Nursing Commons^™

Pain Management In Patients With Fibromyalgia, Linsey Fischer

Honors Undergraduate Theses

Fibromyalgia is a chronic widespread pain disorder that can also cause fatigue, depression, sleep disturbances, and cognitive symptoms. Because the etiology of fibromyalgia is unknown, it is difficult to treat. Research shows that medication alone is insufficient to treat the symptoms of fibromyalgia and that complementary therapies are required to fully manage this disorder. The purpose of this research was to determine what complementary therapies patients with fibromyalgia were currently using. The sample for the survey was taken from fibromyalgia support groups throughout the state of Florida. A total of 15 people diagnosed with fibromyalgia participated in the survey. The …

Exploring Barriers And Consequences Related To Nurses Reporting Child Abuse, Asmita Devkota

Honors Undergraduate Theses

Background: Child abuse is a pervasive and serious problem in the United States. Over 3 million children are the victims of some kind of physical assault by adults. Due to their prolonged contact with children and opportunity to report, nurses should be trained to accurately assess, identify, and manage cases of child abuse. The purpose of this study was to examine student’s experiences with Child Protective Services, and explore their confidence and attitudes related to identifying and reporting child abuse. Factors associated with non-reporting were identified.

Methodology: This was an exploratory, descriptive study. Students enrolled in the online …

Associations Between Pre-Pregnancy Weight Status And/Or Gestational Weight Gain And Obesity In Older Children, Marisa P. Hammond

Honors Undergraduate Theses

Childhood obesity is a global health concern that puts children at risk for developing serious health complications. With increasing rates worldwide, it is important to determine how to decrease its prevalence and promote prevention in future generations. Emerging evidence indicating that pre-pregnancy weight status and/or gestational weight gain (GWG) may be linked with overweight/obesity in children. Much of this body of research focused on weight status of offspring at birth and at preschool age. The purpose of this study is to: (1) analyze the research findings regarding obesity in children 5 to 18 years and their mother’s pre-pregnancy weight status …

Canine-Assisted Therapies Among U.S. Veterans With Post Traumatic Stress Disorder: An Integrative Review Of The Literature, Olivia A. Kondos

Honors Undergraduate Theses

A sizeable number of U.S. veterans of all ages experience post-traumatic stress disorder (PTSD) which can impact their quality of life; physically, mentally and socially. Consequences of PTSD are associated with physical and emotional disabilities, including ideation of self-harm and even suicide. Increasingly, animal-assisted therapies (AAT) are used to treat PTSD and other physical and behavioral conditions in veterans. Over the decades, AATs have used dogs, cats, horses, and dolphins among other animals. The purpose of this integrative review is to examine the use of AAT focusing on canine assisted therapy (CAT) among veterans diagnosed with PTSD. The methodology involved …

Prevalence And The Contributing Factors Of Insomnia Among Adolescents In Selected Secondary Schools Of Udupi District Karnataka, Saraswathi Hebbar Ms, Tessy Treesa Jose Dr, Shalini Nayak Ms

Manipal Journal of Nursing and Health Sciences

Background: Sleep is a necessary constituent of an individual’s health and wellbeing. The relationship between insomnia and psychiatric condition is now receiving increased attention. In adolescents, the sleep deprivation over time increases risk of depression, lowered self-esteem, and engagement in unsafe behaviour. Screening is very important to prevent further complications of insomnia. Methods: A cross-sectional survey among 1,070 adolescents by using demographic proforma, Athens insomnia scale, and self-structured questionnaire. Results: Out of 1,070 subjects, the prevalence of insomnia was found to be in 40% of the adolescents. The physical, psychological, social, academic, family, and environmental factors contribute to adolescent insomnia. …

The Influences Of Mindfulness And Neuromotor Exercise Mode On Balance In Healthy Older Adults, Maxine Hicks

