Nursing Commons^™

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …

Improving Nursing Knowledge On Antibiotic Therapy To Prevent Pneumonia Readmissions, Muskuda Deen

Walden Dissertations and Doctoral Studies

Lack of education on the appropriate use of antibiotic therapy can lead to an increase in early readmissions for patients with community-acquired pneumonia (CAP). The purpose of this project was to educate medical-surgical nurses at an inpatient hospital in the southern region of the United States on the appropriate use of antibiotic therapy to decrease early CAP readmissions. The project practice question was whether the infection control clinical practice guidelines would increase the medical-surgical nurses’ knowledge on the appropriate use of antibiotic therapy to decrease the 30-day readmission rates for patients diagnosed with CAP. The staff education development was guided …

Staff Education On The Use Of The Lace Index In Clinical Settings, Carrole Dorcent

Walden Dissertations and Doctoral Studies

As of 2008, the Centers for Medicare and Medicaid Services has instituted monetary penalties for institutions with excess readmissions. As a result of these initiatives, hospitals are investing resources and efforts to educate their staff to use tools aimed at reducing readmission rates. The LACE index tool is one metric used to identify patients at high risk for readmission. The practice-focused question addressed in this project was whether the use of a teaching module is effective at improving clinical staff knowledge on the LACE index. The purpose of the project was to develop a teaching module to educate advanced practice …

The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu

Walden Dissertations and Doctoral Studies

Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital …

Effective Postdischarge Communication From Nursing Staff To Mental Health Patients, Paula Renee Garrison

Walden Dissertations and Doctoral Studies

AbstractMental health patients have a history of decreased follow-up appointments, poor diet, and medication noncompliance after discharge from inpatient facilities in addition to multiple co-morbidities, making a return to the community difficult. The practice problem was an increase in hospital readmissions of mental health patients within 30 days postdischarge due to inadequate post-discharge education and follow-up communication. Using Rodgers’s recovery on mental health theory and Revan’s action learning theory, a staff education program was developed to educate 10 nursing staff and two social workers on how to effectively implement postdischarge communication at 3 days and 30 days after discharge from …

Added Sugar Consumption And Prediabetes In U.S. Adults: A Cross-Sectional Analysis Of The National Health And Nutrition Examination Survey, 2013-2018, Nadia Markie Sneed

All ETDs from UAB

Prediabetes is a modifiable risk factor for type 2 diabetes (T2D) that effects 88- million U.S. adults. Added sugar is linked to the risk for prediabetes through direct and indirect mechanisms that promote hepatic and whole-body insulin resistance. Added sugar is overconsumed and totals ~13% of American’s daily caloric intake, with consumption highest for non-Hispanic Blacks and Hispanic minority populations also disproportionality affected by prediabetes and T2D. The effects of total added sugar on prediabetes have been mixed; however, total added sugar intake has primarily been examined using added sugar proxies (e.g., sugar-sweetened beverages, fructose), likely increasing systemic measurement error …

Influence Of Race, Gender, Rurality, And Dyadic Health On Symptom Pattern Trajectories In Persons With Advanced Heart Failure, Macy Lynn Stockdill

All ETDs from UAB

Individuals living with heart failure experience a high symptom burden that must be addressed to improve their quality of life as well as the quality of life of their family caregivers. This is a challenging task as different situational and individual factors, including clinical/physiological factors and cultural factors, can affect an individual’s symptom experience. The purpose of this dissertation study was to examine existing symptom pattern trajectories and associated factors (sociodemographic, clinical/physiological characteristics, dyadic health) among a sample of under-resourced and racially diverse older adults with advanced heart failure living in the Deep South. This purpose was accomplished through four …

Developing A Core Set Of Nursing-Sensitive Indicators For International Pediatric Oncology Nursing Practice, Courtney Erin Sullivan

All ETDs from UAB

Although nursing sensitive indicators (NSIs) have been developed to measure factors influencing nursing care quality and patient outcomes in general and in select specialty areas, a core set of NSIs for international pediatric oncology nursing practice does not exist. Quality nursing care delivery in pediatric oncology is essential to achieving optimal patient outcomes and closing the 50% survival gap between high-income and low- and middle-income countries. To enhance global childhood cancer outcomes influenced by nursing, this dissertation research was conducted with the purpose of developing a preliminary core set of NSIs for international pediatric oncology nursing that is important, actionable, …

