Nursing Commons^™

Clinicians’ Perspectives And Utilization Regarding Harm Reduction In Nursing Practice In Care Of Persons With Addiction: A Literature Review, Audrey Killarney

Grace Peterson Nursing Research Colloquium

Clinicians’ perspectives and utilization regarding harm reduction in nursing practice in care of persons with addiction: A literature review

Audrey Killarney, BS

Prof. Michelle Neuman, MSN, APN, RN

NSG 598: Graduate Research Synthesis

18 August 2017

Introduction

Background & Significance

Harm reduction is a concept best described as the recognition that individuals will engage in unhealthy behaviors, and the goal is to minimize the associated potential harm. (Stockwell, Reist, Macdonald, Benoit, & Jansson, 2010). Classically, it was used an alternative model of care for treating smokers and controlling the spread of HIV and hepatitis B (Henwood, Padgett, & Tiderington, 2014). …

Incidence Of Pediatric Melanoma, Brittany Bendoff

Grace Peterson Nursing Research Colloquium

Background: Over the last 40 years the number of new melanoma cases is not only increasing in adults, but also in children. The rate of pediatric melanoma in males and females ages 1 to 19 has increased by 2% per year since 1973. Risk factors for adult melanomas are well understood, whereas due to the rarity of pediatric melanomas, the risk factors have not been established

Objectives: The purpose of the integrative literature review is to discover if and why the incidence rates of pediatric melanoma are increasing This review will also explore the trends in pediatric melanoma and detection …

Outdoor Physical Activity And Mental Health, Justyna Helinska, Elizabeth Hartman

Grace Peterson Nursing Research Colloquium

Abstract

Background: According to the Center for Disease Control and Prevention (2013), about 25% of US adults have a mental illness. The economic demand that treatment for mental illness involves is extensive. Recent evidence suggests that the outdoor environment that consists of exercise may have an effect on mental health. Present review of literature is unclear how effective this intervention might be if incorporated into an inpatient psychiatric setting.

Objective: Examining the benefits of incorporating outdoor physical activity as an intervention to treat psychiatric disorders.

Method: The literature search for the research topic was found using the databases of: CINAHL …

Coping Strategies Associated With High Quality Of Life In People Diagnosed With Multiple Sclerosis: An Intagrative Literature Review, Alyssa Fitzhugh

Grace Peterson Nursing Research Colloquium

Background: People suffering from Multiple Sclerosis (MS) face many challenges including physical disability, financial strain, and cognitive changes. While the coping mechanisms used to address these stressors can greatly impact one’s quality of life, limited studies are conducted to understand positive coping strategies used by this population.

Objectives: The purpose of this integrative literature review was to examine the types of coping strategies that have a positive impact on quality of life in individuals diagnosed with Multiple Sclerosis.

Methods: An integrative literature review was conducted. The keywords “coping, coping strategies, quality of life, multiple sclerosis, and MS” were used to …

Effective Nursing Interventions For Patients With High Health Anxiety: An Integrative Literature Review, Christina Hetz

Grace Peterson Nursing Research Colloquium

Effective Nursing Interventions For Patients With High Health Anxiety: An Integrative Literature Review

Christina Hetz

Faculty Sponsor: Dr. Young-Me Lee, PhD, RN, Larry Maturin MSN, APN, ACNS-BC, CEN, CCRN

Background: Patients with high health anxiety over seek medical services, resulting unnecessary and possibly invasive tests, consultations, and medication. This behavior ultimately results in iatrogenesis and causes symptoms of high health anxiety to increase.

Aim: The purpose of this integrative literature review was to identify interventions to lessen symptoms of high health anxiety, and the healthcare providers most successful in providing these interventions.

