facilitate weight loss. If so, nurses are well positioned to recommend such tools as part of their efforts to prevent childhood obesity and help children and parents better manage childhood obesity when it is present. However, there are no guidelines that nurses can use to determine what applications …

Exploring The Vicious Cycle Of Pediatric Asthma And Anxiety, Taylor Irwin

HIM 1990-2015

Asthma is the most common chronic disease of childhood. Children diagnosed with asthma are twice as likely to have a comorbid anxiety disorder as their non-asthmatic peers. The presence of both asthma and anxiety in the pediatric patient creates an environment of poor asthma control, and places them at risk for a variety of negative health events. Little is known about comorbid anxiety’s role in asthma health maintenance. Research has identified the link between these two conditions but causation is difficult to conclude. The aim of this thesis is to assess the current state of the science regarding pediatric asthma …

Factors That Influence Implementation Of Pain Management Strategies In The Neonatal Intensive Care Unit, Geraldine Martinez

HIM 1990-2015

In the United States, 10% to 15% of newborns are admitted to the neonatal intensive care unit (NICU). Painful procedures are unavoidable during NICU care; the neonate experiences approximately 12 painful procedures per day. Inconsistent and/or inappropriate pain management in the NICU remains a problem. The purpose of this study is to identify the prevalent factors that influence the implementation of pain management strategies among nurses who work in a NICU setting in a Central Florida hospital. This study was conducted using a voluntary and anonymous electronic survey. The survey was divided into two sections; the first section designed to …

Use Of Complementary And Alternative Therapies: A Pilot Survey, Hector Ortiz-Cintron

HIM 1990-2015

Meeting patient expectations in relation to pain management is an essential component of palliative and end-of-life care. However, previous research has demonstrated that pain is highly prevalent, especially during the four months prior to death. Poorly controlled pain contributes to cognitive failure, depression and an inability to complete daily activities. Unfortunately, pain and symptom management are often inadequate for patients placed in hospice care. The purpose of this study is to evaluate the perspectives of hospice nurses on complementary and alternative therapies to determine if there is an educational need in order to aide in the management of chronic pain …

Addressing Need For Research-Focused Nurses By Increasing Interest And Socialization At The Undergraduate Level, Sarah Thomas

HIM 1990-2015

The U.S. shortage of qualified nursing teachers and researchers is affecting national health care outcomes. Methods such as fast-tracking Baccalaureate nurses into graduate programs and embedding leadership development early into nursing curricula have been proposed to address faculty and research shortages. Early interest in nursing research careers increases likelihood of enrollment in graduate education. One way undergraduate nursing students may develop an interest in research careers is through a mentored apprenticeship with research-active faculty. In this thesis, the author uses an autoethnography methodology to examine the benefits that a mentored research apprenticeship model brought to her undergraduate experience. Her experience …

Examining General Versus Condition-Specific Health Related Quality Of Life Across Weight Categories In An Adolescent Sample, Autumn G. Dalton

Undergraduate Honors Theses

Approximately 34% of adolescents are overweight or obese which can be accompanied by physical, psychosocial, and economic consequences. Increasingly, pediatric overweight/obesity research has focused on Health Related Quality of Life (HRQoL) as a health outcome. This study examined differences in HRQoL across weight categories in adolescents, specifically, the sensitivity of using a general versus condition-specific measure. Further, the influence of gender was explored.

Data were extracted from Wave 2 of Team Up for Healthy Living, a school-based obesity prevention program targeting adolescents in Southern Appalachia. Participants (N = 918; 50% Female; 93% Caucasian; 90% 9^th graders) completed …

Endoscopic Pancreatic Pseudo-Cyst Drainage, Judith Dorsam Rn

Patient Care Services / Nursing

No abstract provided.

