Other Nursing Commons^™

Investigating Relationships Between Diabetes Distress, Diabetes Self-Care Behaviors, Intention To Use And Actual Use Of A Personal Health Record Within 30 Days Of Hospital Discharge In Persons With Type 2 Diabetes, Khaliah Fisher-Grace

Electronic Theses and Dissertations

Background: Diabetes distress (DD) is defined by emotional and behavioral challenges caused from diabetes and its management. Diabetes self-care behaviors can be compromised by DD. Personal Health Record (PHR) use has been associated with improvements in HbA1c, blood pressure, and LDL-C, but the relationship between DD and PHR use is unknown. Aims: 1) to determine differences between sociodemographic variables and intention to use and actual use of PHR in hospitalized persons with Type 2 Diabetes Mellitus (T2DM), 2) to investigate the relationship between DD, intention to use a PHR and actual use of a PHR within 30 days of hospital …

Collaborative Human-Machine Interfaces For Mobile Manipulators., Shamsudeen Olawale Abubakar

Electronic Theses and Dissertations

The use of mobile manipulators in service industries as both agents in physical Human Robot Interaction (pHRI) and for social interactions has been on the increase in recent times due to necessities like compensating for workforce shortages and enabling safer and more efficient operations amongst other reasons. Collaborative robots, or co-bots, are robots that are developed for use with human interaction through direct contact or close proximity in a shared space with the human users. The work presented in this dissertation focuses on the design, implementation and analysis of components for the next-generation collaborative human machine interfaces (CHMI) needed for …

Perceived Social Support, Family Relationships, And Health-Related Quality Of Life Among Women With Breast Cancer In Jordan., Hedaya Rateb Hina

Electronic Theses and Dissertations

Introduction: Breast cancer is the most common cancer among Jordanian women. Perceived social support (PSS) and family relationships are strongly associated with positive psychosocial outcomes and health-related quality of life (HRQoL). This area was widely explored in Western countries, but little attention was devoted to investigate this area in Middle East region. Purpose: to investigate the interrelationships among PSS, family relationships, and HRQoL of women with breast cancer in Jordan using an exploratory cross-sectional design. Method: The contextual model of HRQoL designed by Ashing-Giwa (2005) provided the foundation for this study. A total of 140 women were …

School Nursing Practice And Experiences During School Closures, Susie E. Birden Brown

Electronic Theses and Dissertations

This evidence-based quality improvement project was to evaluate public school nurses’ relationships and reaction to their new work environment during the closure of schools in Northern California resulting from the COVID-19 pandemic. This project addressed the change in school nursing, especially the nurses’ working environment. A stress management program was offered to the school nurses as an intervention to give them information on perceived stress. The stress management program included mindfulness and stress-relieving techniques over a 1-month period. The research methodology used in the project was a pre- and postintervention using the Perceived Stress Scale-10 (PSS) to measure if the …

Opioid Use Disorder: A Crisis Of Concern, Evangella Harville

Electronic Theses and Dissertations

According to a statement from the U.S. Centers for Disease Control and Prevention, between 2000 and 2017, approximately 700,000 people died from drug overdoses in the United States. Approximately 128 persons lose their life each day from an opioid overdose. The data for this study were collected by the vice president of operations at the study site from a preexisting database for 2019 and 2020. The participants were inpatient patients, 18 and older, both male and female, and were from all ethnicities. The study facility was located in Western New York and offered a 30-bed inpatient treatment center with 24-hour …

Addressing The Psychosocial State Of High-Risk Individuals Undergoing Hereditary Cancer Screening By Advanced Practice Registered Nurses (Aprns) In The Community Oncology Setting, Aquilina Kerubo Thompson

Electronic Theses and Dissertations

Abstract

Neoteric advances in genetics make it possible to define genetic risk in cancer, and there should be methods in place to provide comprehensive genomic care with oncology advanced practice registered nurses bridging this gap. The current scope of nursing practice stipulates genetic and genomic literacy; however, there remains a deficit among advanced practice registered nurses in identifying and addressing psychosocial distress during the genetic cancer risk assessment process. Oncology advanced practice registered nurses must be equipped with the knowledge that the genetic cancer risk assessment also involves protecting patients from the psychosocial repercussions of carrying a hereditary cancer gene …

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Advance Care Planning Protocols And Hospitalization, Rehospitalization, And Emergency Department Use In Home Health, Sharon Bigger

Electronic Theses and Dissertations

Aim. The aim of this study was to examine the relationship of advance care planning protocols with hospitalization, rehospitalization, and emergency department use rates in U. S. home health agencies (HHA).