Method: An integrative literature review was conducted using …

The Role Of Implicit Bias On Racial/Ethnic Health Disparities And Its, Anna Kim

Grace Peterson Nursing Research Colloquium

Background: Health disparities are differences in wellness and disease that exist between populations. Health disparities based on race and ethnicity exist in the United States, and implicit bias on the part of the provider may play a part. Objectives: The purpose of this integrative literature review is to describe if implicit bias based on race/ethnicity is found among health care professionals and its impact on health outcomes. Methods: Original studies published after 2006 were found using the CINAHL Complete database. Those that measured implicit bias in health professionals and studied racial/ethnic disparities were included. Results: Six original studies were analyzed, …

Early Life Antibiotic Exposure And Its Association With Overweight/Obesity: An Integrative Review Of The Literature, Margaret Pfaff

Grace Peterson Nursing Research Colloquium

Early Life Antibiotic Exposure and its Association with Overweight/Obesity: An Integrative Review of the Literature

Margaret Pfaff

Faculty Sponsor: Dr. Shannon Simonovich

Background: Prevention of or treatment for obesity could improve quality of life for many people. Infancy may be a critical period during which efforts should be focused to mitigate modifiable factors that may influence the risk for developing obesity.

Objectives: This integrative literature identified factors associated with greater incidence or effects of antibiotic exposure during infancy and examined the connection between early life antibiotic exposure and later in life overweight/obesity.

Method: This analysis followed the Whittemore and Knafl …

Caregivers To Those With Traumatic Brain Injury: Identifying Caregiver Stressors And Effective Interventions, Andrea Vanover

Grace Peterson Nursing Research Colloquium

Abstract

Background: Traumatic Brain Injury is form of acquired brain injury that occurs when a sudden external trauma causes damage to the brain and depending on the severity of the injury, patients will need long-term care from caregivers who provide complete support to the affected. Feelings of stress make caregivers vulnerable to depression, anxiety, and reduce their ability to deal with coping which will further complications of caregiving.

Objective: The purpose of this literature review is to synthesize the research to identify caregiver stressors and clinically proven treatments to reduce caregiver stress in caregivers to those with TBI

Methods: Articles …

Evaluating The Role Of Community Advisory Boards: With Persons Who Inject Drugs In Photovoice Research, Nicole Pallas

Grace Peterson Nursing Research Colloquium

Background: The use of community advisory boards (CABs) is a source of leadership in community-based participatory research (CBPR); however, not all researchers have incorporated CABs, and others have restricted CAB involvement for feasibility purposes. Although there is literature about utilizing CABs in a variety of CBPR studies, less is known about the challenges and successes of working with persons who inject drugs (PWIDs) as CAB members in photovoice methodology, as well as their perceptions throughout the process.

Objectives: The purpose of this qualitative study was to investigate the role CABs play in photovoice research while determining PWIDs’ capacity to fulfill …

Role Of Education In Organ Donation: An Integrative Literature Review, Angelica Dickey

Grace Peterson Nursing Research Colloquium

Role of Education in Organ Donation An Integrative Literature Review

Angelica Dickey

Faculty Sponsor: Angel Butron, RN

Background: Currently in the United States alone, there are over 120,000 individuals waiting for a transplant and on average, 22 individuals will die each day waiting. The current need for organs significantly outweighs the number of organs donated and the education process can help this balance.

Objectives: The purpose of this integrative literature review was to measure the general knowledge of non-healthcare professionals on organ donation and how earlier education can help increase rates of donation.

Method: An integrative literature review was conducted …

Advanced Maternal Age And The Correlation Between Cesarean Birth Rates, Hope Campbell

Grace Peterson Nursing Research Colloquium

According to the Center for Disease Control and Prevention (CDC), the mean age of mothers at the delivery of their first child has increased from 24.9 years to 26.3 years between 2000 and 2014. Miscarriages, financial instability, lack of a partner and more effective contraception may also be associated with the increasing rate of delayed pregnancy. The increasing rate of delayed pregnancy could contribute to the higher rate of cesarean section deliveries in women over the age of 35 which could lead to an increased risk to mother and fetus. The rising cesarean rate is associated with rising costs and …

Nurses Lack Education In Caring For Patients With Down Syndrome, Sarah Coughlin

Grace Peterson Nursing Research Colloquium

Abstract

Individuals with Down Syndrome have a longer life expectancy due to medical advancements made over the past several years. This creates a concern that nurses are not being effectively educated to provide competent care for this population. The purpose of this research was to conduct an integrated literature review which identified nursing knowledge deficits in providing competent care for patients with Down Syndrome. It also examined how nurses can be best educated to provide care for individuals with Down Syndrome to improve their quality of life. Scholarly articles were found searching scholarly databases such as PubMed and CINAHL Complete. …

