Other Nursing Commons^™

Transitional Care Of Adult Patients With Diabetes Following Hospitalizations, Eric Tobin

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project was to incorporate a diabetes transitional care program using group visits to improve self-care management behaviors and glycemic control in diabetic patients at a southern California hospital.

Background: Diabetes is a challenging healthcare problem associated with significant mortality and morbidity issues. In 2012, 29.1 million people, or 9.3% of the U.S. population, were diagnosed with diabetes, and 28.9 million of those patients were 20 years of age and older. Today, diabetes is of epidemic proportion worldwide, and a projection of 5.4% of the adult population will have diabetes by 2025. The …

The Contemporary Use Of Nurse Practitioners In U.S. Emergency Departments, Jeffrey L. Bevan

Doctor of Nursing Practice Scholarly Projects

Problem: The increased demand for emergency care in the United States (U.S.) has been well-documented and there is growing utilization of nurse practitioners in U.S. emergency departments. However, little is known about the nurse practitioner (NP) role in the emergency department setting within the past five years.

Purpose: The purpose of this project was to describe the demographic characteristics of patients, patient conditions treated, diagnostic tests ordered, and procedures performed by nurse practitioners in a national sample of U.S. emergency departments.

Methodology: This secondary analysis used a non-experimental quantitative, descriptive exploratory design to review data from the National Hospital Ambulatory …

Promoting Oral Health Knowledge In African American College Students, Terri Huff-Simmons

Doctor of Nursing Practice Scholarly Projects

Objective. The primary aim was to assess African American college student's knowledge of oral health and healthcare access.

Methods. The project was a quantitative descriptive study using a pre and posttest design. A pre questionnaire containing items regarding oral hygiene and oral health based on the recommendations of the American Dental Association (ADA) as well as questions about access to oral healthcare was distributed to African American college students to measure their knowledge. A demographic questionnaire was distributed. Students participated in a 20-30 minute oral health educational program. A post-test was given 4-6 weeks after the initial pre-test.

Results. …

Evidence-Based Strategies To Minimize Risk For Opioid Pain Medication Misuse Among Patients With Chronic Pain In A Primary Care Setting, Carolyn Diane Coleman

Doctoral Projects

Background: Prescription opioid pain medication misuse has become a nationwide epidemic. Many states have implemented prescription drug monitoring programs (PDMP) to assist in combating the problem of prescription opioid pain medication misuse. Evidence-based clinical practice guidelines as well as the PMDP should be utilized by healthcare providers to guide treatment of chronic pain with opioid pain medications. Purpose: The purpose of this doctoral capstone project was to determine if providers are accessing the Prescription Drug Monitoring Program (PDMP) and utilizing evidence-based guidelines to minimize opioid pain medications misuse among patients with chronic pain in a primary care setting. …

Attention Deficit Hyperactivity Disorder And Mindfulness Practice In Children And Adolescents: A Comprehensive Review Of Evidence-Based Research, Donna Nikander

Doctoral Projects

Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental illness in the United States among male and female children and adolescents between the ages of 3 and 17. The emerging fields of neurobiology and neuroimaging have proposed a relationship between mindfulness meditation therapies—initially referred to as mindfulness-based stress reduction (MBSR) and now simply known as mindfulness—and improvements in attention and self-regulation, two major problem areas for ADHD sufferers. Furthermore, recent studies suggest that mindfulness therapies may be effective in reducing symptoms of ADHD in children and adolescents. The purpose of this paper is to review, analyze and synthesize the …

Admission Medication Reconciliation Process To Improve Patient Outcomes, Vanessa Ann Irwin

Doctoral Projects

Medication reconciliation is an important process in the acute care setting that has implications for patient safety and outcomes. The medication reconciliation process occurs at transitions in care and involves disciplines including; nurses, pharmacists, and physicians. The role of the nurse in the admission portion of the process includes collecting and entering home medication information into the electronic medical record. It is crucial for the medication information to be entered in an accurate, timely, and complete manner.

The addition of the electronic medical record has not solved documentation challenges related to medication reconciliation but has added more transparency of issues. …

Commercial Sexual Exploitation: The Role Of The Advanced Practice Nurse In Screening Patient At-Risk, Sheri Rickman Patrick

Doctoral Projects

Problem: Human trafficking or commercial sexual exploitation (CSE) is a global problem effecting every country including the United States. The impact of human trafficking while it is devastating to individuals, the impact goes well beyond individual victims and undermines the health, safety and security of all nations (U.S. Department of State Publication, 2007, p. 5).This research is an attempt to assess the knowledge of advance practice nurses or nurse practitioners (NP) in the subject of commercial sexual exploitation and their willingness to screen their patients who may be at-risk.

