Nursing Commons^™

Implementing A Discharge Tool To Decrease The Length Of Stay In The Observation Unit, Mafe Chase, Tyson Hallock

All Nursing Boot Camp Posters

No abstract provided.

Male Involvement In Family Planning Among Squatter Settlement Residents Of Karachi, Fahmida Khowaja, Mehak Pervaiz, Naushaba Khatoon

Journal of Asian Midwives (JAM)

Background: Worldwide, the Contraceptive Prevalence Rate (CPR) increased from 54.8% to 63.3%. However, Pakistan’s current CPR is estimated to be 35%. Men can play an important role in increasing CPR by providing support to their partners, yet their role has been overlooked in targeted reproductive health strategies. The aim of this study was to assess the awareness and practices of married men regarding Family Planning (FP).
Material and Method: This cross-sectional study was conducted among 419 married men, residing in an urban squatter settlement of Karachi. Participants were selected through non-probability convenience sampling and a structured questionnaire was used to …

Higher Education In Midwifery In Pakistan: A Proposed Framework, Rafat Jan, Arusa Lakhani, Karyn Kaufman

Journal of Asian Midwives (JAM)

Access to a skilled professional midwife is the right of each woman. Research evidence shows that midwives prepared to international standards decrease rates of morbidity and mortality and promote health of both mothers and infants. At present, in Pakistan, there are several midwifery cadres, with different formal education levels, who provide maternal and child health services. There are currently three types of diploma programs each serving a different cadre. Until 2012, there was no opportunity to obtain higher education in midwifery in the country. This absence contributed to non-acceptance and invisibility of midwifery as a profession. As a result, midwives …

Cultural Assessment: A Study Of Midwives’ Knowledge, Attitude And Self-Reported Practice In Uganda, Mercy Muwema, Karen Drake, Pamela Friesen, Grace Edwards

Journal of Asian Midwives (JAM)

Background: Cultural assessment is critical due to the increased movement and resettlement of people across the globe, and diverse cultural groups in Uganda. This is putting the health care delivery systems serving the communities under pressure to recognize the different attitudes of people towards health and to develop care systems that are effective in meeting diverse needs. However, despite the importance of cultural assessment in nursing literature, little is known about the cultural assessment competence of Ugandan midwives. This study assessed the knowledge, attitude, and practice of midwives in this assessment process.

Methods: A descriptive correlational design was used to …

Knowledge, Attitudes, And Perceptions Of Nurse Practitioners About Antibiotic Stewardship, Robert M. Hamilton

Theses and Dissertations

Background: Antibiotic stewardship (ABS) is a set of strategies to optimize the use of antibiotics with the goal of reducing antibiotic resistance, improving patient outcomes and decreasing unnecessary costs. ABS affects all venues of patient care, including outpatient, inpatient, and long-term care. While many strategies for ABS exist and best practice continues to evolve, successful ABS programs utilize a multidisciplinary approach. Nurse practitioners (NPs) play an essential role in health care education and represent a valuable potential resource for ABS efforts. The purpose of this study is to describe the knowledge, attitudes, and perceptions of NPs towards ABS.Methods: A convenience …

The Relationship Between Nursing-Faculty Incivility And New-Graduate-Nurse Self-Confidence During Transition To Practice: A Correlational Study, Martha Kershaw

CUP Ed.D. Dissertations

Decreased self-confidence is seen in nursing students who experience nursing-faculty-to-nursing-student-incivility and in new-graduate-nurses during their transition to practice. Using a quantitative correlational design, I examined the relationship between nursing-faculty-to-nursing-student incivility and new-graduate-nurse self-confidence including the extent to which the relationship exists and whether the relationship existed for some groups more than others, specifically male and female nurses, and nurses who graduated from associate’s degree and Bachelor of Science programs. Through the surveys completed by 212 registered nurses who had been practicing less than three years, the participants reported on their experience with nursing-faculty-to-nursing-student incivility using the Perceived Faculty Incivility Scale …

