Nursing Commons^™

The Supervision Of School Nurses In New Jersey: Parallel Needs, Actions, And Impacts On Student Care, Lee-Ann Halbert

Theses and Dissertations

New Jersey Certified School Nurses (NJ-CSNs) practice in an environment of parallel needs and actions where the primary goal is the education of the students in the building, yet the health and safety of each student are paramount. The research presented here evaluates how the supervision provided to the NJ-CSNs affects their clinical practice and other areas of decision-making in the school setting. This mixed methods research study of 557 NJ-CSNs reveals that school nurses who are supervised by an educator whose background includes being a registered nurse are better able to provide the optimal support for the nurses, and …

Rural Critical Care Nurses’ Suggestions For Decreasing End-Of-Life Care Obstacles, Lisa Smith, Renea L. Beckstrand

Journal of Undergraduate Research

Our research focused on gathering a rural cross-sectional, survey which will help determine the direction to move to improve the End-Of-Life care given by rural critical care nurses. The first step of our research was looking up over 1,300 rural hospitals names, addresses, phone numbers, and number of nursing staff at each hospital across the United States. I and another teammate were assigned to this task, and spent most of our research time completing it.

Nursing Perceptions Of End Life Care Obstacles In Critical Access Hospitals, Rebekah Leavitt, Renea Beckstrand

Journal of Undergraduate Research

Death is an unavoidable occurrence. Nurses are on the front lines when it comes to caring for dying patients. When providing end of life (EOL) care for critically ill patients, nurses frequently come across obstacles (Beckstrand, Giles, Luthy, Callister & Heaston, 2012). The purpose of this study is to identify the largest and the most frequent obstacles when providing EOL care to rural critical care patients. Our intent is to use the data to improve EOL care for rural patients and their families.

One quarter of community hospitals in the United States are critical access hospitals (CAH) and 19 percent …

Effect Of Implementation Of Simulation On Critical Thinking Skills In Undergraduate Baccalaureate Nursing Students, Joanne M. Knoesel

Dissertations, Theses, and Capstone Projects

Human patient simulation (HPS) is a time and cost intensive teaching modality that is used widely in nursing education, and has been implemented with little evidence to support its efficacy (Jeffries & Rizzolo, 2006). Researchers note the lack of reliable tools to measure learning using this teaching modality, and consequentially there is a paucity of research linking critical thinking and simulation (Jeffries, 2007; Kneebone, 2003; Nehring, 2008). Nursing clinical decision making affects patient outcomes. Critical thinking is a key factor in clinical decision making. A review of the relevant literature is equivocal on the use of simulation in undergraduate nursing …

Hypertonic Saline Versus Mannitol To Improve Brain Relaxation In Craniotomy: A Case Study, Morgan Cornell

Nurse Anesthesia Student Capstones

In neurosurgical procedures, including craniotomy for tumor, neurosurgeons often require a reduction of brain swelling to optimally perform the surgery. The reduction of brain swelling is termed brain relaxation. The anesthesia professional can accomplish brain relaxation using multiple techniques. One such technique is the infusion of certain intravenous fluids to change the osmotic pressure within the cranial vault thereby reducing brain edema (Jaffe, 2014). Highly osmolar fluids such as mannitol and hypertonic saline can be infused to decrease brain edema. Currently, mannitol remains the gold standard for medical treatment of intracranial pressure in neurosurgical procedures (Marko, 2012). This review seeks …

The Impact Of Intraoperative Goal-Directed Fluid Therapy, Marc Yacovone

Nurse Anesthesia Student Capstones

Anesthetists provide intra-operative fluid therapy by utilizing a variety of different methods. Deciding on the appropriate method is multifaceted, and the choice of method is a determinate of safe and effective outcomes. Camach-Navarro et al. (2015) determined that postoperative complications are linked to either giving too much or too little fluid. Unfortunately, the deleterious effects of improper fluid therapy are often overlooked.

