Nursing-Dissertations
Permanent URI for this collectionhttps://hdl.handle.net/11274/8864
Browse
Browsing Nursing-Dissertations by Issue Date
Now showing 1 - 20 of 699
- Results Per Page
- Sort Options
Item A retrospective study to identify unique contributors to falls in hospitalized adult hematology patients(1/10/2020) Mbango, Catherine; Toms, RobinA fall may be defined as an event that results in a person coming to rest inadvertently on a lower level surface or an unplanned descent to the floor with or without injury. Fall prevention is a concept associated with hindering a fall from happening through advance care planning or action. The body of knowledge on falls, risk factors, consequences, and prevention originates from studies of older persons who have experienced a fall. The medical community has made several efforts toward fall risk assessment with an emphasis on prevention of the reoccurrence of falls, but this approach could potentially skew attention away from initial fall prevention efforts. The purpose of this retrospective case-control study was to identify unique contributors to falls in hospitalized adult cancer patients with a hematologic diagnosis. Falls in this population are a great safety concern for nurses and other healthcare providers. Patients with hematologic disorders are at an increased risk of sustaining an injury due to their low platelet counts resulting from chemotherapy and radiation treatments. Patient falls, and patient falls with injury are healthcare outcome measures that are currently being used to evaluate the quality of hospital nursing care, and are an integral part of the National Database of Nursing Quality Indicators (NDNQI). The Centers for Medicare and Medicaid Services no longer reimburses hospitals for in-hospital falls with injury, therefore, placing a greater burden on nursing staff to ensure patient safety through the development of nurse-driven fall prevention strategies, and the implementation of risk reduction plans of care. A total of 94 electronic medical records, which served as the primary sources of data were reviewed in this study and data on ten independent variables and one dependent variable were analyzed. Simple logistic regression between continuous variables and one dependent variable, and cross-tabulation between categorical variables and the dependent variable was used to analyze study results. Stepwise logistic regression was utilized for the final analysis of data. The relationship between fall incident and fall risk assessment score on admission was significant, X2 (1) = 6.153, p<.013, Cramer’s V = .256. Additional research is planned for generalizability.Item Capability beliefs to access research-based knowledge in emergency department registered nurses who provide direct care: A two-group randomized control trial(1/11/2019) McKinney, Ivy; Dello Stritto, Rita A.The purpose of this study was to examine the effect of an evidence-based practice video on capability beliefs of emergency nurses to access research-based knowledge for everyday practice. A randomized, two-group, experimental design was implemented using a sample of 260 emergency department (ED) nurses. The experimental group consisted of 147 nurses, each of who viewed the intervention video, which demonstrated user-friendly ways to access research-based knowledge. The remainder of the participants viewed an unrelated video. Confidence levels were measured using the Evidence-Based Practice Capability Beliefs Scale (EBPCBS) post intervention. For inferential findings, data was analyzed using Independent T-tests and Mann-Whitley U. Descriptive statistics and p-values were compared and Chi-square statistics were used. The setting for data collection for this study was online via a link to a survey in PsychDATA. Convenience sampling using a peer-referral strategy was used to recruit participants. Demographic information was obtained following completion of the survey. There were statistically significant differences (p< 0.05) between the randomized groups for each survey question, as well as overall confidence levels. Confidence levels were measured as mean scores for the six questions on the EBPCBS, with the intervention group consistently scoring higher. Descriptive statistics for the sample found no significant differences between the two groups based on demographic data. The ED nurses, who viewed the intervention video, reported significantly higher confidence levels (M = 3.00, SD = 0.63) to access research-based knowledge, when compared to ED nurses who viewed an unrelated video group (M = 2.51, SD = 0.98). Key words: evidence-based practice, research-based practice, research-based knowledge, capability beliefs, nursing best practice, nurse decision-making.Item The lived experience of fathers caring for their child with cystic fibrosis(1/2/2019) Shardonofsky, Jana; Cesario, SandraCystic fibrosis (CF) is a life-shortening genetic disease with many treatment requirements that necessitate the participation of a caregiver, especially if the patient is a child. Most studies of the quality of life of caregivers of children with CF have focused on the mental health of mothers, reflecting a biased underlying assumption that mothers are the primary caregivers. The aim of this study was to explore the experience of fathers caring for a child with CF. Twenty