Critical Care Nursing Commons^™

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Engaging Student Nurses In A Professional Association, Nicholas Craig

Student Engagement Posters

Nicholas Craig discusses student engagement at Linfield College with regard to his involement with the Critical Care Nurses' Club.

The Use Of Behavioral Pain Assessment Tools And Pain Outcomes In Nonverbal Patients, Patrick A. Healy

Honors Undergraduate Theses

Acute and critical care patients experience significantly more pain than those patients on a general nursing unit. Due to the severity of their condition, acute care patients may be nonverbal and unable to self-report their pain. Behavioral pain assessment tools are a method of objectively measuring pain in patients who are unable to communicate. While the use of these tools has been shown to improve short- and long-term outcome for patients, there is a paucity of evidence as to nurses' perceptions related to their use. The purpose of this study is to investigate acute care nurses' perceptions of the relationship …

Organizational Behaviour During Instability: A Critical Discourse Analysis Of Shared Mental Model Through Various Forms Of Acute Care Learning Using Mixed Methods, Adam Morse, Ryan Chan

Western Research Forum

Background: The purpose of this study is to better understand nurses' performance based on training processes. This will determine if group training will increase performance compared to independent training through a shared mental model in a contextual setting of unpredictability mediated by the effects of nurses’ perceptions of patient safety climate. A mixed methods study is conducted using critical discourse analysis of organizational documentation and semi-structured interviews to determine measures of contextual setting when identifying and treating sex trade workers.

Methods: Pragmatic study will analyze two groups of 125 nurses each determining the impact of group and individual …

Social Support, Relationship Quality, And Self-Care Behaviors In Patients With Heart Failure, Majdi Mohammad Rababa

Theses and Dissertations--Nursing

The purpose of this dissertation was to examine the associations among social support, gender, relationship quality, and self-care behaviors in patients with heart failure (HF). Specific aims were to: 1) compare the psychometric properties of the 12-item and the 9-item European Heart Failure Self-Care Behavior Scale (EHFScBS) when used to measure self-care behaviors in patients with HF in the United States; 2) determine whether gender moderated the association between perceived social support and daily sodium intake in patients with HF; and 3) determine whether a patient’s gender and relationship with the primary family caregiver (spousal or non-spousal) moderated the association …

Increasing Student Registered Nurse Anesthetists Clinical Self-Efficacy Using Peer Mentoring, Megan Christine Bass

Doctoral Projects

The purpose of this project is to determine if clinical self-efficacy is increased in SRNAs at The University of Southern Mississippi after participation in the peer mentoring program. The project was a one-group pre and posttest design in a sample of SRNAs who received peer mentoring. To evaluate the students’ perceived clinical self-efficacy before and after the peer mentoring educational intervention, the Rowbotham and Schmitz Student Self-Efficacy scale (SSE) (2013) was adapted and administered to second-year SRNAs (N=17). Clinical performance, skill and knowledge development, social interaction with clinical faculty, and coping with clinical stress are the four areas evaluated by …

Patient Experiences In Intensive Care Units: A Systematic Review, Serpil Topçu, Şule Ecevit Alpar, Bilgi Gülseven, Ayda Kebapçı

Patient Experience Journal

The aim of this systematic review is to analyze the data gathered from studies conducted to determine patient experiences in intensive care and levels of the recollection of the intensive care period that were published between December, 1998 – April, 2013. The systematic review was carried out screening of the related publications. The findings of the systematic review were studied under the following two titles: “remembering the intensive care period” and “recalled experiences” of patients. Studying 15 papers which were found suitable to the inclusion criteria of the review indicated that majority of the patients had recollection of the intensive …

Adverse Psychological Effects Of Patients In Medical Isolation Due To Healthcare-Associated Infections, Kristin Brill

Grace Peterson Nursing Research Colloquium

Background: Patients placed in medical isolation due to healthcare-associated infections experience adverse psychological effects that can impact their quality of life.

Objectives: The purpose of this integrative literature review was to identify the adverse effects of patients in medical isolation as well as explore coping strategies that can be used to decrease these adverse effects.

Method: An integrative literature review was conducted using the databases of CINAHL, PsychInfo, PubMed, and PsychArticles. Search terms included adverse effects, negative effects, effects, adverse outcomes, negative outcomes, isolation precautions, contact isolation, droplet isolation, airborne isolation, isolation, coping and psychology.

