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Title: A COMPARISON OF THE QUALITY OF CARE AND COST EFFICIENCY BETWEEN ANESTHESIA PROVIDERS.
Creator: Carter, Daniel A, Blackwell, Christopher, Decker, Jonathan, University of Central Florida
Abstract / Description: The development of anesthesia has greatly contributed to the safety of surgeries, reduced the level of invasiveness of many procedures, and provided increased comfort for patients. The delivery of anesthetics has been primarily provided by one of two unique health care providers: a trained physician who has specialized in anesthesia, or an advanced practice nurse—the certified registered nurse anesthetist (CRNA). Both providers have a similar scope of practice, are nationally certified, and...
Show moreThe development of anesthesia has greatly contributed to the safety of surgeries, reduced the level of invasiveness of many procedures, and provided increased comfort for patients. The delivery of anesthetics has been primarily provided by one of two unique health care providers: a trained physician who has specialized in anesthesia, or an advanced practice nurse—the certified registered nurse anesthetist (CRNA). Both providers have a similar scope of practice, are nationally certified, and often work side-by-side. However, in recent years there has been some controversy between the two providers regarding autonomy, safety, and quality of services. The purpose of this study was to utilize current research comparing the two professions to determine if there is a difference in the quality of care and cost effectiveness between these two providers. This research was focused on studies performed in the United States after 1985. Results indicated no significant differences in quality of care between providers; however, a cost difference does exist. CRNA's provide a high quality of care equivalent to their physician counterparts, but at a reduced price. They additionally offer access to care in rural areas that lack anesthesiologists. Limitations include an inability to assess the impact of doctoral level programs for nurse anesthetists (required for entry into practice beginning in 2025) and how this may affect the main components of patient care assessed in this study (quality of care and cost). Future studies should look at ways to improve the relationship between the two providers and to remove barriers to nurse anesthetists' scope of practice in order to increase overall access to care.
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Date Issued: 2018
Identifier: CFH2000389, ucf:45859
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000389

Title: PEDIATRIC MISSCARE SURVEY TO FILL IN THE GAPS.
Creator: Baker, Molly S, Diaz, Desiree, Andrews, Diane, University of Central Florida
Abstract / Description: Missed nursing care, according to Kalisch and Williams, is nursing care that is not completed to the highest quality of care, leading to an increase in hospital costs and poor patient outcomes. Missed nursing care can occur with any patient population; however, a survey by Kasich called the MISSCARE Survey has only been used in the adult and neonatal populations. Pediatric patients are a diverse and complex subset of the population, differing greatly from the adult and neonatal populations,...
Show moreMissed nursing care, according to Kalisch and Williams, is nursing care that is not completed to the highest quality of care, leading to an increase in hospital costs and poor patient outcomes. Missed nursing care can occur with any patient population; however, a survey by Kasich called the MISSCARE Survey has only been used in the adult and neonatal populations. Pediatric patients are a diverse and complex subset of the population, differing greatly from the adult and neonatal populations, thus identifying a need for a focused pediatric survey to effectively study missed nursing care in the pediatric setting. The purpose of this research, therefore, was to create and validate a pediatric nursing care survey. A convenience sample of 10 pediatric experts completed the Expert Panel Survey to determine a content validity ratio (CVR) and content validity index (CVI) of a modified, MISSCARE Survey (Kalisch and Williams, 2009). Items determined to be essential by ninety percent or more of the participants (CVR > 0.78), were included in the MISSCARE-Pediatric Survey. Results showed that the CVI of the MISSCARE-Pediatric Survey determined by the Expert Panel was 0.9, meaning the items are essential to the pediatric population (Gilbert and Prion, 2016a). The created MISSCARE-Pediatric Survey includes 18 questions in section A (Types of Missed Nursing Care), 28 questions in section B (Reasons for Missed Nursing Care), and 9 questions in Demographics. Future research will determine content reliability of the MISSCARE-Pediatric Survey.
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Date Issued: 2018
Identifier: CFH2000401, ucf:45752
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000401

