Nursing Commons^™

The Impact Of Role Perception Gaps Among Nurses: An Integrative Review, Anita Fennessey, Drnp, Rn, Cne

College of Nursing Posters

Background & Significance

• Inadequate communication has consistently been indicated as a contributor to adverse events in all areas of healthcare (Paltved et al, 2017).
• Factors related to individual, team, work environment, organizational and institutional aspects have also been shown to influence patient safety, with increased chances of causing patient harm (Rezende da Silva dos Santos, Campos & Celestino da Silva, 2018).
• Efficient communication among healthcare members is considered a contributing element in promoting a culture of safety (Rezende da Silva dos Santos, Campos & Celestino da Silva, 2018).
• Errors in communication can compromise continuity of care and place patient safety …

Early Activity And Mobility Of Intensive Care Unit Patients To Reduce Hospital Length Of Stay And Improve Patient Outcomes: An Integrative Review, Scott D. Crofts

Doctoral Dissertations and Projects

Patient physical inactivity during hospital admission is a key contributor to increased length of stay and poor outcomes. Patient inactivity and immobility in the intensive care unit (ICU) setting promote the loss of physical function and increase the risk of complications such as pressure injuries, bone demineralization, lung infections, and ICU delirium. The cumulative effects of immobility are persistent through discharge, as patients are at risk for the long-term effects of posthospitalization muscle atrophy and weakness. The purpose of this integrative review was to examine current evidence to determine if early activity and mobility in the ICU setting reduce length …

The Lived Experiences Of Faculty Conducting Post-Simulation Debriefing In Nurse Practitioner Programs, Jodi Borden Duncan

Doctoral Dissertations and Projects

Simulation-based education is a teaching–learning pedagogy widely used in nursing programs today. While much research has been done on student perceptions of simulation and the fact most learning occurs in the post-simulation debriefing session, little research has been done on how learning takes place in debriefing. Nurse practitioner faculty also use simulation as a teaching methodology, but the implementation of debriefing methods and faculty experiences with debriefing sessions are not known. As simulation may not be counted as direct clinical hours in nurse practitioner programs, more research must be done before the substitution of hours can be considered. The substitution …

The Effects Of Dietary And Lifestyle Management On Diabetic Neuropathy, Courtney Renee Wyatt

Doctoral Dissertations and Projects

Numerous patients who have uncontrolled diabetes have developed complications associated with diabetic neuropathy. The apparent knowledge deficit and noncompliance have led to the development of clinical concerns related to improving patient outcomes. This scholarly project assesses the effects of dietary, weight, and exercise management on improving diabetic neuropathy symptoms. The debilitating effects of diabetes continue to affect numerous people each day. Uncontrolled diabetes can create innumerable complications, including diabetic neuropathy. Appropriate nutrition associated with accountability, monitoring, and proper education can alleviate the progression of uncontrolled diabetes. Assessment of the improvement of diabetic neuropathy with dietary and exercise management is examined …

Enhancing The Patient Experience By Providing A Visual Cue To Reference/Reinforce Medication Communication, Janet Radzykewycz

Doctoral Dissertations and Projects

Purpose: The purpose of this project was to examine how placing a visual cue (sticker) for patients and nurses to reference during the patient’s acute care admission on the Telemetry unit will affect the patient’s perception of medication communication (purpose and side effects of medications). Background: Approximately 1.3 million people annually in the United States experience an injury due to medication-related errors. Hospitalized patients are at greatest risk for medication errors at the time of discharge due to medication changes in the acute care environment and these changes being implemented in the patient’s plan of care in the home environment. …

Chronic Diseases And Inpatient Care Among The Middle-Aged And Elderly People In Indonesia, Ema Madyaningrum

Journal of Health Research

Background: The prevalence of chronic diseases contributes to an increase in healthcare utilization that results in increased vulnerability in middle and old age. This study aims to determine the factors that influence in-patient care among the middle-aged and elderly.