Minor surgical procedures which result in little to no blood loss, often lead to positive outcomes using the fixed volume calculation approach to fluid therapy. However, when major surgical procedures are performed on sick patients a fluid management …

The Role Of Platelet Rich Plasma In Pain Management And Decrease In Opioid Use, Sara Cunha

Nurse Anesthesia Student Capstones

Platelet-rich plasma, also known as PRP, has become increasingly popular for the treatment of orthopedic injuries and symptomatic pain that results from such injuries. By promoting a localized inflammatory response, PRP injections increase blood flow to the injured area and expedite the healing process, thereby leading to pain relief. PRP has the potential to be a key player in the future of pain management. However, current evidence of the impact of PRP on pain relief is controversial. This paper aims to review the most current randomized controlled trials evaluating the efficacy of PRP in pain relief in a variety of …

Neurotoxic Effects Of Anesthesia On The Developing Brain, Nicole Hachey

Nurse Anesthesia Student Capstones

Each year, thousands of neonates receive anesthesia and/or sedation for various surgical procedures. With advancements in neonatal care and surgical techniques, the number of infants receiving anesthesia globally will continue to increase. A relatively large and growing body of literature suggests that exposure to general anesthetics can be detrimental to the developing brain. Based upon various animal studies, it is thought that exposure of the immature brain to anesthetic agents may result in apoptosis, neurodegeneration and ultimately long-term cognitive deficiencies (Walters & Paule, 2016). This information presents a dilemma for practitioners when caring for a neonate requiring a surgical procedure, …

Thoracic Epidural Versus Continuous Intercostal Catheter For Patients Undergoing Video Assisted Thoracoscopic Surgery (Vats), Brittany Guilmet

Nurse Anesthesia Student Capstones

Advances in technology have pushed many practitioners towards the implementation of minimally invasive surgery. Many different specialties have rapidly adopted this new approach and patient outcomes have improved as a result of this transition. One specialty, thoracic surgery, has evolved with this change through the development of video assisted thoracoscopic surgery (VATS). Despite improved patient outcomes, thoracic surgery remains one of the most painful procedures that a patient can endure. Although there are many different analgesic modalities available, the gold standard for post-operative analgesia in this patient population remains unknown. The aim of this literature review is to compare the …

Regional Anesthesia And Breast Cancer Recurrence, Michael Dunnington

Nurse Anesthesia Student Capstones

Breast cancer is the most common type of cancer in women in the United States, and surgical resection is the definitive treatment. However, cancer recurrence and metastasis remains a concern for the lifetime of the patients affected. Therefore, much interest has been focused on how anesthetic technique may impact the rates of cancer recurrence and metastasis following breast cancer surgery. In this review, the potential for regional analgesia to reduce the recurrence rate of breast cancer post-operatively is discussed. Supporting evidence from multiple studies is presented, along with a discussion of potential areas of future research that is needed. At …

Dexmedetomidine In The Prevention Of Emergence Delirium In Children, Lauren Anderson

Nurse Anesthesia Student Capstones

This review examines the use of intravenous dexmedetomidine in the role of decreasing or preventing emergence delirium in pediatric patients undergoing ambulatory surgery. The included randomized controlled trials evaluated the administration of dexmedetomidine, whether as a bolus, infusion, or in combination, and its effectiveness in preventing or reducing emergence delirium. The analysis scales for emergence delirium varied between studies, and it was noted that multiple scale components overlapped with pain scale components used in the trials. It has also been noted that differentiating between pain and emergence delirium can be challenging for clinicians (Somaini, Engelhardt, Fumagalli & Ingelmo, 2016). To …

간호대학생의 노인 간호의도에 영향을 미치는 요인, Phoebe (Yeon) S. Kim, Insun Jang

Nursing Faculty Publications

No abstract provided.