fathers of children with CF were studied by use of a semistructured interview using Husserl’s descriptive phenomenology. Six themes emerged from the interviews: feeling overwhelmed, feeling isolated, experiencing altered family dynamics, actively seeking resources, experiencing financial strain, and feeling hope. Fathers of children with CF reported distressing experiences in connection with their child’s diagnosis of CF and during the course of their child’s disease, but they also a had strong feelings of hope for the future.Item Exploring hematology oncology nurses experiences of moral distress using a grounded theory approach(1/2/2020) Buitrago, Joaquin A; Freysteinson, Wyona M.Moral distress is historically defined as occurring when an individual knows the right thing to do, but due to institutional or interpersonal constraints, is unable to do it. Moral distress is associated with increased burnout and turnover for healthcare professionals and potentially even adverse outcomes for patients, all of which are costly for healthcare systems. Moral distress is most prominent in emergency room, intensive care and oncology nurses, with most studies focused on nurses in the emergency and intensive care settings. While moral distress has been broadly defined for oncology nurses there is a dearth of information specific to hematology-oncology nurses, for whom extended length of stay related to treatment and related toxicities may influence the contributing factors to their experience of moral distress, distinct from those experienced by emergency and intensive care nurses. This qualitative study applied a Grounded Theory approach to explore hematology-oncology nurses’ experience of moral distress. The use of constant comparison techniques within this methodology allowed for exploration and identification of patterns of moral distress in this unique nursing population and relationships between those patterns. These insights informed what contributing factors to moral distress may be similar to or distinct from those experienced by nurses in other specialties. The identification of these contributing variables informs more robust theoretical models and can guide the development of interventions specific to the hematology-oncology nursing community.Item Exploring hematology/oncology nurses’ recognition of patients at risk of sepsis(1/7/2021) Brydges, Ninotchka; McFarlane, JudithThis descriptive exploratory study, guided by Carper’s (1978) patterns of knowing, explored hematology/oncology nurses’ recognition of patients at risk of sepsis. Semi-structured open-ended interview questions (with additional prompts as necessary) were used during individual face-to-face interviews of 14 clinical nurses to understand their experience when caring for hematologic/oncologic patients at risk of sepsis and how they differentiate between sepsis and other treatment-related complications such as those related to chemotherapy. Interviews were digitally recorded and subsequently were carefully analyzed using Colaizzi’s (1978) method of analysis. The primary finding of this analysis was the overarching theme of Act Quickly and Decisively. This study, regarding the recognition and differentiation of sepsis, may enhance understanding of the experiences and tools used by clinical nurses in hematologic/oncologic settings. Recommendations for further research include the development of an evidence-based educational training module focused on early assessment and intervention, including differentiation alert tools. Improved understanding resulting from the development of such a training module would subsequently improve patient outcomes.Item Beyond hearing: Nurses' active empathetic listening behaviors from the voice of the patient(1/8/2020) Myers, Karen K., MSN; Krepper, RebeccaThe purpose of this study was to distinguish between effective and ineffective nurse active empathetic listening (AEL) behaviors as perceived by adult inpatients from an acute care hospital. Nurse communication and more specifically, nurse listening is at the core of nurse-patient interaction and influences quality, safety, and patient experience. Nurse listening from the patient’s perspective is poorly understood with a large gap in nursing science. A non-experimental two-group comparison descriptive study was conducted to determine if there was a difference in AEL behaviors as perceived by patients for nurses who listened (n=194) and those who did not (n=50). The two groups were identified based on the response to an initial filter question. A total of 244 medical and surgical patients responded to survey instruments (biographical data form; AEL survey) sent either to their home address or via email at a minimum of 15 days post discharge from a large acute care facility. No statistical difference was found between the demographics of the two groups. An independent t-test (α=.05) revealed a statistically significant difference in the two groups perception of listening behaviors for those who listened and those who did not based on total score, subscales (sensing, processing, and responding) and each of 11 AEL items. The AEL behavior most frequently identified by all participants as most important to them as a patient was “My nurses understood how I felt.” The Cronbach’s alpha calculated for the AEL scale’s total score and subscales