Nursing Commons^™

Halo Gravity Traction Can Mitigate Preoperative Risk Factors And Early Surgical Complications In Complex Spine Deformity, Sravisht Iyer, Oheneba Boachie-Adjei, Henry Ofori Duah, Kwadwo P. Yankey, Rufai Mahmud, Irene Wulff, Henry O. Tutu, Harry Akoto

College of Nursing Faculty Research and Publications

Study Design.  Retrospective review of prospective cohort. Objective.  We sought to examine the role of halo gravity traction (HGT) in reducing preoperative surgical risk. Summary of Background Data.  The impact of HGT on procedure choice, preoperative risk factors, and surgical complications has not been previously described. Methods.  Patients treated with HGT before primary surgery were included. The FOCOS Score (FS) was used to quantify operative risk. FS was calculated using patient-factors (ASIA, body mass index, etiology), procedure-factors (PcF; osteotomy planned, number of levels fused, etc.), and curve magnitude (CM). Scores ranged from 0 to 100 with higher scores indicating increased …

Outcomes Of Implementation Of An Evidence-Based Enteral Feeding Protocol In Neonates Weighing Less Than 1800g At Birth, Rebecca Edwards

MaineHealth Maine Medical Center

Background:

Several studies have demonstrated that the implementation of standardized enteral feeding guidelines can lead to positive outcomes in the neonatal intensive care unit (NICU), including improved nutrition, decreased need for parenteral nutrition (PN), central lines and decreased costs. Furthermore, implementation of standard feeding regimens have significantly reduced the incidence of necrotizing enterocolitis (NEC), a devastating gastrointestinal emergency in neonates. It has been reported that NEC has an iatrogenic component related to variations in feeding practices. While the exact mechanism of the reduced risk of NEC and implementation of feeding protocols is unclear, standard feeding regimens likely improve consistency in …

A Hepatitis C Screening Tool For An Uninsured Population, Kimberly Belle Babcock-Nobles

Doctoral Dissertations and Projects

Hepatitis C virus (HCV) is a public health epidemic effecting 3.5 million people in the United States alone. The uninsured, underserved residents of a rural county in North Carolina have limited access to screening and early detection for HCV. Through collective efforts, a free medical clinic partnered with a grant funded, nonprofit organization to provide free hepatitis C testing by use of a mobile medical unit. The aim of this study was to determine if use of an HCV screening tool would increase the number of patients screened for testing as compared retrospectively to the number of patients screened without …

Raising Awareness Of Compassion Fatigue Among Healthcare Providers In The Coronary Care Unit, Keri Tifft

Doctoral Dissertations and Projects

Compassion fatigue is a pressing issue in critical care units across the healthcare field. There is a sincere desire by nurses to give the best care possible to each of their patients; however, many obligations split the nurse’s attention so they do not feel as if they are providing the best care to their patients. When nurses stop viewing their patients as humans and start viewing them as tasks, the compassion that the nursing profession prides itself on, is no longer there to the degree that is needed for quality care. Increasing awareness of compassion fatigue and teaching nurses and …

Sharing Clinical Notes With Patients: The Nurse Practitioner Perspective, Deborah S. Adelman, Catherine Fant, Debbie Conner

All Faculty and Staff Scholarship

This article outlines a research project conducted to learn more about NPs' attitudes regarding sharing clinical notes with patients through a patient portal. Perceptions were positive overall. To achieve effective health outcomes, patient and family engagement is essential. Shared clinical notes provide an opportunity to achieve these goals.