Background. Since 2003, CMS has required HHAs to report on quality outcomes such as hospitalization, rehospitalization, and emergency department use rates, made publicly available online. Advance care planning (ACP) is a conversation about beliefs, goals, values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on ACP have taken place outside of HHAs among populations with serious …

Assessing The Perceptions And Attitudes Of Burnout Syndrome In Nurse Practitioners In Primary Care Settings, Keisha D. Mckinsey

Electronic Theses and Dissertations

The implications of workload and personal and patient-related burnout have been identified in numerous physicians’ studies. While burnout syndrome has become a subject of great interest for examining provider burnout to assess successful solutions, there is minimal research unique to nurse practitioners in primary care settings. This project was intended to determine the prevalence and effect of nurse practitioners’ burnout in primary care settings and make recommendations for improving nurse practitioners’ overall health and well-being. The key outcomes of concern for this project were, first, improvement in burnout scores on the Copenhagen Burnout Inventory tool pre- and posteducational intervention, and …

A Systematic Review Of Acuity-Based Staffing In Acute Healthcare Environments, Demitria Idella Stafford

Electronic Theses and Dissertations

Nursing leadership is responsible for considering the equity of patient care assignments when providing nursing care. Nursing leadership is responsible for assuring the delivery of patient care assignments with the intent to offer nurses an unbiased, evenly distributed patient load. Effective distribution of patient care assignments ensures patients receive the safest, most efficient, and highest quality of care. The purpose of this project was to provide nursing leadership with an executive summary of a systematic review of evidence-based research on the structure and process of making patient care assignments, and it provided evidence on how those patient care assignments affect …

Trust In The Nurse And Perceived Quality Nursing Care By Adult Oncology Patients With Implantable Vascular Access Port Devices: A Mixed Methods Study, Lois Rajcan

Electronic Theses and Dissertations

Objective: The purpose of this study was to obtain an understanding of nurse behaviors that promote trust and quality nursing care as perceived by oncology patients with totally implantable vascular access devices (TIVAD).

Methods: An explanatory sequential mixed-method design was used to answer the study questions. This design was comprised of two phases: 1) a quantitative online survey of oncology patients with TIVADs followed by; 2) qualitative interviews using purposively selected patients from the survey sample.

Results: Trust in the nurse and perceived quality of nursing care by patients with TIVADs were determined to be of average levels. Two qualitative …

The Lived Experience Of Obesity, Spirituality, And Health Behaviors In African American Women, Andrea S. Poynter

Electronic Theses and Dissertations

Obesity is one of the fastest-growing health concerns impacting all racial, ethnic, gender, and socioeconomic groups in the United States of America. More than one-third of the U.S. adult population is classified as being obese (Obesity Society, 2014). Novak and Brownell (2012) identified that “obesity rates are consistently rising higher each year than in previous years” (p. 2345). Obesity has reached epidemic proportions in all races and genders within the US with African American women comprising a majority of those impacted by this chronic health condition. Obesity rates are well documented within the literature but what is lacking is the …

A Program Evaluation Of A Rural Nursing Academic Partnership, Meagan A. Spencer

Electronic Theses and Dissertations

As the American Association of Colleges of Nursing and Commission on Collegiate Nursing Education continue to promote the implementation and creation of literature on academic partnerships, a Christian university, sought to evaluate its academic partnership with a for-profit hospital for the first time in regard to student perspectives. The purpose of this mixed-methods program evaluation was to describe the student perceptions of the academic partnership in trusting, collaborating, and engaging nursing students and recruiting and retaining nursing graduates to rural hospitals and health care facilities. Measurable impacts included both qualitative and quantitative coding of the levels of trust, collaboration, and …

Lowering Perceived Stress Levels In Undergraduate Nursing Students, Caitlin Dodd

Electronic Theses and Dissertations

This project analyzed the effects of guided meditations and a stress management class on undergraduate, prelicensure nursing students’ perceived stress levels. College students and professional nurses are both susceptible to having high stress levels. Mindfulness activities have been shown to lower stress levels. Undergraduate, prelicensure nursing students participated in this project determining the effects of guided meditations and a stress management class on perceived stress levels in a quantitative, pre- and postinterventional study. Participants in the project completed a stress management class and 18 guided meditation sessions in an undergraduate classroom setting. The researcher used the Perceived Stress Scale-10 (PSS-10) …

Qualifications Of Executive Nurses For Service On Hospital Boards, Michelle Lee Foxx

Electronic Theses and Dissertations

Abstract Healthcare governing boards have responsibility for the legal and financial stability of the organization. They are assuming more responsibility for quality care and outcomes. Nurse leaders have valuable insights into key shared governance issues such as quality of care, financial performance, legal requirements, and regulatory oversight. Yet, only 5% of the 3.2 million nurses in the U.S. health workforce hold a seat on hospital governing boards in the United States. The purpose of this study was to explore how nurses with executive experience perceive their own leadership qualities in the context of established requirements for executive hospital boards. Fifty …

