Nursing Commons^™

Letter From The Editor-In-Chief: Publishing In Peer-Reviewed Journals, Nohemi Sadule Rios

Nursing & Health Sciences Research Journal

No abstract provided.

Doctoral Education And Preparation For Nursing Faculty Roles, Angela M. Mcnelis, Kristina Dreifuerst, Rhonda Schwindt

College of Nursing Faculty Research and Publications

Background

Despite increased enrollment in doctoral programs and the encouraging numbers of graduates intending to pursue faculty positions, lack of adequate preparedness to assume the faculty role may adversely impact retention and consequently undermine efforts to reduce the shortage.

Purpose

Understanding doctoral nursing students’ and recent graduates’ expectations of their educational experience related to preparation for an academic career is needed to inform curricular revisions and advise guidance to ensure role readiness.

Methods

A secondary analysis of 24 interviews with current PhD and doctor of nursing practice (DNP) students and recent graduates from both degree programs was performed to gain …

Dysphagia Screening To Prevent Hospital-Acquired Pneumonia Rates, Namneet Sekhon

Dissertations

Problem Pneumonia is a leading cause of death worldwide and affects all ages. Pneumonia may be acquired by aspiration and a bedside nursing dysphagia screen may reduce hospital acquired pneumonia (HAP) rates for stroke patients. The aim of this study was to evaluate use of the dysphagia screen for all patients receiving a computed tomography (CT) scan of the head in the emergency department (ED).

Method An observational, descriptive design for all patients who received a CT of the head in the ED and admitted over a 60-day period. The rate of dysphagia screening with the DePaul Hospital Swallow Screen …

Pilot Evaluation Of A New Urine Progesterone Test To Confirm Ovulation In Women Using A Fertility Monitor, Thomas Bouchard, Richard J. Fehring, Mary Schneider

College of Nursing Faculty Research and Publications

Background

Progesterone rises ~24–36 h after ovulation. Past studies using ultrasound-confirmed ovulation have shown that three consecutive tests with a threshold of 5μg/mL of urine progesterone (pregnanediol-3-glucuronide, PDG), taken after the luteinizing hormone (LH) surge, confirmed ovulation with 100% specificity.

Purpose

The purpose of this study was to a evaluate a new urine PDG self-test to retrospectively confirm ovulation in women who were monitoring ovulation using a hormonal fertility monitor.

Methods

Thirteen women of reproductive age were recruited to test urine PDG while using their home hormonal fertility monitor. The monitor measured the rise in estrogen (estrone-3-glucuronide, E3G) and LH …

Anesthetic Considerations For Patients Under The Influence Of Marijuana And/Or Cannabidiol: Anesthesia Interactions And Implications, Alexa Schimmel

Nurse Anesthesia Student Capstones

This manuscript investigates the use of marijuana, including edibles and cannabidiol (CBD), and its effects on anesthesia. This topic of research is very recent without an abundance of information. Various articles discuss the route of marijuana use including inhalation, ingestible and extracts of the plant, including CBD. For this manuscript, the term marijuana will pertain to both inhaled and ingested marijuana unless otherwise noted; ingestible marijuana is also known as edibles. This manuscript explains the mechanism of action of marijuana and CBD, the general guidelines for the use and how each affect the administration and impact of anesthesia.

Oxygen Use In The Delivery Room And The Outcome Of Bronchopulmonary Dysplasia: A Retrospective Review., Blair Wagner

Doctor of Nursing Practice Papers

Recent evidence confirms the first 10 minutes after birth are extremely important for the short and long-term outcomes of premature infants, specifically for the risk of developing bronchopulmonary dysplasia (BPD). Neonates who are resuscitated with 100% oxygen concentration in the delivery room during the first 10 minutes after birth have a 35% chance to develop BPD (Vento, 2009). Neonates who are resuscitated with lower oxygen levels in the first 10 minutes of life have a 15% chance of developing BPD. BPD is diagnosed when a neonate requires oxygen at ³28 postnatal days or at 36 weeks corrected gestational age, along …

Human Papillomavirus, Alexandra Irwin

Nursing Student Class Projects (Formerly MSN)

The Human Papillomavirus (HPV) is a sexually transmitted infection that is not curable. HPV can damage cell DNA which increases the risk of oncogene expression; this leads to an increased risk of cancer. HPV is one of the leading causes of cervical cancer, among other types of cancers. Prevention is key because HPV is usually asymptomatic. The population at risk is anyone sexually active, including participation in oral sex. The health care provider should advocate for preventative measures against HPV. There are vaccinations that prevent the contraction of HPV that should be given before a person is sexually active for …

Aortic Stenosis, Danielle Ridgway

Nursing Student Class Projects (Formerly MSN)

Aortic stenosis (AS) is a condition where the opening of the aortic valve becomes narrower. The narrowing can be caused by age associated calcification, congenital bicuspid aortic valve, or inflammation associated with rheumatic heart disease. AS due to calcification is the most common heart valve disorder in North America and is increasing in prevalence due to increased life expectancy and an aging population. It is imperative for nurses to maintain an in depth understanding of the pathophysiology of the disease with resulting hemodynamics changes in order to effectively care for this patient population.

