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- Title
- A COMPARISON OF COMPUTER AND TRADITIONAL FACE-TO-FACE CLASSROOM ORIENTATION FOR BEGINNING CRITICAL CARE NURSES.
- Creator
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Anzalone, Patricia, Sole, Mary Lou, University of Central Florida
- Abstract / Description
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Purpose: Education of the novice critical care nurse has traditionally been conducted by critical care educators in face-to-face classes in an orientation or internship. A shortage of qualified educators and growth in electronic modes of course delivery has led organizations to explore electronic learning (e-learning) to provide orientation to critical care nursing concepts. Equivalence of e-learning versus traditional critical care orientation has not been studied. The primary aim of this...
Show morePurpose: Education of the novice critical care nurse has traditionally been conducted by critical care educators in face-to-face classes in an orientation or internship. A shortage of qualified educators and growth in electronic modes of course delivery has led organizations to explore electronic learning (e-learning) to provide orientation to critical care nursing concepts. Equivalence of e-learning versus traditional critical care orientation has not been studied. The primary aim of this study was to examine the equivalency of knowledge attainment in the cardiovascular module of the Essentials of Critical Care Orientation (ECCO) e-learning program to traditional face-to-face critical care orientation classes covering the same content. Additional aims were to determine if learning style is associated with a preference for type of learning method, and to determine any difference in learning satisfaction between the two modalities. Methods: The study was conducted using a two-group pretest-posttest experimental design. Forty-one practicing volunteer nurses with no current critical care experience living in southwest Florida were randomly assigned to either the ECCO (n=19) or face-to-face (n=22) group. Those in the face-to-face group attended 20 hours of classroom instruction taught by an expert educator. Those in the ECCO group completed the lessons on line and had an optional 2 hour face-to-face discussion component. Pre-test measures included the Basic Knowledge Assessment Test (BKAT-7), modified ECCO Cardiovascular (CV) Examination, and Kolb Learning Style Inventory (LSI). Post-tests included the BKAT-7, modified CV Examination, and Affective Measures Survey. Results: The majority of subjects were female, married, and educated at the associate degree level. Their mean age was 39.5 + 12 years, and they averaged 9.9 + 11.7 years of nursing experience. The diverging learning style was assessed in 37% of subjects. Classroom instruction was preferred by 61% of participants. No statistical differences were noted between groups on any demographic variables or baseline knowledge. Learning outcomes were compared by repeated measures analysis of variance. Mean scores of subjects in both groups increased statistically on both the BKAT-7 and modified CV Examination (p=<.01); however, no significant differences (p> .05) were found between groups. Preference for online versus classroom instruction was not associated with learning style (X2 = 3.39, p = .34). Satisfaction with learning modality was significantly greater for those in the classroom group (t=4.25, p=.000). Discussion/Implications: This is the first study to evaluate the ECCO orientation program and contributes to the growing body of knowledge exploring e-learning versus traditional education. The results of this study provide evidence that the ECCO critical care education produces learning outcomes at least equivalent to traditional classroom instruction, regardless of the learning style of the student. As participant satisfaction was more favorable toward the classroom learning modality, consideration should be given to providing blended learning if using computer-based orientation programs. Replication of this study with a variety of instructors in varied geographic locations, expanded populations, larger samples, and different subject matter is recommended.
Show less - Date Issued
- 2008
- Identifier
- CFE0002192, ucf:47888
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0002192
- Title
- An Exploratory Study of Physiologic Responses to a Passive Exercise Intervention in Mechanically-ventilated Critically Ill Adults.
- Creator
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Amidei, Christina, Sole, Mary, Byers, Jacqueline, Covelli, Maureen, Smith, Gerald, University of Central Florida
- Abstract / Description
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Muscle weakness is the most common and persistent problem after a critical illness. Early mobilization of the critically ill patient, beginning with passive exercise and progressing to ambulation, may mitigate muscle effects of the critical illness. However, mobilization may produce adverse effects, especially early in the illness when risk for physiologic deterioration is common. If safe, introducing a mobility intervention early in the illness may facilitate ventilator weaning, shorten...