Coping Behaviors Of African Americans With Inflammatory Bowel Disease: A Focused Ethnography, Patricia Scott

Electronic Theses and Dissertations

Background: Increasing numbers of African Americans are being diagnosed with inflammatory bowel disease (IBD) in the United States (Dahlhamer, Zammitti, Ward, Wheaton, & Croft, 2016). Little is known about the influence of culture on coping with the disease. Method: Twelve African American adults with IBD were interviewed and observed using a focused ethnography. Results: Data analysis resulted in four major themes: (1) spending time living in the bathroom; (2) time and food restricted eating practices and cultural food avoidance; (3) dealing with a life full of stress; and (4) the practice of seclusion to promote health. Discussion: Participants described coping …

The Relationship Of Self-Efficacy And Clinical Reasoning Of Undergraduate Nursing Students, Amy G. Holder

Electronic Theses and Dissertations

Aim. This investigation aimed to discover if a there is a correlation between a student’s clinical reasoning self-efficacy and a student’s actual clinical reasoning ability. Also, this research sought to discover the connection between an undergraduate nurse’s self-efficacy of clinical reasoning and the locus of control of that student. Finally, this investigation sought to discover if perceived self-efficacy of clinical reasoning changed over time.

Background. The ability to successfully navigate the process of clinical reasoning is critical to providing safe, effective care for patients. For nurses, this process begins to develop in nursing school. Unfortunately, evidence suggests that newly graduated …

The Experiences And Well-Being Of Mexican Immigrant Women Living In Traditionally Non-Latinx Communities In Western North Carolina, Melinda Bogardus

Electronic Theses and Dissertations

North Carolina has, in recent decades, experienced significant growth in its Latinx, and more particularly Mexican immigrant population. As a traditionally non-Latinx state, or a state without a long-standing, large Latinx population, many communities and healthcare and service providers within North Carolina still lack knowledge, resources, and skills needed to serve and support Latinx immigrant populations well. Guided by interpretive description, this qualitative study on Mexican immigrant women in Western North Carolina sought to gain knowledge and understanding of what it is like for them to live in a traditionally non-Latinx region and how immigration has affected their well-being. Asking …

Utilization Of A Concurrent Query Form To Improve Clinical Documentation In A Va Facility For Patients With Stroke Or Tia, Lisa A. Keefner

Electronic Theses and Dissertations

Caring for stroke patients diagnosed with acute ischemic stroke (AIS) and transient ischemic attack (TIA) at Veterans Health Administration (VHA) acute care hospitals is a very complex process that centers on accurate documentation. Inaccurate or missing documentation leads to patient safety issues, lower quality care, and inaccurate Veteran Equitable Resource Allocation (VERA) classification for reimbursement. This pilot project’s 3 problems of interest include improving provider response to clinical queries about documentation, capturing national metrics collected by the VHA, and accurately representing veterans in VERA classification. Based on a review of the literature available on patient treatment file (PTF) accuracy and …

Effect Of Creatinine Point-Of-Care Testing On Turnaround Time For Computed Tomography Exams With Intravenous Contrast, Shannon Haltom

Electronic Theses and Dissertations

Abstract

Emergency departments often have a stigma of long wait times. They face multiple challenges related to the flow of patient care due to the variety of factors that affect care and treatment. In order to support patient-centered care, the purpose of this project was to determine if point-of-care testing of creatinine decreases turnaround time for computed tomography exams with intravenous contrast in the emergency department. A mixed methodology of consecutive sampling and retrospective data collection was used. In all, 128 ratio data elements were reviewed, including a retrospective review of 64 charts from September 2018 and a consecutive sample …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

Improving Low Health Literacy In Poststroke Patients By Educating The Health Care Staff, Marthilde Brzycki

Electronic Theses and Dissertations

Abstract

Lack of health literacy in the poststroke patient population is a serious issue; with the addition of the homeless population to that group, the result may be devastating. According to the American Heart Association and American Stroke Association (AHA/ASA, 2016), stroke is considered the primary cause of death and one of the chief reasons for disability in the United States, and nearly75% of strokes occur in those who are 65 years of age or older. Nurse practitioners are vital, providing necessary training and stroke education to the nursing and other health care staff. This DNP project was initiated to …

Determining Nurse Practitioner Core Competencies Utilizing A Delphi Approach, Tracey Chan

Electronic Theses and Dissertations

Background: Competency-based education (CBE) has been recommended for nurse practitioner (NP) education. To implement CBE, existing NP core competencies need to be reduced in number and refined.