Analysis Of Cell-Free Circulating Tumor Dna In 419 Patients With Glioblastoma And Other Primary Brain Tumors., David E Piccioni, Achal Singh Achrol, Lesli A Kiedrowski, Kimberly C Banks, Najee Boucher, Garni Barkhoudarian, Daniel F Kelly, Tiffany Juarez, Richard B Lanman, Victoria M Raymond, Minhdan Nguyen, Judy D Truong, Annie Heng, Jaya Mini Gill, Marlon G Saria, Sandeep C Pingle, Santosh Kesari

Articles, Abstracts, and Reports

Aim: Genomically matched trials in primary brain tumors (PBTs) require recent tumor sequencing. We evaluated whether circulating tumor DNA (ctDNA) could facilitate genomic interrogation in these patients. Methods: Data from 419 PBT patients tested clinically with a ctDNA NGS panel at a CLIA-certified laboratory were analyzed. Results: A total of 211 patients (50%) had ≥1 somatic alteration detected. Detection was highest in meningioma (59%) and gliobastoma (55%). Single nucleotide variants were detected in 61 genes, with amplifications detected in ERBB2, MET, EGFR and others. Conclusion: Contrary to previous studies with very low yields, we found half of PBT patients had …

Adolescent Obesity In The Past Decade: A Systematic Review Of Genetics And Determinants Of Food Choice, Eleanor T. Campbell, Alexis T. Franks, Paule V. Joseph

Publications and Research

Background and purpose: As the incidence of global obesity increases, concerns about adverse health outcomes in adolescents continues to rise. The complexity and expense of this problem require early recognition and specific preventive treatments. Knowledge of genetics and determinants of food choices contributing to adolescent obesity warrants further examination. The primary goal was to appraise the literature from the past decade (2007–2017) on the current state of food choice and genetic determinants of adolescent overweight/obesity in the United States. The secondary goal was to determine trends in the literature and areas for future research.

Methods: A systematic review of research …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Commencement Program 2019, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2019 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 | Criteria for Institutional Awards—Loma Linda University and Loma Linda University Health

15 | Loma Linda University Health and Loma Linda University Honorees

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

• School of Medicine, 35
• School of Pharmacy, 66
• School of Dentistry, 79
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, …

Asian Midwifery In 2019, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Examining Clinical Indications For Cesarean Section In A University Hospital In Karachi, Pakistan, Zehra Kanji, Shannon D. Simonovich, Nida Najmi, Jessica Bishop-Royse

Journal of Asian Midwives (JAM)

Background and objectives: Current research reports that Pakistan exceeds the recommended percent of deliveries via cesarean sections, including both emergent and non-emergent. In order to better understand the high rate of cesarean sections in Pakistan we examined the medical and non-medical indications of these surgeries at a private university hospital in Karachi.

Methods: A retrospective analysis of patient medical record data was conducted from January 1st, 2018 to March 31st, 2018. The data collected was analyzed using SPSS 25.

Results: The total number of deliveries during the period was n= 1,211, out of which n=602 (49.70%) were CS. The top …

Prior Authorizations And Continued Treatment In Addiction Medicine, Wendy Hunting

Doctoral Projects

Introduction: Patients that require medication assisted treatment for opioid addiction can have their treatment delayed through the prior authorization process. A prior authorization is required by many insurance companies and can cause lengthy delays before the drug is approved. The two drugs that were considered for this project were Suboxone® (buprenorphine/naloxone) and Sublocade® (buprenorphine). These drugs are used for the treatment of opiate addiction. The proposed solution to the problem was to use quality improvement methods to implement a tracking and tickler system to improve the approval time from the insurance company.