Methods: We conducted a repeated cross-sectional study using the Indonesia Family Life Survey 4 (IFLS 4) in 2007 (10,754 participants) and IFLS 5 in 2014 (12,058 participants). Chronic diseases include hypertension, diabetes mellitus, tuberculosis, asthma, coronary heart diseases, liver diseases, cancer, arthritis, gout, high cholesterol, prostate illness, kidney diseases, and digestive diseases. We used the frequency distribution, and logistic regression to …

A Nurse-Led Telehealth Program For Diabetes Foot Care: Feasibility And Usability Study, Hsiao-Hui Ju, Rashmi Momin, Stanley Cron, Jed Jularbal, Jeffery Alford, Constance Johnson

Faculty, Staff and Student Publications

BACKGROUND: Diabetes mellitus can lead to severe and debilitating foot complications, such as infections, ulcerations, and amputations. Despite substantial progress in diabetes care, foot disease remains a major challenge in managing this chronic condition that causes serious health complications worldwide.

OBJECTIVE: The primary aim of this study was to examine the feasibility and usability of a telehealth program focused on preventive diabetes foot care. A secondary aim was to descriptively measure self-reported changes in diabetes knowledge, self-care, and foot care behaviors before and after participating in the program.

METHODS: The study used a single-arm, pre-post design in 2 large family …

Engaging Sleeplessness In Seattle At Clinical Site 1, Benjamin D. Masters, Luis Moreno Nunez, Ally Jo Veenhuizen, Kiana Rendorio

Nursing Leadership in Community Engagement Projects

Introduction

The National Library of Medicine notes an emerging area of research interest is the relationship between substance abuse and sleep (Mahfoud et al., 2009). According to the same 2007 National Survey on Drug Use and Health, “7.6 percent of Americans older than 12 years met the criteria for alcohol abuse or dependence” and goes on to highlight the mundanity of sleep disorder. Additionally, the 2008 National Sleep Foundation’s “Sleep in American” poll demonstrated “addicts in recovery are 5 to 10 times more likely to experience sleep disorders.” (Moufoud et al., 2009). Clinical Site 1 is an agency in Downtown …

Addressing Grade Inflation In Advanced Practice Provider Jesuit Education, Mitzi Marie Saunders

Jesuit Higher Education: A Journal

Grade inflation is defined as a high percentage of high grades in contrast to students’ academic achievements and/or an upward trend in the average grades awarded students. Globally, the A grade is the most common grade issued. Grade inflation is the norm and a topic largely understudied and inadequately addressed. Jesuit faculty can change this trajectory. For some, the matter is more urgent. In advanced practice provider (APP) education, patient safety could be at risk. This paper explores academic grading in the context of Ignatian pedagogy and identifies strategies to reduce grade inflation. It includes a study at a midwestern …

Pressures To Comply Or Defy: How Social Values Influence Perceptions Of Healthcare Workers As Villains, James K. Beggan, Scott T. Allison

Heroism Science

During the Covid-19 pandemic, politicians, the media, and the public labeled frontline workers as heroes. The goal of this article is to examine how certain aspects of the Covid-19 pandemic—such as the nature of the Covid-19 virus, coupled with insufficient governmental and institutional responses—created a situation where it became possible for people to characterize healthcare workers as villains. This approach to medical professionals is rather novel in heroism studies and social sciences. A qualitative review of available data sources provided evidence that frontline healthcare workers were perceived negatively. Experiencing a lack of cooperation from patients and their families, healthcare personnel …

Reducing Postpartum Hemorrhage Rates At Maine Medical Center, Meaghan Smith, Colette Dumais, Tracey E. Mcmillan, Carrie Comeau, Mandy Wallace, Jenelle Boulanger, Jodi-Lynne Vaughn, Kelly Ouellette, Natalia Johnson, Suneela Nayak, Rebecca Brookes

Operations Transformation

In the United States, approximately 700 women die each year from pregnancy related deaths and the most frequent cause of preventable maternal mortality is obstetric hemorrhage. The postpartum hemorrhage (PPH) rate at Maine Medical Center (MMC) is three times the national average. At our facility we care for the most complex patients in the State and we must decrease our rate to accurately reflect our expertise, knowledge and skills.