Factors Contributing To Weight-Gain In Pediatric Psychiatric Patients: An Integrative Literature Review, Holly Ann Douglas Charles

Grace Peterson Nursing Research Colloquium

Obesity and excess weight occur more frequently in the psychiatric patient population. Inappropriate weight gain during in-patient treatment indicates long-term increases in weight. Children are particularly vulnerable to the ill effects of obesity with an increased risk of premature mortality and adult morbidity. Thus, it is imperative to minimize weight gain during psychiatric treatment. The purpose of this review was to identify factors contributing to weight gain in youth psychiatric patients, effective strategies to control modifiable risk factors, and the population that would benefit most from these strategies. An intensive review of literature was conducted. The search utilized multiple databases, …

The Availability & Efficacy Of Non-Pharmacological Interventions For Pain Management For Children With Sickle Cell Disease: A Systematic Review Of The Literature, Uchenna Onyema-Jones

Grace Peterson Nursing Research Colloquium

The Availability & Efficacy of Non-Pharmacological Interventions

For Pain Management for Children with Sickle Cell Disease:

A Systematic Review of the Literature

Uchenna N. Onyema-Jones

Faculty Sponsor: Tamara Poole, MS, APN, FNP-BC

Background: Pain is the leading cause of hospitalizations for many pediatric patients with sickle cell disease and unfortunately it is often sub-optimally managed by healthcare professionals with pharmacological interventions.

Objectives: The purpose of this systematic literature review was to examine the availability and efficacy of non-pharmacological interventions used to manage pain in pediatric patients with sickle cell disease.

Method: A systemic literature review was conducted using the databases …

Best Evidence-Based Best Practices For Helping Women That Are Addicted To Opiates During Pregnancy, Jordan Edwards

Grace Peterson Nursing Research Colloquium

Background: Women of childbearing age that are active opiate users are at high risk of inflicting irreversible damage on not only themselves but onto their unborn children as well. There are limited studies on effective treatment options and education models for pregnant women addicted to opiates. Current practices for helping women that are addicted to opiates do not address the importance of education models for successful cessation of opiate abuse, and defer to treatment options that are used for the general population.

Objectives: The purpose of this integrative literature review was to identify what evidence-based best practices are being used …

Psychological & Psychosocial Deficits Among Pediatric Survivors Of Hematological Neoplasms, Elizabeth Ross

Grace Peterson Nursing Research Colloquium

Background: Pediatric cancer patients are surviving cancer and living long, relatively healthy lives due to advances in pediatric cancer therapeutics. Even with modern medical research and technology, pediatric cancer is still the leading cause of death for children and adolescents in the United States. Based on statistics from the American Cancer Society (ACS), hematological cancers, such as leukemia and lymphoma, are the leading type of non-solid malignancies in children (ACS, 2016). For decades pediatric cancer survival rates have steadily increased with an overall cure rate of over 75%.

While it is great that the survivor rate has and is steadily …

The Influence Of Compassion Satisfaction And Its Effect On The Nurse-Patient Relationship, Brandon Larsen

Grace Peterson Nursing Research Colloquium

No abstract provided.

Intraoperative Blood Pressure And Effect Of Volatile Anesthetic In Brain Dead Organ Donors, Alison Karmanian

Grace Peterson Nursing Research Colloquium

Intraoperative Blood Pressure and Effect of Volatile Anesthetic in Brain Dead Organ Donors

Alison L. Karmanian

Faculty Sponsor: Dr. Pamela Schwartz, CRNA, DNP

Background: There is a large disparity between the number of people waiting for organ transplants and the number of organs available. Optimal hemodynamic management can influence transplant outcomes, therefore evidence-based hemodynamic management should be practiced to maximize scarce donor organs.