Commencement Program 2017, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2017 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | The University Honorees

26 | The Programs, The School Honorees, and The Speakers

• School of Medicine, 27
• School of Pharmacy, 52
• School of Dentistry, 64
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication Sciences and Disorders, Health Informatics and Information Management, Nutrition and Dietetics, Physician Assistant Sciences, Radiation …

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

Endometriosis, Jessica Workman

Nursing Student Class Projects (Formerly MSN)

Many people have heard about endometriosis but not a lot is understood about the condition. Endometriosis is a condition where endometrium, tissue that lines the uterus, grows outside the uterus. This tissue can grow around the ovaries, fallopian tubes, bowels, and bladder. When this occurs, the surrounding tissue becomes inflamed, swollen and irritated which causes scarring. The resulting lesions impede the function of the organs that they surround. The inflammation and tissue damage can lead to bleeding and painful discomfort.

There is much debate over the exact cause of endometriosis and how to best treat the condition. It is also …

Risk Factors For Pressure Injuries Among Critical Care Patients: A Systematic Review, Jenny Alderden, June Rondinelli, Ginette Pepper, Mollie Cummins, Joanne Whitney

Nursing Faculty Publications and Presentations

Objective: To identify risk factors independently predictive of pressure injury (also known as pressure ulcer) development among critical-care patients.

Design: We undertook a systematic review of primary research based on standardized criteria set forth by the Institute of Medicine.

Data sources: We searched the following databases: CINAHL (EBSCOhost), the Cochrane Library (Wilson), Dissertations & Theses Global (ProQuest), PubMed (National Library of Medicine), and Scopus. There was no language restriction.

Method: A research librarian coordinated the search strategy. Articles that potentially met inclusion criteria were screened by two investigators. Among the articles that met selection criteria, one …

Exciting Times In South-Asian Midwifery, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Evaluating A Community Maternal Health Programme: Lessons Learnt, Sheetal Sharma, Padam Simkhada, Vanora Hundley, Edwin Van Teijlingen, Jane Stephens, Ram Chandra Silwal, Catherine Angell

Journal of Asian Midwives (JAM)

Using the example of a community-based health promotion intervention, this paper explores the important triangle between health promotion theory, intervention design, and evaluation research. This paper first outlines the intervention and then the mixed-method evaluation.

In 2007, a non-governmental organisation (NGO) designed and implemented an intervention to improve the uptake of maternal health provision in rural Nepal. A community-based needs assessment preceded this novel health-promotion intervention that empowered women with information on the benefits of seeking care. The intervention had a flexible design and, at several points, the intervention’s progress was assessed and, where necessary, changes were made. The intervention …

Knowledge, Attitude, And Practices Of Mid-Level Providers Regarding Post Abortion Care In Sindh, Pakistan, Marina Baig, Rafat Jan, Arusa Lakhani, Sadia Abbas Ali, Kiran Mubeen, Shahnaz Shahid Ali, Farzana Adnan

Journal of Asian Midwives (JAM)

Background: In Pakistan, half of all pregnancies are unintended (4.2 million per year); out of which 2.2 million end in induced abortions. Almost 700,000 women seek medical treatment for post abortion complications every year. This necessitates access to quality Post-Abortion Care (PAC) services from skilled providers in Pakistan.
Purpose: This study aimed to assess the knowledge, attitude and practices of Mid-Level Providers (MLPs) regarding PAC services in Sindh, Pakistan.
Method: The study utilized a cross-sectional design. Convenience sampling was used to recruit 116 MLPs, including Nurse Midwives (NM), Lady Health Visitors (LHVs), and Community Midwives (CMWs) from different parts …

Birth Experiences Of Primiparous Turkish Women: Public And Private Hospitals, Filiz Okumus

Journal of Asian Midwives (JAM)

