Nursing Commons^™

A Model Of Health For Family Caregivers Of Elders, Florence M. Weierbach, Yan Cao

ETSU Faculty Works

Family members who provide care to their loved ones experience changes in their own health. The caregiver health model (CGHM) is a new model that identifies health holistically and identifies four determinant(s) that contribute to the health status of the family caregiver. The purpose is to introduce the CGHM: Hypothesis 1: the determinants of health in the CGHM contribute to the health of the Caregiver, Hypothesis 2: the determinants of health contribute to changes in the caregivers’ health at 8 and 16 weeks, and Hypothesis 3: a change in health occurs from baseline to 8 and 16 weeks. Methods: A …

Evaluation Of A Competency-Based Interprofessional Diabetes Management Education Module For Health Professions Students: A Multi-Modular Approach, Bilinda Norman

Doctor of Nursing Practice Projects

The purpose of this study was to evaluate the effectiveness of a competency-based interprofessional diabetes education module, using a multi-modular approach. The results of a needs assessment of health professionals revealed few opportunities for interprofessional diabetes education, other than through “on-the-job” training. A nurse-led, comprehensive diabetes education program was developed to support achievement of interprofessional competencies for health professions students prior to graduation for the improvement of population health for clients with diabetes, following the needs assessment. The program included didactic education and simulation experience encompassing the use of the Alphabet Strategy for diabetes education, addressing the need for interprofessional …

Improving Response Rates To An Alumni Survey In East Africa, Joseph Mwizerwa, Walter Robb, Carolyne Namukwaya, Mary Namuguzi, Sharon Brownie

School of Nursing & Midwifery, East Africa

Feedback from students and graduates is essential to inform ongoing quality improvement in higher education. However, African universities often face implementation issues in alumni surveys, including technological barriers and difficulties in tracking graduates, particularly those from earlier cohorts and rural alumni. Innovative strategies are needed to locate alumni and obtain a good response rate across widely dispersed, rural and remote areas. This paper reports on strategies used to increase response rates in an East African online alumni survey in a context of limited computer/Internet access. The survey aimed to assess the impact of nursing graduates over a 15 year period …

Correlation Of The Boost Risk Stratification Tool As A Predictor Of Unplanned 30-Day Readmission In Elderly Patients, Carol K. Sieck

Dissertations

Carol K. Sieck

Loyola University Chicago

CORRELATION OF THE BOOST RISK STRATIFICATION TOOL AS A PREDICTOR OF UNPLANNED 30-DAY REAMDISSION IN ELDERLY PATIENTS

Risk stratification tools can identify patients at risk for 30-day readmission but available tools lack predictive strength. While physical, functional and social determinants of health have demonstrated an association with readmission, available risk stratification tools have been inconsistent in their use of variables to predict readmission. The Better Outcomes by Optimizing Safe Transitions (BOOST) 8 P's tool is a risk stratification tool developed by the Society of Hospital Medicine but has no published validation studies. The theoretical …

In Patients With End-Stage Renal Disease, How Does Intentional Screening For Depression Compared To Current Screening Practice Affect Mental Health Referrals?, Sara Beth Culbreath

Doctor of Nursing Practice Projects

Depression remains poorly diagnosed and treated in the general population as well as in patients with chronic illness including end-stage renal disease. Referrals to mental health providers and treatment for patients with depressive symptoms are suboptimal leading to decreased adherence to dialysis treatments, increased hospitalizations, and increased mortality. A review of the literature supports intentional screening for depression in the chronically ill population that can easily be incorporated into routine health examinations or, in the case of maintenance hemodialysis patients, the patient’s treatment time. The purpose of this study was to determine if intentional screening for depression in end stage …

An Ecojustice Analysis Of Nursing Education, Kristi Jo Wilson

Master's Theses and Doctoral Dissertations

The concept health is constructed within socioeconomic, political, cultural, and ecological contexts that affect how personnel in the medical and nursing fields practice. The idea of health and its associated practices in Western countries has arisen from modernist discourses such as mechanism and rationalism, which further support a capitalist economic system that stresses efficiency, specialization, and volume for profit. In Western industrial cultures in particular, health is primarily driven by consumerism and market forces and is generally defined within two categories: wellness and illness.