Purpose: The purpose of this study was to examine intraoperative blood pressures and administration of volatile anesthetics during brain dead organ donor procurements. Use of volatile anesthetics was examined to determine how use and dose affected the …

Barriers To Advance Directives, Anna Malia Connor Ticknor

Grace Peterson Nursing Research Colloquium

Abstract

Background: Advanced directives (ADs) are legal documents that allows an individual to document their specific wishes for medical care should they be unable to speak for themselves. The use of advanced directives has implications directing the course of end-of-life care affecting both the cost and direction of care. Advance directives can clarify confusion and provide guidance, but their implementation is not clearly defined within the healthcare system. Despite their implications, multiple surveys indicate these documents have limited use within the United States for reasons that are not easily isolated including lack of knowledge of advanced directives and lack of …

Resilience And Coping In The Adolescent And Young Adult With Type 1 Diabetes, Debra L. Messinger

Seton Hall University Dissertations and Theses (ETDs)

There is a need to understand the roles coping strategies play in enhancing resilience in adolescents and young adults with type 1 diabetes between the ages of 18-30. The purpose of this study was to examine the relationships between and among positive, protective coping strategies (courageous coping), negative coping strategies (defensive coping), and resilience. The Resilience in Illness Model (Haase, Kinter, Monahan, & Robb, 2014) was the theoretical model which guided this research.

A convenience sample was recruited via diabetes organizations’ Facebook and Forum pages, a College Diabetes Network chapter meeting, and Juvenile Diabetes Research Foundations’ (JDRF) sponsored events. Data …

Self-Care Management Strategies Used By Black Women Who Self-Report Consistent Adherence To Antihypertensive Medication, Willie M. Abel, Jessica S. Joyner, Judith B. Cornelius, Danice B. Greer

Nursing Faculty Publications and Presentations

Background: Black women in the USA have the highest prevalence rate of hypertension (HTN) contributing to a higher risk of organ damage and death. Research has focused primarily on poorly controlled HTN, negative belief systems, and nonadherence factors that hinder blood pressure control. No known research studies underscore predominantly Black women who report consistent adherence to their antihypertensive medication-taking. The purpose of this study was to describe self-care management strategies used by Black women who self-report consistent adherence to their antihypertensive medication and to determine the existence of further participation in lifestyle modifications, such as eating a healthy diet and …

Utilization Of Care By Infants With Neonatal Abstinence Syndrome In Delaware, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

From 1999-2013, the nationwide incidence of neonatal abstinence syndrome (NAS) due to maternal drug use rose from 1.5/1000 to 6/1000 hospital births. There is a dearth of information regarding what happens to these children when they are discharged. The purpose of this Practice Inquiry Project is to utilize existing Delaware Medicaid data to retrospectively explore the utilization of services and gaps in care for the infant with NAS in the first year of life. Key findings include less than expected well child visits and immunizations along with higher hospital re-admission rates. This represents missed opportunities for care, also demonstrating the …

Reducing The Risk Of Hypothermia In Neonatal Infants, Monika Klett-Dunbar

Master's Projects and Capstones

Abstract

Global Aim: To improve infant thermoregulation within the first 24 hours of life of the high risk preterm and very low birth weight (VLBW) infant population in the NICU, thereby reducing rates of morbidity and mortality due to complications influenced by infant hypothermia. Project Aim: To reduce the rate of hypothermia at one hour and the first 24 hours of life in the target population of preterm neonates weighing less than 1500 grams with a gestational age less than 32 weeks from 9.5% to < 5% through the consistent use of a specific bundle of interventions applied in the labor and delivery setting, by December 2017. The aim of the current initiative is also to build on the success of the pilot program launched in 2015 by adding to the preliminary bundle of initiatives, and sustaining hard-won achievements by reinforcing education measures to the nursing and medical teams involved in the infant delivery and NICU admission process. Background: Hypothermia is a major factor in morbidity and mortality of low-birth-weight premature infants, …

Midline Catheter Usage In The Neonatal Population, Kelly Freeland

Master's Projects and Capstones

Neonatal sepsis is associated with increased mortality and morbidities including lengthy hospital stays. Neonate’s immature immune system and susceptibility to sepsis make them prone to antibiotic treatment. Lack of recommendations points to the need for evidence-based practices when selecting a vascular access device (VAD). Literature reviewed demonstrated that a midline catheter (MC) was an option for a VAD with neonatal populations requiring antibiotic therapy more than 48 hours. MCs offer fewer complications compared to the peripheral intravenous (PIV) device. The objective of this project is to reduce the amount of pain experienced by neonates by reducing the number of PIV …