Purpose: This study refined and reduced redundancy in the National Organization of Nurse Practitioner Faculties (NONPF) and American Association of Colleges of Nursing (AACN) NP core competencies through the consensus of experts in NP practice. This study used the current NP Core Competencies (NONPF, 2017), the Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006), and the Common Advanced Practice Registered Nurse Doctoral-Level Competencies,(AACN, 2017a) …

Local Anesthesia Before Intravenous Cannula Insertion: Recommendations For Registered Nurses In Practice, Vera Campbell-Jones

Electronic Theses and Dissertations

Abstract

Administering local anesthetics, such as intradermal, should become standard practice for RNs in pretreatments for pain control prior to intravenous insertion. Peripheral venous cannulation has provoked the most fear and anxiety in adult patients about everyday practice in hospitals. Adult patients often state that this procedure causes considerable discomfort. Local anesthesia for cannulation is usually not offered to adult patients who are on general medical units. Evidence has indicated inconsistency in the use of pain management strategies during these procedures. The researcher’s goal in this project was to educate RNs about the intradermal pretreatment procedure, provide education on the …

The Impact Of Direct Nursing On Patient Engagement To Improve Medication Adherence, Shelley Moore

Electronic Theses and Dissertations

This study examined the impact of direct nursing care on patient engagement and medication adherence within the practice setting of specialty pharmacy. It investigated the problem statement, “Among patients with specialty pharmacy dispensed medications, will direct interaction with nurses impact patient engagement and improve medication adherence?” Patient engagement in healthcare is a growing area of knowledge for the effectiveness of care. The research uncovered patient engagement as a predictor of improved medication adherence through effective direct nursing involvement. Methods to measure engagement were the utilization of the ACE™ Altarum Consumer Engagement (ACE) Measure™. By using a proven, researched tool to …

Std Education Among African American Women: An Educational Improvement Initiative, Marqueta V. Abraham

Electronic Theses and Dissertations

Research reveals there is a knowledge gap facing African American women regarding sexual health education, specifically sexually transmitted diseases. The Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ) was used to assess participants’ knowledge and attitudes regarding sexually transmitted diseases. The STD-KQ self-assessment was administered to African American women and utilized to develop a 45-minute education seminar to bridge the knowledge gap. After an education seminar was held, a posttest was administered to test the women’s knowledge and to determine their level of awareness. Using a paired-samples t test, the researcher found an overall increase in awareness of the types of sexually …

Emergency Department Nursing Psychological Care (Early Crisis Intervention) For Adult Victims Of Violent Crime: A Quantitative Study, Barbara Conn

Electronic Theses and Dissertations

Recognition of the significance of early interventions and the importance of addressing psychological trauma for the victim of violence is of utmost importance for quality of life and the victim’s future. The serious impact of psychological trauma on victims of violent crime supports further study to determine whether Emergency Department (ED) nurses assess this trauma and initiate early interventions and referral for ongoing psychological care. Nursing care, assessment and early intervention with victims of violent crime was the focus of this dissertation study.

A quantitative study, with a non-experimental, descriptive design employed retrospective chart reviews to determine whether ED nurses …

Contemporary Nursing In Rural Appalachia: A Hermeneutic Study, Evelyn Brewer

Electronic Theses and Dissertations

Nurses make up a significant source of direct care for individuals, families, and communities. The problematic distribution of nurses and the potential to lose practicing nurses emphasizes the importance of retention and support of nursing professionals, especially in rural locations. One of the best ways to discover what is important to nurses is to ask and listen to the replies.

The focus for this dissertation is the lived experience of registered nurses in a six-county area in three adjoining states in rural South Central Appalachia. The purpose of this study is to interpret and understand the lived experience of contemporary …

The Efficacy Of An Educational Intervention To Improve Low Influenza Vaccination Rates Among Federal Health Care Workers, Cynthia Berfect-Shelby

Electronic Theses and Dissertations

Influenza is a preventable communicable illness that has a significant impact on people of all ages. In 2018 it was estimated that 80,000 people died of influenza-related illnesses. Infants and elderly people are among the most vulnerable populations. The Centers for Disease Control and Prevention and Healthy People 2020 recommend that health care facilities have a 90% vaccination rate. Despite the recommendations and a mandatory directive, many facilities within the Veterans Health Administration struggle to reach influenza vaccination rates above 60%. Pender’s health promotion model was used as the theoretical framework to explore the reasons why health care workers refuse …

The Lived Experience Of Recovery Following Transoral Robotic Surgery (Tors) For Head And Neck Cancer, Katharine Mahalik

Electronic Theses and Dissertations

Abstract

Ongoing advances in minimally invasive surgical techniques, such as transoral robotic surgery (TORS), has enabled select patients with head and neck cancer to receive treatment that results in less disfigurement and dysfunction compared with traditional approaches. While TORS research has focused mainly on functional surgical outcomes, a need exists to understand recovery following TORS from the patient perspective. A hermeneutic phenomenological approach was used to recruit patients who had recently undergone TORS at a major academic health system in northeastern US. Data were collected using audio-recorded telephone interviews and field notes and analyzed concurrently. Participants included 17 HNCS (12 …