Nursing Commons^™

Better Together: Group Prenatal Care Improves Outcomes, Rachel Hanus

All Electronic Theses and Dissertations

Background: Neonatal outcomes have not improved over the past 30 years in spite of increases in funding and utilization. New models of prenatal care, such as Centering Pregnancy, need to be evaluated for effectiveness. This critical review of the literature focuses on comparing birth outcomes, maternal weight gain, and adequacy of prenatal care between group and traditional care models. Results: Newborns with mothers in group care were more likely to be born at later gestational ages and with higher birth weights. Mothers in group care were more likely to use contraception postpartum and have better prenatal attendance. Women in at-risk …

Culturally Sensitive And Holistic Care For Women Who Have Undergone Female Genital Circumcision, Maria Fernanda Honebrink

All Electronic Theses and Dissertations

Background: Around the world, immigration is part of many people’s lives. In that context, obstetric healthcare providers must be ready to deliver culturally sensitive care to women of different backgrounds. Some of these women have undergone female genital circumcision (FGC). As a result, they have unique healthcare needs. Purpose: Conduct a critical literature review designed to discover and evaluate culturally holistic care guidelines being used to provide healthcare to women who have undergone FGC. Results: There is a lack of clinical guidelines for healthcare providers as they care for circumcised women. Randomized controlled trials are not being done due to …

Variations To Birth Outcomes With Labor And Delivery Doula Support, Nicole I. Hunter-Severson

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this critical appraisal of the literature is to discern if there are variations to birth outcomes as a result of having a doula present as a continuous support during labor and delivery. Theoretical/Conceptual Framework: Watson’s (2010) Theory of Human Caring will be the framework for this literature appraisal. Dr. Watson’s theory is founded on holistic care that involves putting a heart-centered caring process into action based upon Watson’s 10 carative factors. Methods: Thirty research articles that were relevant to the scope of variations to birth outcomes as a result of having a doula present as a …

The Influence Of Work Environment On Workplace Bullying And Retention Of New Graduate Nurses, Allisson Marie Kral

All Electronic Theses and Dissertations

Background: The existence and prevalence of workplace bullying and negative work environments may not only have detrimental effects on nurses as individuals, especially new graduate nurses, but also on patient care and safety as well as the health care organization as a whole. Purpose: To provide an examination of strategies that focus on the creation of an empowering work environment that seeks to lessen workplace bullying and increase the retention of new graduate nurses within the profession. Results: Empowering work environments that emphasize zero tolerance of bullying behaviors, the provision of educational experiences and access to information, resources, and support, …

A Critical Review Of Experiences Of Mentally Ill African Immigrants Living In The U.S, Josephine Moraa Masita

All Electronic Theses and Dissertations

Background: Historically, the U.S. has been known to lead the world in refugee resettlement. To date, the U.S. remains the top refugee resettlement country. Refugees are mostly people who have been forced to flee their home countries due to war, persecution, and violence. Because of their immigration status, unique backgrounds, religion, culture, values, perceptions, language barrier, perceived discrimination and stigmatizations, mentally ill immigrants especially those from African countries have posed a challenge to healthcare providers in the U.S. Purpose: The purpose of this research is to review and discuss experiences of mentally ill African immigrants living in the United States. …

Nurse Leader Effect On Burnout Among Mental Health Nurses Working In Inpatient Psychiatric Nursing, Beatrice Masita Paintsil

All Electronic Theses and Dissertations

Background: Burnout is a phenomenon that affects many nurses working in different nursing specialties. Research has shown that nurses working in psychiatry suffer from burnout. Burnout can have serious consequences to the individual nurse, to the patients they are responsible for, and the organization as a whole. Purpose: The purpose of this critical review of the literature is to explore the impact nursing leadership can have on burnout among mental health nurses Conceptual Framework: The Modeling and Role-Modeling theory will be adapted to guide the review and to explain the human relationship of nurse leaders and mental health nurses in …

Reducing Perineum Injuries And Trauma During Vaginal Delivery, Joyce Elaine Pepple

