Other Nursing Commons^™

Minimizing Pain During Childhood Vaccination Injections: Improving Adherence To Vaccination Schedules, Lacey M. Eden, Janelle L. B. Macintosh, Karlen E. Luthy, Renea L. Beckstrand

Faculty Publications

Pain experienced in childhood can lead to long-term and psychologically detrimental effects. Unfortunately, the most common pain experienced in childhood is caused by vaccinations and may lead to non-adherence to the recommended vaccination schedule. As a result, it is the health care provider's responsibility to take measures to reduce vaccination pain; however, there are a plethora of pain relieving interventions during immunizations and it is unclear which interventions are most cost efficient, timely, and effective. Studies have been conducted to investigate the efficacy of different pain management interventions during vaccinations. This review evaluates various pain relieving interventions and provide health …

Np Bookshelf. [Review Of The Book Compassion Fatigue And Burnout In Nursing: Enhancing Professional Quality Of Life, By V. Todaro-Franceschi], Leslie W. Miles

Faculty Publications

This book is not just for nurses who care for the dying patient but for all nurses who find themselves at some point in their career feeling burned out, dissatisfied with work life, bullied, or lacking a sense of meaning and purpose in their professional quality of life. Todaro-Franceschi identifies the causes of compassion fatigue and burnout as being multifactorial, yet having a core symptom of the nurse internalizing suffering to the point that it negatively transforms the care a nurse can give. The target audience is wide, with application to current practitioners, students, nurse educators, and anyone working in …

Vaccination Perceptions Of School Employees In A Rural School District, Janelle Macintosh, Karlen E. (Beth) Luthy, Renea L. Beckstrand, Lacey M. Eden, Jennifer Orton

Faculty Publications

Background: There continues to be a need for increases in adult vaccination rates, especially among those working in environments which may easily become communicable disease outbreak centers, such as school employees in the school environment. The purpose of this study was to evaluate why rural Utah school employees were non-compliant with the influenza and measles, mumps, and rubella (MMR) vaccines, as well as to identify their views on mandatory vaccination policies.

Methods: A questionnaire was distributed to all school employees in a rural Utah school district. Data analysis included frequencies and measures of central tendency and dispersion for quantitative items …

Role Modeling Clinical Judgment For An Unfolding Older Adult Simulation, Kathie Lasater, Elizabeth A. Johnson, Patricia K. Ravert, Doris Rink

Faculty Publications

Nurse educators must foster development of clinical judgment in students to help them provide the best care for the increasing population of older adult patients. This article reports qualitative findings from a mixed-methods study that focused on clinical judgment in the simulated perioperative care of an older adult. The sample was composed of treatment and control groups of prelicensure students (N = 275) at five sites. The treatment group watched a video of an expert nurse role model caring for a patient similar to the simulation patient, whereas the control group did not watch the video. Four weeks after simulation, …

Intraosseous Vascular Access For Alert Patients, Stacie Hunsaker

Faculty Publications

Nurses are often faced with the challenge of starting an IV line in a patient who is dehydrated, has suffered trauma, or is in shock. Even the efforts of the most skilled clinician may fail, while valuable time is lost. Intraosseous access is a rapid, safe, and effective route for delivering fluids and medications, and is recommended by numerous professional and specialty organizations for both pediatric and adult patients. Yet many clinicians remain unaware of the procedure. This article outlines the procedure and devices used, describes support for use in the literature, and discusses various considerations and nursing implications.

Femoroacetabular Impingement: A Guide To Diagnosis In Primary Care, Alec Rimmasch Jr., Patricia K. Ravert

Faculty Publications

Femoroacetabular impingement (FAI) has been a diagnosis for approximately a decade in the medical field. Although FAI was once considered uncommon, it is now documented as 1 of the most common hip disorders. FAI is a variance or overgrowth within the femoral head neck space, acetabular ring, labrum, or cartilage. Patients with FAI frequently present in a general practice setting and endure months of pain and physical therapy before a correct diagnosis is ascertained. Understanding FAI and appropriate treatment and diagnostic procedures will facilitate early diagnosis in the primary care setting, providing the best chance for patient recovery.