Student Preferences For Active Learning And Their Beliefs, Experiences, And Knowledge, Tammy Shilling, Jerome Thayer, Anneris Coria-Navia, Heather Ferguson

Teaching and Learning in Communication Sciences & Disorders

Active teaching methods are believed to facilitate higher-order thinking skills and prepare allied health students for independent clinical decision-making. This quantitative, correlational study aimed to explain the relationships between student preferences for active over traditional methods and their beliefs, the frequency and positiveness of their experiences, and the extent of knowledge they have received regarding active and traditional teaching methods. Two hundred and thirty students completed a 53-item online survey. Students were enrolled in a Doctor of Physical Therapy, Masters in Speech-language Pathology, or Bachelor of Science Nursing program in one of seventeen participating institutions across a ten-state Midwest region. …

Bleeding Risk Assessment In Interventional Radiology., Nathaniel Bond

Doctor of Nursing Practice Papers

Abstract

Background: Interventional Radiology (IR) procedures vary in their bleeding risk. Staff responsible for screening patients in the preprocedural setting may not have adequate education regarding specific factors associated with increased bleeding risk specific to IR patients. Society of Interventional Radiology (SIR) consensus guidelines recommend the use of screening tools, but no tools specific to IR are currently available.

Objectives: To evaluate confidence of staff assessing bleeding risk prior to IR procedures and identify areas where further education may be needed.

Methods: A prospective cohort study design was used to conduct a staff confidence screening tool specific to IR staff …

Building Up Cal Poly Global Brigades Student Group: Reflections On Designing And Implementing One Undergraduate-Led Community Info Session, Caroline Nicole Smith, Jafra D. Thomas

Kinesiology and Public Health

Intro: Global Brigades, an international non-profit organization, trains college students and other pre-professionals in community-based health promotion by mobilizing community service trips around the world, which are taught and led by local community groups. Cal Poly’s Global Brigades student group was founded in 2018, and thus far, they have carried out three annual, medically-focused brigades to Honduras (two in-person, one virtual).

Purpose: The aim of this report is to present the findings of one experiential senior project to promote Cal Poly’s Global Brigades student group^[1] (conducted January to March 2023).

Methods: The student designed material for …

Innovative Strategy To Improve Enteral Nutrition In Prone Positioning With Patients With Covid-19., Jan Powers Phd, Rn, Ccrn, Janette Richardson, Jennifer Rechter Msn, Rn-Bc, Agcns-Bc

Nursing Publications, Posters, & Presentations

BACKGROUND: Enteral nutrition is essential to improve outcomes in patients who are critically ill. Patients in the prone position, including those diagnosed with coronavirus disease 2019 (COVID-19) present additional challenges for enteral nutrition initiation.

METHODS: A novel technique for placing feeding tubes while in the prone position was developed using an electromagnetic placement device and specialty trained clinical nurse specialists. Data were assessed retrospectively to determine effectiveness of this new practice.

RESULTS: Sixty-eight patients had feeding tubes placed while in the prone position; 75% were able to be placed through the postpyloric route, 22% were placed through the gastric route, …

In The Name Of Riwaj: An Ethnographic Study To Explore The Notion Of Women Empowerment Among Bisp Recipients In Rural Sakhro-Sindh, Pakistan, Qurratulain Nasiruddin, Rozina Karmaliani, Nasim Zahid Shah, Tazeen Saeed Ali

School of Nursing & Midwifery

Women empowerment is a national agenda for Pakistan and, one of its manifestations is the nationwide cash transfer program namely Benazir Income Support Programme (BISP). With the help of Bourdieu methodological paradigm of “habitus” this paper analyses empowerment among BISP recipients in their social settings where various social actors such as her husband and wadera of the village dominate her agency but, at the same time, women herself submits her agency to these social actors under the veil of riwaj (social customs). This ethnographic study reveals that the performance of submission among women follows an inner drive for conformation to …

The Wear And Tear Of Racism: Self-Silencing From The Perspective Of Young Black Women, Jewel Scott Phd, Rn, Fnp-C, Kortney Floyd James, Dara D. Méndez, Ragan Johnson, Esa M. Davis

Faculty Publications

Context: Historically, Black women strategically employed silence to endure enslavement to the U.S., and other forms of racial violence. The current study aimed to understand contemporary perspectives on self-silencing. Objective: To explore young adult Black women's experiences of self-silencing and its potential impact on their physical and mental well-being. Methods: Data are from 16 semi-structured interviews with Black women ages 18 to 39 in southwest Pennsylvania conducted between October 2021 - May 2022. We analyzed the interviews using inductive thematic analysis. Results: We identified four themes: “Self-silencing is Inherited,” “Silencing Here and Now,” “Wear and Tear,” and “The Flip Side.” …