Title: NURSING KNOWLEDGE AND PERCEIVED COMFORT LEVEL IN ACUTE INFUSION REACTIONS FROM ANTINEOPLASTIC AGENTS.
Creator: Maiorini, Andrea L, Loerzel, Victoria, University of Central Florida
Abstract / Description: INTRODUCTION: Acute infusion reactions from antineoplastic agents can include hypersensitivity reactions, anaphylaxis, and cytokine release infusion reactions. Severe acute infusion reactions happen in about 5% of the oncology patient population and nurses are responsible for assessment and management of the reaction. This is a high-stress task for a nurse magnified by the lack of exposure. This project explores nursing knowledge and perceived comfort level of acute infusion reactions caused...
Show moreINTRODUCTION: Acute infusion reactions from antineoplastic agents can include hypersensitivity reactions, anaphylaxis, and cytokine release infusion reactions. Severe acute infusion reactions happen in about 5% of the oncology patient population and nurses are responsible for assessment and management of the reaction. This is a high-stress task for a nurse magnified by the lack of exposure. This project explores nursing knowledge and perceived comfort level of acute infusion reactions caused by antineoplastic agents. METHODOLOGY: An original survey was created to test nursing knowledge and assess comfort level. Nursing knowledge was broken down into six subscales: general knowledge of acute infusion reactions, signs and symptoms of hypersensitivity, anaphylaxis, and cytokine release infusion reaction, and drugs most likely to cause hypersensitivity and anaphylactic reactions and cytokine release infusion reactions. Comfort questions were asked on a 6-point Likert scale from extremely uncomfortable to extremely comfortable. There was an additional section in the survey related to nurses' distress and support in situations with acute infusion reactions. The questions were presented using a 6-point Likert scale ranging from strongly disagree to strongly agree. There were two open-ended questions that were designed to allow the nurses to share any additional information about their experiences with acute infusion reactions. Oncology nurses working with adults and pediatric populations were invited to participate. Descriptive statistics were used to analyze the survey results. T tests were used to compare groups and Pearson R statistics were used to examine relationships between total knowledge, knowledge subscale score, and comfort level. RESULTS: 20 nurses completed the survey. 12 were from the adult nurse population and 8 were from the pediatric nurse population. The typical participant was forty-four years of age, had sixteen years experience as a Registered Nurse, and thirteen years experience in the oncology setting. The average total knowledge score was a 56% based on 84 possible points. The basic knowledge section and the anaphylactic signs and symptoms were the highest scoring subscales, both scoring a 62%. Cytokine release infusion reaction signs and symptoms was the lowest scoring subscale with a 45%. There were no significant differences in knowledge between groups. The nurses chose an overwhelming agree/strongly agree when asked to choose the signs and symptoms related to each type of infusion reaction. The total comfort level score indicated that nurses were very comfortable managing acute reactions. There was no significant difference between the adult and pediatric setting comfort level scores. There was no statistically significant relationship between total knowledge score and total comfort level score. DISCUSSION: The knowledge score showed knowledge deficits while the comfort score indicated confidence in management of acute infusion reactions. The high frequency of agree/strongly agree for all three subscales of signs and symptoms indicates that the nurses at least know what to look for even if they cannot assign the specific sign and symptom to the type of infusion reaction. Knowledge about signs of specific types of drug reactions may not be necessary as long as a basic understanding of what to look for and how to manage a reaction is present.
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Date Issued: 2016
Identifier: CFH2000077, ucf:45564
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000077

Title: RETENTION OF CARDIOPULMONARY RESUSCITATION KNOWLEDGE AND PSYCHOMOTOR SKILL AMONG UNDERGRADUATE NURSING STUDENTS: AN INTEGRATIVE REVIEW OF LITERATURE.
Creator: Tirado, Fernanda, Gonzalez, Laura, University of Central Florida
Abstract / Description: Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very...
Show morePurpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: 'student*', 'nurs* student*', 'cardiopulmonary resuscitation (CPR)', 'Basic Life Support (BLS)', 'Advanced Life Support (ALS)', 'Advanced Cardiac Life Support (ACLS)', and 'Retention'. Results: The initial database search yielded a total of sixty-seven articles; of which, nine articles met the inclusion criteria and were utilized in the final analysis. The articles analyzed explored the effectiveness of different training modalities including: self-directed, CD-based, low-fidelity simulation, high-fidelity simulation, collaborative high-fidelity simulation, and deliberate practice. Conclusion: Current training is ineffective both in promoting long-term retention and in delaying the decay of previously learned information. The most effective training modality identified was high-fidelity simulation in conjunction with deliberate practice. The use of collaborative simulation through 'mock codes' maximizes the acquisition and retention of CPR knowledge and skill by providing the highest degree of fidelity. Deliberate practice was the only modality, which resulted in improvement of knowledge and skill over time. The absence of individualized feedback diminishes the effects of repeated practice. Practical experience is also susceptible to the detrimental effects exerted by the lack of feedback.
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Date Issued: 2016
Identifier: CFH2000082, ucf:45567
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000082

Title: NURSING STUDENTS' ATTITUDE AND COMMITMENT TOWARD SUBSTANCE-ABUSING PATIENTS.
Creator: O'Conner, Amy L, Allred, Kelly, Valenti, Michael, University of Central Florida
Abstract / Description: The topic of substance-abuse has received increasing attention in recent years, as the number of individuals experiencing drug abuse and addiction is on the rise. With substance-use on the rise, the number of patients admitted to the hospital with this disorder is increasing also. It is important hospital staff are aware and educated on how to provide adequate care to these patients without judgement regarding their choices or their lifestyle. This study was done to determine how prepared...
Show moreThe topic of substance-abuse has received increasing attention in recent years, as the number of individuals experiencing drug abuse and addiction is on the rise. With substance-use on the rise, the number of patients admitted to the hospital with this disorder is increasing also. It is important hospital staff are aware and educated on how to provide adequate care to these patients without judgement regarding their choices or their lifestyle. This study was done to determine how prepared nursing students are to care for patients with drug abuse or addiction. Specifically, the project explores student nurses' attitudes and commitment toward substance- abusing patients. The 20 item Drug and Drug Problem Perceptions Questionnaire (DDPPQ) was used to measure attitudes and therapeutic commitment in working with drug-abusing patients, and was distributed electronically to approximately 400 nursing students. One hundred thirty-one students participated. Scores ranged from 22-102, with the smaller value representing greater overall commitment and preparedness when working with substance-abusing patients. The mean score reported overall was 58. This score indicates improvement is needed to increase students' therapeutic commitment and ability to provide quality care for patients experiencing substance- abuse. More research needs to be done and programs put into place to reach this goal.
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Date Issued: 2018
Identifier: CFH2000453, ucf:45709
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000453