Objectives: The project goal was to decrease the …

Social Empathy And Associated Factors Among Nurses: A Mixed Method Study, Gudrun Klim

Loma Linda University Electronic Theses, Dissertations & Projects

The aim of this study was to measure and describe social empathy among nurses and to explore how selected demographic, personal, and work-related factors were associated with social empathy. A cross-sectional, observational research design employing mixed methods (i.e., embedded triangulation with quantitative and qualitative components) was used. Registered Nurses employed at a large northwestern US healthcare system comprised the sample (N = 614 [17% response rate]). The sample was recruited via an email invitation that included a link to the study instruments. These instruments included demographic questions developed by the investigator and the following validated tools: Interpersonal and Social Empathy …

2019 Spring Newsletter, Morehead State University. Nursing Department.

Nursing Department Publications Archive

2019 Spring Newsletter of the Department of Nursing at Morehead State University.

Qualitative Methods Of Road Traffic Crash Research In Low- And Middle-Income Countries: A Review, Benjamin D. Holmes, Kristin Haglund, Kirsten M.M. Beyer, Laura D. Cassidy

College of Nursing Faculty Research and Publications

Road traffic crashes are rapidly becoming one of the leading causes of injury and death globally. It is predicted that by 2030 crashes will become the fourth leading cause of disability-adjusted life years (DALYs) (Mathers & Loncar, [11]) and the seventh leading global cause of death (World Health Organization [WHO], [26]). The global death toll due to crashes has already escalated by 46% over the past two decades (The World Bank, [21]).

Low- and middle-income countries (LMICs) are acutely affected by this 'hidden epidemic' (Balch, [ 1]). Ninety per cent of the world's crash-related deaths occur in LMICs where only …

“I Am A Runner”: A Qualitative Analysis Of Women-Runners’ Pregnancy Experiences, Jennifer M. Ohlendorf, Anna L. Anklam, Lindsay Gardner

College of Nursing Faculty Research and Publications

Background

Women runners are a group with potential for health maintenance and health promotion in pregnancy. When providers counsel women to discontinue or cut back on running without cause, an opportunity for health benefits to both woman and baby may be lost.

Aim

This study aims to explicate the experience women runners have in pregnancy to further providers’ understanding of this population’s unique needs.

Methods

An online, qualitative inquiry was employed to explore the experiences of an online community of women runners in pregnancy (N = 22). The Doing Pregnancy framework provided guidance for final stages of the analysis.

Findings …

Interdisciplinary Collaboration Needed In Obtaining High-Quality Medical Information In Child Abuse Investigations, Elizabeth Cleek, Norah L. Johnson, Lynn K. Sheets

College of Nursing Faculty Research and Publications

Background

Despite reporting legislation, healthcare providers (HCPs) do not always report and collaborate in cases of suspected child abuse. Recognizing this leaves children at risk, the Wisconsin Child Abuse Network (WI CAN) sought to understand barriers to mandated reporting and collaboration with child abuse investigators.

Objective

The purpose of the study was to investigate barriers for professionals in providing and obtaining high-quality medical information in child abuse investigations.

Participants and setting

Participants included five discipline-specific focus groups: HCPs, child protective services (CPS), law enforcement, lawyers, and judges. All professionals had been directly involved in Wisconsin child abuse cases.

Methods

This …

Functional Exercise Improves Mobility Performance In Older Adults With Type 2 Diabetes: A Randomized Controlled Trial, Kimberlee A. Gretebeck, Caroline S. Blaum, Tisha Moore, Roger Brown, Andrzej Galecki, Debra Strasburg, Shu Chen, Neil B. Alexander

College of Nursing Faculty Research and Publications

Background: Diabetes-related disability occurs in approximately two-thirds of older adults with diabetes and is associated with loss of independence, increased health care resource utilization, and sedentary lifestyle. The objective of this randomized controlled trial was to determine the effect of a center-based functional circuit exercise training intervention followed by a 10-week customized home-based program in improving mobility function in sedentary older adults with diabetes.