All Electronic Theses and Dissertations

Background: Perineal trauma and injury is extremely common during vaginal birth. Nurse-midwives and other obstetric providers should explore the most current literature for possible ways that perineal trauma and injury during vaginal birth can be avoided in patients. Purpose: To determine if hands-on perineum care, given by healthcare providers during labor and delivery, decreases perineal trauma and injury in women giving birth vaginally, compared with as opposed to women delivering vaginally who do not receive any hands-on perineum care. Results: Some hands-on techniques may improve perineal outcomes, but the hands-on techniques vary in effectiveness. The majority of providers currently prefer/use …

Community Care Paramedicine Program, Mary Beth Sather

All Electronic Theses and Dissertations

The Community Care Paramedicine Program is an emerging field across the United States that utilizes the expertise and service of Paramedics within the community they serve. In this program, paramedics are integrated into the local healthcare system and overseen by emergency and primary care physicians along with additional support to hospitals, municipalities, residents, and insurance companies in several ways. The role of the Community Care Paramedic adapts to the specific needs of the community they serve. This is a growing program which has shown success in rural communities in providing initiatives for a healthier community and studies have shown that …

Implications For Delayed Versus Immediate Umbilical Cord Clamping, Laura Ann Shaver

All Electronic Theses and Dissertations

Purpose: The purpose of the critical review of literature was to identify and analyze benefits of delayed umbilical cord clamping in full term and preterm infants with a focus on iron stores, hemoglobin, hematocrit, and hyperbilirubinemia. Methods: Twenty-two articles were included in the critical literature review with the purpose of determining whether delayed umbilical cord clamping caused increases in iron stores, hemoglobin and hematocrit, or had no clinical significant increases in hyperbilirubinemia causing neonatal jaundice and the need for phototherapy treatment. Results/Conclusion: Delayed umbilical cord clamping is a low risk, cost effective intervention that is safe and has many benefits …

Quality And Quantitiy Of Patient Sleep In The Hospital: Perceptions And Measures, Karen Chalich Rn

Nursing Posters

Inadequate sleep may result in physical and cognitive dysfunction. During hospitalization, interruptions from excessive noise, lights, and interruptions contribute to poor quality sleep. Patient and nurse reports of perception of sleep quality differ, with few studies comparing perception to measured quality and quantity of sleep. This non-experimental study compared patient and nurse perception, quality, and quantity of hospitalized medical patient's sleep.

Reduced Cost And Decreased Length Of Stay Associated With Acute Ischemic Stroke Care Provided By Nurse Practitioners: A Single Primary Stroke Center Experience, Leah Roering Np, Michelle Peterson Np, Muhammad Shah Miran Md, Melissa Freese, Kenneth Shea Md, M Fareed K. Suri Md

Nursing Posters

Nurse practitioner (NP) have a wider role in modern stroke centers providing quality evidence based care to patients with both in and outpatient settings for acute ischemic stroke (AIS) and transient ischemic attack (TIA) patients. We studies the outcome measures, length of stay (LOS) and cost before and after implementation of nurse practitioners as the primary medical provider in a community based stroke center.

Quality Leadership Academy: Cauti Reduction Project, Melissa Fradette

Nursing Posters

Plan:

In the fiscal years of 2014 and 2015, 31 out of 66 (47%) catheter-associated urinary tract infections (CAUTIs) were acquired in patients with neurological diagnoses. This led to increased costs, decreased reimbursement, and hospital-acquired condition penalties. A thorough review of CAUTIs revealed 15 of the 31 (48%) were attributed to insertion practices; infections were acquired within 6 days of urinary catheter insertion. Eleven of the 15 (73%) were inserted in the operating room (OR).