An Evaluation Of The Impact Of Medical Home Structures And Care Processes On Temporary Profile Days Among Active-Duty U.S. Army Soldiers, Tanekkia M. Taylor-Clark

All ETDs from UAB

Readiness, the Armed Forces’ ability to carry out a range of military operations, is one of the U.S. Army’s highest strategic priorities. The medical readiness of soldiers is a critical component of overall operational readiness. The greatest threat to medical readiness is acute musculoskeletal injuries (MSIs). Medical providers place soldiers on medical limitations referred to as a “temporary profile” to facilitate treatment and recovery of acute MSIs. Poorly managed temporary profiles negatively impact soldiers’ work attendance and performance, leading to the loss or limitation of over 25 million training/duty days annually. Changes within the primary care setting, including implementing the …

Implications Of Day-To-Day Oulsatility Index Change And Corticosteroid Use In Pediatric Traumatic Brain Injury, Jeremy D. Jordan

All ETDs from UAB

A traumatic brain injury (TBI) is a disruption of the normal function and structure of the brain after a direct or indirect injury. In children, TBI continues to be a significant cause of mortality resulting in the death of over 20 children per day in the United States (Reuter-Rice et al., 2015). Additionally, children who survive TBI have increased rates developmental delay, physical disabilities, neurologic impairment, and mental health disorders (Barlow et al., 2005). A TBI occurs in two phases. The primary injury is the physical insult to the brain that occurs at the time of the injury. The secondary …

The Relationship Between Anosgnosia For Hemiplegia After Stroke And Fall Events In The Acute Inpatient Stroke Rehabilitation Population, Elizabeth Mosley Byrd

All ETDs from UAB

Background/Significance: Inpatient falls on acute stroke rehabilitation units remains a significant issue that negatively affects healthcare costs and causes physical and psychological injury. Prevelance of falls in the stroke rehabilitation population may be due to the presence of anosognosia for hemiplegia (AHP), which is as an unawareness of physical disability. Though the link between AHP and falls has been suggested in the literature, a formal investigation has not been conducted to address the relationship between the variables. Purpose: To explore the association between the presence of anosognosia for hemiplegia after stroke and patient fall events while admitted to an acute …

An Exploration Of The Manifestation Of Parentification Among Young Carers Of Persons With Huntington’S Disease, Bailey Hendricks

All ETDs from UAB

Due to the progressive deterioration of motor, cognitive, and psychological function experienced by individuals diagnosed with Huntington’s disease, there is the potential for children in the home to adopt a caregiving role. These young carers typically serve as informal, secondary caregivers, providing multifaceted, extended care without any lessening of typical family, home, or school/work-related responsibilities. In time, this role may result in parentification, a type of role reversal with both positive and negative outcomes for the child. A secondary analysis of qualitative data of the experiences of children who have a parent with Huntington’s disease was conducted. Transcripts of qualitative …

Challenges For Nurse Anesthetists Re-Entering Practice Following Substance Use Disorder Treatment, T'Anya Marye Carter

All ETDs from UAB

Substance use disorder (SUD) is a persistent, relapsing condition that is present in approximately 10% of anesthesia providers, who, compared to other healthcare providers, face a greater risk of developing an SUD by virtue of constant access to medications. The ability of Certified Registered Nurse Anesthetists (CRNAs) to obtain employment or maintain employment after treatment for SUD treatment is not well documented. CRNAs in recovery from SUD in the United States experience challenges when attempting to return to work following treatment for SUD for reasons yet to be identified. The purpose of this qualitative multiple-case study was to explore the …

Interprofessional Reflective Journals: Content Themes And Self-Regulated Learning, Joan M. Tunningley

Journal of Occupational Therapy Education

Self-reflection has been linked with clinical reasoning, academic, and clinical outcomes. The purpose of this study was to examine self-reflective journal entries from thirty students for interprofessional core competencies and for self-regulated learning components. The text data was analyzed using an in-depth three cycle coding process, thoroughly described in the methods. The findings were structured into two themes confirming interprofessional content learning: collaboration, team, and communication; and respect and roles. One additional theme emerged, transformation and relatedness, which indicated self-regulated learning components as well as supporting transformative learning. This qualitative case-study contributed to the research of occupational therapy students’ self-reflection …