Knowledge And Attitudes Regarding Cervical Cancer Screening Among Women Living With Hiv/Aids In Malawi: A Cross-Sectional Study, Jasintha Mtengezo

Graduate Doctoral Dissertations

Cervical cancer is the third most frequent cancer among women worldwide and about 265,672 women die from the disease annually. Abnormal cervical cells caused by human papillomavirus are more common in HIV-positive women than in HIV-negative women due to their compromised immune system. Malawi, in Sub-Saharan Africa, is one of the countries with the highest rates of cervical cancer and HIV in the world. The incidence of cervical cancer and deaths can be reduced by 80% if women go for screening. There are limited studies about cervical cancer screening behavior, level of knowledge and attitudes regarding cervical cancer and screening …

Surgical First Assist: An Educational Program For Advanced Practice Providers, Sandra Walton Mobley

Doctoral Projects

As the number of surgical procedures increase, many Advanced Practice Providers (APPs) are being required to scrub in as a First Assist (FA). Unfortunately, many APPs lack any formal surgical training. The Association of perioperative Registered Nurses (AORN) now requires that all advanced practice providers in the perioperative environment to complete a course that complies with Registered Nurse First Assist (RNFA) standards. The purpose of this project was to evaluate knowledge acquisition of APPs participating in a surgical FA educational program. A surgical FA course was comprised of five days of didactic learning, which included lecture, small groups, skills lab, …

Comparison Of A Numeric And A Descriptive Pain Scale In The Occupational Medicine Setting, George Francis Mcmahon Iii

Doctoral Projects

Pain is a universal phenomenon. The assessment of a patient’s pain is difficult to objectively obtain because the perception of the pain by the patient is influenced by many subjective perception variables. These variables can inflate or deflate the patient’s self-reported pain level which can adversely affect the medical provider’s ability to accurately create a treatment plan for the patient. This study compared the patient’s response to a self-rating of their pain on a numeric pain scale with the response given by the patient on the Mankoski pain scale. Comparison of the numeric pain scale to the Mankoski pain scale …

Barriers In Hypertension Management Among Culturally Diverse Patients In An Urban Urgent Care Setting, Navpreet Kaur

Doctoral Projects

Hypertension is the leading cause of deaths related to cardiovascular disease conditions. A vast number of patients are not taking their medications as prescribed by the physicians. This non-adherence to hypertensive treatment plans results in increased numbers of cases of unstable blood pressure. Medication adherence will help to manage the controllable cardiovascular diseases and will automatically decrease the incidences of emergent cases in hospitals and urgent care clinics. It will further decrease the costs of diagnostic evaluations used during the emergent visits. This decreased patient load in the emergency rooms will improve quality patient care. The study timeframe of data …

Understanding The Skills Necessary For Advanced Practice Nurses In Oncology To Deliver Bad News To Patients With Cancer: The Results Of A Delphi Analysis, Matthew Michael Burke

Doctoral Projects

Overcoming the dichotomy of providing bad news in a compassionate, empathetic manner that strengthens dialogue and enhances a caring environment is the ultimate challenge advanced practice nurses (APN) face in oncology. This study aims to understand the skills necessary for APNs in oncology to deliver bad news to patients with cancer.

Using a Delphi analysis, an established method of developing a consensus, a novel, patient-centered survey tool has been developed designed to extract as much information as possible about the present issue from an expert panel. Oncology APNs were recruited via Facebook. The survey tool was administered using a web-based …

Comparing Two Surgical Outcomes: Minithoracotomy Or Full Sternotomy In Coronary Artery Bypass Grafting Surgery, Shirin Badrkhani

Doctoral Projects

Cardiovascular diseases and heart-related conditions can be life-threatening; however, some cardiovascular conditions can be managed with open heart surgery. Coronary artery bypass grafting (CABG) is the most common type of heart surgery performed on adults. There are two different surgical procedures to correct cardiac defects: mini-thoracotomy and full sternotomy. Mini thoracotomy approach has been shown to reduce complications, such as pneumonia, excessive blood loss, and infection in mitral valve repair surgeries. However, little research has been done to compare these two surgical approaches performed for patients undergoing coronary artery bypass grafting (CABG).