Study Abroad Programs: Using Alumni And Graduate Students As Affiliate Faculty, Sheri Palmer, Debra Wing, Leslie Miles, Sondra Heaston, Karen H. De La Cruz

Faculty Publications

To expand student appreciation of global health and diversity, many schools of nursing offer study abroad programs. However, this type of labor-intensive program can be difficult in light of faculty shortages and constrained resources. The authors discuss how these issues were addressed using alumni and graduate students as affiliate teachers in 3 clinical study abroad settings.

Underutilization Of Primary Care Providers In Treating Opiate Addiction, Jennifer Jenkinson, Patricia K. Ravert

Faculty Publications

There are inadequate numbers of care providers or treatment programs to treat opioid abuse. Although many primary care nurse practitioners care for patients who are dependent on or abuse opioids, they are not allowed to prescribe the schedule 3 medications to treat them. This option is available to primary care physicians with additional training. This article discusses the effectiveness of opioid substitution therapy in a primary care setting, the patient populations, patient satisfaction, and barriers preventing primary care providers from providing treatment to opioid patients. Nurse practitioners can help overcome some of these barriers and improve access to this underserved …

Nln/Jeffries Simulation Framework: State Of The Science Summary, Patricia K. Ravert, Julie Mcafoees

Faculty Publications

In summer 2011, a research task force from the International Association of Clinical Simulation and Learning (INACSL), in consultation with Dr. Pamela Jeffries, invited international nursing researchers and educators to participate in a project to evaluate state-of-the-science and existing research regarding the simulation model/framework (Jeffries, 2005, Jeffries, 2007). The model/framework was developed to define simulation education variables and provide an organized guide. The 21 researchers and educators worked on one of five teams, one for each of the five existing major model/framework constructs (Teacher, Student, Educational Practices, Outcomes, and Simulation Design Characteristics).

Cultural Aspects Of Latino Early Childhood Obesity, Lauren Clark, Susan L. Johnson, Mary E. O'Connor, Jane H. Lassetter

Faculty Publications

The problem of Latino childhood obesity is well known, and experts agree that the sooner it is addressed in a child’s life, the better. Strong evidence from nationwide studies suggests that obesity begins in infancy for Mexican Americans. National data demonstrate the dramatic increase in weight-for-recumbent length above the 95th percentile (using the NCHS growth chart) among Mexican American children between National Health and Nutrition Examination Survey (NHANES) and the Third National Health and Nutrition Examination Survey (NHANES III) (Ogden et al., 2006). High rates of childhood obesity affect the long-term health potential of children, since childhood obesity tracks into …

Medical Home Model Of Patient-Centered Health Care, Sandra N. Berryman, Sheri P. Palmer, James E. Kohl, Jon S. Parham

Faculty Publications

The medical home offers a patient-centered model of care. The foundation of a medical home is the organized and continuous interprofessional care of patients.

Late-Life Body Mass Index And Dementia: An Integrative Literature Review, Sarah Slade, Patricia K. Ravert

Faculty Publications

Dementia and obesity are significant public health concerns. Alzheimer's disease affects 5.3 million adults, while 72.5 million adults are obese. Emerging evidence linking body mass index (BMI) and dementia suggest that, although a high BMI in midlife is associated with a greater risk for dementia, a high BMI in late life is considered protective and should not necessarily be considered a risk factor for dementia. Beginning in midlife, practitioners should trend patient BMI numbers. Major fluctuations during this time should be monitored and nutritional counseling and cognitive screenings offered to help patients maintain a healthy BMI and detect early cognitive …

Cost-Effective Asthma Treatments For Uninsured Or Underinsured Pediatric Patients, Karlen E. (Beth) Luthy, Emilianne Dougall, Renea L. Beckstrand

Faculty Publications

Nurse practitioners should constantly compare a medication's potential effect with its associated cost, thus identifying the most cost-effective treatment plan. Such an approach is warranted for both pediatric and adult patients. Prescribing medications for children who are uninsured or underinsured can be especially challenging, particularly for those patients diagnosed with a chronic health condition requiring routine treatment and follow-up. Asthma can be such a chronic illness for which the cost associated with treatment may become a barrier to compliance with the treatment plan. Cost-effective treatment options for asthma in the pediatric patient are presented.