To explore this concept further, I interviewed seven nurse scholars who see health in a different …

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …

Polycystic Ovary Syndrome Treatment, Moneka Angilene Patterson

Walden Dissertations and Doctoral Studies

Polycystic ovary syndrome (PCOS) is an endocrine system disorder that affects women of reproductive age. If not treated properly, PCOS can lead to infertility. Lack of proper treatment of PCOS may also result in medical complications such as diabetes or heart disease. The rural clinic where this project took place did not have a mandatory guideline for treatment of PCOS; therefore, no standardized method of diagnosis or treatment of PCOS existed. The purpose of this project, guided by the IOWA evidence-based practice model, was to educate providers on the evidence-based guideline for diagnosis and treatment of PCOS outlined by the …

The Critical Role Of The Psychiatric Emergency Response Team In The Adoption Of A Violence Risk Assessment Tool., Angela Mackay

Walden Dissertations and Doctoral Studies

Workplace violence is a persistent problem in health care, and incidence rates have increased over the years. Traditional reporting systems, relying mostly on paper formats, are inadequate for developing effective predictive models for intervention and reducing acts of violence by patients to staff. The purpose of the development and deployment of the psychiatric emergency response team (PERT) was to provide effective intervention within the MIAHTAPS (Altered Mental status, Irritability, Agitation, History of Violence, Threatening, Attacking Objects, Pacing, and Staring) behavior prediction tool to reduce the severity and rates of violence in a hospital setting. Lewin's change theory was used to …

Investigating The Incidence Of Postoperative Mild Cognitive Impairment In Cognitively Intact Patients Aged 65-80 Years Undergoing General Anesthesia For Surgery, Bryon Ward

Doctor of Nursing Practice Projects

The purpose of this prospective, descriptive pilot study is to establish a baseline measure for mild cognitive impairment (MCI) in patients aged 65-80 years following elective surgery with general anesthesia (GA). Older adults scheduled for elective surgery routinely undergo GA with a combination of volatile and intravenous anesthetic agents. Current literature shows that patients aged 65-80 who receive GA agents are at increased risk for MCI postoperatively. Data also suggests that further studies are necessary in order to more completely evaluate alternative anesthesia techniques and agents that may prove to reduce the risk and incidence of MCI associated with anesthesia …

Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown

Walden Dissertations and Doctoral Studies

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of …

The Relationship Between Substance Use And Academic Performance In Baccalaureate Nursing Students, Alexa Roberts, Calli Baumberger

Williams Honors College, Honors Research Projects

Drug and alcohol use is a negative way to cope with stress in undergraduate nursing students, which may affect academic performance. The purpose of this study was to examine the relationship between substance use and academic performance in baccalaureate nursing students. This study was guided by the Transactional Model of Stress and Coping by Lazarus and Folkman and used a non-experimental, correlational design. The sample included pre-nursing, accelerated, and second-, third-, and fourth-year nursing students at a public mid-Western university. The sample size was 146 subjects. Alcohol use was measured with the AUDIT questionnaire, drug use was measured by the …

Effects Of Education And Exposure On Associative Stigma Of Psychiatric Nursing In Junior Level Nursing Students, Geoffrey George, Hayley Groubert, Gabrielle Glandorf

Williams Honors College, Honors Research Projects

Stigma towards mental illness affects not only persons with mental illness but the psychiatric nursing professionals who care for them. Education and exposure may affect this associative stigma. The purpose of this study was to examine the effect of an eight­-week undergraduate mental health nursing rotation on associative stigma towards psychiatric/mental health nursing in students. The study was guided by attribution theory and used a non­experimental design and convenience sampling of undergraduate nursing students enrolled in the mental health nursing course. Associative stigma was measured utilizing the Psychiatric/Mental Health Clinical Placement Survey for First Day of Placement, (Hayman­White & Happell, …

Relationship Between Self-Efficacy And Work Experience In Baccalaureate Junior And Senior Level Nursing Students, Mallory Wilson, Taylor Byers

Williams Honors College, Honors Research Projects

Background: New nursing graduates entering the healthcare fields have demonstrated competency with clinical skills during their education. However, limited experience with skill performance can leave them prone to clinical errors. Higher self-efficacy levels increase competency as individuals create higher goals and are more easily able to perform tasks. Therefore, work experience during nursing school may increase nursing students’ self-efficacy as they become comfortable performing clinical skills.

Purpose: The purpose of this study is to examine the relationship between employment in health care facilities and self-efficacy of clinical skills in undergraduate nursing students.