Maternal Depression Trajectories And Child Bmi In A Multi-Ethnic Sample: A Latent Growth Modeling Analysis, Charlotte V. Farewell, Ryley Donohoe, Zaneta Thayer, James Paulson, Jacinda Nicklas, Caroline Walker, Karen Waldie, Jenn A. Leiferman

Psychology Faculty Publications

Background

Perinatal (antenatal and postpartum) depression impacts approximately 12% of mothers. Perinatal depression can impact everyday functioning for mothers, and the relationship with, and development of, their children. The purpose of this study was to investigate depression trajectories from the antenatal period through 54-months postpartum and associations with child body mass index at 54-months postpartum.

Methods

This study applied latent growth modeling to the Growing Up in New Zealand study, which is a longitudinal pregnancy cohort study that provides nationally representative-level data, to investigate associations between depression at three time points (antenatal, 9-months postpartum, 54-months postpartum) and child body mass …

The Role Of Sleep Curtailment On Leptin Levels In Obesity And Diabetes Mellitus, Maryam Mosavat, Mitra Mirsanjari, Diana Arabiat, Aisling Smyth, Lisa Whitehead

Research outputs 2014 to 2021

Emerging evidence has identified sleep as a significant, but modifiable, risk factor for metabolic syndrome, diabetes, and obesity. Leptin, an adipocyte-derived peptide and a regulator of food intake and energy expenditure, has been shown to be associated with a short sleep duration in the pathophysiology of obesity and consequently type 2 diabetes. This review focuses on the current evidence indicating the effects of a short sleep duration on the regulation of leptin concentration in association with obesity and diabetes mellitus. In summary, the evidence suggests that sleep deprivation, by affecting leptin regulation, may lead to obesity and consequently development of …

How Is Organisational Fit Addressed In Australian Entry Level Midwifery Job Advertisements, Dianne Bloxsome, Courtney Glass, Sara Bayes

Research outputs 2014 to 2021

Background: Midwifery job retention is an ongoing global issue. Prior research has recognised that considering an individual’s attributes in relation to their work environment may assist in improving job satisfaction among midwives, leading to improved long-term job retention in the midwifery profession. The aim of this study was to evaluate whether, and how organisational fit is addressed in current entry level midwifery job advertisements within Australia. Methods: Midwifery jobs were searched for within 12 search engines, using the search term ‘midwife’, including Seek.com, Indeed.com, government employment websites for all Australian states and territories, and private health organisation websites. Data were …

Comparing An Ehealth Program (My Hip Journey) With Standard Care For Total Hip Arthroplasty: Randomized Controlled Trial, Rosemary Saunders, Karla Seaman, Laura Emery, Max Bulsara, Catherine Ashford, Judith Mcdowall, Karen Gullick, Beverley Ewens, Trudy Sullivan, Charlotte Foskett, Lisa Whitehead

Research outputs 2014 to 2021

Background: The role of eHealth programs to support patients through surgical pathways, including total hip arthroplasty (THA), is rapidly growing and offers the potential to improve patient engagement, self-care, and outcomes. Objective: The aim of this study is to compare the effects of an eHealth program (intervention) versus standard care for pre- and postoperative education on patient outcomes for primary THA. Methods: A prospective parallel randomized controlled trial with two arms (standard care and standard care plus access to the eHealth education program) was conducted. Participants included those who underwent THA. Outcome measures were collected preadmission, at 6 weeks, and …

Development Of A Breech-Specific Integrated Care Pathway For Pregnant Women: Protocol For A Mixed Methods Study, Sara Morris, Sadie Geraghty, Deborah Sundin

Research outputs 2014 to 2021

Background: The development of an integrated care pathway with multidisciplinary input to standardize and streamline care for pregnant women experiencing breech presentation at 36 or more weeks of gestation poses several challenges because of the divisive and contentious nature of the phenomenon. Although many clinicians are interested in obtaining the skills required to safely support women desiring a vaginal breech birth, the primary trend in most health care facilities is to recommend a cesarean section. Objective: This paper aims to discuss the mixed methods approach used in a doctoral study conducted to generate new knowledge regarding women’s experiences of breech …

Going-It Alone: The University Progression Of Women Nursing Students Who Are The First Person In Their Intimate Relationship To Go To University, Lesley Andrew, Leesa Costello, Ken Robinson, Julie Dare