The Lived Experience In Relation To The Educational Needs Of Nurses Caring For Induced Hypothermia Patients, Marie Regina Hankinson

Student Theses, Dissertations and Capstones

Background: Ongoing educational development is essential to ensure the effectiveness of professional nurses’ learning experiences. Understanding the ways in which workplace learning occurs is fundamental to enabling nurse educators to deliver that knowledge. Induced hypothermia was introduced as a new treatment modality in 2005 and education surrounding the care of the hypothermia patient is lacking in the literature. Purpose: The purpose of this study is to illuminate how nurses learn new knowledge in the clinical setting. Theoretical Framework: The learning theory chosen for this study is the three dimensions of learning by Illeris (2004). Methods: Semistructured interviews were conducted with …

Transition To Practice Experience: The Impact On Newly Licensed Rn Performance, Patricia P. Lawson

Student Theses, Dissertations and Capstones

This quantitative non-experimental descriptive correlational design sought to answer the question if there was a difference in newly licensed RN (NLRN) performance at one-year post hire after participation in a nurse residency program that offers a formalized curriculum that extends throughout the entire year, one that offers a formalized curriculum that does not extend throughout the entire year, or one that does not provide a formalized curriculum. The study utilized the Six Dimension Scale of Nursing Performance (SDNP) and evaluated NLRN performance on six subscales: leadership, critical care, teaching/collaboration, planning/evaluation, interpersonal relations/communication, and professional development at one-year post hire. Benner’s …

Professional Nursing Value Development In Nursing Students Who Participate In International Service Learning, Heather Ferrillo-Diiulio

Student Theses, Dissertations and Capstones

Background: International Service Learning (ISL) is becoming widely used in nursing education as a means to provide global learning opportunities. Concrete outcomes for these experiences have not been clearly supported in previous research. Determining if ISL experience facilitate the development of Professional Nursing Values (PNV) can support the use of ISL as a viable pedagogy. Purpose: The purpose of the study was to determine if there were a difference in PNV development in students who participate in ISL as part of their clinical experiences compared to those who do not. The hypothesis was that there was a difference in the …

Factors That Predit Levels Of Sleepiness Of Advanced Practice Nursing Students, Deana Shevit Goldin

Student Theses, Dissertations and Capstones

Background: Due to arduous demands of graduate education, advanced practice nursing (APN) students who are classified as adult learners are at risk for suffering sleep deprivation. Factors contributing to sleep deprivation include stress, expected academic challenges, and everyday life stressors. Purpose: This study investigated if APN students’ grade-point average (GPA), gender, and employment status predicted levels of daytime sleepiness. Theoretical Framework. The psychological well-being model selected for this study was consistent with the theory that sleep is a resource essential to well-being; adequate sleep is the resource needed to optimally manage stressful life demands. Methods. Bivariate and multiple regression were …

Cancer-Related Fatigue Clinical Guideline And Protocol For Hospitalized Oncology Patients: A Quality Improvement Project, Sulotte Valcin Amilcar

Student Theses, Dissertations and Capstones

Background: Cancer-related fatigue is one of the most common symptom experienced by cancer patients throughout their cancer trajectory. However, very little effort has been made within many oncology practices to assess this clinical problem and to provide timely nursing interventions to reduce its impact. While there have been tremendous advancements in the treatments of the disease aspects of cancer in term of medicine and advanced technology, basic assessment of related physiological concerns, such as fatigue, have not seen the same progress. Purpose: The purpose of this quality improvement project was to develop an evidence-based cancer-related fatigue assessment guideline and a …

Chemotherapy Side Effects At Home: A Nursing Impact, Gwendolyn E. Saint-Clarke

Student Theses, Dissertations and Capstones

Background: Approximately 32% of all lymphoma patients experience immunocompromised severe avoidable side effects of nadir at home after discharge postchemotherapy. The certified oncology nurses employed at a large metropolitan hospital in Atlanta, Georgia, lack standardized discharge guidelines that include regulatory organizations’ recommendations to assist patients/families with at-home self-management of the avoidable side effects. Purpose: The purpose of this quality improvement project was to utilize the institution’s existing postchemotherapy discharge protocol to assess certified oncology nurses’ knowledge of severe avoidable side effects of nadir; modify the existing healthcare institution’s postchemotherapy discharge protocol to reflect standardized practice for promoting clinical practice continuity …