Title: SENSORY EXPERIENCES OF CHILDREN WITH AN AUTISM SPECTRUM DISORDER AND NURSING INTERVENTIONS FOR OVER STIMULATION.
Creator: Ballentine, Felicia, Waldrop, Julee, University of Central Florida
Abstract / Description: Background: Autism spectrum disorders (ASD) are a group of neuro-developmental disorders that are characterized by impaired social interaction, communication, and restricted or repetitive behavior. Children with an ASD also display significant sensory experiences due to sensory disintegration. This integrative review of literature examines the sensory experiences of children with an ASD and determines nursing interventions that will enable them to better cope within the hospital setting....
Show moreBackground: Autism spectrum disorders (ASD) are a group of neuro-developmental disorders that are characterized by impaired social interaction, communication, and restricted or repetitive behavior. Children with an ASD also display significant sensory experiences due to sensory disintegration. This integrative review of literature examines the sensory experiences of children with an ASD and determines nursing interventions that will enable them to better cope within the hospital setting. Method: an extensive search of databases and current literature on sensory experiences of children with an ASD and interventions that facilitate coping. Results: Children with an ASD experience a wide range of sensitivity and defensiveness toward stimuli that differs on an individual basis. There is no current research that reflects nursing interventions for children with an ASD, therefore interventions from other heath care occupations were examined and applied to nursing. Conclusion: Further research is needed to better understand sensory defensiveness and research is needed in the area of nursing interventions to enable the best nursing care of children with an ASD.
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Date Issued: 2011
Identifier: CFH0004063, ucf:44795
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004063

Title: GENETIC INTERVENTION AS A LIFESTYLE APPROACH: AN ANALYSIS OF DISEASE AND TREATMENT.
Creator: Dempton, Jennifer, D'Amato-Kubiet, Leslee, University of Central Florida
Abstract / Description: Purpose: The scientific knowledge of how genes affect disease expression and evolution can facilitate more effective environmental and drug therapy interventions delivered by health care professionals. The purpose of this paper is to a) describe the role of genetic science in healthcare; b) explore genotype determinants for environmental and pharmacological interventions; c) and analyze ethical dilemmas, barriers to access, and allocation of resources based on genotype. Methods: A review of...
Show morePurpose: The scientific knowledge of how genes affect disease expression and evolution can facilitate more effective environmental and drug therapy interventions delivered by health care professionals. The purpose of this paper is to a) describe the role of genetic science in healthcare; b) explore genotype determinants for environmental and pharmacological interventions; c) and analyze ethical dilemmas, barriers to access, and allocation of resources based on genotype. Methods: A review of literature was conducted from the disciplines of nursing, medicine, psychology, and sociology using the CINAHL, Ebsco Host, Medline, and PsychINFO databases. The search was limited to peer reviewed, full text article in English that dated from 1987 to 2011. Inclusion criteria were articles describing environmental, pharmacologic, and nutritional influence on genetic expression. Forty-five articles on genetic intervention were chosen for further review, in addition to five book publications which met inclusion criteria. Many of the sources retrieved were obtained from the biomedical sciences and published in the last decade, owing to more recent innovations in genetic discovery. Results: Disease and treatment must be approached according to genetic profiles for effectiveness and to increase health outcomes. Several variations were found regarding response to pharmaceuticals, as well as environmental exposures, based on genotype. Conclusions: Health care has been practiced using a 'universal protocol' approach; however, as the literature reveals, each individual genotype must be taken into account to provide optimal care.
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Date Issued: 2011
Identifier: CFH0004060, ucf:44792
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004060