Spirituality Education For End Of Life Clinicians: A Quality Improvement Project, Mark S. Valigorsky

DNP Projects

Significance and Background: The focus of this project was to strength the knowledge, comfort, and training of end of life(EOL) clinicians working with patients in the palliative care and hospice environments. While spirituality is considered one of the essential domains of hospice care, it is an area that is often brushed aside by staff and patients and their families. Spirituality is inadequately addressed due to knowledge deficits, time issues, and lack of self-efficacy. Addressing spiritual care is particularly important for patients with chronic and end stage illnesses. Patients and their families view spirituality as a way of coping with suffering. …

Reducing Acute Kidney Injuries In The Cardiovascular Intensive Care Unit By Implementing A Nurse Driven Hydration Protocol, Chelsea N. Singleton

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this project was to implement a nurse-driven hydration protocol to potentially decrease the risk of acute kidney injuries (AKI) in patients undergoing contrast procedures, which in turn should reduce length of stay.

Background

The project was implemented in a CVICU and Cardiac Catheterization Lab (CCL) Lab in an academic center in Houston, Texas.

Methodology

The project utilized Lean Six Sigma methodology and SBAR communication among staff utilizing a nurse-driven protocol to ensure hydration orders were activated during pre- and post- procedure. The staff were educated on how to implement the protocol prior to the start of …

Commencement Program 2023, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2023 Events of Commencement

5 | The Academic Procession

6 | Institutional Administration

7 | Board of Trustees

8 | Significance of Academic Regalia

9 | University History Highlights

11 | Criteria for Institutional Awards

13 | Loma Linda University Health and Loma Linda University Honorees

25 | The Program, The School Honorees, and The Speakers

• School of Medicine, 26
• School of Pharmacy, 52
• School of Dentistry, 69
• School of Public Health, 93
• San Manuel Gateway College, 108
• School of Allied Health Professions—Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication …

Effect Of Preoperative Skin Cleansing On Instances Of Surgical Site Infections, Katie Armington, Jessica Blank, Madison Waterhouse, Cynthia Gavett, Hailey Tofflemoyer, Rachelle Cassidy, Lindsay Bushnell, Jennifer Barriere, Anastasia Colbath

Nurse Residency

Background

• On a single square centimeter of skin, there can be as many as 10 million aerobic bacteria

• Bacteria on a patient’s skin is the leading cause of infection related to surgery

• 17% of all hospital acquired infections come from surgical site infections

• Surgical site infections cost about $3,000 $29,000 per patient

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

Relationship Between Angiotensin-Converting Enzyme Inhibitors And Angiotensin Receptor Blockers Prescribing And Delirium In The Icu-A Secondary Analysis, Malissa A. Mulkey Phd, Aprn, Ccns, Ccrn, Cnrn, Sikandar Khan, Anthony Perkins, Sujuan Gao, Sophia Wang, Noll Campbell, Babar Khan

Publications

As many as 80% of critically ill patients develop delirium increasing the need for institutionalization and higher morbidity and mortality. Clinicians detect less than 40% of delirium when using a validated screening tool. EEG is the criterion standard but is resource intensive thus not feasible for widespread delirium monitoring. This study evaluated the use of limited-lead rapid-response EEG and supervised deep learning methods with vision transformer to predict delirium. This proof-of-concept study used a prospective design to evaluate use of supervised deep learning with vision transformer and a rapid-response EEG device for predicting delirium in mechanically ventilated critically ill older …

“Ain't About The Money, Ain't About The Haircut”: Experiences Of Servant Leadership In Black-Owned Barbershops And Beauty Salons During The Covid-19 Pandemic, Hunter M. Boehme, Robin M. Dawson Phd, Rn, Cpnp-Pc, Tameka Williams, Lídia Gual-Gonzalez, Chloe Rodriguez-Ramos, Natalie Brown, Bryceson Hernandez, Lekendra Kidd, Melissa S. Nolan Ph.D., Mph