Practice Vs. Evidence: Predicting Insertion Length And Verifying Placement Of Feeding Tubes In Neonates., Brittany L. Tipton

Doctor of Nursing Practice Papers

The placement of nasogastric (NG) and orogastric (OG) feeding tubes is one of the most common procedures performed in the Neonatal Intensive Care Unit (NICU). According to the literature, as many as 44% of feeding tubes are placed in the incorrect location in children (Parker, Withers, & Talaga, 2018). The purpose of this process evaluation project was to analyze the current processes and human factors in predicting insertion length and verifying placement of feeding tubes in neonates. The goal was to use the data obtained to compare current practices to current evidence. If warranted, the ultimate goal was for the …

Gouty Arthritis, Erin Dutt

Nursing Student Class Projects (Formerly MSN)

Gout is an arthritic condition that can lead to destruction of the affected joints. Often the main complaint is severe pain of the big toe but could affect other joints. Due to the frequency of this condition, the family nurse practitioner (FNP) could easily encounter it in family practice. What causes the joint destruction is the deposit monosodium urate crystals (MSU) along a joint due to hyperuricemia. Not only can gout cause permanent joint damage, it also increases the risk for kidney damage. Treatment will be aimed at managing acute attacks and lowering serum uric acid (SUA) levels. Controlling modifiable …

Malignant Hyperthermia, Courtney Stevenson

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia (MH) is a rare but life-threatening medical emergency. It is a skeletal muscle disorder that leads to a hypermetabolic reaction. It occurs in response to the administration of inhaled anesthetics and depolarizing muscle relaxants.

Myocardial Infarction, Sarah Robinson

Nursing Student Class Projects (Formerly MSN)

Myocardial infarction (MI) is a life threatening condition that causes irreversible damage and necrosis of the myocardium due to prolonged ischemia (Davies, 2016). Myocardial ischemia is often a result of coronary artery disease that develops through a process called atherosclerosis (Andrus et al., 2015). It is estimated that every 40 seconds a person in the United States suffers from a myocardial infarction (Center for Disease Control and Prevention, 2017). Healthcare providers have the opportunity to decrease the incidence of MI through primary prevention. Educating patients on the importance of modifying risk factors such as diabetes mellitus, dyslipidemia, and hypertension requires …

Hirschsprung-Associated Enterocolitis, Erin Shann

Nursing Student Class Projects (Formerly MSN)

Hirschsprung disease (HD) occurs when there is an abnormal development in the enteric nervous system leading to ganglion cells being absent in the colon (Avansino & Levitt, 2017). HD presents as severe abdominal distention, failure to pass a meconium stool within the first 48 hours of life, difficulty feeding, bilious vomiting in the newborn period, and as prolonged severe constipation in the older child (Avansino & Levitt, 2017). Undiagnosed HD can lead to a life-threatening condition called enterocolitis. Enterocolitis presentation varies per individual with the most common symptoms, including abdominal distention, foul-smelling explosive stools, loud rumbling noises coming from the …

Dementia And The Role Of Alzheimer Disease, Jodi Kiessling

Nursing Student Class Projects (Formerly MSN)

Alzheimer disease is a progressive disease causing cognitive and functional decline with the hallmark sign of plagues and tangles within the brain. Genetics, inflammation, accumulation of beta-amyloid protein and breakdown of the blood brain barrier are all contributing factors in the disease. Treatment is not curative and is focused on symptom management and management of pre-existing chronic diseases.

Pheochromocytoma, Cody Plapp

Nursing Student Class Projects (Formerly MSN)

• Pheochromocytoma presents with unusual symptomology and can remain difficult to diagnose. Early detection is paramount along with pre-surgical pharmacological intervention for best outcomes. Decrease manipulation of tumor to avoid additional secretion of catecholamine (Chung et al., 2018). From an anesthesia perspective, pheochromocytomas in patients presents a severe risk to the preservation of life pre, intra, and post-operatively. It remains necessary to prevent hemodynamic instability and to prevent administration of drugs which may elicit hemodynamic instability, since prolonged hemodynamic instability may lead to loss of life or chronic disability (Sonntagbauer et al., 2018).