Situated Peer Coaching And Unfolding Cases In The Fundamentals Skills Laboratory, Deborah O. Himes, Patricia K. Ravert

Faculty Publications

Using unfolding case studies and situated peer coaching for the Fundamentals Skills Laboratory provides students with individualized feedback and creates a realistic clinical learning experience. A quasi-experimental design with pre- and post-intervention data was used to evaluate changes in student ratings of the course. An instrument was used to examine students' self-ratings and student comments about each lab. We found that students' ratings of the lab remained high with the new method and self-evaluations of their performance were higher as the semester progressed. Students appreciated the personalized feedback associated with peer coaching and demonstrated strong motivation and self-regulation in learning. …

Oncology Nurses' Obstacles And Supportive Behaviors In End-Of-Life Care: Providing Vital Family Care, Renea L. Beckstrand, Joan Collette, Lynn Callister, Karlen E. (Beth) Luthy

Faculty Publications

Purpose/Objectives: To determine the impact of obstacles and supportive behaviors in end-of-life (EOL) care as perceived by hospital-based oncology nurses.

Design: A 69-item mailed survey.

Setting: National random sample.

Sample: 1,005 nurse members of the Oncology Nursing Society who had provided EOL care for patients with cancer.

Methods: Three mailings yielded 380 usable responses from 912 eligible respondents, resulting in a 42% return rate.

Main Research Variables: Size and frequency of EOL care obstacles and supportive behaviors for patients with cancer in a hospital setting.

Findings: Results of this research demonstrate the need for more EOL education and help in …

Emergency Nurses' Suggestions For Improving End-Of-Life Care Obstacles, Renea L. Beckstrand, R. Daniel Wood, Lynn C. Callister, Karlen E. (Beth) Luthy, Sondra Heaston

Faculty Publications

Introduction: More than 123 million ED visits are reported annually. Many patients who arrive for care to help extend their lives instead die while in the emergency department. Emergency departments were designed to save lives rather than to provide optimal end-of-life (EOL) care. Emergency nurses care for these dying patients and their families. The purpose of this study was to determine what suggestions emergency nurses have for improving EOL care.

Methods: Emergency nurses were asked which aspects of EOL care they would like to see changed to improve how patients die in emergency departments. Of the 1000 nurses surveyed, 230 …

The Last Frontier: Rural Emergency Nurses’ Perceptions Of End-Of-Life Care Obstacles, Renea L. Beckstrand, Virginia C. Giles, Karlen E. (Beth) Luthy, Lynn C. Callister, Sondra Heaston

Faculty Publications

Introduction: Caring for dying patients is part of working in a rural emergency department. Rural emergency nurses are prepared to provide life-saving treatments but find there are barriers or obstacles to providing end-of-life (EOL) care. This study was completed to discover the size, frequency, and magnitude of obstacles in providing EOL care in rural emergency departments as perceived by rural emergency nurses.

Methods: A 57-item questionnaire was sent to 52 rural hospitals in Idaho, Wyoming, Utah, Nevada, and Alaska. Respondents were asked to rate items on size and frequency of perceived obstacles to providing EOL care in rural emergency departments. …

Emergency Nurses' Perception Of Department Design As An Obstacle To Providing End-Of-Life Care, Renea L. Beckstrand, Ryan J. Rasmussen, Karlen E. (Beth) Luthy, Sondra Heaston

Faculty Publications

Introduction: Of the 119.2 million visits to the emergency department in 2006, it was estimated that about 249,000 visits resulted in the patient dying or being pronounced dead on arrival. In 2 national studies of emergency nurses' perceptions of end-of-life (EOL) care, ED design was identified as a large and frequent obstacle to providing EOL care. The purpose of this study was to determine the impact of ED design on EOL care as perceived by emergency nurses and to determine how much input emergency nurses have on the design of their emergency department.