Is Chlorhexidine An Effective Antiseptic To Prevent Clabsi For Picc Line Maintenance In The Neonatal Population?, Lauren Blankenship

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Central venous catheters (CVCs) are inserted in order to administer fluids and medications. A peripherally inserted central catheter (PICC) is a type of CVC. While beneficial, central line associated bloodstream infection (CLABSI) is a risk for patients having a CVC inserted. Antiseptics are used for skin preparation when inserting a central line to prevent infection and during maintenance of the central line. Currently, the Center for Disease Control recommends the use of chlorhexidine for central venous catheter insertion in patients two months of age or older. Studies have found reduced CLABSI rates with the use of chlorhexidine for CVC insertion …

Portion Size Selection In Relation To Hemoglobin A1cs, Brian L. Dixon

Undergraduate Honors Theses

Obesity has been recognized as an increasing issue within our country. Obesity contributes to many health related issues, including type 2 diabetes mellitus. Portion size is a factor that has generated clinical research interest. The aim of this study was to determine if there was a relationship between management of diabetes measured by hemoglobin A1c and portion size selection for type 2 diabetics. In this study, subjects selected portion sizes of four different foods. Data were compared to recent A1c levels. Due to the small sample size, nonparametric statistical analysis was used. The relationship of grain portion weight selection and …

Factors Associated With Physical Activity In Kindergarten Children, Carol Hammonds

Dissertations and Theses (Open Access)

Background: Reversing obesity is an urgent public health need for children: worldwide, in 2011 more than 40 million children under the age of five were either overweight or obese. Increasing intensity and duration of physical activity is a strategy to aid in preventing and reducing obesity. A minimum of 60 minutes per day of moderate to vigorous physical activity is recommended for children. School settings, such as full-day kindergarten, where 74% of children in the United States are enrolled, provide opportunities for population-based interventions to increase physical activity, yet little objective data exist on current levels of physical activity in …

How Do Black Nulliparous Women Cognitively Construct Birth?, Marianne F. Moore

Dissertations and Theses (Open Access)

A focused ethnography was conducted to determine the cognitive constructions about birth described by nulliparous Black women in an urban area of the Southwestern US; also, during postpartum, how do these women reconcile expectations with the actual birth? Semi-structured interviews were conducted before birth and after birth.

Women, 16 or older, 17 - 33 weeks carrying a singleton fetus and without anomalies or problems like pre-gestational diabetes, NYHA Cardiac Class III/IV, cancer, renal failure, or sickle cell anemia that eliminated vaginal birth were sequentially recruited and sampled in an affiliated ultrasound clinic. Women scheduled for an anatomy scan were approached. …

Understanding The "Big Picture": End-Of-Life Decisions In The Picu, Amy J. Howells

Dissertations and Theses (Open Access)

Objective: Describe critical care providers' cognitive constructions or their interpretation of the process of decision-making that influences both the technique of conversations and the recommendations given to parents regarding limitation or withdrawal of life sustaining treatments from terminally ill children in the PICU. Design: Qualitative Medical Ethnography. Setting: Tertiary care children's hospital affiliated with a college of medicine. Participants: Eleven critical care providers in the department of pediatrics (attending physicians, critical care fellows, pediatric nurse practitioners, physician assistants). Interventions: In depth, semi-structured interviews designed to explore the experiences of providers in the participation of end-of-life care decision-making. Measurements and Main …

An Educational Intervention To Increase Clabsi Bundle Compliance In The Icu, Shelby Lane Holden

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Title: An Educational Intervention to Increase CLABSI Bundle Compliance in the ICU Context: “Forty-eight percent of patients in intensive care units (ICU) require central line placement for administration of fluids and medications” (How-to Guide, 2012). However these lines potentially pose serious complications for patients including central line-associated bloodstream infections (CLABSI). Hospitals have placed great emphasis on preventing CLABSI by use of evidenced based central line bundles. Objective: The purposes of this study were to evaluate nursing documentation compliance rates with central line bundle adherence, and to determine if the CLABSI rates significantly decreased post central line bundle educational intervention in …

Nurses' Job Satisfaction In Northwest Arkansas, Kaitlin Mcdowell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

During the month of October 2013, approximately 450 registered nurses working at a hospital in Northwest Arkansas were surveyed. All registered nurses were included in the study and were given the survey with instructions to complete it and return it within 30 days. A modified version of the McCloskey/Mueller Satisfaction Scale by Tourangeau was utilized, evaluating factors as they related to job satisfaction such as control and responsibility, scheduling, professional opportunities, praise and recognition, balance of family and work, relationship with coworkers, salary/vacation/benefits, maternity leave/child care, care delivery, social contact, research opportunities, and decision making. These variables were all rated …

Professional Quality Of Life And Emergency Department Nurses' Communication Patterns, Elvira Dominguez-Gomez Phd