exhibited strong reliability. In conclusion, the findings of this study begin to narrow the gap in nursing science related to nurse listening behaviors from the perspective of the patient. Through a better understanding of nurse listening, practice changes can be implemented to impact quality, safety, and the patient experience.Item A randomized controlled trial evaluating the effectiveness of an online educational intervention on interprofessional team collaboration(10/28/2021) Garey, Amanda Kay; Landrum, PeggyThe purpose of this study was to examine the effectiveness of an online interprofessional education competency (IPEC) online educational module intervention on the level of interprofessional team collaboration (ITC) on three subscales, as measured with the Assessment of Interprofessional Team Collaboration Scale (AITCS-II) in interprofessional healthcare providers. A two-group randomized controlled trial, with repeated measures design was used for this study. This study was conducted from October 2020 to June 2021. A computer-based randomized generator assigned 161 subjects to the intervention (n = 75) or control group (n = 86). The intervention group participated in an IPEC focused module and the control group participated in a routine family-centered care module. Data collection for both the intervention group and control group occurred at three time points: at baseline, immediately after completion, and at 1 month after completion of the module. The intervention group had statistically significant differences in all three subscales of the validated AITCS-II tool immediate post-intervention in partnership (p < .001), coordination (p < .001), and cooperation (p < .001) in comparison to the control group. The control group was not statistically significant at any time period. The intervention module was effective in increasing the level of collaboration within healthcare teams. This study supports assessing teams for their level v of interprofessional collaboration, providing insight into strengths and weaknesses of interprofessional teams, and integrating Interprofessional Education Collaborative (IPEC) related education is impactful. Study outcomes can assist organizations in building strategic plans to meet professional development goals and quality outcomes. The study findings have the potential to motivate healthcare leaders and researchers to replicate similar studies and seek further evidence to translate research into practice.Item Reducing novice baccalaureate nursing student test anxiety and improving test performance through a test-taking intervention: A pilot study(10/3/2018) Schrader, Patricia Kyle; Young, AnneThe purpose of this experimental posttest only study was to examine the effectiveness of a three hour test-taking program, when compared to a presentation on professional nursing roles program, on test anxiety levels and test performance of junior undergraduate nursing students enrolled in a baccalaureate college of nursing. The Transactional Model of Test Anxiety by Zeidner (1998) guided the literature review and development a cognitive intervention to modify an individual’s personal variable of study skills in hopes of reducing test anxiety and improving test accuracy. The presentation was followed by 14-weeks of online activities to reinforce concepts and application of a systematic approach to answer test questions. The pilot study included a diverse sample of 57 subjects, from 20 to 47 years of age, who were randomized into either the intervention or control groups. The test anxiety scores, measured by the Test Anxiety Inventory by Spielberger et al. (1980), included total test anxiety (TAI-T), worry (TAI-W), and emotionality (TAI-E), were gathered immediately prior to the final exam. The final exam, accounted for 15% of the course grade was the HESI® fundamental specialty exam, served as the academic performance measurement. The results revealed first semester junior nursing students have a moderate (64.9%) to high (15.8%) propensity of test anxiety. A one tailed independent t-test was used to reject all four directional hypotheses. This educational intervention followed with 14 weeks of application activities did not decrease total test anxiety scores compared to the attention control group (p = 0.44). Nor did the test anxiety subscales of worry (p = 0.48) and emotionality (p = 0.37) differ significantly between groups. The slight improvement in the HESI® fundamental specialty exam mean score of 32.9 points in the intervention group was not statistically significant (p = 0.21). The effect size for this particular educational intervention was very small. A power analysis revealed larger sample sizes are needed for future research. Test anxiety is a complex construct which will require a much more robust holistic intervention to modify more than a few personal variables in order to improve academic performance.Item Pain catastrophizing and prolonged opioid use following lumbar fusion(10/30/2017) Lall, Maureen P.; Restrepo, Elizabeth; Hamilton, Patricia A.; Scott-Tilley, DonnaHealthcare providers commonly prescribe long-term opioid therapy for patients following lumbar fusion despite a lack of evidence that opioids are a safe or effective intervention for chronic pain. The purpose of this prospective, longitudinal study was to examine the