Title: ASSESSMENT OF PERINATAL NURSES' KNOWLEDGE OF ANTIPHOSPHOLIPID SYNDROME AND NURSING MANAGEMENT OF PREGNANT WOMEN WITH ANTIPHOSPHOLIPID SYNDROME.
Creator: Dennen, Gabrielle, Waldrop, Julee, University of Central Florida
Abstract / Description: Background: Antiphospholipid syndrome (APS), a complex autoimmune disorder, is associated with thromboembolic events and 7%-25% of unexplained fetal losses. No research exists on perinatal nurses' knowledge of APS or its nursing management. Purpose: To assess perinatal nurses' knowledge and nursing management of pregnant women with APS. This pilot study also may justify a study with a larger sample size and more recruitment sites, as well as determine the need for an educational program on...
Show moreBackground: Antiphospholipid syndrome (APS), a complex autoimmune disorder, is associated with thromboembolic events and 7%-25% of unexplained fetal losses. No research exists on perinatal nurses' knowledge of APS or its nursing management. Purpose: To assess perinatal nurses' knowledge and nursing management of pregnant women with APS. This pilot study also may justify a study with a larger sample size and more recruitment sites, as well as determine the need for an educational program on APS for perinatal nurses. Methodology: This is a descriptive cross-sectional pilot study. Ninety-two registered nurses working in perinatal areas from a metropolitan medical center in the Southeastern United States completed a 20-item survey on demographics and knowledge about APS and nursing management of patients with APS. Analyses: Descriptive statistics were conducted to characterize the sample. ANOVA, t tests, Pearson's correlation, and logistic regression were used to determine factors associated with knowledge of APS and its nursing management. Conclusion: The average score of participants on the 8 knowledge items of the survey was 1.4. Only current work area was associated with knowledge scores, however, previous familiarity with APS was associated with higher scores.
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Date Issued: 2013
Identifier: CFH0004336, ucf:45039
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004336

Title: MINIMIZING INCIVILITY IN THE WORKPLACE TO INCREASE RETENTION OF NEW GRADUATE NURSES.
Creator: D'Ambra, Amanda, Andrews, Diane, University of Central Florida
Abstract / Description: Efforts to maintain a sufficient nurse workforce are hampered by dissatisfaction with the work environment. Incivility in the work environment is a major source of dissatisfaction. A healthy work environment is associated with higher levels of job satisfaction and improved retention. New graduate transition programs have been recommended as a deterrent to high levels of turnover associated within the first two years of employment, some of which is related to incivility. The purpose of this...
Show moreEfforts to maintain a sufficient nurse workforce are hampered by dissatisfaction with the work environment. Incivility in the work environment is a major source of dissatisfaction. A healthy work environment is associated with higher levels of job satisfaction and improved retention. New graduate transition programs have been recommended as a deterrent to high levels of turnover associated within the first two years of employment, some of which is related to incivility. The purpose of this thesis was to examine the influence of incivility in the nursing workplace on new graduate job satisfaction and determine if there is an association between participation in new graduate nurse transition programs and satisfaction with the work environment. A systematic review of the literature was performed using MEDLINE- EBSCOhost, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Sixteen studies, which met search criteria, were reviewed. Themes that emerged included workplace incivility, nurse residency programs, mentoring through preceptors, and empowerment. Findings indicated that incivility in the workplace was a significant predictor of low job satisfaction in new graduate nurses. While graduate nurse transition programs are associated with improved satisfaction and retention rates for these nurses, nothing in the literature indicated that graduate nurse transition programs had a direct impact on empowerment and job satisfaction related to the incivility these nurses experience.
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Date Issued: 2012
Identifier: CFH0004244, ucf:44945
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004244

Title: Stressors Experienced by Emergency Department Registered Nurses at the Bedside: A Phenomenological Study.
Creator: Heglund, Stephen, Wink, Diane, Andrews, Diane, Leuner, Jean, Malvey, Donna, Chase, Susan, University of Central Florida
Abstract / Description: The Emergency Department (ED) as a workplace for the Registered Nurse (RN) is a stressful environment. Reasons are thought to include interactions with other members of the interdisciplinary team as well as the situations associated with the environment of the ED such as trauma, death, sadness, joy and the general unpredictability of each moment. Studies have documented general health care workplace stress and its influence on staff, but a very limited number of studies have concentrated on...
Show moreThe Emergency Department (ED) as a workplace for the Registered Nurse (RN) is a stressful environment. Reasons are thought to include interactions with other members of the interdisciplinary team as well as the situations associated with the environment of the ED such as trauma, death, sadness, joy and the general unpredictability of each moment. Studies have documented general health care workplace stress and its influence on staff, but a very limited number of studies have concentrated on the ED. No widely published studies have identified stressors from the perspective of the ED RN.This dissertation is an interpretive phenomenological study that seeks to understand the experience of being an ED RN through the exploration of the perceptions of stress as lived by individuals who practice their art and science in this unique setting. Materials for evaluation and thematic identification were obtained through personal interviews of practicing nurses. The stories told by the participants communicated what each individual found to be negatively stressful as well as what each found to be positively stressful.Conclusions based on the findings of this work suggest a need for the ED RN to be able to depend on the presence of several factors in order to be able to function with as little distress as possible. The optimal ED environment for the RN is posited to be supportive of the individual goals of the RN, provide adequate resources and foster a communicative interdisciplinary environment. Recommendations are made to improve resource management and interdisciplinary relations.
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Date Issued: 2012
Identifier: CFE0004384, ucf:49408
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004384