Methods: The design was web-based with advanced practice nurses who are …

Factors Leading To Rapid Response Team Interventions In Adult Medical-Surgical Patients, Christine M. Tarver

Doctoral Projects

Rapid Response Team Intervention (RRTI) is a widely used intervention in acute care hospitals in the United States. Demonstrated effectiveness in preventing transfer to higher level of care or in decreasing in-hospital mortality has not been established. This exploratory study used a retrospective chat1 review to examine differences between medical-surgical acute care inpatients who had an RRTI and a control group. CutTent literature lacks information on proactive detection of patients who may be more likely to deteriorate and therefore require a Rapid Response Team Intervention. Therefore, this study's PICO question was: Are there statistically significant differences between medical-surgical adult inpatients …

Tobacco Use And Attachment Style, Mary Heath Wise

Undergraduate Honors Theses

Tobacco has been recognized as the number one cause of preventable death in America and results in almost 5.2 million years of potential life lost each year. The use of tobacco products is highly correlated with pulmonary disease, cardiovascular disease, and other forms of chronic illness in America. Within the last ten years new tobacco products have been trending in the tobacco market such as the water pipe/hookah and e-cigarettes. With e-cigarettes and other newer forms of tobacco on the rise, it is important to look at the underlying factors for using all kinds of tobacco products as a means …

Nurse’S Perceptions Of Visitor’S Adherence To Transmission-Based Precautions, Jocelyn K. Spenillo

Undergraduate Honors Theses

Transmissions based precautions are measures implemented in various clinical health care settings as a means to prevent the transmission of infectious diseases and decrease instances of healthcare acquired infections (HAI). HAI’s result in increased cost to hospitals, longer hospitalization for patients, increased patient suffering, and fatal patient outcomes. While staff member adherence to transmissions based precautions are mandated through various organizations and hospital policies, a review of literature indicates little research has been conducted regarding visitor compliance with transmission-based precautions. The potential implications in healthcare from visitor non-adherence acquired infections are unknown; revealing a gap in literature and supporting the …

Nurses Caring For Adults With Autism In An Emergency Department: A Survey Of Knowledge, Shauna Marie Miller

Doctoral Projects

Autism is a complex neurodevelopmental disorder characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. The nurse (RN) in the emergency department (ED) plays an important role in the receiving, treatment, and management of the patient with autism. RNs must understand the unique challenges of caring for individuals with autism. Fortunately, autism is an active area of research, with copious resources available to assist those affected by this disorder; however, no studies were found evaluating nurses’ knowledge of autism and the number of resources for nurses caring for this population was limited. Nursing is an …

Bio-Identical Hormones Utilized For Treating Menopausal Symptoms: Are They Safe?, Maria D. White

Doctoral Projects

The use of compounded bioidentical hormones in the various forms of gels, creams, and troches has increased in popularity. The population of menopausal women is at a crossroads with the cascade of symptoms and determining what are their options. The Endocrine Society, the Food and Drug Administration, and the National Menopause Society do not support the use of bioidentical hormones, despite the support for bioidentical hormone replacement therapy (BHRT) by the American Academy for Anti-Aging Medicine and other proponents for BHRT. The literature review reveals the need for studies documenting the safety of BHRT. The objective for this study was …

Pain Management At End Of Life When There Is A Co-Occurrence Of Substance Use Disorder: A Qualitative Metasynthesis, Kristina Olfson

Doctoral Projects

Pain management, end of life (EOL) care, and substance use disorder (SUD) are individually identified as National healthcare challenges and priorities. Despite 50 years of advances in the understanding of pain management, pain is still inconsistently assessed and undertreated in all populations, including those with life limiting illness. When a patient with a life limiting illness and history of SUD is encountered, pain management becomes further complicated. Effective pain management for all patients, regardless of coexisting complications, is an ethical obligation of health care providers. Given the lack of research into EOL pain management of patients with SUD, it is …

A Comparison Of Pedagogical Approaches To Error Communication Training, Marie Annette Gilbert

Doctoral Projects

Purpose: The purpose of this study was to compare the effectiveness of two different pedagogical approaches to error communication training.

Background: The literature advocates full, transparent communication following a medical error. However, many barriers to such disclosure exist. A significant barrier is healthcare providers do not feel prepared for these difficult conversations. This can be particularly challenging in a pediatric setting when the conversation with a parent may be more demanding than similar conversations in the non-pediatric settings.