prevalence and predictors of prolonged, prescribed opioid use in a cohort of 57 patients undergoing elective lumbar fusion. Prior to surgery, participants completed a demographic and clinical variables questionnaire and the Pain Catastrophizing Scale (PCS). Sixty-one percent (n = 35) of participants reported preoperative opioid use. The mean preoperative pain rating was 7.65 (SD = 1.87), and the mean pain catastrophizing score was 28.85 (SD = 14.72). Three months following lumbar fusion, participants self-reported their prescribed opioid use and their postoperative pain intensity. Forty-four percent (n = 22) of participants reported continued opioid use. The mean postoperative pain intensity rating was 3.12 (SD = 2.15). Pain catastrophizing was neither significantly correlated with time to opioid cessation (r = .03, p = .86), nor with postoperative pain intensity (r = -.04, p = .82). Multiple regression analysis was conducted to identify the best combination of age, sex, employment status, educational level, preoperative pain intensity, preoperative opioid use, disability status, and pain catastrophizing to predict time to opioid cessation. Bivariate analysis identified a strong correlation between time to opioid cessation and preoperative opioid use (r = .46, p = .000), and a moderate correlation between time to opioid cessation and disability (r = .29, p = .022). Multiple regression analysis indicated that preoperative patient characteristics predicted prolonged, postoperative opioid use, and accounted for 18% of the variance in time to opioid cessation [R2 = .322, R2adj = .179, F(8, 38) = 2.254, p = .044]. Among preoperative patient characteristics, preoperative opioid use was the sole predictor that significantly contributed to the model (β = .466; p = .005). Thus, screening patients for opioid use prior to lumbar fusion may help to identify patients at increased risk of prolonged opioid use following lumbar fusion.Item Experiences of direct care registered nurses using a professional practice model: A qualitative study(10/9/2019) Kitchen, Rhonda; Young, AnneOBJECTIVE: The goal of this descriptive phenomenological research was to explore the individual and collective lived experiences of inpatient, direct care nurses practicing in a community-based hospital within the framework of a nursing professional practice model. Method: A snowball sampling methodology was employed. Data were collected via semi-structured focus groups with twenty participants. Qualitative data analysis followed Colaizzi’s steps to arrive at common themes and provide rich detail. Scientific rigor and trustworthiness were maintained. Results: Six main themes emerged the described the nurses’ lived experiences with the PPM. Foundation of care; promotion of consistent and standardized patient care. Professional knowledge; expanding personal knowledge and subsequent sharing of this knowledge to edify nursing peers. Reflective practice; change in practice and improved patient care facilitated by reflective practice and reflective thinking. Collegiality; PPM use facilitated interdisciplinary communication and professional growth. Cohesion of model components, whole PPM greater than the sum of the individual components. Inconsistency of use; fragmented model use and reinforcement. These themes incorporated the aspect of model use, outcomes, and opportunities for improvement. Findings: If institutions want to implement and actively use a PPM, active promotion beyond a simple orientation is required. The PPM must be highly visible, consistently reinforced, and use continuously evaluated. Administration, managers, and nursing staff need a congruent expectation and understanding of model use and adoption. Managers should evaluate model use as part of the performance review process. Nurses should familiarize themselves with the institutional PPM, actively engage the PPM, and hold one another accountable for PPM use.Item Exploring perceptions of learner presence in online baccalaureate degree completion students(11/13/2017) Olson, Christina C.; Mancuso, Peggy; Benham-Hutchins, Marge; Liu, Fuqin, 1977-; Stankus, Jo-AnnOnline baccalaureate completion students represent a large and growing population in nursing education today. The purpose of this descriptive exploratory study was to (a) measure Learner Presence in online RN-to-BSN students, (b) identify student characteristics that may relate to Learner Presence, (c) identify program-specific characteristics that may relate to Learner Presence, and (d) determine if, and how, student and program-specific characteristics affect the variable of Learner Presence. Two instruments were used. The Modified Community of Inquiry Learner Presence Scale (MCLPS) is a 21-item self-report based on the social and cognitive presence constructs of the Community of Inquiry Survey (Arbaugh, et al., 2008). The researcher developed the 14 item, RN-to-BSN Student and Program Characteristics Questionnaire, which is based on key characteristics of RN-to-BSN students and program characteristics of online education. The setting for this study was internet based, and a purposeful convenience sample consisted of 239 online RN-to-BSN students in the United States. Descriptive statistics, confirmatory analysis of the MCLPS, Pearson Product Moment correlations, and Independent t tests were