Methods: A 25-item questionnaire regarding ED …

Evaluation Of Methods To Relieve Parental Perceptions Of Vaccine-Associated Pain And Anxiety In Children: A Pilot Study, Karlen E. (Beth) Luthy, Renea L. Beckstrand, Amy Pulsipher

Faculty Publications

Introduction: The pain and anxiety associated with vaccination is a significant reason why parents are reluctant to have their children vaccinated. Distraction methods and vapocoolant sprays may be use to modify the parent's perceptions of their child's pain and anxiety, thus encouraging parents to return for the child's next vaccination.

Methods: A convenience sample of 68 parents with children ranging in age from 2 to 12 years was selected. The parents and the child were randomly assigned to three groups: a control group, a DVD distraction group, or a vapocoolant spray group. After the child was vaccinated, parents evaluated the …

A 2010 Survey Of The Inacsl Membership About Simulation Use, Teresa Gore, Patrick Van Gele, Patricia K. Ravert, Cédric Mabire

Faculty Publications

Background: The survey was used to identify current nursing simulation practices of the INACSL membership.

Method: The similarities between U.S. and international responders identified: (a) the education/experience of simulation educators, (b) use of a theory/conceptual framework, (c) use of commercial based simulation products and internally created scenarios, (d) interprofessional simulation, (e) student roles played in simulation, (f) regulation of simulation by licensing/governing body, and (g) simulations based on objectives.

Results: Significant differences were noted: (a) mandatory viewing of recording, (b) length of debriefing time, (c) ratio of simulation counted as clinical hours, (d) use of National League for Nursing simulation …

History And Development Of The Simulation Effectiveness Tool (Set), Victoria L. Elfrink Corgi, Kim Leighton, Nancy Ryan-Wenger, Thomas J. Doyle, Patricia K. Ravert

Faculty Publications

Background: There has been a lack of reliable and valid instruments measuring human patient simulation effectiveness reported in the literature. Two related studies addressing this concern are described.

Methods: A multi-phased pilot investigation at a single nursing program (N=161) and a follow-up multi-site national study (N=645) evaluated the reliability of the Simulation Effectiveness Tool (SET) as a measure of the effectiveness of a simulated clinical experience (SCE).

Results: Findings from the pilot study resulted in a revision of the original 20-item evaluation tool to a 13-item 3-point ordinal scale instrument. Two subscales, “confidence” and “learning” were noted with Chronbach's alpha …

Debriefing Experience Scale: Development Of A Tool To Evaluate The Student Learning Experience In Debriefing, Shelly Jensen Reed

Faculty Publications

Background: Debriefing represents the reflection phase of the simulation process, in which feelings are resolved and learning is solidified, but the nursing student experience during debriefing is largely unknown.

Method: The Debriefing Experience Scale was developed from debriefing literature and expert opinion. This scale was used in 2 research studies and refined through the use of factor analysis.

Results: The resulting scale, divided into 4 subscales, consists of 20 items defining the nursing student debriefing experience.

Conclusions: The Debriefing Experience Scale has the potential to assist in providing further insight.

Giving Birth: The Voices Of Women In Tamil Nadu, India, Cheryl A. Corbett, Lynn Clark Callister

Faculty Publications

Purpose: The purpose of this qualitative descriptive study is to describe the perceptions of childbearing women living in Tamil Nadu, India. This study can increase cultural understanding and foster cultural competence in nurses caring for Indian women.

Study Design and Methods: Women were invited to share their childbearing experiences. Following institutional review board approval, interviews were held with 22 women who had given birth in the previous 18 months to a viable infant. The women were grateful for the opportunity to share their perspectives with an interested nurse investigator. Data collection proceeded concurrently with data analysis. Themes were generated collaboratively …

Developing Positive Attitudes Toward Geriatric Nursing Among Millennials And Generations Xers, Barbara A. Heise, Vickie Johnsen, Deborah O. Himes, Debra Wing

Faculty Publications

Despite the increase of the older adult population, there exists a shortage of health care professionals trained to help this population remain independent as long as possible. Ageism, common among younger adults, affects the capacity building of health care for older adults. Research has indicated that increased knowledge about older adults, as well as exposure to the elderly, may alter nursing students' attitudes regarding careers in gerontological nursing. However, questions remain as to what are the most effective ways to provide gerontological content in nursing programs and enhance attitudes toward older adults. With the understanding that younger adults see a …