Sickle Cell Anemia, Esther Bassaw

Nursing Student Class Projects (Formerly MSN)

Sickle cell anemia (SCA) is an inherited autosomal recessive disorder of red blood cell caused by an abnormality of hemoglobin called sickle hemoglobin (HbS) (Centers for Disease Control and Prevention (CDC), 2017). African countries carry the highest incident of individuals with the SCA(CDC, 2017). In the United State, approximately 1 in 12 African-Americans carry the trait for SCA, and 1 of every 350 African-American infants born have the disorder (CDC, 2017). Individuals with sickle cell disease exhibit significant morbidity and mortality. Clinical manifestations of SCA are chronic hemolysis and acute vaso-occlusive crisis, which causes severe pain, infections, and chronic organ …

Opiate Addiction And Considerations For Anesthesia, James Saltanovitz

Nursing Student Class Projects (Formerly MSN)

Opiate addiction and awareness are problems and should be of interest to our society, particularly those working in healthcare. This poster provides statistics that provide the reader with information of the depth of the problem in the United States. The poster presents information for the reader to better understand opiate addiction’s pathophysiology, signs, and symptoms. For anesthesia providers there are many different evaluations that can be made to make sure that us at risk or opiate dependent patients are safe while under anesthesia. The poster presents many alternative options to help prevent patients’ from feeling pain, while also keeping them …

Augmented Mean Arterial Blood Pressure And Vasopressor Selection In Patients With Spinal Cord Injury, Jayme Schroeder

Nurse Anesthesia Student Capstones

Blood pressure management in the acute period following spinal cord injury is a critical concern; one that anesthesia and critical care providers are often able to directly measure and regulate. It has been hypothesized that supraphysiologic blood pressure maintenance during this acute phase may improve recovery, however there is limited high-quality evidence to reinforce and guide management. Based on included prospective and retrospective studies, which provide the highest level of evidence available, The American Association of Neurologic Surgeons does provide the following level III recommendation: MAP goals of 85–90 mm Hg for 5–7 days post-injury should be considered. With regard …

Safe Sleep In The Nicu., Amy Rudd

Doctor of Nursing Practice Papers

Sleep related infant deaths continue to be an issue in Kentucky with 95% of deaths having at least one sleep related risk factor identified. Evidence from the literature suggests safe sleep practice in the neonatal intensive care unit is inconsistent and nurses may face many barriers when implementing safe sleep. The purpose of this project was to determine current nursing knowledge and practice of safe sleep, as well as how parent education occurs in a local NICU through the use of a survey. The survey was developed and distributed to staff at University of Louisville Hospital NICU nurses to determine …

Analysis Of Unplanned Extubations At A University Neonatal Intensive Care Unit., Elizabeth Turcotte

Doctor of Nursing Practice Papers

Unplanned extubations represent a serious adverse event that occurs within neonatal intensive care units. The current literature on unplanned extubations suggests that the incidence of these events can be reduced in the clinical setting. UEs represent the primary respiratory-related adverse event in the neonatal intensive care unit (NICU) and can result in cardiopulmonary collapse requiring emergent reintubation (Carvalho, Mezzacappa, Calil, & Machado, 2010). Staff members of the University of Louisville’s neonatal intensive care unit collected data surrounding unplanned neonatal extubations from November 2017 through December 2018. These data have been used to target modifiable risk factors temporally associated with unplanned …

The Effect Of High Flow Nasal Cannula Weaning Protocol On Decreasing Length Of Stay In Pediatric Intensive Care., Debbie Farrell

Doctor of Nursing Practice Papers

Background: High-flow nasal cannula (HFNC) is a type of non-invasive respiratory support that has decreased the rate of intubation in infants and children. It is utilized in the PICU and the wards. Due to the increased volume of patients on HFNC, a standard HFNC weaning protocol was created to improve the management of these patients.

Methods: Potential patients were identified through the Virtual Pediatric System (VPS) with the criteria of ages 1 month to 6 years old, admitted to the PICU during the months of January to March of 2018 and 2019, with diagnosis of bronchiolitis and requiring HFNC. Chart …

Implementation And Evaluation Of A Neonatal Chest Tube Simulation Lab For App Competency., Tracey Miller

Doctor of Nursing Practice Papers

Pneumothorax in the neonatal period is a potentially life threatening condition that requires Neonatal Advanced Practice Providers to respond rapidly and competently in order to prevent complications of morbidity and mortality. It has become increasingly difficult to establish initial competency as well as maintain competency in low volume high acuity emergency procedures such as chest tube placement. The purpose of this practice based quality improvement project was to implement a simulation based training program in chest tube placement for the Neonatal Advanced Practice Providers within Norton Children’s Neonatology. The goal was to have all Advanced Practice Providers (APP) be able …