conducted. Multiple logistic regression was also used to answer the research questions. A weak negative correlation (r =-.192, p < .003) was found between age and Learner Presence. Additionally, three significant predictors of Learner Presence scores included the course activities used in online courses: (a) papers (p = .042), (b) group projects (p = .008), and (c) online presentations (p = .011) were determined. Group projects were positively associated with higher Learner Presence scores (t = 2.679), whereas online presentations (t = -2.55) and papers (t = -2.044) were negatively associated with lower Learner Presence scores.Item The lived experiences of women during their journey to diagnosis of systemic lupus erythematosus(11/18/2020) Broadway-Duren, Jacqueline B.; Cesario, Sandra; Nibert, AinslieSystemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects women during the third or fourth decade of life. The multisystemic nature of the disease is associated with highly variable onset. The purpose of this descriptive phenomenological study is to explore the meanings of the participant’s life experiences, their perceived challenges of delayed diagnosis, and the influence on their health outcomes. The results of the study are intended to inform health care providers of the challenges encountered by patients while seeking a diagnosis of SLE. It is estimated that SLE affects nearly 1.5 million persons in the United States (US) and three to four times more prevalent in African American females than Caucasian females. Historically, in the U.S., SLE patients had poor outcomes and significant morbidity and mortality. It is theorized that delayed diagnosis of SLE is associated with insufficient health care provider knowledge of clinical manifestations and diagnostic criteria. The study explored the patient's perspective on the challenges faced while seeking a diagnosis. Study participants were recruited from the Houston Chapter of the National Lupus Foundation and the local faith community throughout metropolitan Houston, Texas. Purposive sampling was used to recruit participants who met the inclusion criteria including women age 18 years or older, a confirmed diagnosis of SLE, and English speaking and reading. Data were collected through one-hour semi-structured audio-recorded via Zoom, Face Time, or phone interviews and a demographic data questionnaire. The framework of Lincoln and Guba (1985) will address trustworthiness and will be used to ensure credibility, dependability, transferability, and confirmability. Data analysis will be on-going and guided by Colazzi’s (1978) method of analysis. The steps of Colazzi's method include (1) familiarization, (2) identifying significant statements, (3) formulating meanings, (4) clustering themes, (5) developing an exhaustive description, (6) producing the fundamental structure, and (7) seeking verification of the fundamental structure.Item Caring in nursing education: The role of the educator(11/18/2021) Gillson, Suzanne M; Freysteinson, WyonaThe purpose of this study was to discover the perception and demonstrating of caring by nurse educators towards nursing students in the classroom setting. A phenomenological hermeneutic design was used to elicit and express this experience. The questions guiding the study were: 1.) What is the perception of caring by the nurse educator in the nurse educator to nursing student relationship? 2.) How is caring demonstrated in the nurse educator to nursing student relationship? Thirteen experienced nurse educators teaching both undergraduate and graduate-level students discussed their perceptions of caring for students in the classroom. A classroom was defined as a face-to-face modality in a synchronous format during a set time of instruction. The philosophical underpinning was based on the work of Paul Ricoeur and included both structural analysis and phenomenological interpretation. The structural analysis unearthed three salient elements within the nurse educator’s world: the students’ nature, the context of the classroom, and the degree of support from the university. The phenomenological interpretation revealed the following themes: embodied caring, why we care, developing a rhythm of caring, influences on caring, and caring communication. Implications for nurse educators is the discovery that caring is based in a shared humanity. Caring for students is a decisive action that also models desired behaviors. Nurse educators can create safe and optimal learning environments that are relational, professional, and able to uphold the standards of the nursing profession.Item Predictors of cardiac arrest in rapid response systems(11/2/2017) Halverson, Colleen C.; Restrepo, Elizabeth; Bailey, Catherine; Zeigler, Vicki L.Medical errors occur in hospitals throughout the United States (US). These errors result in more than one million injuries and nearly 98,000 deaths annually. The Institute of Medicine report, “To Err is Human”, highlighted the US healthcare system’s failure to do enough to prevent mistakes. Hence, patient safety has become a focal issue. One safety strategy implemented to rescue patients was Rapid Response Systems (RRS). The purpose of this study was to determine whether patient characteristics and RRS interventions could predict the patient outcome of an in-hospital cardiac arrest (IHCA). This