Dissertations

The purpose of this mixed methods embedded design study was to examine relationships between compassion satisfaction, burnout, compassion fatigue/secondary trauma, and perceived levels of communication difficulty in emergency room nurses employed at a health care system. Quantitative data was collected from a purposive sample of 43 emergency room nurses using the Professional Quality of Life Scale (ProQOL), the Silencing Response Scale, and a demographic form. The study's embedded qualitative component was participants' experiences with traumatic cases in the emergency room. Qualitative data was collected via telephone interview with 10 emergency room nurses obtained from a subset of the original sample …

Visions Of Living With Parkinson's Disease: A Photovoice Study, Danice Greer, Cheryl Cooper, Melinda Hermanns

Faculty Posters

This poster was presented at the May 2014 UT Tyler Faculty Awards.

Fetal Heart Monitoring, Nursing Surveillance, And Cesarean Birth, María Del Carmen Colombo Phd

Dissertations

Purpose: Birth by cesarean delivery is a major public health issue with nearly one in three births delivered by cesarean section. Cesarean birth may be necessary to save mother or baby, but the rapid rise since 1996 without concomitant reduction in maternal and neonatal morbidity and mortality may indicate this mode of delivery may be over utilized. Cesarean births pose significant maternal and newborn health risks. Identification of factors that may contribute to reduction in the first cesarean birth in low-risk women who are nulliparous, term gestation, with single fetus in head down position (NTSV) is a health priority. The …

Transitioning Adolescents With Type I Diabetes To Adult Care, Kathyann Kenny Marsh Phd

Dissertations

Background: Care transitions, defined as hospital discharge or movement from one healthcare setting to another, are currently a major concern for healthcare providers and policy makers alike. These care transitions are occurring in the context of increasingly fragmented care and have been known to result in hospital readmissions, adverse events, and medication errors. The adolescents' transition between pediatric and the adult care system is not only fragmented but occurs at a time when they are most vulnerable and ill equipped for change. Objectives: The purpose of this research was to conduct a feasibility study to examine if the use of …

A Phenomenological Study Of Acceptability Of Preexposure Prophylaxis Therapy Within The Lived Experiences Of Hiv Negative Male-To-Female Transgender Young Adults, Gloria N. Nwagwu Phd

Dissertations

The male-to-female transgender (MtF-TG) are individuals assigned a male gender at birth but self identify as female. MtF-TG young adults experience discrimination, stigmatization, isolation, and homelessness as a result of gender identity and gender expression. The transgender populations are linked to high rate of new HIV infection. The use of Preexposure prophylaxis (PrEP) therapy demonstrated a decrease in HIV infection risk ranging from 42% to 73% among sexual minority individuals. The goal of this three-part study was achieved through concept analysis, data collection, and analysis. The following aims were addressed; analyze the concept of transgender, explore currently used HIV prevention …

Hospital Fall Prevention Using Interactive Patient Care Technology, Verna A. Sitzer Phd, Mn, Rn, Cns

Dissertations

The impact of patient engagement in hospital fall prevention using interactive patient care technology is not known. The purpose of this investigation was to examine the engagement of hospitalized patients in a computer-based, interactive patient care fall prevention pathway, comprised of a self-assessment of fall risk questionnaire and a fall prevention video, and hospital fall outcomes. The aims were to 1) formulate an interactive patient care technology conceptual framework to guide the study, 2) provide reliability and validity evidence for a patient self-assessment of fall risk questionnaire, and 3) explore the relationship between the fall prevention pathway engagement characteristics and …

Reducing "Failure To Rescue" Occurrences: A Pilot Project Incorporating High-Fidelity Simulation During Mock Codes, To Enhance Pediatric Nurses' Clinical Knowledge And Skills, Denise Dawkins

Doctoral Projects

Thanks to advances in technology, the survival rate of infants and children with critical illnesses has improved. One consequence has been an increase in the acuity levels of hospitalized pediatric patients, which may heighten the risk of in-hospital cardiopulmonary arrest. Patient safety can be compromised by nurses who do not detect subtle clinical changes in a patient's condition, do not perform accurate interventions, or do not apply critical thinking (failure to rescue). The Institute of Medicine (10M) in 1999 estimated that approximately 100,000 people died each year as the result of poor care.