Title: ADVANCED PRACTICE NURSING IN THE FAITH COMMUNITY SETTING: A CASE STUDY.
Creator: Lindsey, Chianta, Chase, Susan, University of Central Florida
Abstract / Description: The purpose of this case study is to demonstrate the effectiveness of an Advanced Practice Nurse in providing spiritual and nursing care within a faith community setting. The study will describe the process of developing a Parish Nurse program using a Nurse Practitioner to offer wholistic health care to parishioners. It will also illustrate the collaborative process of developing a free health center within a faith based organization, using the Nurse Practitioner to manage the health center...
Show moreThe purpose of this case study is to demonstrate the effectiveness of an Advanced Practice Nurse in providing spiritual and nursing care within a faith community setting. The study will describe the process of developing a Parish Nurse program using a Nurse Practitioner to offer wholistic health care to parishioners. It will also illustrate the collaborative process of developing a free health center within a faith based organization, using the Nurse Practitioner to manage the health center and deliver health care services. In order to demonstrate the need for parish nurse care, the case study used an anonymous survey to provide insight into the health status of the congregation, as well as to determine perceived needs of parishioners. Excerpts from the researcherÃ‚Â's journal and audio-taped interviews of parishioners and key leaders within the community was used to express congregantsÃ‚Â' experiences of receiving parish nurse care, and to convey the need for a free community health center in the target population. A utilization review was conducted to demonstrate the profile of the patients who have accessed the services of the health center. The findings revealed three commons themes of parish nurse care; presence, spiritual support, and health care liaison. The study also revealed parishioners had an expedited referral process and improved patient provider relationships. Additional findings determined that the free health center was able to be operated by many of the members of the faith based organization, and was effective in managing chronic conditions such as hypertension and diabetes. Advanced Practice Nurses who are Parish Nurses have an opportunity to practice in a more wholistic manner, and offer advanced level care to parishioners and the community at large to improve health outcomes.
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Date Issued: 2010
Identifier: CFE0003308, ucf:48510
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003308

Title: Organizational Complexity, Emergency Management Plan Adequacy, and Nursing Home Resiliency: A Contingency Perspective.
Creator: Boyce, Cherie, Wan, Thomas, Zhang, Ning, Oetjen, Reid, Rivera, Fernando, Kapucu, Naim, University of Central Florida
Abstract / Description: Some social and organizational behavior scientists measure resiliency through anecdotal qualitative research, i.e. personality analyses and stories of life experience. Empirical evidence remains limited for identifying measurable indicators of resiliency. Therefore, a testable contingency model was needed to clarify resiliency factors pertinent to organizational performance. Two essential resiliency factors were: 1) a written plan and 2) affiliation with a disaster network.This contingency...
Show moreSome social and organizational behavior scientists measure resiliency through anecdotal qualitative research, i.e. personality analyses and stories of life experience. Empirical evidence remains limited for identifying measurable indicators of resiliency. Therefore, a testable contingency model was needed to clarify resiliency factors pertinent to organizational performance. Two essential resiliency factors were: 1) a written plan and 2) affiliation with a disaster network.This contingency study demonstrated a quantifiable, correlational effect between organizational complexity, disaster plan adequacy and organizational resiliency. The unit of analysis, the skilled nursing facility proved vulnerable, therefore justifying the need for a written emergency management plan and affiliation with a disaster network. The main purpose of this research was to verify the significance of emergency management plans within a contingency framework of complexity theory, resource dependency, systems theory, and network theory. Distinct sample moments quantified causal relationships between organizational complexity (A), plan adequacy (B) and resiliency (C). Primary and secondary research data were collected from within the context of public health and emergency management sectors within the State of Florida.
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Date Issued: 2015
Identifier: CFE0005929, ucf:50842
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005929

Title: Nurse Managers, Work Environment Factors and Workplace Bullying.
Creator: Parchment, Joy, Andrews, Diane, Neff, Donna, Conner, Norma, Yan, Xin, Saunders, Carol, University of Central Florida
Abstract / Description: The purpose of this dissertation is to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of nurse managers in acute care settings across the United States.Over 30 years of workplace bullying research exists. Consequences are linked to intent to leave, turnover, and harmful emotional and physical effects. Published studies identifying nurse managers as targets of workplace bullying and work environment factors that...
Show moreThe purpose of this dissertation is to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of nurse managers in acute care settings across the United States.Over 30 years of workplace bullying research exists. Consequences are linked to intent to leave, turnover, and harmful emotional and physical effects. Published studies identifying nurse managers as targets of workplace bullying and work environment factors that contribute to nurse managers being recipients of workplace bullying either, downward from their leaders, horizontally from their nurse manager peers, and upwards from their clinical nurses were not identified.A descriptive, cross-sectional design using an online survey was utilized. Descriptive, inferential, and multivariate analyses were used to identify relationships and the likelihood of workplace bullying occurring. Thirty-five percent (n = 80) of nurse managers reported being a target of workplace bullying. Managers sustained occasional (56%, n = 45) and severe (44%, n = 35) levels of workplace bullying, 65% (n = 43) identified their executive nurse leader as the predominate perpetrator. Authentic leadership, job demand, job control correlated significantly (p = (<).01) with workplace bullying and job demand demonstrated the strongest likelihood (OR = 3.9) for predicting workplace bullying. Nurse Managers are four times more likely to be a recipient of workplace bullying when their job responsibilities are classified as demanding. This study expanded the science and demonstrated that nurse managers, the backbone of organizations, are recipients of workplace bullying emanating predominately from executive nurse leaders, but also from clinical nurses and their nurse manager peers. Given the harmful consequences of workplace bullying, as 'guardians' of and 'advocates' for their teams, executive nursing leaders, have an ethical and operational responsibility to ensure nurse managers are able to practice in a safe environment.
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Date Issued: 2015
Identifier: CFE0005986, ucf:50771
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005986