Electronic Theses and Dissertations

This study investigated the roles of mindfulness and balance to optimize strategies for fall prevention in healthy older adults. The purpose of this study was to examine the association of mindfulness with respect to balance in healthy older adults who are experienced in meditative versus non-meditative modes of neuromotor exercise. This was a comparative descriptive study that used a convenience sample of N=86 older adults (20 male; mean age = 69.33 ± 7.24; range: 60 – 93 years). The sample included experienced participants of meditative (e.g., yoga, Tai chi) and non-meditative (e.g., partnered dance) neuromotor exercise recruited from community yoga, …

‘I Stayed With My Illness’: A Grounded Theory Study Of Health Seeking Behaviour And Treatment Pathways Of Patients With Obstetric Fistula In Kenya, Anne Khisa, Grace M. Omoni, Isaac K. Nyamongo, Rachel F. Spitzer

School of Nursing & Midwifery, East Africa

Background: Obstetric fistula classic symptoms of faecal and urinary incontinence cause women to live with social stigma, isolation, psychological trauma and lose their source of livelihoods. There is a paucity of studies on the health seeking behaviour trajectories of women with fistula illness although women live with the illness for decades before surgery. We set out to establish the complete picture of women’s health seeking behaviour using qualitative research. We sought to answer the question: what patterns of health seeking do women with obstetric fistula display in their quest for healing?

Methods: We used grounded theory methodology to analyse data …

The Impact Of Standardized Patients On Physical Assessment Skills, Clinical Judgment, And Self-Efficacy In Undergraduate Nursing Students, Allison Mueller

Electronic Theses and Dissertations

The healthcare industry is seeing constant changes in patient acuity, expanding care environments, new healthcare policies, and continual advancements in research and technology. To overcome these challenges, nurses must receive education that adequately prepares them with confidence, clinical judgment, and the proper skills to provide safe and quality care to patients. More specifically, nurses must have strong physical assessment skills, sound clinical judgment, and high levels of self-efficacy (Chong, Lim, Liu, Lau, & Wu, 2016; Institute of Medicine (IOM), 2010). Peer physical assessments are generally the standard for practicing and validating physical assessment skills (Slater, Bryant, & Ng, 2016). Standardized …

Telemedicine For The American Indian/Alaska Native Population, Janine M. Good

Senior Honors Theses

When compared to other Americans’ health, a worse health status is seen among the American Indian and Alaska Native population. American Indians and Alaska Natives are faced with numerous disparities in healthcare, such as decreased access to healthcare. Additionally, healthcare data about this group are missing. Although health beliefs and traditions can differ among tribes, there are also similarities. Telemedicine is the use of technology (i.e., phone, videoconferencing) to deliver healthcare. This healthcare service may be beneficial for this population’s healthcare needs because of telemedicine’s possible advantages. Although telemedicine also has disadvantages, a knowledge of and respect for American Indian …

Goals Of Exclusive Breastfeeding And The Effectiveness Of Programs And Initiatives In Attaining Them, Natalie Scott

Senior Honors Theses

Over recent years, breastfeeding has gained renewed significance in research and practice. Both in the United States and around the world, especially in poor countries that do not have easy access to quality healthcare, breastfeeding has been shown to dramatically and positively affect the health and lifespan of infants. However, there is still a low prevalence of effective breastfeeding practices universally. Even with the presence of global programs and goals that are geared toward exclusive breastfeeding habits, global rates are lower than what is desired. There are various determinants of breastfeeding that factor into a woman’s decision and practice of …

Mental Disorders And Associated Factors Among Adolescents In Juvenile Detention, Stewart Mbelwa

School of Nursing & Midwifery, East Africa

Introduction: The number of children and adolescents admitted in Dar es Salaam juvenile centers due to misbehavior and criminal offences has risen from 20 to 30 per month. Increasing aberrant behaviors in children have been linked to mental disorders. Assessment of presence mental health disorders as the main cause of these behaviors would be important to restore mental health of children and assist the system to impose a fair trial.