Mild Traumatic Brain Injury: Are Ed Providers Identifying Which Patients Are At Risk?, Barbara Stuart, Barbara Mandleco, Renea L. Beckstrand, Sondra Heaston

Faculty Publications

Objective: To identify patients with specific ED discharge diagnoses reporting symptoms associated with a mild traumatic brain injury (MTBI), compare frequency/severity of MTBI symptoms by discharge diagnosis, investigate head injury education provided at ED discharge, and learn about changes made by MTBI patients after injury.

Methods: The Post Concussion Symptom Scale, a demographic questionnaire, and open-ended questions about the impact the injury had on patients' lives were completed by 52 ED patients, at least 2 weeks after injury, discharged with concussion/closed head injury, head laceration, motor vehicle crash (MVC), or whiplash/cervical strain diagnoses.

Results: Between 1 and 23 MTBI symptoms …

Code Simulations And Death: Processing Of Emotional Distress, Jane D. Leavy, Calvin J. Vanderhoff, Patricia K. Ravert

Faculty Publications

It is important for nursing students to be exposed to critical patient care scenarios because high stress clinical situations, such as patient codes, occur unexpectedly and infrequently in the clinical setting. In addition, it is important for nursing students to be exposed to the reality of patient death in order to help them overcome fears associated with death and to develop effective coping strategies. Students may or may not have an opportunity to deal with patient codes or patient death in the clinical setting, therefore simulation labs provide students with the opportunity to practice important clinical skills and discuss emotions …

Perspectives On Nursing: Using Multimedia Interviews To Influence Career Decisions, Karen M. Lundberg, Michael C. Johnson, Cheryl A. Corbett, Michael Thompson

Faculty Publications

Students often have misconceptions regarding the reality of nursing and the opportunities available to nurses that sometimes result in poor choices related to pursuing nursing as a career. To help prenursing students make better-informed career decisions and address misunderstandings, faculty developed the DVD and Web site Perspectives on Nursing, a collection of 15 nurse interviews. The authors describe and discuss the project, the value of recorded nurses' stories, analysis of student feedback, and recommendations.

A New Life For The Care Plan?, Laura K. Heermann Langford, Ann Tinker, Marc-Aurel Martial

Faculty Publications

The current hot topic within clinical informatics is meaningful use and incentive payments defined under the Health Information Technology for Economic and Clinical Health (HITECH) Act's electronic health record (EHR) incentive program. This recent legislation calls for healthcare providers to meet a set of minimum requirements using a certified EHR. The point of this government program is to support the widespread adoption of the EHR. The program lays out an overall plan that incentivizes hospitals and providers to implement, adopt, and "meaningfully" use an EHR. The incentive program starts with basic data entry and exchange in a standardized manner, with …

Improving Immunization Rates In The Clinic And In The Community, Karlen E. (Beth) Luthy, Arlene M. Sperhac, Sandra A. Faux, Joseph K. Miner

Faculty Publications

Over the past decade, the United States haas had tremendous success in achieving very high immunization compliance rates among children, sometimes as high as 91%. However, despite progress toward controlling the spread of communicable disease through immunizations, more than 2.1 million children nationwide are not adequately immunized. Even among US children who are adequately immunized, only about half of them actually received their immunization on time.

Postpartum Depression And Culture: Pesado Corazon, Lynn Clark Callister, Renea L. Beckstrand, Cheryl A. Corbett

Faculty Publications

The purpose of this article is to describe what the -literature has shown about postpartum depression (PPD) in culturally diverse women. The majority of qualitative studies done with women identified as -having PPD have been conducted with Western -women, with the second largest group focusing on Chinese women. This article reviews the qualitative studies in the literature and discusses how the management of PPD in technocentric and ethnokinship cultures differs. Social support has been shown to be significantly related to fewer symptoms of PPD, and culturally prescribed practices may or may not be -cultural mediators in decreasing the incidence of …