Implementation Of An Evidenced-Based Practice Curriculum To Improve Nursing Practice For Epidural Administration And Monitoring, Chatty O'Keeffe

Master's Projects and Capstones

Abstract

Epidural analgesia (EA) is one inpatient pain management option prescribed by Acute Pain Services (APS) at VA Puget Sound Health Care Services (VAPSHCS). Historically, EA nursing care at VAPSHCS has been managed by surgical units. However, in the last two years, facility restructuring and budget constraints have led to reorganization and consolidation of units. The reduction in units providing nursing EA care has resulted in an overflow of EA patients to the medical intensive care unit (MICU). A previous gap analysis of the compliance in nursing performance of EA nursing care on the surgical acute care unit demonstrated poor …

Meta-Regression: Prognostic Models As Objective Predictors Of Mortality Among Icu Cancer Patients, Sheila Donnell

Nursing Theses and Dissertations

Cancer patients admitted to the intensive care unit (ICU) may be experiencing complications of disease or treatment-related effects. While acute complications related to disease and/or its therapeutic management vary in severity, the approach to ICU-centered care is complicated by actual versus perceived risks of poor outcomes. Prognostic models that inform clinical judgment of nurses and physicians may prove helpful in this population. The Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II) and Sequential Organ Failure Assessment (SOFA) are ICU-based models predicting 30-day mortality among the general ICU population. Although studies have been …

The Need Of Lactation Consultant For Night Shift, Joyce Fung

Master's Projects and Capstones

Abstract

Breastfeeding can provide many health benefits for both mother and baby. To increase the health benefits for patients, a change project will be implemented to increase the rates of exclusive breastfeeding for postpartum patients. The project will be focusing on teaching and be providing information on health benefits of exclusive breastfeeding. Our project is aiming to increase the rates of exclusive breastfeeding by providing lactation consultants during night shift.

Surveys and interviews were conducted pre-program and found most patients are unaware of the health benefits of breastfeeding and the lactation consultant services provided by the hospital. The method used …

Investing In The Float Pool: A Cost Effective Alternative For Staffing Shortages, Christen Straw

Master's Projects and Capstones

Abstract

Inpatient facilities have historically utilized contract nurses as a short-term solution to staffing shortages. Research suggests that utilizing the float pool provides a cost-effective alternative that has the potential to save the organization millions of dollars per year. This project aims to explore the financial impact of the float pool by increasing the volume of nurses by 50% within six months, individualizing the onboarding process to fit the needs of this complex department, and initiating a shared decision making model for identifying and implementing change. The overarching goal of this project is to provide a cost-saving alternative to staffing …

The Role Of The Clinical Nurse Leader In Reintroducing And Sustaining A Successful Cancer Risk Assessment Program In A Community Hospital Setting, Tiffany Gishizky

Master's Projects and Capstones

Abstract

The goal of implementing a comprehensive cancer risk assessment (CRA) program prompted the evaluation of a community-based breast center microsystem and previous CRA program for feasibility and sustainability. The development of a value proposition by the Clinical Nurse Leader student highlights the role in the advancement of the nursing profession as an interdisciplinary leader. Review of current literature facilitated development of program structure and identification of downstream revenue sources. Data analysis includes historical patient volume, screening and procedural reimbursement rates, population statistics and organization market share, and program financial impacts. Data synthesis reveals a CRA program demonstrates potential revenue …

Clearing The Pathway To Chemotherapy Certification For Inpatient Nurses, Shari Lee Kellen Rn, Ocn, Onn

Master's Projects and Capstones

Abstract

A clinical nurse leader (CNL) project was conducted, in a medical-surgical oncology unit in a community-based hospital, to evaluate and improve upon the decreasing number of chemotherapy certified nurses. A Likert survey of the nurses provided a self-assessment of competency in handling chemotherapy patients, and perceived barriers to achieving chemotherapy certification. The surveys revealed that nurses felt fearful of exposure to hazardous medications, that chemotherapy assignments were too stressful, and that there was minimal chemotherapy competency amongst leadership. An education program was implemented, covering proper use of personal protective equipment (PPE) and safe handling, practicing resilience to mitigate stress, …