observational descriptive study: (a) examined instances in which RRS were activated when triggers (the afferent arm of RRS) were detected for patients in a pre-arrest phase of resuscitation, and (b) reviewed interventions undertaken during the medical emergency team (MET) event (the efferent arm of RRS). Data from the American Heart Association’s “Get with the Guidelines®—Resuscitation” (GWTG®-R) database were used to answer research questions about patient characteristics and RRS interventions associated with IHCA. Binary logistic regression (LR) was conducted to analyze GWTG®-R data that spanned ten years (2005-2015). Data were from 401,651 cases from over 700 hospitals. Using Statistical Program for the Social Sciences (SPSS) software LR resulted with three models, but the effect sizes were small (0.06 to 0.17). The predictor variables with a high probability for IHCA included: Triggers — (a) respiratory, (b) neurologic, (c) medical, and (d) unknown; (e) black race; (f) surgical-cardiac illnesses; (g) 250 to 499 bed hospitals; (h) cardiac drug(s); (i) non-invasive ventilation; (j) invasive ventilation; (k) continuous ECG monitoring; and (l) expert consultations. The study adds knowledge and offers nurses direction as practicing nurses, educators, and researchers to improve patient safety through focus on preventing failure to rescue by using RRS. RRS within GWTG®-R hospitals achieved their purpose to reduce the incidence of IHCA, since only 1% (3,497) of patients who had RRS activated, had IHCA.Item Development and validation of an instrument to measure nurses' beliefs toward deaf and hard of hearing interaction(11/21/2018) Lewis, Audra Janine; Keele, RebeccaCommunication barriers experienced by Deaf signers, non-signing deaf, and hard of hearing (DdHH) individuals in healthcare environments are multidimensional and complex. Investigating what nurses believe about DdHH patient interaction is an important step in minimizing barriers and improving nursing care. This research addressed the lack of reliable instruments to assess nurses’ beliefs toward DdHH interaction through instrument development guided by King’s (1981) Theory of Goal Attainment and Transactional Communication Model. A quantitative methodological design was used to develop and test the validity and reliability of an instrument to measure registered nurses’ beliefs toward interaction with DdHH patients and certified interpreters (CIs). An initial pool of items to assess registered nurses’ beliefs toward DdHH interaction was developed based on an extensive review of literature. Item pool content was validated by six content experts including one Deaf signer, one Deaf nurse, two hard of hearing nurses, and two hearing CIs. The initial D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) included 58 items. The first wave of data collection and analyses resulted in a 25-item DdHH-IBS/RN consisting of two factors: Personal-Social Beliefs Domain and Interpersonal Beliefs Domain. The 25-item DdHH-IBS/RN was subjected to a second wave of data collection and analysis to further refine and validate the instrument. Psychometric analysis of two separate groups of data concluded that the newly developed DdHH-IBS/RN is a reliable and valid scale to measure nurses’ beliefs towards DdHH interaction. Results of confirmatory factor analysis (CFA) supported the hypothesized structure of the scale and provided some evidence for its factorial validity. Results of correlation analyses revealed a weak positive correlation between years of experience interacting with non-signing deaf and hard of hearing individuals and Personal-Social mean scores. Regression results indicated that the overall model moderately predicted Personal-Social subscale mean scores and had no significance in predicting Interpersonal subscale mean scores. Independent samples t tests showed significant differences between participants with and participants without prior education and experience specific to DdHH interaction on both Personal-Social and Interpersonal subscale mean scores. Further improvement of scale items, and retesting for validity and reliability is recommended.Item Factors influencing academic success among nurse anesthesia students(11/24/2021) Tubog, Tito D; Liu, FuqinThe admission process to nurse anesthesia programs is very rigorous. Students enrolled in nurse anesthesia education are academically and experientially prepared for graduate work. However, some students are not academically successful in the didactic learning phase of the program. There is limited research on academic success in the didactic learning phase of the nurse anesthesia program. There is a need to learn about academic success from the perspectives of students who have successfully passed the didactic learning phrase. To better understand the students' views on the factors influencing academic success in the didactic learning phase of the nurse anesthesia curriculum, a qualitative descriptive research design was conducted. A total of 14 participants were included in this study. All participants are students enrolled for at least 18 months in a nurse anesthesia school. A semi-structured interview questionnaire was used to gather data. The method proposed by Lundman and Graneheim was used for content analysis. Six themes emerged from the data analysis. The data showed