Objective: This study aimed to determine the presence of mental disorders and associated factors among children and adolescents within Dar es Salaam juvenile systems and explore factors that may affect …

Family Planning Practices Of Rural Community Dwellers In Cross River State, Nigeria., A. J. Etokidem, W. Ndifon, Ekaete Asuquo, J. Etowa

School of Nursing & Midwifery, East Africa

Background: Nigeria is the most populous nation in Africa and the seventh most populous in the world. Despite a high fertility rate of 5.5 per woman and a high population growth rate of 3.2%, Nigeria’s contraceptive prevalence is 15%, which is one of the lowest in the world. The objective of this study was to determine the knowledge of family planning and family planning preferences and practices of rural community women in Cross River State of Nigeria.

Materials and Methods: This was a cross-sectional study involving 291 rural women. Convenience sampling method was used. The women were assembled in a …

The Influence Of The Supernumerary Clinical Nurse Educator Role On Advancing Graduate Nurses’ Quality Of Patient Care: A Mixed-Methods Study In A Private Western Australian Health Service, Tracey Coventry

Theses

Theoretical and anecdotal evidence suggests that the presence of the supernumerary clinical nurse educator (CNE) in the acute care hospital clinical environment will positively affect patient quality outcomes. However, the supernumerary role suffers from scrutiny in response to the financial constraints of healthcare organisations, and is questioned regarding sustainability. The lack of empirical research diminishes the CNE role and its benefit for patient quality of care. This research focuses on newly qualified graduate registered nurses (GRNs) employed in a graduate programme and supported by the CNE in the clinical environment in order to articulate the effect of the supernumerary CNE …

Exploring The Concept Of Receptivity To Bereavement Support: Implications For Palliative Care Services In Rural, Regional And Remote Western Australia, Pippa Blackburn

Theses

Background: Palliative care services are primary organisations that provide bereavement support in Australia and aim to mitigate potential adverse outcomes of grief and bereavement The success of bereavement services depends, in part, on how ‘receptive’ the bereaved are to receiving support. Although palliative care services provide support services for bereaved carers and families, there still remains a discord between what is delivered, what is needed and factors that deter or encourage a person’s receptiveness to support.

Purpose: The aim of this research was to examine utilisation of bereavement support through the ‘lens’ of receptivity. Bereavement and receptivity are complex multifactorial …

Text Messaging In The Patient-Centered Medical Home To Improve Glucose Control And Retinopathy Screening., Janice M Miller, Ann G. Phalen, Albert Crawford, Anthony Frisby, Barry S. Ziring

College of Nursing Faculty Papers & Presentations

Purpose: To evaluate the effectiveness of a text messaging program (TMP) to improve glucose control, retinopathy screening (RS) rates, and self-care behaviors in patients with uncontrolled type 2 diabetes.

Methods: A single-group design with a quasi-systematic random sample (n=20) received educational/exhortational text messages on their cellular phones for 3 months. Subjects, 12 of whom identified as a minority ethnicity, were mostly male, aged 27-73 years.

Results: Glucose control and RS rates improved significantly. Subjects (>70%) reported changes in self-care behaviors.

Conclusion: Leveraging ubiquitous technology, a TMP for patients with limited access to healthcare education, holds promise

College Health Clinic Population Health Improvement Plan Project, Kathryn M. Flynn

Walden Dissertations and Doctoral Studies

A college community health improvement plan (CHIP) focusing on the indicators of nutrition and weight status, and physical activity and fitness is designed with the goal of reducing obesity risk, improving health, and preventing chronic disease. The precede proceed model, logic model, innovative care for chronic conditions model, self-care theory, and Bandura's social cognitive learning theory were used as a research design framework for assessing, planning, and managing sustainability through a two-year college health clinic. The research questions were: what are the current health promotion inputs and activities in terms of environment, ecology, education, and policy and what could be …

Patients, Preferences, And Portals: Barriers Identified To Accessing Personal Health Information Through A Secure Online Website, Helen Patricia Fox-Mccloy

Walden Dissertations and Doctoral Studies

Patient engagement is one of the 6 quality directives issued by the Institute of Medicine for patient-centered care. Federal meaningful use regulations require health care organizations to offer patients a secure online website, or patient portal, to access their health information. Although the patient portal offers patients the opportunity to be more involved in their care, the portal has not been widely used. However, barriers to utilization are best understood from the perspective of the patient. Any barriers to patients accessing the portal are also barriers to patient engagement. The purpose of this project was to understand from the patient …