Introduction: We wished to better understand primiparous women’s childbirth experiences in private and public hospitals. Within the context of high caesarean section rates, in both private and public hospitals in Turkey, the experiences of women who delivered vaginally needs to be considered if we aim to decrease the number of caesarean births. We, therefore, conducted a descriptive study of women’s vaginal birth experiences in two hospitals in Istanbul.
Methods: Two hundred and forty primiparous women, from two hospitals (one public, one private), who had vaginal births, were included in this descriptive study. Information was obtained from medical records and through …

The Historical Development Of The Midwifery Profession In Bangladesh, Malin Bogren, Farida Begum, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Sexual and reproductive health and rights have been identified as the core areas of practice, theory and research for the midwifery profession. The midwifery profession, as defined by the International Confederation of Midwives Global Standards, is new in Bangladesh. This paper aims to give an overview of the historical process that has taken place in the past decades to develop the midwifery profession in Bangladesh. The professional development of midwives is the result of many years of collaboration and relationship building among stakeholders such as the government, non-government organizations, academia, professional associations, United Nations agencies, and donors. All are working …

Development Of Mentorship Module And Its Feasibility For Community Midwives In Sindh, Pakistan: A Pilot Study, Amber Hussain Sayani, Rafat Jan, Susan Lennox, Yasmeen Jan Mohammad

Journal of Asian Midwives (JAM)

Numerous articles describe the concept of mentorship for providing professional support in midwifery settings in different countries; however, in Pakistan the concept is under developed. Before implementing the concept in the Pakistani context, it was important to first develop a mentorship module and pilot test the idea. Therefore, the aim of the present study was to develop and test a mentorship module to determine its feasibility for educating community midwives about providing mentoring, so that a formal mentorship program could be established in the future. The training aimed to provide skill focused mentorship training to experienced midwives, so that they …

An Examination Of The Moderating Effect Of Proactive Coping In Nicu Nurses, Britan M. Moore

Loma Linda University Electronic Theses, Dissertations & Projects

The NICU environment is unique in that the patient population consists of critically ill neonates. Research has revealed that there are increased levels of depression, secondary traumatic stress, and burnout in nurses. Problem solving and support seeking coping strategies have been shown to be associated with lower levels of burnout and increased patient and job satisfaction in general staff nurses. Multiple linear regression and a hierarchical stepwise technique was used to conduct moderator analyses assessing whether the use of problem solving or support seeking strategies moderated the relationship between secondary traumatic stress levels and burnout as well as between depressive …

Predictors Of Postpartum Depression Among Women In Karachi, Pakistan, Vimla Gill John

Loma Linda University Electronic Theses, Dissertations & Projects

Pakistan has the highest prevalence of postpartum depression (PPD) among Asian countries. The purpose of this quantitative, cross-sectional study was to determine the predictors of PPD among women in Karachi, Pakistan. The Transactional Model of Stress and Coping was used as a framework. A purposive convenience sample of 234 postpartum women was taken from out-patient departments of a tertiary care hospital in Karachi, Pakistan. A survey in English and Urdu containing the Edinburgh Postnatal Depression Scale (EPDS), DUREL Religion Index Subscale three, Cohen’s 10-item Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support (MSPSS), Abuse Assessment Screen, Traditional postpartum …

Clinicians’ Perspectives On Adopting A Lung Cancer Palliative Care Intervention, Shaunna Siler

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the significant progress in implementing palliative care interventions for cancer patients, few intervention studies seek healthcare clinicians’ input prior to implementation. The purpose of this research was then to explore palliative care and oncology clinicians’ (e.g., physicians, nurses, social workers, and chaplains) perspectives on current challenges and useful practices in meeting the quality of life needs of lung cancer patients and family caregivers, and to increase the likelihood of the adoption of a palliative care intervention based on understanding current trends in palliative care delivery at three outpatient oncology sites. The conceptual framework used for this study was the …

Critical Care Nurses' Experiences Of Family Behaviors As Obstacles In End-Of-Life Care, Caitlin Brook Mallory