Results: Five common adverse psychological …

Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair

Dialogue & Nexus

Since the 1940s, both end-of-life care and advancements in medical technologies have expanded exponentially. This article explores the advancements in medical technologies and how these have altered the way that Western society grieves death. With the capabilities to prolong life, the family, the patient, and the medical team, all grieve the end of life in different ways. This article provides a chronological analysis of palliative care, hospice care, and various medical advancements. These changes in medicine are then paralleled with alterations in the bereavement process. This article explores historical narratives of Western society’s transformation of grief through the lens of …

An Examination Of The Moderating Effect Of Proactive Coping In Nicu Nurses, Britan M. Moore

Loma Linda University Electronic Theses, Dissertations & Projects

The NICU environment is unique in that the patient population consists of critically ill neonates. Research has revealed that there are increased levels of depression, secondary traumatic stress, and burnout in nurses. Problem solving and support seeking coping strategies have been shown to be associated with lower levels of burnout and increased patient and job satisfaction in general staff nurses. Multiple linear regression and a hierarchical stepwise technique was used to conduct moderator analyses assessing whether the use of problem solving or support seeking strategies moderated the relationship between secondary traumatic stress levels and burnout as well as between depressive …

The Application Of Grounded Theory: An Example From Nursing Workforce Research, Latoya J. Lewis-Pierre 4572586, Joann Kovacich, Linda Amankwaa

The Qualitative Report

The application of grounded theory was the conduit to theory development in this study. The intent was to explore nurse manager, educator, preceptor, and new graduates’ perceptions of workplace readiness for new graduates entering an Intensive Care Unit. Research participants were drawn from five different ICUs: Medical, Coronary Care, Surgical, Neuroscience, and Trauma. One-on-one interviews were conducted to collect participants’ perspectives on readiness to practice in the ICU. Using grounded theory, four themes emerged giving rise to the novice nurse embracing the ICU theory (NNEIT). Reflections on the type of grounded theory used, reasons for the selection, challenges faced in …

Grounded Theory And The Conundrum Of Literature Review: Framework For Novice Researchers, Mohamed T. El Hussein, Andrea Kennedy, Brent Oliver

The Qualitative Report

The issue of the literature review remains a conundrum and a controversy within the discourse on grounded theory methodology. Grounded theory researchers are expected to minimize preconceptions to ensure the concept of interest is grounded in data, yet at the same time are required to evaluate existing literature to support institutional ethics and scientific review of the research proposal. In addressing this dilemma, we espouse that literature review in grounded theory should comprise a multistage nonlinear approach to the literature and introduce a framework for novice grounded theory researchers. This framework offers a reflexive, dynamic and integrative process for conducting …

The Use Of Physical Restraints In Long-Term Care In Spain: A Multi-Center Cross-Sectional Study, Gabriel J. Estévez-Guerra, Emilio Fariña-López, Eduardo Núñez-González, Manuel Gandoy-Crego, Fernando Calvo-Francés, Elizabeth Capezuti

Publications and Research

Background: Physical restraint is a procedure used frequently in long-term care. It is a controversial practice because its use is associated with numerous complications and also affects freedom and individual autonomy. The objective of this study was to examine the use of physical restraint of long-term care residents with the ability to move voluntarily.

Methods: We conducted a cross-sectional observational and correlational multi-center study. Nine centers agreed to participate. Of the 1,200 people present at the time of data collection, those without voluntary movement or in the facility for less than a month were excluded. Thus, the final sample was …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

Role Of Stress And Social Resources On Biomarkers And Fatigue In Staff Nurses: A Biobehavioral Approach, Mona Cockerham

Dissertations and Theses (Open Access)

Purpose

Consecutive 12-hr workdays can contribute to increased stress and fatigue and negative biological responses in nurses, potentially compromising quality of patient care and safety. The primary purpose of this study was to assess changes in stress, fatigue, and biological responses (salivary cortisol and alpha-amylase) over three consecutive 12-hr workdays in acute care nurses and how stress and social resources function in predicting fatigue and biological responses.

Methods

In a prospective study, 81 acute care nurses completed questionnaires and provided saliva samples four times: pre-shifts and post-shifts of day 1 and day 3.

Results

Although stress and biological responses did …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John

Honors Undergraduate Theses

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.

Methods: A total of 768 articles were found in a literature search including all literature from 2005 to …

Psychological Distress And Cardiac Disease, Tracey Vitori

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate the association of psychological distress with cardiac disease, events, and mortality. Specific aims were to: 1) to evaluate the association between hostility level and recurrence of acute coronary syndrome (ACS) and all-cause mortality in patients with coronary heart disease (CHD); 2) to evaluate the psychometric properties of the Brief Symptom Inventory (BSI) hostility and anxiety subscales in a group of incarcerated participants at high risk of cardiovascular disease; and 3) to evaluate the association of patient and caregiver psychological state with quality of life in both patient and caregiver, and postoperative complications …

Burnout: Absence Of Binding Diagnostic Criteria Hampers Prevalence Estimates, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Comments on an article by Jef Adriaenssens et al. (see record 2015-00662-015). In a recent review paper, Adriaenssens et al. concluded that about 26% of emergency nurses (EN) suffer from burnout and described their results as alarming. While commentators applaud Adriaenssens et al. efforts to provide a clearer picture of ill-health in EN, they thought that these authors' conclusions were weakened by a fundamental fact, namely, the absence of consensual, clinically valid diagnostic criteria for burnout. Trying to determine the prevalence of a condition that has no binding diagnostic criteria is problematic. Indeed, depending on how researchers decide to …

Delirium Screening Instrument Knowledge And Perception Among Cardiovascular Intensive Care Nurses, Brittany Lynn Dahl

DNP Projects

Background: Delirium is a serious condition that affects critically ill adult patients in the intensive care unit. Bedside nursing delirium measurements are considered a dependable source of information that can be used for clinical decision-making. Nurse education and assessment of perceptions is important when building a framework for successful delirium assessment. However, few data exist about nursing perceptions and practices associated with delirium screening instruments. The overall purpose of this project is to examine nurse perceptions and knowledge about delirium and delirium screening instruments at the University of Kentucky (UK) Hospital’s Cardiovascular Intensive Care Unit (CVICU).