Body Piercing And Health Complications Among College Students In Puerto Rico, Elsie Goicochea

Walden Dissertations and Doctoral Studies

The incidence and prevalence of body piercing health complications among students is a public health matter that has not been researched in Puerto Rico. College students are the most consistent participants in body piercing activities and have reported health complications resulting in visits to medical offices and emergency rooms. Based on the health belief model, which is used to explain and predict health attitudes, the purpose of this quantitative nonexperimental study was to analyze the health risks and possible complications occurring after body piercing and to investigate the association between sex and age and medical complications. Data were collected from …

The Effect Of Health Literacy In Low Estimated Glomerular Filtration And Diabetes, Nicklett Johnston Johnston

Walden Dissertations and Doctoral Studies

Health literacy is widespread, but its potential is not recognized. By not recognizing health literacy, patients have the burden of coping with diabetes with renal complications without full knowledge of their responsibility to their health. The focus of the project was to assess participants with diabetes with low health literacy and low mean glomerular filtration rate (eGFR). The project goal was achieved by the assessment of the participants' health literacy and eGFR before and after education for their diabetes, then assessed to determine if teaching the participants would improve their health literacy, lab values, and overall health. Participants were recruited …

Improving New Nurses' Transition To Practice, Merri Morgan

Walden Dissertations and Doctoral Studies

Almost 30% of new nurse graduates leave the position within the first year of practice, and almost 60% leave within 2 years. When new nurse graduates do not effectively transition into practice, nursing satisfaction is affected, and additional costs are incurred by their organizations through continual hiring of nurses. The purpose of this project was to develop a comprehensive, evidence-based nurse residency program (NRP) for new nurse graduates working in a 16-bed intensive care unit (ICU) of a 160-bed community hospital in the mid-Atlantic region of the United States. Using a team approach, Rosswurm and Larrabee's model of evidence-based practice …

Pediatric Emergence Delirium In The Postoperative Setting, Jennifer Miranda Snell

Walden Dissertations and Doctoral Studies

Emergence delirium (ED), also known as emergence agitation, is a postoperative condition characterized by aberrant cognitive and psychomotor behaviors following general anesthesia. The incidence of ED is 3 to 8 times higher in children 5 years of age or less. There is no standard of nursing practice for managing ED symptoms in the pediatric surgical population. The purpose of this quality improvement project was to address a gap in knowledge needed to inform clinical decision-making when managing ED in the postoperative setting. Using an educational presentation for post anesthesia care unit (PACU) nurses, this project introduced the use of non-pharmacological …

Consensus In Anesthesia Handoff Reporting, Robin Lee Anselm

Walden Dissertations and Doctoral Studies

Despite some improvement, no consensus exists to perfect quality in anesthesia handoff practice and policy. This quality improvement project was designed to assist a local anesthesia and perioperative workforce questioning the quality of its current handoff. Theories and models used to inform the project included the Inter-Professional Team Collaborative, Lewin's change theory, the continuous quality improvement theory, and the knowledge to action model. The communication assessment tool (CAT) functioned as a needs assessment yielding a gap in handoff practice of 25 participants. The CAT also served as the post project evaluation survey. The situation, background, assessment, and recommendation (SBAR) tool …

Structured Physical Activity And Dietary Education Program For Obese Adolescents: An Evaluation Of A Quality Improvement Project At A Rural Primary Care Clinic, Andrietta Wright Barnett

Walden Dissertations and Doctoral Studies

Childhood obesity is a worldwide epidemic. In the United States, approximately 17% of adolescents are obese; and 13% of the general population is overweight. Obese adolescents are at threefold risk for developing chronic health conditions in adulthood, including type II diabetes, hypertension, and heart disease. The purpose of this project was to evaluate the results of a quality improvement program to reduce adolescent obesity as measured by BMI 5% over 18 months in a rural health primary care clinic. The health belief model and theory of planned behavior guided the project as adolescents need to first understand the risks associated …