Specifically, there is inadequate data to compare these …

Human Papillomavirus Vaccine Program, Magdalena Ruiz

Doctoral Projects

Pediatric primary care focuses on maintaining patients’ health, preventing diseases, and assessing children’s developmental milestones. Vaccine administration and disease prevention are key components of a well-child exam for pediatric patients; however, vaccine refusal is an important complication of pediatric patient care. Of particular interest to this researcher is the HPV vaccine which was approved by the Federal Drug Administration and is currently recommended by the Centers for Disease Control and Prevention (2016) for both males and females, beginning at 11 or 12 years of age through age 26 years. The HPV vaccine protects against diseases and cancers caused by the …

Exploring Ways To Improve Healthcare Access For The Homeless Population In Merced County, Stella Nwasoka Adesokan

Doctoral Projects

Homelessness is a societal dilemma that affects people in the United States and around the globe. Homelessness relates to poor health conditions that affect the living conditions of individuals (Institute for Urban Initiatives, 2018). Chronic and acute illnesses are rampant in this group, most of these illnesses are treatable but accessing healthcare poses a challenge for this vulnerable population. Homeless persons are often unable to access healthcare due to fear and denial of ill health, difficulty in communicating health needs, and low self-esteem (Lamb & Joels, 2014).

In the study, questionnaires were administered to 25 homeless individuals through random sampling. …

Barriers In Health Care In Hmong Men And Women With Cardiac Diseases, Ying Thao

Doctoral Projects

Lauver’s theory of care seeking behaviors is applied to identify perceived barriers to accessing healthcare in Hmong men and women that may influence care seeking behaviors. The purpose of this study is to identify barriers in accessing health care among Hmong men and women ages 50 to 80 with cardiovascular heart disease (CHD) and risk factors for CHD (e.g., diabetes, hyperlipidemia, and hypertension). A quantitative descriptive analysis was used to look at demographic characteristics while a multiple regression analysis was used to statistically compare correlations between barriers to care, risk factors for CHD, sex, and access to health care. The …

A Retrospective Chart Review Pilot Study Of Fall Prevention Through A New And Innovative Care Model, Lydia Smith

Doctoral Projects

According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related mortality in the geriatric population, and they are the most common cause of brain injury and hip fracture. The prevalence for falls is 30% in patients over 65 in the United States who experience a fall annually, and the prevalence in dementia patients can be up to 80% annually; the consequences of falls can include injury, reduction in mobility, depression and decreased socialization with peers (CDC, 2015). The purpose of this retrospective chart review pilot study is to examine the number of falls …

Pilot Study: Program Evaluation Of Peanut Oral Immunotherapy In A Private Clinic, Kinga Olson

Doctoral Projects

The privilege of providing a therapy perceived by patients and families as “life changing” has seasoned physicians describing food oral immunotherapy (OIT) as one of “the most impactful and rewarding thing that they have done in medicine” (Wasserman, Jones, & Windom, 2018). OIT is a medical treatment that allows the immune system to become desensitized to a food to which it may otherwise be allergic. This is not a cure for food allergies but a way to decrease the incidence of anaphylaxis due to accidental ingestion. Living with food allergies can be distressing due to the daily fear of exposures. …

Pilot Study Of A Breastfeeding Support Training Program Designed Particularly For Infants With Common Congenital Anomalies And Defects, Gretchen Nelson Ezaki

Doctoral Projects

The American Academy of Pediatrics (American Academy of Pediatrics [AAP], 2018), the World Health Organization (World Health Organization [WHO)], 2018), and The March of Dimes (March of Dimes, 2016) recommend exclusive breastfeeding for the first six months of life. In 2014, 79% of women in the United States began breastfeeding their infants, but only 40.7% and 18.8% continued breastfeeding exclusively at three and six months respectively (Centers for Disease Control and Prevention, 2017). This doctoral project promotes breastfeeding by creating and testing simple teaching algorithms for training registered nurses to support breastfeeding, including for infants with trisomy 21, congenital heart …

Promoting Self-Efficacy Among Head And Neck Cancer Patients, Lily Lam

Doctoral Projects

Current survivorship visits at the Stanford head and neck oncology program are not standardized to address ongoing post-treatment sequelae. The objectives of this study help to address whether current non-standardized visits actually help to empower patients to self-manage their chronic diagnosis of head and neck cancer by measuring their self-efficacy levels before and after their post-treatment survivorship visit.