Title: The Impact of Relational Coordination and the Nurse on Patient Outcomes.
Creator: Dejesus, Fanya, Andrews, Diane, Sole, Mary Lou, Neff, Donna, Yan, Xin, Unruh, Lynn, University of Central Florida
Abstract / Description: Healthcare quality remains a significant issue due to fragmentation of care in our complex U.S. healthcare systems. While coordination of care is foundational to healthcare quality as well as identified as a National Priority, fragmentation and uncoordinated care continues to afflict our systems. The purpose of this study was to explore the relationship between relational coordination and adverse nurse sensitive patient outcomes, namely hospital acquired pressure ulcers, patient falls with...
Show moreHealthcare quality remains a significant issue due to fragmentation of care in our complex U.S. healthcare systems. While coordination of care is foundational to healthcare quality as well as identified as a National Priority, fragmentation and uncoordinated care continues to afflict our systems. The purpose of this study was to explore the relationship between relational coordination and adverse nurse sensitive patient outcomes, namely hospital acquired pressure ulcers, patient falls with injury, catheter- associated urinary tract infection, and central line-associated blood stream infection. A retrospective correlational survey design using cross sectional data was used to conduct this quantitative study. An electronic relational coordination survey was sent to 1124 eligible registered nurses from 43 nursing units within a 5-hospital magnet-designated healthcare system to gather their perception of the strength of relationship and communication ties of their work team. The nurse practice environment as well as nurse education were control variables. With 406 nurses who completed the survey (36% response rate), findings revealed that the stronger relational coordination ties are amongst the healthcare team, the lower the rate of adverse nurse sensitive patient outcomes as indicated by their inverse relationship. (rs=-.31, p=.050). In a Negative Binomial Regression model, relational coordination was a significant predictor (?-1.890, p=.034) of nurse sensitive patient outcomes whereas nurse education level (p=.859) and nurse practice environment (p=.230) were not. Data affirms that relational coordination, a relationship and communication intensive form of coordination does impact patient outcomes. This research provides significant information to health care leaders and institutions with goals of improving patient care outcomes through enhancement of coordination of care and optimization of healthcare teams.
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Date Issued: 2015
Identifier: CFE0005939, ucf:50823
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005939

Title: INTERVENTIONS FOR CHILDHOOD OBESITY: EVALUATING TECHNOLOGICAL APPLICATIONS TARGETING PHYSICAL ACTIVITY LEVEL AND DIET.
Creator: DiPietro, Jessica, Norris, Anne, University of Central Florida
Abstract / Description: Overweight and obese children have increased risks for multiple preventable diseases and conditions which can impair their physiological health and significantly increases the overall cost of their healthcare. Free mobile applications and technology for weight loss, dietary tracking, and physical activity may be quite useful for monitoring nutritional intake and exercise to facilitate weight loss. If so, nurses are well positioned to recommend such tools as part of their efforts to prevent...
Show moreOverweight and obese children have increased risks for multiple preventable diseases and conditions which can impair their physiological health and significantly increases the overall cost of their healthcare. Free mobile applications and technology for weight loss, dietary tracking, and physical activity may be quite useful for monitoring nutritional intake and exercise to facilitate weight loss. If so, nurses are well positioned to recommend such tools as part of their efforts to prevent childhood obesity and help children and parents better manage childhood obesity when it is present. However, there are no guidelines that nurses can use to determine what applications or technologies are most beneficial to children and their parents. The purpose of this project is to develop such guidelines based on a review of the scientific literature published in the last 5 years. Articles regarding healthy-lifestyle promoting mobile applications and technological approaches to health and fitness interventions were identified by searching articles indexed by CINAHL, Psychinfo, Medline, ERIC, IEEE Xplore, and Academic Search Premier. Identified articles were assessed using Melnyk's hierarchy of evidence and organized into tables so that implications for research and suggestions for practice could be made.
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Date Issued: 2014
Identifier: CFH0004616, ucf:45255
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004616