Methods: A non-experimental correlational study using convenience sampling, …

A Systematic Review: The Prenatal And Postnatal Events Associated With Infant Mortality Rate (Imr), Ariel L. Thomas, Sarah A. Awwad, Briana E. Clark

Williams Honors College, Honors Research Projects

Infant mortality rate (IMR) is an indication of overall population health, maternal and child health, accessibility and quality of primary health care, and the availability of community resources. The current IMR in the United States is high despite advances made in the medical field. The purpose of our systematic review is to describe and critically appraise research about prenatal events, postnatal events, and increased infant mortality rate and to give nursing practice recommendations to help decrease the rate. We used CINAHL, Medline and PubMed to find 20 research articles. Overall, the research stated that going to prenatal visits had a …

Effect Of Interventions On Infant Mortality Rates: A Systematic Review, Sophia H. Simone, Emily K. Swaim

Williams Honors College, Honors Research Projects

Infant mortality rate (IMR) is defined as the number of infant deaths per 1,000 live births. Infant mortality is the time period beginning with the infant’s first breath and continuing until the first year of life. In 2006, 6.71 infants died in The United States of America (USA) for every 1,000 live births, compared with 6.86 in 2005 and 6.89 in 2000. Although the USA IMR has fallen steadily in recent decades, the nation still ranks 27th among industrialized countries. Further, IMR disproportionately affects racial and ethnic groups in the USA. Despite research about prevalence, predictors, interventions, and major efforts …

Effects Of Environmental Stressors And Design On Patient Outcomes In Icu Patients, Lauren Lea Mcnary, Jenea Ruttino, Kylie Thanasiu

Williams Honors College, Honors Research Projects

Over four million patients are admitted to the intensive care unit (ICU) every year. The ICU, along with many health care settings, is generally regarded as a stress inducing environment, which may contribute to negative patient outcomes. Yet, there has been little progress in developing environments that are optimal to patient healing and using evidence-based design for ICUs. Aspects of environment studied that can be manipulated to increase positive patient outcomes are aroma, light, noise, private rooms, windows, and layout of the room. The purpose of this systematic review is to answer the PICO question, in hospitalized critically ill adults, …

Effectiveness Of School-Based Interventions Versus Family-Based Interventions In The Prevention And Treatment Of Childhood Obesity, Ashley Capestrain, Emily Montague, Meghan Frantz

Williams Honors College, Honors Research Projects

Childhood obesity affects 155 million children worldwide. As prevalence increases, it is important to identify effective interventions in the treatment and prevention of childhood obesity. Obesity may result in short and long term effects linked to some of the leading causes of morbidity and early mortality. The purpose of this systematic review is to identify, review, and critically appraise evidence from studies examining the effect of family and school based interventions. This review answers the following PICO question: In children, how do family based interventions compare to school based interventions, in the prevention and treatment of obesity? Methods included literature …

Effects Of Kangaroo Care On Procedural Pain In Preterm Infants: A Systematic Review, Alyssa M. Pagni, Sophia Kellar, Mary Rood

Williams Honors College, Honors Research Projects

Approximately 64,000 preterm infants are born annually in the United States. With preterm infants enduring between 10-16 painful procedures daily, it is important for nurses to use interventions that effectively decrease pain. Procedural pain in premature infants may result in short-term and long-term negative physical, cognitive, and emotional effects. Kangaroo care is the act of holding an infant making skin on skin contact. The purpose of this systematic review is to identify, review, and critically appraise the evidence from studies examining the effect of Kangaroo Care on procedural pain in premature infants. Literature was searched in university databases and Google …

The Relationship Between Alcohol Use And Familial And Social Influence In College Nursing Students, Darren C. Crooks, Kathleen A. Gillota

Williams Honors College, Honors Research Projects

College students are a population with a high prevalence of risky consumption of alcohol and nursing students, specifically, are no exception. Yet few studies have been done on the use of alcohol in the student-nurse population. Since nursing education and practice are highly stressful, unhealthy coping strategies, such as risky alcohol consumption, are sadly common and seriously detrimental.

This paper explores the self-reported consumption of alcohol in undergraduate nursing students as related to peer, familial, and social influences. Based on the Biopsychosocial Model, many different factors contribute to alcohol use. Using anonymous online survey methodology and convenience sampling, data about …

Efficacy Of Animal-Assisted Therapy Across Pediatric Care Settings: A Systematic Review, Holly Howser, Thomas Dixon, Jessica Nunez

Williams Honors College, Honors Research Projects

With alternative therapies and complementary medicine becoming increasingly popular and supported by research, it is important for healthcare workers to be prepared to encounter and use these therapies in practice. A common problem in the pediatric healthcare setting is stress in patients and families during healthcare treatment. Animal assisted therapy (AAT), more commonly known as pet therapy, is a form of complementary alternative therapy that has been examined in this population. The purpose of this systematic review is to explore the effect of AAT on treatment outcomes in pediatric patients across clinical settings. The methods used to guide this systematic …

A Study Of Skin-To-Skin Care During Cesarean Birth: A Mother's Experience, Kristen Bertrand

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Hyperammonemia After Lung Transplantation: Best Practice Recommendation, Kathryn Bradley