Self-Efficacy And Cultural Competency Assessment Of The Associate Degree Nursing Student, Deborah Smith Hartman

Walden Dissertations and Doctoral Studies

Effective nursing care can be threatened when nurses are not culturally attuned with their patients. Associate degree nursing (ADN) students receive information about diverse ethnicities in the nursing curriculum, but it may not be sufficient to provide the expertise necessary to care for patients of various cultural backgrounds. The purpose of this quantitative study was to explore the 2nd year ADN students' levels of cultural competence and their perceptions of self-efficacy in working with Caucasian, African American, Native American, Hispanic, and Asian ethnicities. The study used a cross-sectional survey design to determine if a relationship existed between the students' reported …

Development And Evaluation Of An Evidence-Based Educational Process To Reduce Post-Transplant Infections, Erica Vanessa Henderson

Walden Dissertations and Doctoral Studies

The targeted transplant center's abdominal organ transplant unit had difficulty providing

adequate education to patients prior to discharge, which had resulted in a 24% readmission rate within 30 days due to infections. Patients and caregivers were unavailable to receive education despite multiple attempts, which made it challenging for health care providers to complete this aspect of their job, resulting in a negative impact on patients' long-term outcomes. A more structured educational environment was needed to provide appropriate and effective patient and caregiver education to increase adherence and positive outcomes. The health promotion model served as a foundation for the development …

Perfecting Patient Bed Flow In The Emergency Department, Kim-Sun Moreira

Walden Dissertations and Doctoral Studies

Emergency department (ED) crowding is a serious problem in the United States. Crowding in the ED can result in delays that may negatively affect patient outcomes and increase the cost of care. The purpose of this project was to understand strategies that can help to improve patient flow in the ED. The plan-to-do-study act model for process improvement influenced this project. Secondary data were collected for a 2-month period to determine the impact of workflow processes (patient boarding time in ED, surge capacity and workflow processes including the impact of ancillary departments) on the movement of admitted patients from the …

Leadership Development For The Formal Nurse Leader, Lori Neu

Walden Dissertations and Doctoral Studies

Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …

Translating Evidence Of Skin-To-Skin And Rooming-In To Practice, Francisca Njoku

Walden Dissertations and Doctoral Studies

The old practice of separating the mother-baby-dyad was without measurable benefits to mothers or their infants. Evidence has shown that skin-to-skin care (SSC) prevents hypothermia and hypoglycemia, decreases crying during painful procedures in newborns, and reduces maternal anxiety, stress, and postpartum depression. Rooming-in care (RIC) has been linked to an increase in the rate of breastfeeding and mother-infant interaction, as well as a decrease in the infant morbidity rate. This project assessed the effect of an educational intervention to increase rates of SSC and RIC in an obstetric unit, in addition to measuring nurses' attitudes and barriers in relation to …

Understanding Self-Management Decision Making In Heart Failure, Constance Louise Schumacher

Walden Dissertations and Doctoral Studies

Heart failure patients are responsible for managing fluctuations in symptoms between exacerbations by employing treatment adherence, active monitoring, and management strategies based on expert guidelines. Despite education, delayed help seeking persists among those in the need of acute medical intervention, as evidenced by high hospital admission and readmission rates. The purpose of this qualitative grounded theory study was to explore the decision making processes undertaken by heart failure, community-dwelling individuals as they experience symptom changes. Eighteen face-to-face interviews were conducted with participants who had heart failure and received self-management education from a home care agency in Southern Ontario, Canada. Data …

Quality Improvement Initiative About Patient Engagement With Clinicians In A Community Hospital, Cheryl Simpson

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a global health problem and efforts are needed to improve the care of individuals affected by the disease. A recent strategy for improving care within the healthcare system is patient engagement. Nurses and other health care clinicians can apply patient engagement into their clinical practice to improve the care they provide to their patients. Therefore, the purpose of this project was to increase the knowledge and awareness of patient engagement among clinicians who work with CKD patients. This quality improvement project used Lewin's force field analysis to analyze driving and restraining forces to help develop …