Objectives: The aims of …

Family Presence During Resuscitation Of Adults: The Impact Of An Online Learning Module On Critical Care Nurses' Perception And Self-Confidence, Kelly Powers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family presence during resuscitation (FPDR) involves offering family members the option to remain with their loved one who is undergoing life-saving measures. FPDR has been shown to enhance comfort and facilitate grieving, and 90% to 100% of patients and family members support it as an option. However, critical care nurses are not fully supportive of FPDR and approximately only one-third implement it in their care of patients. The perceived risks of FPDR are cited as a primary reason for lack of support and implementation. Yet, the perceived risks have not been proven, while the benefits have been established in research. …

Workplace Violence: Emergency Department Versus Medical Surgical Nurses, Dakeita K. Roakes

Nursing Theses and Capstone Projects

The purpose of this study is to answer the following question: Does a registered nurses department, medical-surgical versus emergency department, change the amount of workplace violence they may experience? To accomplish this, a cross sectional descriptive study using an anonymous web-based Workplace Violence questionnaire survey by Wolters Kluwer Health was used to collect data from nurses working on medical-surgical units and in the emergency department at the facility. The findings indicate more physical violence with more frequent or occasional occurrences in emergency departments. The medical-surgical nurses reported more intimidation or emotional violence and never experience workplace violence.

An Explanatory Study Of Maternal Stress And Coping With A Cystic Fibrosis Child, Leslie G. Potter

Ellmer School of Nursing Theses & Dissertations

The purpose of this study was to explore the concept of coping with a cystic fibrosis (CF) child and to define coping strategies from the perspective of the mother. The research design was based upon a phenomenological approach with analysis of transcribed, semi-structured interviews with mothers of CF children. A purposive sample of eight mothers with CF children were interviewed to explore the maternal CF experience. Each interview was tape recorded and followed up with a phone call to allow the mothers to add additional information, if so desired. Data analysis consisted of reviewing each typed, verbatim transcript to categorize …

The Influence Of Nursing Experience And Education On Nurses Inferences Of Patients' Suffering, Patricia A. Coots

Ellmer School of Nursing Theses & Dissertations

A primary dimension of nursing is caring tor patients who suffer. This study examined the inferences made about patients' suffering oy 65 registered nurses employed in acute care health facilities. Utilizing The standard Measure of Inferences of Suffering Questionnaire. the purpose of the study was to explore the influence of nursing education and experience on the degree of pain and psychological distress inferred by the nurses. Analysis of Covariance was used to test for group differences on the basis of nursing education when number of months of nursing experience was controlled. Although nursing education did not influence nurses' inferences of …

Development And Testing Of The Stress Adaptation Scale For Parents With Chronically Ill Children (Sasp), Carolyn M. Rutledge

Ellmer School of Nursing Theses & Dissertations

This research study consisted of four phases used to develop and test the Stress Adaptation Scale for Parents with Chronically Ill Children (ASP). The first phase dealt with developing the items on the SASP from a review of the literature and the researcher's professional experience. The SASP was then divided into the six categories of health care, social, personal, familial, financial, and spiritual. In phase II, content validity was evaluated by a panel of experts. In phase III, stability over time and face validity was demonstrated using 26 parents of chronically ill children. The SASP achieved a Pearson's r=.85 with …

Perceived Job Stress In Critical Care Nursing In A Military Setting, Jeannette Theriault

Ellmer School of Nursing Theses & Dissertations

The purposes of this study. were: to explore job-related perceptions of stress in a group of military critical care nurses; and to determine if differences in anxiety and stress levels existed between nurses working in coronary care (CCCU) and medical/surgical intensive care (ICU) settings using the State/Trait Anxiety Inventory and the Questionnaire of Stressful Factors in Intensive Care. A free response question and a force-response checklist were also used to identify and rank work-related stressors. The sample of Navy nurses (n=105) consisted of 39 CCU nurses, 62 medical/surgical ICU nurses and 4 critical care supervisors. The results of the mailed …

The Cardiovascular Effects Of Human Contact With Coronary Artery Disease Patients In The Coronary Care Unit, Margaret A. Palmour

Loma Linda University Electronic Theses, Dissertations & Projects

Ten coronary artery disease patients were selected using purposive method of sampling and observed for six hours. It was postulated that 1) Human contact with coronary artery disease patients in the coronary intensive care unit would be associated with significant (p = 0.05) changes in the electrocardiogram such as: (a) increased heart rate more than 10 per cent, (b) changed atrio-ventricular conduction more than 10 per cent, (c) changed ST segment one millimeter or more and (d) increased frequency of ectopic beats more than 10 per cent. 2) The degree of stress and cardiac response was related to a number …