Theses and Dissertations

Background: Critical care nurses (CCNs) frequently provide end-of-life care for critically ill patients. CCNs may face many obstacles while trying to provide quality EOL care. Some research focusing on obstacles CCNs face while trying to provide quality EOL care has been published; however, research focusing on family behavior obstacles is limited. Research focusing on family behavior as an EOL care obstacle may provide additional insight and improvement in care. Objective: What are the predominant themes noted when CCNs share their experiences of common obstacles, relating to families in providing EOL care? Methods: A random geographically dispersed sample of 2,000 members …

Lysozyme Association With Circulating Rna, Extracellular Vesicles, And Chronic Stress, Sarah K. Abey, Yuana Yuana, Paule V. Joseph, Natnael D. Kenea, Nicolaas H. Fourie, Lee Anne B. Sherwin, Gregory E. Gonye, Paul A. Smyser, Erin S. Stempinski, Christina M. Boulineaux, Kristen R. Weaver-Toedtman Phd, Acnp, Anp, Christopher K.E. Bleck, Wendy A. Henderson

Publications

Background Stress has demonstrated effects on inflammation though underlying cell-cell communication mechanisms remain unclear. We hypothesize that circulating RNAs and extracellular vesicles (EVs) in patients with chronic stress contain signals with functional roles in cell repair. Methods Blood transcriptome from patients with Irritable Bowel Syndrome versus controls were compared to identify signaling pathways and effectors. Plasma EVs were isolated (size-exclusion chromatography) and characterized for effectors’ presence (immunogold labelling-electron microscopy). Based on transcriptome pathways and EV-labelling, lysozyme's effects on cell migration were tested in human colon epithelial CRL-1790 cells and compared to the effects of CXCL12, a migration inducer (wound assay). …

Positive Thinking Training Intervention For Caregivers Of Persons With Autism: Establishing Fidelity, Abir K. Bekhet

College of Nursing Faculty Research and Publications

More than 3.5 million in the US are diagnosed with autism spectrum disorder (ASD) and caregivers experience stress that adversely affects their well-being. Positive thinking training (PTT) intervention can minimize that stress. However, before testing the effectiveness of PTT, its fidelity must be established. This pilot intervention trial examined fidelity of an online PTT intervention for ASD caregivers with a random assignment of 73 caregivers to either the online PTT intervention or to the control group. Quantitative data [Positive Thinking Skills Scale (PTSS)] and qualitative data (online weekly homework) were collected. The mean scores for the PTSS improved for the …

The Lived Experience Of Retention And Progression Of Black/African American Nursing Students, India Mylon Medley

Loma Linda University Electronic Theses, Dissertations & Projects

Despite recent strides to increase workforce diversity, nurses continue to inadequately reflect the ethnic composition of the population they serve. To effectively answer the national calls for increased diversity in the nursing workforce, there must be a greater representation of minority students studying nursing. However, minority nursing students, especially those of Black/African American descent, have less access to nursing education, poorer retention and progression rates in nursing programs, and are more likely to withdraw from programs. The existence of an increasingly diverse nursing workforce depends upon the recruitment, retention, progression, and graduation of minority students. Whereas Historically Black Colleges and …

Opioid Prescription And Use After Laparoscopic Cholecystectomy, Valynn Christina Haslam

Theses and Dissertations

Background: Opioid abuse has become a serious public health issue. While adequate pain management is an ethical responsibility for health care providers, responsible stewardship of controlled substances is of equal concern. Opioids are often prescribed for treatment of acute pain post-operatively. The purpose of this study is to examine opioid prescription practices and use of opioids after laparoscopic cholecystectomy. Methods: A convenience sample of 42 patients scheduled for laparoscopic cholecystectomy were enrolled in the study. Using a descriptive study design, patients were interviewed by phone 6-10 days post-operatively using a scripted questionnaire. The average number of excess prescribed opioid medication …