Methods: Participants (n = 111; mean age 70.5 [7.1] y; mean body mass index 32.7 [5.9] kg/m²) were randomized to either a moderate-intensity functional circuit training (FCT) plus 10-week home program to …

A Patient-Centered Medical Home Model For Improvement Of Healthcare For The Homeless Population: An Integrative Review, Dale Ellen Strickland

Doctoral Dissertations and Projects

The homeless population is surrounded by many obstacles while trying to obtain the essentials of life including food, water, shelter, clothes, medical care, and safety. In many areas of the United States and other countries homelessness is becoming an increasing problem. Compared to standard healthcare, the Patient-Centered Medical Home Model is offering a better experience for homeless patients. This integrated review provides a selection of published studies and information on the homeless population and the beginning of the Patient-Centered Medical Home Model to improve access and healthcare to many homeless patients. As the model is accepted by more medical professionals, …

State Requirements For Mandatory Vaccine Education Prior To Exemption, Chelsea Lynn Schult

Theses and Dissertations

Background: To prevent the spread of Vaccine Preventable Diseases (VPD’s), school-aged children in the United States are required to receive vaccinations. In certain states, parents have the option to exempt their child from becoming vaccinated due to medical, religious, or personal reasons. The purpose of this research was to identify which states require mandatory vaccination education prior to granting vaccine exemptions and to identify the various types of required vaccination education.Methods: Immunization program managers from states requiring parents seeking exemptions to receive mandatory vaccination education were asked a series of open-ended questions. The interviews were conducted via telephone. The education-related …

Framework For Collaborative Teaching: Strengths And Challenges For A Different Service Paradigm In Haiti, Patricia Mason, Judith C. James-Burga

Journal of Global Education and Research

Nursing education in Haiti is in transition. This article describes the teaching/learning experiences of participants in a nursing educational project in Haiti. The project was guided by an integrative framework of the educational collaborative model, constructivism and situated learning theory. Reflections on the experiences lead to the realization of these four lessons: (a) the service provided must supplement, not negate the values and strengths of the host community; (b) it is important to provide sustainable service; (c) methods used by international educators must be respectful and relevant; and (d) international educators must be willing to engage in the identification and …

Developing Resilience Training For The Healthcare Employee In A Rural Medical Center, Sandra E. Gothard

Electronic Theses and Dissertations

In the clinical setting and in their personal lives, health professionals are confronted with many stressors that impact their time and the clarity of their role. Stressors are emotional, moral, or spiritual in nature as a result of exposure to suffering and death. There are often occupational stressors, such as reduced social support, excessive workload, or a prolonged misalignment among personal needs, individual values, and the work role. As a result of these challenges, health care employees need to create coping skills when stressors and demands become hindrances to personal well-being and their professional ability to care for others. Developing …

Ibuprofen Does Not Increase Blood Pressure In Preeclampsia, Sofia Costas, Sherry Hutton, Cindy Kenyon

Books, Presentations, Posters, Etc.

Objective: The aim of this IRB approved study was to evaluate the impact of ibuprofen on Mean Arterial Pressure (MAP) in the immediate postpartum period of women with preeclampsia.

Design: A retrospective chart audit of 633 preeclampsia patients who had treated severe hypertension (BP > 160/105) during their hospital stay.

Setting: Metropolitan Level 3 facility in Portland OR.

Patients/Participants: 169 patients met criteria; received magnesium sulfate postpartum and had severe hypertension postpartum. 60 were randomly selected, 30 received ibuprofen, 30 did not.

Methods: Baseline was obtained at 2 hours postpartum. Each patients MAP for each 24 hour interval were …

Use Of A Communication Tool To Improve The Perception Of Continuity Of Care, Annette Lotz

Electronic Theses and Dissertations

Inadequate or incorrect communication during transfer from skilled nursing facilities leads to misunderstandings about patient care needs, jeopardizes patients’ trust in the health care system, and leads to poor clinical outcomes. Due to gaps in communication from one health care setting to another, it was essential to determine if a patient-centered discharge tool would improve patients’ perception of continuity of care. The purpose of the study was to implement a patient-centered tool that would help improve the information needed at the time of discharge from a skilled nursing facility. Roy’s Adaptation Model supports the relevance of effective communication in the …

Enhancing Chronic Pain Management Motivational Interview Among Lower Back Pain Patients, Melissa L. Hines-Antico

Doctor of Nursing Practice Final Manuscripts

Purpose: Untreated chronic pain is a nationwide epidemic affect individual physically, psychologically, and financially. Low back pain is the most common subset of chronic pain. Restricted clinic time and a focus on procedural/prescriptive methods for managing pain prohibits patient education regarding self-care, and formation of a relationship with the provider.