factors that influenced academic success during the didactic portion of the NA education: (1) utilization of effective study strategies and methodology, (2) transition to deep learning behaviors, (3) integration of learning styles and technology, (4) consideration of individual teachers, (5) staying connected and (6) adjusting to being a NA student. These findings may be used for educators, nurse anesthesia leadership, and institutions offering nurse anesthesia education. Academic success is influenced by a combination of cognitive, noncognitive, and sociodemographic factors. In the didactic phase of NA education, noncognitive factors have shown to be a driver to the academic performance of t students. The findings of this study added new dimensions and perspectives to the body of research in NA education. The findings have implications for nurse anesthesia education, policy, practice, and future studies. Stakeholders involved in students' academic success during the didactic phase of the NA curriculum may develop plans to address factors contributing to academic success to assist students in their academic journey.Item Assessing senior baccalaureate nursing students’ attitudes toward sexual health education as a nursing responsibility following a family life and sexual health education intervention(11/4/2020) Kuntz, Dora May; Toms, RobinAccording to the Centers for Disease Control and Prevention, approximately one in four adolescents has a sexually transmitted infection. Early sexual health education provided by specially trained educators has been shown to decrease early sexual debut and lower risk behaviors in adolescents. Approximately 80% of registered nurses feel sexual health education to adolescents is within their role; however, most report feeling uncomfortable or unprepared to provide the education. The purpose of this study was to measure the effectiveness of a one-hour family life and sexual health education intervention called Family Life and Sexual Health, FLASH, provided to senior-level, fourth-semester undergraduate nursing students, enrolled within two baccalaureate schools of nursing in the southeast United States, on improving scores on the Students’ Attitudes Towards Addressing Sexual Health Questionnaire, SA-SH. James’ Pragmatisms, Theory of Truth, was used to guide this mixed-methods, two-group, pretest-posttest design. Fifty-three participants were randomized into the FLASH education group and 48 participants were randomized into an attention control group who received a course in stress management for a total of 101 study participants. To prevent potential contamination, both the intervention and attention control groups received their presentations simultaneously in one, one-hour sessions during the same day, at the same time. The SA-SH was administered as a pre-test and post-test for both groups. The FLASH participants had a statistically significant improvement in total sum scores on the SA-SH Questionnaire (F (1, 41) =19, p-value <0.01). The FLASH group also demonstrated significant increases in comfort levels towards providing sexual health education in their future occupations on the questionnaire (p < 0.001). No significant differences in the groups were found in role responsibility, future working environment, or fear of negative impacts on future patient relationships. Thematic analysis of the qualitative data showed less perceived barriers in study participants who were randomized into the FLASH education intervention compared to those in the attention control stress management course. A one-hour FLASH course presented to senior-level, fourth-semester undergraduate nursing students can improve attitudes, especially comfort levels, toward providing sexual health education to fifth-grade students. Implications for nursing include incorporating sexual health education specific to the adolescent population into Baccalaureate nursing programs. These findings suggest a one-hour FLASH education intervention improves overall attitudes, comfort, and decreases perceived barriers to providing sexual health education to fifth-grade students.Item The decision-making experiences of caregivers regarding feeding tube placement in community dwelling adults(11/8/2019) Muoki, Deltra Catrece; Cesario, SandraDespite the increase in feeding tube placement as people live longer with chronic illness, the research is scarce regarding how to care for the caregiver of individuals with chronic illnesses especially with percutaneous endoscopic gastrostomy feeding tubes (PEG). This study aims to explore the caregiver’s experience regarding decision-making for PEG feeding tube placement in community dwelling adults. PEG feeding tubes are placed when individuals are unable to orally consume adequate nutrition. PEG feeding tubes ensure that individuals are able to meet their nutritional needs, but they can be accompanied by complications and other challenges that may affect daily living. Subsequently, caregivers may be involved in order to help manage care, which could lead to caregiver burden if there is lack of support. The National Institute of Nursing Research’s recent movement towards relieving caregiver burden and enhancing quality of life support the importance of this study. A descriptive phenomenological study was conducted at six post-acute care rehabilitation and