Spring Into Action: Role Models For Sun Safety., Kelsey A. Grothouse

Doctor of Nursing Practice Papers

Ultraviolet radiation during childhood increases a person's risk for skin cancer later in life. Research has provided support for a multifaceted intervention that targets youth in order to decrease these future risks. The purpose of this paper is to discuss the implementation of an intervention that taught youth athletic football coaches and parent helpers to act as role models and influence sun safe behavior in their youth athletes in order to help reduce the carcinogenic effects of UV radiation in the future. The intervention consisted of a one-hour training session with coaches and parent helpers of a youth football team …

Carbon Dioxide Embolisms During Laparoscopic Surgery, Leanne M. Jobin

Nurse Anesthesia Student Capstones

With the advancement of technology over the past few decades, laparoscopic surgery has significantly increased in popularity among many surgical subspecialties including: general surgery, gynecology, and urology. Many procedures that traditionally required open access with large incisions have been replaced with laparoscopic approaches as it offers many advantages such as, faster recovery, less postoperative pain, and shorter hospital stays. Despite its many advantages, it creates numerous anesthesia challenges and considerations when caring for patients undergoing laparoscopic procedures. Among these challenges, are carbon dioxide embolisms. This manuscript involves research and previous case studies that were conducted on carbon dioxide embolisms during …

Neonatal Nurses’ Knowledge And Assessment Of Necrotizing Enterocolitis (Nec) In The Premature Infant., Kathryn Taylor Van Hoose

Doctor of Nursing Practice Papers

Necrotizing Enterocolitis (NEC) is the most common gastrointestinal emergency seen in the Neonatal Intensive Care Unit (NICU) (Cleveland Clinic, 2015). NEC occurs most frequently in premature infants, accounting for approximately 60 to 80 percent of all cases (Singh et al., 2008). Mortality rates associated with NEC are estimated to be between 20 and 30 percent reaching upwards of 50 percent for patients requiring surgical intervention (Cleveland Clinic, 2015). There is an abundance of research surrounding the pathophysiology, potential causes, and protective factors related to NEC in the premature infant. Comparisons of various interventions such as: feeding practices and protocols, administration …

Decreasing Musculoskeletal Injuries Among Operating Room Personnel Through The Use Of Anti-Fatigue Mats., Hannah Raake

Doctor of Nursing Practice Papers

Work-related musculoskeletal disorders (WRMDs) are a common occurrence among operating room (OR) personnel due to certain job requirements including standing in a static position for long periods of time. The American Association of Operating Room Nurses (AORN) ergonomic guidelines support interventions (anti-fatigue mats, shoe in-soles, etc.) aimed at decreasing the rates of WRMDs among OR personnel. A 3-month pre- and post-intervention trial was established at one Southern Indiana hospital to assess the efficacy of anti-fatigue mats in the OR theatre. Two anti-fatigue mats were placed in each OR, cardiovascular operating room (CVOR), and endoscopy room for use with each case. …

Infuse!_Volume 3_Number 1_ 2019, College Of Nursing

Infuse! College of Nursing Magazine

No abstract provided.

Evidence-Based Cardiac Monitoring: A Practice Change, Joseph Paul Urbanski

Doctoral Projects

Background: Overuse of cardiac monitoring (CM) in acute care settings contributes to increased healthcare spending and cost of services for patients. Additionally, inappropriate use of CM can contribute to wastefulness of healthcare resources, increases in hospital staff workloads, and can be improved with best evidence-based practice recommendations. A Midwest acute care hospital lacked an evidence-based, systematic method to define care for patients requiring CM.

Objective: The purpose of the project was to pilot an evidence-based CM change initiative, determine feasibility for sustainment, and propose next steps for adoption of the change initiative across non-emergency department, non-intensive care inpatient CM units …

Reproductive Risk Factors Of Thyroid Cancer Among Females: A Hospital Based Case Control Study, Aseela S Ms, Athirarani M. R Ms, Sasikala

Manipal Journal of Nursing and Health Sciences

Introduction: The most frequent endocrine malignancy seen in adults is thyroid cancer. The incidence of thyroid cancers are increasing all over the world. It is one of the cancers in women diagnosed at a younger age. The objective of the study was to identify reproductive risk factors of thyroid cancer among females. Material and methods: The research design used was a hospital-based-case-control study. The samples were 86 cases and 172 controls recruited from the surgical outpatient department of Medical college hospital, Thiruvananthapuram. Cases were patients who had undergone thyroidectomy and histopathological examination confirmed of thyroid cancer and controls were patients …

School Of Nursing Newsletter Summer 2019, Southern Adventist University School Of Nursing

Southern Nursing - School of Nursing Newsletter

The Summer 2019 issue of the newsletter features information on accreditation renewal, appointment of Dr. Holly Gadd as dean, nursing honor class awards, spring break mission trips, faculty updates, and Campus Research Day.