Given the convenience sampling method, 17 patients were enrolled in this quasi-experimental pilot study. Demographic information was collected for each patient: gender, ethnicity, smoker status, and age. Head and neck cancer patients would first be surveyed before and after their follow up …

Associate And Baccalaureate Degree Nursing Students’ Knowledge Of And Attitudes Toward Medication Errors And Reporting Medication Errors: Implications For Curriculum Development, Tabatha Diann Teal

Graduate Theses and Dissertations

This paper evaluates senior nursing students’ knowledge and attitudes of medication errors and reporting errors. This study was conducted to evaluate a need for improvements to nursing education on these two concepts. This mixed method study was conducted using a modified version of the Medication Administration Error Reporting Survey by Wakefield, Uden-Holman, and Wakefield (2005) and focus group sessions at four nursing programs in the Southern United States. Medication errors continue to be a threat to patient safety and underreporting exists due to the stigma surrounding admitting a mistake. Evaluating nursing students’ knowledge and attitudes on these concepts is a …

A Comparison Of The Curricula Of The Top-Ranked Prelicensure Baccalaureate Nursing Programs In The United States, Silvia Imanda

Graduate Theses and Dissertations

What constitutes an ideal prelicensure nursing curriculum is not well understood. Specifically, what are the strategic curricular sequencing and curricular themes or focus might be included to contribute to producing high quality graduates? The purpose of this qualitative multiple case study investigation was to look at successful programs and identify effective curricular sequencing and curricular themes or focus that might be inferred to have contributed to producing high quality graduates. Seven top-ranked prelicensure baccalaureate nursing programs were selected based on three national college rankings services. Based on data from interviews and publicly accessible documents, seven case studies were compared and …

A Living Experience Of Feeling Listened To: A Parsesciencing Inquiry, Teodora Duarte-Quilao

Dissertations, Theses, and Capstone Projects

Listening is the phenomenon of interest and feeling listened to is considered the universal humanuniverse living experience. The aim of this investigation is to contribute new knowings and understanding to the universal humanuniverse living experience of feeling listened to. The purposes of the investigation are: (a) to discover the discerning extant moment of the universal humanuniverse living experience of feeling listened to, (b) to expand the human becoming paradigm, and (c) enhance the disciplinary knowledge of Parsesciencing (Parse, 2016) and disciplinary knowledge in general. People in all areas of life experience being disregarded and not listened to. The significance is …

Enhancing Patient Medication Knowledge: Utilizing An Educational Tool To Improve Patient Satisfaction Scores, Elizabeth Orgon

Master's Projects and Capstones

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has recognized the need for medication education with communication about medication as a patient satisfaction indicator. Literature shows a medication guide or tool that is readily accessible and easy to understand for the patient can help provide nurses with a teach back method to help increase patient knowledge about common medications. Continued use of this tool will then positively affect communication between patients and providers thereby increasing medication communication related HCAHPS survey scores. Review of current Stanford Health Care HCAHPS survey data shows that all nursing units are continually …

Familial Aggregation Of Ideal Cardiovascular Health And Cardiovascular Disease Disability-Adjusted Life Years In Parent-Offspring Dyads: Analysis Of The Framingham Heart Study, James M. Muchira

Graduate Doctoral Dissertations

Background: Ideal cardiovascular health (iCVH) is defined as the simultaneous presence of seven health metrics-physical activity, not-smoking, healthy diet, healthy body weight, and blood cholesterol, blood pressure, and blood glucose levels as defined by evidence-based guidelines. Evidence suggests familial aggregation of single cardiovascular disease (CVD) risk factors but research on clustering of seven iCVH metrics and CVD disability-adjusted life years (CVD DALYs) within families is lacking.