skilled nursing facilities in Houston, Texas and the surrounding areas. Caregivers had some role in the decision-making for PEG feeding tube placement and intended to spend at least 4 hours per day providing direct care. Purposive sampling, data collection, and data analysis using Colaizzi’s method was conducted simultaneously. The transcripts were read and re-read with significant themes and meanings placed into a word document. They were then categorized into subthemes and placed in an excel spreadsheet for identification of overlapping themes. Although all participants expressed there was no regret in the decision to place a PEG feeding tube because it was a necessity and best for the patient, they expressed concerns about lack of education that was provided before and after PEG feeding tube placement as well as concerns about the complications. The findings suggest the need for support and adequate preparation from nurses in order to relieve caregiver burden and improve care.Item The experiences of new graduate nurses hired into adult intensive care units(11/9/2017) Degrande, Heather; Liu, Fuqin, 1977-; Greene, Pam; Stankus, JoAnnIt is a common practice that new graduate Registered Nurses (NGRNs) are hired into adult Intensive Care Units (ICUs) on initial entry into practice. There exists a practice readiness gap between nursing curricula and actual clinical practice expectations at adult ICU settings. This practice readiness gap can lead to negative consequences and subsequent nurse turnover, which is a concern nationwide. Nonetheless, many NGRNs survived their initial transition and continue to practice at adult ICU settings. The purpose of this study was to explore the experiences of nurses who were hired into adult ICU as NGRNs and were starting their third year of practice. Nurses hired into critical care areas tend to exhibit competence within two years of initial hire (Benner, Kyriakidis, & Stannard, 2011). The study used the hermeneutic phenomenology research approach. Data analysis revealed the overall meaning of the experience: coming to terms with being comfortable with being uncomfortable. The six themes associated with being comfortable with being uncomfortable were confidence and uncertainty, gaining experiences and forever learning, intuitive knowing and intuition, difficult and stressful, being courageous and assertive, and the team and persons of support. NGRNs can survive to become competent adult ICU nurses; however, the findings of this research reveal the need to promote exposure to clinical situations, resilience and self care, and teamwork and mentoring to ensure successful transition and overall retention of new nurses hired into in adult ICU.Item A descriptive phenomenological study of nursing student experiences of clinical data use in clinical rotations(11/9/2017) Straughn, Marcia; Liu, Fuqin, 1977-; Lee, Mikyoung; Zeigler, VickiClinical learning experiences are important opportunities for nursing students in that they gather and synthesize data of patients’ conditions, provide appropriate nursing interventions, and evaluate patient outcomes, applying their knowledge and skills learned from the classroom in real practice. In order to ensure quality clinical learning for nursing students, it is vital to hear the voices of nursing students on how they experience clinical learning, particularly with regards to clinical data use. This qualitative, exploratory approach was conducted, using descriptive phenomenology as the philosophical framework, through in-depth interviews with eighteen junior and senior baccalaureate nursing students at a large, public university in Texas. The interview data were analyzed according to Colaizzi’s method of descriptive phenomenological data analysis. Theme 1: Help Wanted was revealed in descriptions of needing or wanting help with using clinical data. Theme 2: Making Sense, included descriptions about ways that clinical data make sense and ways that clinical data assisted students in making sense in both clinical and classroom. Theme 3: Recognizing Usefulness emerged from descriptions of how clinical data was used or could be used. Participant descriptions of how clinical data in clinical rotations was related to communication illuminated Theme 4: Engaging in Communication. Descriptions of the impact of the assigned nurse on student experiences with using clinical data in clinical rotations resulted in the emergence of Theme 5: Nurse as Key Player. Lastly, Theme 6: Emotionally Charged, emerged from descriptions about emotional experiences related to experiences of clinical data use in clinical rotations. The thematic findings were reduced according to Colaizzi’s method, resulting in an exhaustive statement of description, and a descriptive statement of identification of the phenomenon of interest. The findings may be used to assist nurse educators in developing effective ways to help students use clinical data for effective clinical learning. Suggestions to achieve this aim include improved orientation for educators and nursing staff and emotional support for students. Policy development to address barriers to effective clinical learning and the development of the future nursing workforce remains an important strategy for supporting nursing students and their preparation for entry into professional nursing practice.