Publications

The COVID-19 pandemic had a disproportionate, negative effect on Black Americans. Black-owned barbershops/beauty salons are traditionally trusted, yet little is known regarding how these “virtue locales” were affected by the pandemic. This theory-guided, qualitative descriptive study explored owners' experiences in addressing their clients’ and community well-being during the first pandemic year, revealing four emergent themes: 1) “blessings” and cultural expectations informed a moral imperative to become servant leaders, 2) long-standing relationships resulted in opportunities to engage on topics of physical and mental health, 3) Barbershop/beauty salon-based COVID-19 information and resources led to individual and community empowerment, and 4) Barbershops and …

Never-Ending Parenting: Challenges Experienced By Caregivers Of Adults With Severe Autism, Andrea Palerino

Dissertations, Theses, and Capstone Projects

Despite the large number of children with autism spectrum disorder (ASD) who are annually aging out of the school-based systems in the United States, much of the academic literature has been focused on the concerns and challenges of preschool or school-aged children with ASD. As a result, there lacks a clear understanding of how primary caregivers of adult children with severe autism spectrum disorder (SASD) utilize various forms of capital to navigate care.

This qualitative descriptive study explored some of the challenges experienced by primary caregivers of adult children with SASD. Convenience sampling was used to conduct semi-structured interviews with …

Gender Role Conflict, Campus Climate, And Satisfaction Among Male Undergraduate Nursing Students, Randelle Sasa

Dissertations, Theses, and Capstone Projects

Background. Gender role conflict (GRC) has been identified in the literature as a contributing factor to male undergraduate students’ dissatisfaction with the nursing program. Utilizing Bandura’s social cognitive theory as guiding framework, this study examined the relationships between GRC, campus climate (CC), satisfaction with the nursing program (SS), and demographic factors among male undergraduate nursing students. Understanding the associations between these variables may inform success initiatives for these at-risk students.

Methods. A cross-sectional survey was developed from valid and reliable instruments. The Gender Role Conflict Scale – Short Form measured GRC; the adapted Inventory of Male Friendliness in Nursing Programs …

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

Social Identities And Campus Belonging As Predictors Of Flourishing Among College Students, Christine Gilchrist

Dissertations, Theses, and Capstone Projects

Annual data since 2012 shows college students’ flourishing (a measure of psychological well-being) in continuous decline, with 2022 showing the largest decrease. Since the knowledge base of the predictors of flourishing is limited, how college executives can best address this issue is unclear. Variations in flourishing have been observed in studies that examined the relationship between food insecurity (DeBate et al., 2021), race/ethnicity (Lipson et al., 2018, 2022; Nyunt et al., 2022; Parr, 2022), immigration status (Cadenas & Nienhusser, 2021), as well as gender identity and sexual orientation (Parr, 2022). The intersectional impact of demographic and social identities has not …

The Effects Of Music Therapy On Elderly Adults With Dementia, Jeante J. Jackson

Dissertations, Theses, and Capstone Projects

As people age, the brain is more susceptible to changes that diminish cognitive function. In recent years neuroscience has found convergent evidence between music therapy and brain architecture, as it has shown the generation of new connections in the brain or a reorganization and possible strengthening of existing connections already in the brain. However, the literature regarding music training’s effects on executive control, selective attention, and speech processing is lacking particularly when it comes to older populations.

This study investigated Verbal Working Memory, Visuospatial Attention and Task Initiation, and Auditory Selective Attention in a 91-year-old adult (B.P.) diagnosed with dementia. …

The Early Impact Of Covid-19 On Intensive Care Nurses’ Personal And Professional Well-Being: A Qualitative Study, Kelly Calkins, Jill L. Guttormson, Natalie S. Mcandrew, Holly Losurdo, Danielle Loonsfoot, Shania Schmitz, Jacklynn M. Fitzgerald

College of Nursing Faculty Research and Publications

Objective

To describe the impact of the COVID-19 pandemic on intensive care nurses personal and professional well-being.

Research Methodology/Design

A descriptive, qualitative design was used. Two nurse researchers conducted one-on-one interviews via Zoom or TEAMS using a semi-structured interview guide.

Setting

Thirteen nurses who were working in an intensive care unit in the United States participated in the study. A convenience sample of nurses who completed a survey in the larger parent study provided an email and were contacted by the research team to participate in interviews to discuss their experiences.

Main Outcome Measures

An inductive approach to content analysis …