Purpose: To examine trends and relationship of parental iCVH and offspring iCVH and CVD DALYs at similar age across the lifespan.

Methods: A secondary data analysis of the Framingham Heart Study (FHS) Dataset-Original and …

Evidence-Based Practice Guide And Workflows: Improving Hospital Throughput And Reducing Emergency Department Overcrowding, Maulah Halley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hospitals in the United States are experiencing disruptions to patient throughput. These disruptions create barriers to patients who seek emergent care in the Emergency Department (ED) and who must be moved to hospital inpatient beds after the decision to admit has been made. As a result, patients requiring hospital admission via the ED may have long wait times, which, in turn, contribute to ED crowding and overcrowding. The root causes of ED overcrowding are inefficiencies within the system and the inability of hospitals to meet demand. Although bed capacity on any given unit may not be altered, ED patient’s arrival …

Prevalence And Use Of High-Fidelity Simulation In Family Nurse Practitioner Programs, Christina Rosa Pendrak Pepin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family nurse practitioner (FNP) programs represent almost 60% of all accredited primary-care NP programs in the U.S. in 2015. Increased enrollments and creation of new NP programs has led to a shortage of appropriate clinical sites and the increased competition for quality clinical sites. FNP programs have turned towards utilizing innovative ways to address this shortage including the use of high-fidelity simulation. However, a lack of literature supports substituting traditional clinical hours with high-fidelity simulation. Only 45 articles were found over a 35-year period describing the use of high-fidelity simulation in an FNP program and of those published since 2014, …

Nurses’ Experiences And Perceptions Of Using Online Resources For Patient And Family Education: A Qualitative Interview Study, Carrie Grinstead, Sarah Sumner, Julius Shakari, Martha Inofuentes

Books, Presentations, Posters, Etc.

No abstract provided.

Oncology Navigation: Improving The Patient Experience, Rhonda Hjelm

Books, Presentations, Posters, Etc.

No abstract provided.

Associations Of First Trimester Co-Use Of Tobacco And Cannabis With Prenatal Immune Response And Psychosocial Well-Being, Kristin Ashford, Amanda Fallin-Bennett, Andrea Mccubbin, Amanda T. Wiggins, Sheila Barnhart, Joshua A. Lile

Perinatal Research and Wellness Center Faculty Publications

PURPOSE: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only.

METHODS: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, CRP, MMP8), were collected, although cytokine data were only available for 122 women.

RESULTS: Participant average age was 29.1 years, approximately half had a high …

The Hemoglobin A1c Of African-Americans/Blacks With Diabetes Mellitus Type Two Using Low-Fat Diabetes Plate Diet, Ednah K. Makori

Doctor of Nursing Practice Projects

Diabetes Mellitus type two (DMT2) is a chronic disease that leads to high blood sugar in the body and if not corrected over a period of time, it leads to development of complications. Some of those complications include blindness, kidney failure, and retinopathy, among others. DMT2 continues to affect many people in the USA, especially African-Americans/Black who have the highest prevalence as compared to other races. Proper diet management especially the Low-Fat diabetes diet helps to decrease Hemoglobin A1c, which could result in reduction of risk of developing complications and morbidity related to DMT2. This project was done to educate …

Differences In Kaplan Integrated Exam Scores Based On Institutional Factors, Lee Ann Danner

Graduate Theses and Dissertations

Registered Nurses constitute the largest health care occupation in the United States. Current entry-level education for the profession of nursing is either an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) (Altman, 2011). After successful completion of a nursing program, all nursing graduates must apply to take the National Council Licensure Examination (NCLEX-RN). The pass rate for first time United States educated NCLEX-RN exam test takers in 2017 was 87.11% leaving 12.89% unsuccessful (NCSBN, 2018). A nursing programs quality and recruitment are often influenced by a students’ ability to pass the NCLEX-RN on the first attempt. …