Method: Individuals from three different professional groups were recruited; physicians, pharmacists, and nurses. A randomized controlled study was conducted to investigate …

Cultural Humility: A Lifelong Process For Professional Nurses, Jenny Adelstein

Senior Honors Projects

Cultural humility is necessary for all nurses in order to provide the best quality patient care. It is a life-long process of self-reflection and self-critique, which allows nurses to examine differences and similarities between their own beliefs, values, and health care goals with those of their patients (Schuessler et al., 2012). Cultural humility helps nurses to recognize potential differences in the meaning of health and wellness among their patients, and to begin to understand the many challenges to accessing quality health care. Cultural immersion programs is one educational strategy to allow nursing students to develop cultural humility through acquiring critical …

Survival Of The Fittest: The Role Of Linguistic Modification In Nursing Education, Brenda Strauch Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project’s long term goal was to improve English-as-a-Second-Language (ESL) nursing student retention. Improving the quality of multiple choice exams is a first crucial step. ESL students find multiple-choice exams to be one of the most challenging aspects of nursing school. One reason for this is the presence of linguistic errors in exam questions. Linguistic errors include: irrelevant question content, poor sentence structure, and culturally biased words or phrases. Non-ESL students are less affected because exams are written in their native language. Linguistic modification, as part of best practices in item writing, removes these types of errors. The U.S. Department …

The Effect Of Worked Out Modeling In Nursing Simulation, Jayne Josephsen

Boise State University Theses and Dissertations

This study provides a research framework that incorporates cognitive load theory (CLT) into simulation design and implementation, as well as providing a pilot tool to measure cognitive load specific to nursing simulation. The pedagogy of CLT is based in an understanding of cognitive architecture, which includes working memory, long-term memory, various types of cognitive load, and schema development. A quasi-experimental quantitative design was used with a convenience sample of senior baccalaureate nursing students who participated in simulation as part of their coursework. The treatment group received a worked out modeling intervention, designed upon the CLT instructional intervention of the worked …

A Post Discharge Support Program For Patients Experiencing Psychological Non-Epileptic Seizures: A Pilot Project, Lahoma Prather

Graduate Theses, Dissertations, and Capstones

Abstract

Rationale: There are no accepted standards of care for patients with psychological non-epileptic seizure (PNES) disorder. However the literature regarding PNES identified three common themes including acceptance of the diagnosis; consistent support and follow up; and development of appropriate outcome indicators. This pilot project was designed to address these themes rather than focus on a specific treatment modality.

Methods: The pilot project was initiated at the University of Louisville Comprehensive Epilepsy Center (CEC) to evaluate the feasibility of a post-discharge support program for the PNES population. Outcomes identified for measurement included seizure frequency, health care utilization, anti-epileptic medication use …

Improving Patient Satisfaction After Primary Total Knee Arthroplasty Using Nurse Practitioner-Driven Preoperative Education, Jennifer A. White

Doctor of Nursing Practice Scholarly Projects

Total joint arthroplasty is an undisputed option for relieving pain and improving the function of an arthritic joint. The number of patients undergoing total knee arthroplasty (TKA) annually is expected to increase by 600% in the next two decades (Lau, Gandhi, Mahomed, & Mahomed, 2012).

Current research shows that while 81-89% of patients who have had a TKA are satisfied postoperatively, there is room to improve patient satisfaction by providing further education preoperatively. While research cannot agree on a single, specific variable that influences patient dissatisfaction, a review of the literature shows that patients repeatedly note their “unmet expectations” as …

Strangulation Assessment, Evidence Collection, And Documentation Guidelines For Forensic Nurse Examiners: A Pilot Project, Sally Sturgeon

Graduate Theses, Dissertations, and Capstones

Accurate and thorough physical assessment, with accompanying documentation, are essential components for appropriate legal intervention for victims in all strangulation cases. There is a need for this strangulation assessment, evidence collection, and documentation protocol. Forensic nurse examiners who work with strangulation victims need to be sure that their assessment, evidence collection, and documentation are complete, accurate, and consistent to help ensure perpetrator accountability.

Napnap Position Statement On Immunizations, Lacey M. Eden

Faculty Publications

The National Association of Pediatric Nurse Practitioners (NAPNAP) fully supports timely and complete immunization of all infants, children, adolescents, and adults to maximize the health and well-being of all people. Routine childhood immunizations prevent approximately 2.5 million deaths every year (World Health Organization, 2012). Maintaining the highest immunization rates possible is essential to prevent outbreaks of vaccine preventable diseases across the nation (Centers for Disease Control and Prevention [CDC], 2013). The CDC recommends that all children, adolescents, and adults be immunized to protect children who are most vulnerable to serious illness and death (CDC, 2014). In concert with the American …

How Women Manage Their Pain Non-Pharmacologically During Labor Outside The Hospital Setting, Sarah Christine Schueler

Research Horizons Day Posters

No abstract provided.

Pain, Agitation, And Delirium In The Intensive Care Unit, Elizabeth A. Bailey, Theresa Harris, Haley Hoy, Sandra Carpenter

Research Horizons Day Posters

No abstract provided.