Research outputs 2014 to 2021

© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This article argues for an expansion of the idea of the first-in-family student to include the student whose spouse or partner has not been to university. Between 2015 and 2016, a qualitative longitudinal study, guided by Gadamer’s hermeneutic philosophy, was undertaken. Twenty-nine undergraduate women nursing students who began university in a heterosexual intimate relationship participated. All 29 were interviewed in their fourth semester of their degree (or part-time equivalent), and 23 of these 29 completed a second interview in their last semester. Thematic analysis of …

Sociocultural Practices Affecting The Care Of Preterm Infants In The Ghanaian Community, Esther Abena Adama, Deborah Sundin, Sara Bayes

Research outputs 2014 to 2021

Introduction

Although culture is an integral part of health, there is scarcity of evidence on the influence of culture on caregiving experiences of parents of preterm infants. The aim of this study was to explore the influence of sociocultural practices on caring for preterm infants in the Ghanaian community.

Method

Narrative inquiry was utilized to explore the influence of sociocultural practices on the care of preterm infants from 21 mothers, 9 fathers, and 12 household members. Data were collected through face-to-face semistructured interviews and observations at participants’ homes.

Results

Analysis of data resulted in three threads/themes—respect for the elderly, use …

Questionnaires To Measure Process And Structure Of Quality Indicators For Pediatric Nursing, Maria Forsner, Evalotte Mörelius, Lena Hanberger

Research outputs 2014 to 2021

Introduction The quality of nursing care has a significant impact on the outcomes of care. The specific needs of children requiring hospital care make it essential to monitor and compare data not only on the medically oriented outcome measure but also on nursing care, structure, and process, requiring perspectives from registered nurses (RNs) and nurse managers (NMs). Thus, this project aimed to evaluate the structure and process of nursing quality indicators in pediatric hospital care with questionnaires distributed to RN and NM. Methods We developed separate questionnaires for NMs and RNs to assess the process and structure of the quality …

Intensive Care Nurse-Family Engagement From A Global Perspective: A Qualitative Multi-Site Exploration, Rahel Naef, Petra Brysiewicz, Natalie S. Mc Andrew, Patricia Beierwaltes, Vico Chiang, David Clisbee, Jennifer De Beer, Junko Honda, Shota Kakazu, Martin Nagl-Cupal, Ann M. Price, Sandra Richardson, Anna Richardson, Tara Tehan, Amanda Towell-Barnard, Sandra Eggenberger

Research outputs 2014 to 2021

Background: Critical illness is distressing for families, and often results in negative effects on family health that influence a family's ability to support their critically ill family member. Although recent attention has been directed at improving care and outcomes for families of critically ill patients, the manner in which nurses engage with families is not fully understood. Objectives: To describe nurses’ perceptions and practices of family engagement in adult intensive care units from a global perspective. Design: A qualitative-descriptive multi-site design using content analysis. Settings: The study was conducted in 26 intensive care units of 12 urban, metropolitan, academic medical …

Clinical Staff Perceptions On The Quality Of End-Of-Life Care In An Australian Acute Private Hospital: A Cross-Sectional Survey, Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

Research outputs 2014 to 2021

Objective: To explore the perceptions of clinical staff on the quality of end-of-life care in an acute private hospital. Methods: A descriptive cross-sectional study with a convenience sample of clinical staff in an acute private hospital were surveyed using a validated end-of-life survey. Data from the surveys were analysed using descriptive statistics for quantitative responses and inductive content analysis for the open-ended responses. Results: Overall, 133 staff completed the survey. Of these, 107 had cared for a dying patient in the hospital. In total, 87.6% of participants felt confident in their ability to recognise a dying patient and 66.7% felt …

Midwives’ Strategies For Coping With Barriers To Providing Quality Maternal And Neonatal Care: A Glaserian Grounded Theory Study, Yakubu Ismaila, Sara Bayes, Sadie Geraghty

Research outputs 2014 to 2021

Background: Midwives face direct and indirect barriers in their workplaces that have negative consequences on their ability to provide quality care to women and neonates, however, they still carry on with their duties. This study aimed at investigating the coping strategies that Ghanaian midwives adopt to be able to complete their work. Methods: Glaserian Grounded theory was used in this study. Data were collected through non-participant observations and semi-structured interviews. The study participants included 29 midwives who worked in labour/birthing environments and a pharmacist, a social worker, a national Health Insurance Scheme manager and a health services manager. Findings: The …