Patients and families place great trust in …

Long-Acting Reversible Contraceptive Methods, Same-Day Initiation And Early Removal, Sandra Mary Loehner

Doctoral Projects

Objective: The study was conducted to identify the early removal rate of Long-Acting Reversible Contraceptive (LARC) methods and factors associated with early removal.

Study Design: A non-experimental descriptive design based upon retrospective chart review of electronic medical records (EMR) was used. There was a total of 96 subjects, ages 15-47 years who had a LARC method inserted within a 12-month time period and subsequent removal within 6-months of insertion date. Subjects were grouped according to same-day insertion versus non-same-day insertion.

Results: Seventy percent of study subjects with early removal had their LARC method inserted under a same-day protocol. Most subjects …

Electronic Medical Record In The Simulation Hospital: Does It Improve Accuracy In Charting Vital Signs, Intake, And Output?, Carel M. Mountain

Doctoral Projects

The introduction of electronic health records has created a shift in the way nursing care is delivered (McBride, Delaney, & Tietze, 2012; Furukawa, Raghu, & Shao, 2010). A factor which heavily influences a nurse’s ability to navigate and utilize EMR is adequate education in the use of computerized documentation (McBride, et al., 2012). There is an increased risk for error at the bedside without the correct knowledge and skills regarding EMR documentation (Kelly, Brandon, & Docherty, 2011). This skill should be introduced during the pre-licensure education of the nurse.

Two groups of associate degree nursing students attending a small community …

Self-Reported Neurogenic Bowel And Bladder Management In Acute Hospitalized Chronic Spinal Cord Injured Patients: Its Role In Clinical Practice, Mary Lupe Jimenez

Doctoral Projects

Patients with spinal cord injuries and disorders (SCI/D) are at risk for mismanaged bowel care during acute hospitalization, which can lead to numerous medical complications ranging from loss of personal dignity and privacy to many serious medical conditions, some of which are life threatening. Additionally, mismanagement of bowel care during acute hospitalization may lead to costly extended hospital stays. The project was to describe bowel and bladder care for SCI/D patients during acute hospitalization using a self-reported questionnaire submitted by approximately 46.6% of SCI/D patients from the Veterans' Affairs Central California Health Care System. The self-report questionnaire was designed by …

Chronic Non-Cancer Pain In The Ed: Are Nurses Sbirt-Ready?, Dorothy James Moore

Doctoral Projects

Emergency department (ED) Registered Nurse (RN) understanding of chronic pain management is critically important. By some estimates, 30% of all opioid pain medications in the United States (US) are prescribed from EDs. At the same time, prescription drug abuse is America’s fastest growing drug problem. While RNs have significant contact time with chronic pain patients who may also be drug abusers, RNs often use the stigmatizing label, “drug-seeking” for certain key patient behaviors and may not feel confident intervening constructively with these patients. This project reviews literature pertaining to SBIRT use for substance abuse in the ED and surveys ED …

Impact Of Cue-Based Feeding Protocol On Premature Infants' Outcomes And Hospital Length Of Stay, Diana Michele Easley Cormier

Doctoral Projects

The project was an oral feeding practice change from traditional, gestational-age/volume-driven feeding progression to developmentally-based, infant-driven feeding progression. The infant-driven (cue-based) feeding protocol was implemented with goals to improve premature infants' feeding outcomes, and decreased the infant's length of hospitalization. The project was designed to implement a cue-based feeding protocol for oral feeding initiation and progression, within the neonatal intensive care unit (NICU) at Community Regional Medical Center (CRMC), and then retrospectively evaluate the impact of the cue-based feeding protocol on feeding outcomes. In order to realize full implementation of a NICU feeding practice change, multiple components, such as electronic …

Humor As A Buffer For Stress In Nurse Anesthesia Students, Kayla C. Forbis

Honors Theses

This simple, quantitative study was carried out on 18, first-year, CRNA students to determine if humor could act as a buffer for some of his or her perceived stress. Before an impending final exam, when stress levels would most likely be at their highest, the students were broken into three groups: a control group, a non-humorous group, and a humorous group. The students in the control group ranked their level of stress on a 0-10 scale without any other intervention. The other two groups watched a video clip, either humorous or non-humorous, while ranking their perceived stress on a scale …