Title: WORK ENVIRONMENT AND THE EFFECT ON OCCUPATIONAL COMMITMENT AND INTENT TO LEAVE: A STUDY OF BEDSIDE REGISTERED NURSES.
Creator: Cortelyou-Ward, Kendall, Fottler, Myron, University of Central Florida
Abstract / Description: The purpose of this research was to determine the effect work environment has on occupational commitment and intent to leave the profession for bedside registered nurses. Subscales of autonomy, control over the practice setting, nurse-physician relationship, and organizational support were incorporated into the analysis to determine which aspect of work environment most directly effects occupational commitment and intent to leave the profession. The research was undertaken in order to help...
Show moreThe purpose of this research was to determine the effect work environment has on occupational commitment and intent to leave the profession for bedside registered nurses. Subscales of autonomy, control over the practice setting, nurse-physician relationship, and organizational support were incorporated into the analysis to determine which aspect of work environment most directly effects occupational commitment and intent to leave the profession. The research was undertaken in order to help administrators determine the ways in which work environment can be improved upon in order to retain bedside registered nurses in the profession. An explanatory cross sectional survey was distributed to 259 direct care bedside registered nurses employed at a rural, system affiliated hospital in Central Florida. Human subject protection was assured through the University of Central Florida Institutional Review Board. A 77 item questionnaire containing 9 demographic questions, 57 questions from the Nursing Work Index- Revised (NWI-R), 8 questions from Blau's occupational commitment scale, and 3 questions from Blau's intent to leave scale was distributed to all direct care nurses. Subjects were also given the opportunity to complete 3 short answer questions. A 32.8 percent response rate was achieved for a total of 85 complete and usable surveys. Data analysis showed that the work environment is positively related to occupational commitment and negatively related to intent to leave. In addition each of the four subscales (autonomy, control over the practice setting, relationship with physicians, and organizational support) were also positively related to occupational commitment and negatively related to intent to leave the profession. Implications for organizations, public policy and future research are discussed.
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Date Issued: 2007
Identifier: CFE0001851, ucf:47343
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001851

Title: FACTORS THAT INFLUENCE IMPLEMENTATION OF PAIN MANAGEMENT STRATEGIES IN THE NEONATAL INTENSIVE CARE UNIT.
Creator: Martinez, Geraldine, Allred, Kelly, University of Central Florida
Abstract / Description: In the United States, 10% to 15% of newborns are admitted to the neonatal intensive care unit (NICU). Painful procedures are unavoidable during NICU care; the neonate experiences approximately 12 painful procedures per day. Inconsistent and/or inappropriate pain management in the NICU remains a problem. The purpose of this study is to identify the prevalent factors that influence the implementation of pain management strategies among nurses who work in a NICU setting in a Central Florida...
Show moreIn the United States, 10% to 15% of newborns are admitted to the neonatal intensive care unit (NICU). Painful procedures are unavoidable during NICU care; the neonate experiences approximately 12 painful procedures per day. Inconsistent and/or inappropriate pain management in the NICU remains a problem. The purpose of this study is to identify the prevalent factors that influence the implementation of pain management strategies among nurses who work in a NICU setting in a Central Florida hospital. This study was conducted using a voluntary and anonymous electronic survey. The survey was divided into two sections; the first section designed to describe the sample, and the second section containing a Likert-type scale that assessed the nurses' general pain knowledge, knowledge of pain assessment, and awareness of accepted pain management strategies. The survey was adapted from previously published research. Results indicate pain was more likely to be addressed when nurses collaborated closely with the attending physician. The majority of nurses were aware of current protocols for pain management on the unit but not all nurses agreed those protocols were adequate. Results also indicated pain assessment education is being provided in the NICU and the nurses feel confident in their skills to assess pain, however, not all nurses agreed that pain is being well managed in their unit. There appears to be a gap between the nurse's knowledge/skill to assess pain and implementation of strategies to decrease pain. Although it is the nurse's responsibility to prevent and treat newborn pain in the NICU, not all nurses agreed that newborn pain is well managed in their unit and some believe pain to be an unavoidable experience in the NICU. Nurse-physician collaboration is key to evidence based newborn pain management.
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Date Issued: 2014
Identifier: CFH0004609, ucf:45271
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004609