Understanding The Barriers To Ghanaian Midwives’ Ability To Provide Quality Care: Using Classic Grounded Theory Methodology In A New Context, Yakubu Ismaila, Sara Bayes, Sadie Geraghty

Research outputs 2014 to 2021

Background:

Interpretive-naturalist methodologies, including Grounded Theory are increasingly being used in health research in Ghana however, none of the studies that have used Grounded Theory in the setting has used the methodology in full.

Aim:

The main aim of this article is to describe the experiences, the strengths and limitations of using Glaserian Grounded Theory methodology to understand the barriers to Ghanaian midwives’ ability to provide quality maternal and neonatal care.

Design:

Glaserian Grounded Theory methodological principles were adhered to in this study in relation to the use of literature, participant recruitment, data collection and analysis, and theory development. Data …

Nursing And Allied Health Staff Perceptions And Experiences Of A Volunteer Stroke Peer Support Program: A Qualitative Study, Rosemary Saunders, Kien Chan, Renée M. Graham, Elena Adams, Caroline E. Bulsara, Karla Seaman, Marcella Cranny-Connolly

Research outputs 2014 to 2021

Purpose: Stroke brings about physical, cognitive, and psychosocial changes and, conse-quently, many stroke survivors feel underprepared for the transition from hospital to home. Nursing and allied health staff have a key role in stroke rehabilitation. Peer support programs have been found effective in supporting stroke survivors, alongside hospital staff caring for stroke patients, by providing experiential knowledge that staff are not able to provide. Aim: This study explored the perceptions and experiences of nursing and allied health staff of a volunteer peer support program for stroke inpatients. Methods: This study utilised a qualitative, evaluative case study design. This study was …

Examining The Average Scores Of Nursing Teamwork Subscales In An Acute Private Medical Ward, Martina Costello, Kylie Rusell, Tracey Coventry

Research outputs 2014 to 2021

Background: Healthcare is delivered by multidisciplinary healthcare teams who rely on communication and effective teamwork to ensure safe patient care. Teamwork builds on employee cohesion and reduces medical and nursing errors, resulting in greater patient satisfaction and improved healthcare. Effective teamwork not only improves efficiency and patient safety but leads to a healthier and happier workplace, reducing burnout among healthcare professionals. The purpose of this paper is to describe the findings of a pilot project on an acute medical ward in Western Australia. The aim was to understand the participants perceived level of teamwork to support future work practices and …

An Early Collaborative Intervention Focusing On Parent-Infant Interaction In The Neonatal Period. A Descriptive Study Of The Developmental Framework, Charlotte Sahlén Helmer, Ulrika Birberg Thornberg, Evalotte Mörelius

Research outputs 2014 to 2021

Moderate to late preterm infants are at risk of developing problems later in life. To support attachment and infants’ development, high quality parent-infant interaction is important. Parent-infant interaction is known to improve through intervention programs but since no such intervention program is addressed directly to moderate to late preterm infants, a tailor-made intervention was developed. The aim was to describe the rationale, development, framework and practical provision of a new early collaborative intervention program. This study has a descriptive design and the intervention is described using the Template for Intervention Description and Replication. During an intervention-session, the preterm infant’s cues …

Estimating The Economic Cost Of Nurse Sensitive Adverse Events Amongst Patients In Medical And Surgical Settings, Aileen Murphy, Peter Griffiths, Christine Duffield, Noeleen M. Brady, Anne Philomena Scott, Jane Ball, Jonathan Drennan

Research outputs 2014 to 2021

Aims: To identify the costs associated with nurse sensitive adverse events and the impact of these events on patients’ length of stay. Design: Retrospective cohort study using administrative hospital data. Methods: Data were sourced from patient discharge information (N = 5544) from six acute wards within three hospitals (July 2016–October 2017). A retrospective patient record review was undertaken by extracting data from the hospitals’ administrative systems on inpatient discharges, length of stay and diagnoses; eleven adverse events sensitive to nurse staffing were identified within the administrative system. A negative binomial regression is employed to assess the impact of nurse sensitive …