Design: Article review yielded 20 articles that supported the use of motivational interviewing for chronic pain in lower back pain patients. They were evaluated for their strength of evidence on a scale of 1-6. One article was ranked level I as a meta-analysis, and six were ranked as level II …

Implementation Of An Evidenced-Based Concussion Management Protocol Utilizing Telemedicine In A Student Health Center, Shelly Benfield

Doctor of Nursing Practice Final Manuscripts

Background: An estimated 3.8 million concussions occur yearly in the United States and the incidence of youth concussions is on the rise. If untreated or unrecognized, more serious complications of concussions include post-concussion syndrome, second impact syndrome, and chronic traumatic encephalopathy. Clinic leadership in a southern California student health center identified systematic inefficiencies and noted a lack of standardized follow-up concussion appointment times which resulted in decreased clinic efficiency.

Purpose: The purpose of this evidenced-base project was to implement an effective concussion protocol and follow-up treatment plan that would improve clinic efficiency without negatively impacting concussion outcomes.

Evidence-based Interventions: A …

Variables Associated With Successful Vascular Access Cannulation In Hemodialysis Patients: A Prospective Cohort Study, Linda L. Coventry, Jon M. Hosking, Doris T. Chan, Evelyn Coral, Wai H. Lim, Amanda Towell-Barnard, Diane E. Twigg, Claire M. Rickard

Research outputs 2014 to 2021

BACKGROUND: Successful vascular access (VA) cannulation is integral to the delivery of adequate dialysis, highlighting the importance of ensuring the viability of arteriovenous access in hemodialysis (HD) patients. Missed VA cannulation can lead to infection, infiltration, hematoma or aneurysm formation resulting in the need for access revision, central venous catheter (CVC) placement, or permanent loss of VA. Cannulation-related complications can also negatively impact on a patient's dialysis experience and quality of life. This study aimed to identify patient, VA and nurse factors associated with unsuccessful VA cannulations.

METHODS: A prospective cohort study was conducted in HD patients with a permanent …

Use Of New Oral Anticoagulants In Preventing Ischemic Stroke In Patients With Atrial Fibrillation, Travis Hunt, Blaine Winters, Rod Newman

Student Works

Atrial fibrillation (AF) affects millions of Americans and puts them at increased risk for ischemic stroke. It is important for providers to recognize AF and know when it is appropriate to treat patients with anticoagulation. There are several options available for anticoagulation. Warfarin is the most widely used anticoagulant. Other alternatives to warfarin are new oral anticoagulants (NOACs) which are increasingly prescribed in recent years. It is vital providers know the differences between warfarin and NOACs, and what is the most appropriate anticoagulant to use for their patient with AF. The purpose of this paper is to review the clinical …

Use Of Best Practice Alerts To Improve Adherence To Evidence-Based Screening In Pediatric Diabetes Care, Daniel Desalvo, Sara K. Bartz, Blair Mockler, Rona Y. Sonabend

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: Youth with type 1 diabetes (T1D) are at increased risk for comorbid autoimmune conditions and long-term complications. To help with early identification of these complications, the American Diabetes Association (ADA) has published evidence-based screening guidelines. The aim of our quality improvement intervention was to improve and sustain adherence to the ADA recommended screening guidelines to >90% for youth with T1D in the Texas Children’s Hospital (TCH) Diabetes Center by utilizing best practice alerts (BPA) within the electronic medical record (EMR).

Methods: In accordance with the ADA Standards of Care screening guidelines for youth with T1D, we analyzed the database …