Factors That Lead To Hospital Readmissions And Interventions That Reduce Them: Moving Toward A Faith Community Nursing Intervention, Deborah J. Ziebarth

International Journal of Faith Community Nursing

Abstract

Hospital readmissions affect over 80 percent of all Medicare enrollees. Hospitals have a responsibility to their Medicare patients to keep them safe after discharge in their homes and communities. With changes in the Medicare reimbursement model, hospitals are examining efficient methods of decreasing avoidable re-admissions. A Faith Community Nurse Transitional Care Program may be just the answer to improve patient’s discharge experience, ensure post-discharge support and reduce re-hospitalization.

Methods

In preparations for testing a Faith Community Nurse Transitional Care Program Model, a systematic integrative review was needed. Using PRISMA, a search was done, inclusion criteria identified, and articles retrieved. …

Examining Faith Community Nurses’ Perception And Utilization Of Electronic Health Records, Carole N. Mattingly, M. Eve Main

International Journal of Faith Community Nursing

Abstract

The purpose of this study is to identify current faith community nurse documentation practices, explore factors impacting intention to adopt electronic health records, and identify perceived barriers and benefits to electronic health record use among faith community nurses practicing in the Midwest. The technology acceptance model is used to examine impact of perceived usefulness and perceived ease of use of electronic health records on intention to adopt.

This study is a quantitative exploratory research study utilizing a cross-sectional researcher-developed 39-item questionnaire. Surveys were distributed by mail and e-mail to faith community nurses practicing in South-Central Indiana and Western Kentucky. …

Practice Matters: Screening And Caring For Those With Hypertension, Dawn M. Garrett Wright, Maria E. Main, Mary L. Branstetter

International Journal of Faith Community Nursing

The purpose of this article is to review best practices for screening and monitoring hypertension for Faith Community Nurses (FCNs). Epidemiological data regarding hypertension will be presented, along with current guidelines for blood pressure monitoring. Information on lifestyle modification and patient education resources is included to assist the FCN to improve service to patients at risk for and with current hypertension.

An Evaluation Of Patient Satisfaction With Telephone Follow-Up In An Urgent Care, Audia L. Ellis

Doctor of Nursing Practice Scholarly Projects

Telephone follow-up (TFU) is a very valuable innovation. It is a service that is found to be desirable by both patients and health care professionals. It has been utilized successfully in a variety of settings, however, evidence of its use or evaluation of its use in the urgent care setting has not been found. Through evaluation of patient satisfaction (PS) with use of the protocol, new cost and labor effective interventions were constructed and implemented with the goal of meeting patients’ needs.

This study utilized mixed method methodology and employed a descriptive design. Convenience sampling was utilized and a sample …

Loma Linda Nurse - Vol. 23, No. 01, Loma Linda University School Of Nursing

Loma Linda Nurse

Contents

From the dean

2 | Elizabeth Bossert shares her thoughts

News

4 | New dean continues tradition of strong leadership at LLU School of Nursing

6 | Honoring outgoing dean Marilyn Herrmann

7 | New BS-to-DNP program to begin

8 | First class of CRNA students graduates

9 | Vision 2020 charts future of Loma Linda University Health

10 | School expands to fill West Hall and upgrades skills laboratories

Features

12 | Learning assistance program offers safety net for struggling nursing students

14 Alumni profile: Dexter Emoto honored by grateful patient

15 | Student profile: Christian Rawlon gives …

Access To Care Barriers For Native American Veterans, Joanne Kristen Rhoads

Doctoral Projects

There are very few studies that examine Native American Veterans and access to care issues. Therefore, the researchers implemented an exploratory, descriptive, qualitative project to explore and identify the potential barriers that Native American Veterans have experienced with access to healthcare and participation in veteran benefit programs. A purposeful sample consisted of 14 Native veterans from the American Indian Veteran Association who were eligible for veteran services, and were willing to participate in the project. Fieldwork was performed in the natural environment of the Sierra Nevada foothills on the ancestral homeland of a California Tribe. The facilitator utilized a demographic …

Nursing Students’ Experiences With High-Fidelity Simulation, Rana Halabi Najjar, Bret Lyman, Nick Miehl

Faculty Publications

Research has revealed the effectiveness of simulation for facilitating student development of self-efficacy, knowledge, clinical judgment, and proficiency in technical skills. This grounded theory study was conducted to describe the experience of nursing students in high-fidelity simulation and develop a model which explicates the experience of nursing students in simulation. Focus group interviews were conducted with three cohorts of students enrolled in a baccalaureate nursing program who experienced simulation four to twelve times per academic year. Five prominent themes emerged during analysis Emotional Processing; Anxiety; Making Connections; Fidelity; and Learning. The Simulation Learning Model – Student Experience (SLM-SE) was developed …