Title: NURSE PRACTITIONER STUDENT KNOWLEDGE AND ATTITUDES TOWARDS SKIN CANCER ASSESSMENTS.
Creator: Woodmansee, Ryan, Loerzel, Victoria, University of Central Florida
Abstract / Description: Background: Skin cancer is the most commonly diagnosed cancer each year in the United States. With skin cancer and the demand for nurse practitioners (NPs) in primary care both on the rise, an accurate assessment of how well NP students are being prepared to perform skin cancer assessments is needed. Patient outcomes are directly linked to early detection and treatment which is essential for all types of skin cancer, especially melanoma. Nurse Practitioners need to be able to recognize the...
Show moreBackground: Skin cancer is the most commonly diagnosed cancer each year in the United States. With skin cancer and the demand for nurse practitioners (NPs) in primary care both on the rise, an accurate assessment of how well NP students are being prepared to perform skin cancer assessments is needed. Patient outcomes are directly linked to early detection and treatment which is essential for all types of skin cancer, especially melanoma. Nurse Practitioners need to be able to recognize the early stages of malignancy versus benign skin lesions and perform accurate skin examinations. The ability to assess practitioners' knowledge while they are still students will give us a better understanding of how well they are being prepared to perform skin cancer assessments in primary practice. This information will inform educators where improvement in skin cancer education is needed. Methodology: Following IRB approval, nurse practitioner students enrolled in a gerontology course fall 2016 were invited to participate in this exploratory, descriptive study. Twenty NP students completed the Knowledge, Attitudes and Practice of Skin Cancer Assessments (KAP-SCA) survey. The survey has 80 questions about lesion identification, knowledge of general skin facts, education in NP Program, and knowledge, attitudes, and confidence levels during skin care assessments. Descriptive statistics (frequencies and percentages) were used to analyze demographics. Total scores and subscale scores for the KAP-SCA instrument were examined with descriptive statistics. Spearman's Rho statistics were used for correlations among knowledge, attitude, training and practice. Results: The typical NP student was female, age 31 years and enrolled in the family nurse practitioner program at UCF. The majority of NP students had an average knowledge score for general skin cancer knowledge and photo lesion identification questions. However, the majority (70%) of NP students did not agree that the dermatology training they received in their NP program prepared them for practice. Discussion: Most NP students do not feel confident performing skin cancer assessments and basic dermatology procedures upon graduation. Most NP students had a difficult time differentiating between benign and malignant lesions, and would refer the patient to a specialist due to their lack of knowledge or confidence in diagnosis. Conclusions: Information obtained from the KAP-SCA survey demonstrated that the majority of NP students lacked confidence performing skin cancer assessments and had difficulty recognizing if a lesion was benign or malignant. This information can be helpful in informing educators on where improvement in skin cancer education is needed in NP programs.
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Date Issued: 2017
Identifier: CFH2000153, ucf:45925
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000153

Title: THE USE OF PHYSICAL RESTRAINTS AMONG NURSING HOME RESIDENTS: DO DISPARITIES EXIST?.
Creator: Fashaw, Shekinah, Chisholm, Latarsha, University of Central Florida
Abstract / Description: Introduction: The purpose of this study is to examine how nursing home (NH) characteristics, specifically racial composition of nursing homes residents, influences the use of physical restraints. As the population ages and becomes more diverse, it is essential to mitigate/eliminate racial/ethnic disparities in quality care. Methods: This is cross-sectional study using a 2010 national data set from Brown University Center for Gerontology and Healthcare Research. This study employs Donabedian's...
Show moreIntroduction: The purpose of this study is to examine how nursing home (NH) characteristics, specifically racial composition of nursing homes residents, influences the use of physical restraints. As the population ages and becomes more diverse, it is essential to mitigate/eliminate racial/ethnic disparities in quality care. Methods: This is cross-sectional study using a 2010 national data set from Brown University Center for Gerontology and Healthcare Research. This study employs Donabedian's Structure-Process-Outcome (SPO) conceptual framework. Statistical analysis includes univariate, bivariate, and a logistic regression model. It is hypothesized that nursing homes with higher proportions of black residents, more Medicaid residents, and for-profit ownership status will be associated with higher prevalence of physical restraint use. Results: Findings show that nursing homes with high proportions of blacks have a lower likelihood of high physical restraint use. Nursing homes with a higher proportion of Medicaid-reliant residents have a higher likelihood of restraint use, as does for-profit nursing homes. Discussion: The findings indicate that there are no racial/ethnic disparities present in the use of physical restraints in nursing homes. There is indication of socio-economic disparities, since nursing homes with higher Medicaid-reliant residents are associated with greater restraint. There are policy implications associated with these findings, including raising Medicaid per diem or implementing a quality performance payment incentive. Further research will be needed to determine ways to reduce racial/ethnic disparities in nursing homes. This research, adds to the nursing home literature focused on socio-economic disparities.
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Date Issued: 2014
Identifier: CFH0004700, ucf:45401
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004700

Title: RISK OF MEDICATION ERRORS IN THE HOME: AN INTEGRATIVE LITERATURE REVIEW.
Creator: Crescenzi, Maria M, Bushy, Angeline, University of Central Florida
Abstract / Description: Regardless of the setting, medication errors are of great concern when associated with an individual's health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative...
Show moreRegardless of the setting, medication errors are of great concern when associated with an individual's health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant articles in the English language between 2006 to 2017, including CINAHL, MEDLINE, PubMed, and PsycINFO. Search terms included 'medication errors', 'home care', 'post-discharge', 'hospital readmission', and 'medication error risks in the home'. Exclusion criteria included medication errors in acute and extended care settings. The integrative review involved reading, analyzing and selecting articles, and summarizing on a matrix. Findings on occurrences of medication errors in the home included impaired client mental status, confusion related to medication names, limited understanding of medication purpose in the care plan and its side effects, level of health literacy, and client-provider miscommunication in discharge planning. Consistent and conflicting findings are discussed along with gaps in the literature. Limitations and implications for nursing practice, policy, research, and education are also noted.
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Date Issued: 2017
Identifier: CFH0000223, ucf:44678
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0000223

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