Evidence-Based Diabetic Discharge Guideline: A Standardized Initiative To Promote Nurses' Adherence, Marjorie V. Scarlett

Student Theses, Dissertations and Capstones

Background: Diabetes mellitus (DM) affects more than 29.1 million Americans. Standardized clinical practice guidelines recommended by regulatory healthcare agencies are the standard of care for diabetic patients and must be adhered to by healthcare professionals providing care. Purpose: The purpose of this quality improvement project was to identify Centers for Medicare and Medicaid Services’, Joint Commission on Accreditation of Healthcare Organization’s, and other professional healthcare organizations’ guidelines for nurses’ knowledge of evidence-based discharge practices; determine level of nurses’ knowledge on evidence-based discharge practice process; develop a quality improvement plan, including development of an evidence-based guideline for diabetic discharge instructions; present …

Steroid-Induced Hyperglycemia In Patients With Malignancies: Healthcare Team Adaptation To A Paradigm Shift, Miriam Ingrid Silva

Student Theses, Dissertations and Capstones

Background: Caring for patients with malignancies and presenting hyperglycemia has been an ongoing problem that needed to be addressed. The Endocrinologist Society and the Joint British Diabetes Societies for Inpatient Care suggested a change in the process by which patients in this population are managed. Purpose: The purpose of this project was to implement evidence-based practice guidelines for managing steroid-induced hyperglycemia focusing on the interdisciplinary team and adaptation of nurses who care for patients with malignancies. Theoretical Framework: The theoretical framework selected for this project was Roy’s Adaptation Model. Methods: This project used a mixed method approach, with a triangulation …

Health Care Providers' Knowledge Of Childhood Obesity Within The Hispanic Community, Daysi Fardales

Student Theses, Dissertations and Capstones

Background: Recent studies indicate a rise in the prevalence of obesity in children of various age groups. Obesity was officially recognized as a disease by the American Medical Association (AMA) in June 2013. It has been acknowledged as a progressive epidemic public health crisis in the United States for the past 20 years. This is a health care concern that needs examination and the development of new and more effective prevention and treatment modalities for obesity in children. Environmental, hereditary, behavioral, and socioeconomic factors play a significant role in the prevalence of obesity (Rooney, Mathiason, & Schauberger, 2011). Childhood obesity …

Addressing Obstetric Health Care Providers' Nutritional Insight In The Low Socioeconomic Population, Nicole Theresa Marshall

Student Theses, Dissertations and Capstones

Background: During a woman's pregnant state, a diet that is adequate in nutrition is critical to the developing fetus, especially in the lower socioeconomic status population. The healthcare provider is charged with the acute fundamental awareness of this additional factor that can grossly impact pregnancy. Nutritional advice from the health care provider is one of many key points that contribute to the successful outcome of the pregnancy. Purpose: The purpose of this quality improvement project was to develop a standardized, evidence-based practice (EBP) protocol for the management of maternal nutrition, gestational weight gain, and physical activity for provider use at …

Increasing Role Of Nurse Practitioners In House Call Programs, Nengliang (Aaron) Yao, Karen Rose, Virginia Lebaron, Fabian Camacho, Peter Boling

School of Nursing Publications

Objectives

Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work.

Design

An observational study using secondary data.

Setting

Medicare Provider Utilization …

Intraoperative Administration Of Intravenous Acetaminophen At Induction Or End Of Surgery And Its Relationship With Opioid Consumption And Pain Scores, Spencer Davis Greenwood

Theses, Dissertations and Capstones

Obesity has become increasingly prevalent in the United States. Bariatric surgeries have increased as the prevalence of obesity has risen, providing an effective alternative to weight loss. Intravenous acetaminophen (IVA) is a safe and effective non-opioid medication that can be given without the risk of respiratory or cardiac complications. Research has shown that the use of IVA during surgery can improve postoperative pain scores, reduce opioid requirements, and improve patient satisfaction.