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Opioid Abuse In Pregnancy: A Systematic Review, Emily Sebunia, Colleen Fearon

Williams Honors College, Honors Research Projects

Prenatal opioid abuse is a serious public health concern and linked with numerous health consequences for both mothers and children. Despite research describing negative outcomes of drug use during pregnancy, it is still a prevalent problem in the United States, with researchers finding that women are at highest risk for substance abuse during their reproductive years. Opioid abuse during pregnancy is common, including opioids such as hydrocodone, oxycodone, morphine, and heroin. Use of these drugs results in both short and long term side effects for the mother and child. Therefore, the prevalence of this problem should not be underestimated. …

The Relationship Between Nurse Manager Leadership Style And The Enculturation Of Shared Governance, Anna Elizabeth Keane

Walden Dissertations and Doctoral Studies

Shared governance, a participative model of governance, implemented by healthcare organizations for more than 30 years has been associated with empowerment, job satisfaction, and retention of registered nurses. Recent studies document a lack of participation in shared governance by registered nurses; the reason for the change is unknown. The nurse managers' role in this change is unknown. The purpose of this non-experimental, cross-sectional survey design study was to test Bass' theory of transformational leadership that examines the relationship between the leadership style of the manager and the enculturation of shared governance in acute care hospitals in the United States. A …

Cervical Cancer Prevention Screening: A Quality Improvement Project To Reduce Variation And Increase Timeliness In Managing And Reporting Abnormal Papanicolaou Smear Results, Dana Greene Rader

Walden Dissertations and Doctoral Studies

Cervical cancer is the fifth most common cancer in United States with more than 12,000 women diagnosed each year and more than 4,000 preventable deaths with minorities disproportionally represented. Cervical cancer prevention strategies rarely focus on the management of abnormal screening results. The purpose of this quality improvement project was to standardize the management program for abnormal cervical cancer screening results within an integrated health delivery system serving a large minority community. The Plan-Do-Study-Act model guided a comprehensive program evaluation with process improvement, including the creation of an electronic quality data reporting tool to formalize the work process and a …

Impact Of A Standardized Tool On Handoff Quality In Nurse Change-Of-Shift Reports, Wilma Lonzame Ayala

Walden Dissertations and Doctoral Studies

Within the context of healthcare delivery, human lives are at risk when health care professionals fail to communicate effectively. Audits by The Joint Commission from 1995 to 2005 revealed that 65% of sentinel events occurred as a result of staff miscommunication, prompting the requirement that standardized handoff tools be deployed. Therefore, this project was completed to improve safety in the hospital through implementation of a standardized tool that could enhance the quality of nurse handoff communication. Mohorek & Webb's (2015) linear model of communication, which emphasizes the importance of encoding, transmission, and decoding in the communication process, provided the framework …

Improving Workflow At The Point Of Care Using The Electronic Health Record, Rox Ann Sparks

Walden Dissertations and Doctoral Studies

The electronic health record (EHR) is an important part of the effort to improve health care and reduce costs in the United States. Primary care providers, among the largest group of caregivers in the nation, often experience difficulty with implementation and utilization of EHRs. Efforts to enhance the provider's effectiveness in the use of the EHR should result in improved patient outcomes as well as decreasing the overall cost of health care. Guided by the diffusion of innovation theory, this project was initiated to develop a plan for improved usage of the EHR in a primary care setting. A survey …

Registered Nurse Job Satisfaction And Nursing Leadership, Maria Candida Libano

Walden Dissertations and Doctoral Studies

Job dissatisfaction among nurses may contribute to disengagement and withdrawal from the profession. The degree of leadership support in the workplace influences job satisfaction, and when nurses are satisfied with their job, they provide better patient care. Guided by the social cognitive theory, which asserts a relationship between behavior change and one's surroundings, this quantitative, exploratory project sought to determine the type of nursing leadership practiced in the facility where the project took place, whether nurses were satisfied with their job, and if patients were satisfied with their care. Participants in the project included 55 registered nurses and 5 nurse …

Improving Breastfeeding Knowledge Of Staff Nurses, Patience Sirri Mbonifor

Walden Dissertations and Doctoral Studies

The World Health Organization advocates that newborn babies require exclusive breastfeeding until 6 months of age to attain a desired level of growth. Despite this recommendation, exclusive breastfeeding rates continue to be at low levels globally. The purpose of this DNP project was to examine best practices for increasing the breastfeeding knowledge of health care workers, and to understand how breastfeeding is promoted in different healthcare systems. The Critical Appraisal Checklist and the Cochrane Handbook for Systematic Reviews framed this systematic literature review. Additionally, Melnyk's levels of evidence was used to evaluate each article. Articles for inclusion were limited to …