A retrospective cohort study of 200 patients (100 per group) undergoing laparoscopic bariatric surgery (LBS) was performed. Statistical analysis was used to determine the relationship between those who received …

What Is The Relationship Of Increased Intraocular Pressure And Body Mass Index In Patients Undergoing Robotic Prostatectomy In Sleep Trendelenburg Position?, Seth Parsons

Theses, Dissertations and Capstones

Introduction: Robotic Prostatectomy is a common procedure performed in surgery centers all over the world, but these procedures can be long and difficult to manage for Anesthesia providers. This study examined the relationship between increased intraocular pressure (IOP) and Body Mass Index (BMI) during Robotic Prostatectomies in Steep Trendelenburg (ST) position. Other variables studied were length of procedure, age, and ASA physical classification.

Methodology: The study was a retrospective cross-sectional design of 100 patients with a BMI over 30 and 100 patients with a BMI under 30 who have undergone Robotic Prostatectomies at Charleston Area Medical Center (CAMC) between …

Business Plan For A Non-Profit Pediatric Iv Pole Wagon Distribution Program, Susan White Hester

Nursing Theses and Capstone Projects

Problem: Children have reported that pain and anxiety were the most difficult part of hospitalization, and under treatment of pain and anxiety can have short and long term effects on health outcomes. Most healthcare professionals recognize a link between emotional health and physical health, but this may be especially true for pediatric patients who may not be able to marshal adequate coping skills due to their developmental age. Providing age appropriate alternatives, such as distraction therapy, may result in less invasive treatments for pediatric patients. Distraction therapy is an effective nonpharmacological intervention that is often under-utilized in the acute care …

Clarifying The Need For Inpatient Medication Education, Pamela Cox Raffaldt

Nursing Theses and Capstone Projects

Low health literacy is a problem for millions of Americans resulting in increased use of avoidable healthcare resources and poor health outcomes. Use of pharmaceutical regimens to manage acute and chronic health issues is the most common treatment modality. Unfortunately, people with low health literacy may have trouble understanding and following provider instructions; reading and following directions on medication bottles, either prescribed and/or over the counter; and identifying proper reasons for taking a medication. The purpose of this study was to increase patient self-agency for the treatment and management of acute and chronic health conditions through medication education. Providing medication …

Effect Of A Student Success Program On The Academic Success Of First Semester Junior Bsn Students, Ann Hardison Black

Nursing Theses and Capstone Projects

Problem: The expectation of the current nurse workforce is to deliver safe quality care while meeting the demands of an ever-changing healthcare system. More nurses are needed to combat the ongoing nursing shortage, as Baby Boomers reach retirement and the need for health care continues to rise. The healthcare industry has a vested interest in schools of nursing graduation rates as they impact the needed supply of nurses to fill vacant positions. Multiple variables collectively influence student success in a nursing program. Many students do not realize the rigor of a nursing curriculum until they are in the midst of …

Primary Care "Catches" Up With Behavioral Health, Michael Hannes Thorarinson

Nursing Theses and Capstone Projects

The problems caused by the lack of care coordination between primary care and behavioral health are well documented. Patients with uncontrolled mental health issues along with chronic health problems cost two to three times the health care dollars to manage than patients who have the same chronic health problems but without uncontrolled mental health issues. Despite this, in rural North Carolina, the de facto level of care coordination is none. Mental health and primary care are completely separate, distinct systems that do not routinely communicate. One of the identified barriers to care coordination is the lack of reimbursement for the …

Does Implementing An Evidence-Based Fall Risk Scale Decrease Fall Rates?, Melissa Jackson Smith

Nursing Theses and Capstone Projects

In this research facility, the falls risk assessment that was previously used was replaced with an evidenced-based tool, the Morse Falls Scale. Fall rates were analyzed for a five month period after implementation of the new scale, from May 1, 2016 – September 30, 2016, and compared to the same months the previous year to see if fall rates decrease with using the evidenced-based scale. Fall prevention is multi-factorial and begins with an assessment of the patients risk for a fall, and interventions which are personalized for each patient. Fall prevention should include all staff, as anyone can make a …