Show moreMuscle weakness is the most common and persistent problem after a critical illness. Early mobilization of the critically ill patient, beginning with passive exercise and progressing to ambulation, may mitigate muscle effects of the critical illness. However, mobilization may produce adverse effects, especially early in the illness when risk for physiologic deterioration is common. If safe, introducing a mobility intervention early in the illness may facilitate ventilator weaning, shorten intensive care unit and hospitals stays, and improve functional status and quality of life for mechanically ventilated critically ill patients. The aim of this study was assess the cardiopulmonary and inflammatory responses to an early standardized passive exercise protocol (PEP) in mechanically ventilated critically ill patients. Using a quasi-experimental within-subjects repeated measures design, mechanically ventilated critically ill adults who were physiologically stable received a single standardized PEP within 72 hours of intubation. The PEP consisted of 20 minutes of bilateral passive leg movement delivered by continuous passive motion machines at a rate of 20 repetitions per minute, from 5-75 degrees, to simulate very slow walking. Physiologic parameters evaluated included heart rate (HR), mean blood pressure (MBP), oxygen saturation, and cytokine levels (IL-6 and IL-10), obtained before, during, and after the intervention. The Behavioral Pain Scale (BPS), administered before, during and after the intervention was used as a measure of participant comfort. The study sample was comprised of 18 (60%) males and 12 (40%) females, with a mean age of 56.5 years (SD 16.9 years), who were primarily Caucasian (N=18, 64%). Mean APACHE II scores for the sample were 23.8 (SD 6.2) with a mean predicted death rate of 48.8 (SD 19.8), indicating moderate mortality risk related to illness severity. Number of comorbidities ranged from 1-10 (X=4). All participants completed the intervention with no adverse events. Using repeated measures analysis of variance (rmANOVA), no significant differences were found in HR, MBP, or oxygen saturation at any of the four time points in comparison to baseline. BPS scores were significantly reduced (F(2.43, 70.42)=4.08, p=.02) at 5 and 10 minutes after the PEP was started, and were sustained at 20 minutes and for one hour after the PEP was completed. IL-6 was significantly reduced (F(1.60, 43.1)=4.351, p=.03) at the end of the intervention but not at the end of the final rest period. IL-10 values were not significantly different at any of the three time points, but IL-6 to IL-10 ratios did decrease significantly (F(1.61, 43.38)=3.42, p=.05) at the end of the PEP and again after a 60 minute rest period. Passive leg exercise was well tolerated by study participants. HR, MBP, and oxygen saturation were maintained within order set-specified ranges during and for one hour after activity, and patient comfort improved during and after the intervention. A downward trend in HR was noted in participants, which is contrary to usual HR response during exercise, and may represent clinical improvement in this population related to reduction in pain. Reduction of mean IL-6 values at the end of the PEP, but not after the rest period, suggests that the PEP was responsible for the initial IL-6 improvement. Improvement of IL-6 to IL-10 ratios from the end of the PEP to the end of the final rest period suggests that IL-10, although non-significant, may have had some effect, indicating that IL-10 increases may occur later than the time period of study.Passive exercise can be used as an approach to facilitating mobilization in mechanically ventilated critically ill adults until they are ready to participate in more active exercise. It could be that more frequent and aggressive exercise, such as passive cycling at faster rates, four times daily, will be tolerated in this population. While the understanding of clinical significance of cytokine profiles in critically ill patients is still evolving, cytokine levels may be useful in explaining benefits of mobilization in this population. Further study is required to replicate the impact of passive exercise on pain, and it may represent a novel approach to pain management in critically ill patients.
Show less - Date Issued
- 2012
- Identifier
- CFE0004350, ucf:49424
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004350
- Title
- EFFECTS OF AN EVIDENCE-BASED INTERVENTION ON STRESS AND COPING OF FAMILIES OF CRITICALLY ILL TRAUMA PATIENTS.
- Creator
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Knapp, Sandra, Sole, Mary Lou, University of Central Florida
- Abstract / Description
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Problem/Purpose: Critical care nurses are frequently exposed to the stress experienced by their patients' families, yet they often do not have the knowledge or skills to help family members cope with the stress of critical illness. While needs and stressors of families of the critically ill have been researched extensively, no prior studies have been conducted to determine the effects of an evidence-based nursing intervention for reducing family members' stress and improving their coping...
Show moreProblem/Purpose: Critical care nurses are frequently exposed to the stress experienced by their patients' families, yet they often do not have the knowledge or skills to help family members cope with the stress of critical illness. While needs and stressors of families of the critically ill have been researched extensively, no prior studies have been conducted to determine the effects of an evidence-based nursing intervention for reducing family members' stress and improving their coping skills. The purpose of this study was to determine if an evidence-based nursing intervention designed to address the needs of family members would reduce stress and improve coping skills in family members of critically ill trauma patients. Additionally, the study assessed the family members' perceptions of how well their needs were met while their loved one was hospitalized in the surgical intensive care unit (SICU). Methods: Using a quasi-experimental, nonequivalent control group design, an evidence-based intervention for critical care nurses was implemented to test its effect on stress and coping of family members of critically ill trauma patients. The study setting was the SICU at a tertiary university hospital in north central Florida. Subjects were family members of critically ill trauma patients who had been hospitalized in the SICU for at least 48 hours. Participants in the control group were given a packet containing instruments that measured 1) anxiety as an indicator of stress (Spielberger's State-Trait Anxiety Inventory ); 2) coping (Lazarus and Folkman's Ways of Coping Questionnaire ); and 3) assessment of family members' perception of having their needs met while their family member was in the SICU (Family Care Survey ). An evidence-based family bundle was implemented over an eight-week period and included an educational program for the nurses. After eight weeks, participants in the experimental group were given the same instruments previously administered to the control group. Anxiety levels, coping skills, and family members' perception of having needs met were compared between the two groups to determine the effectiveness of the evidence-based intervention. Results: A total of 84 family members participated in the study (control = 39; experimental = 45). The majority were women (n=60), spouse or parent of the patient (n=47), and Caucasian (n=70). Mean ages were 45.9 years for the control group and 47.4 years for the experimental group. No differences were noted in the demographic characteristics between the control and experimental groups. Using an independent samples t-test, no significant differences (p > .05) were noted between groups for either state or trait anxiety, although the mean anxiety score was lower in the experimental group. Significant differences between groups were noted on two of the eight coping subscales: Distancing and Accepting Responsibility. Improved coping, although not statistically significant, was noted on four additional subscales: Confrontive Coping, Self-Controlling, Planful Problem-Solving, and Positive Reappraisal. Overall coping scores also improved, but not statistically, for the total Ways of Coping Scale (both 50 and 66 item totals). Although not statistically significant, participants in the experimental group rated four out of eight items higher on the FCS, indicating an increased perception that more of their needs were met, greater overall satisfaction with the care that family members received, increased nurses' consideration of family members' needs and the inclusion of those needs in planning nursing care, and greater encouragement for family members to participate in care. Although findings were not statistically significant, the trend implies increased satisfaction with family care in areas involving family care and family member needs, including needs in planning care and encouragement to participate in care. In areas regarding information and communication, there was overall less satisfaction in both groups. Conclusions: This study provides data that can be used as a guide in developing programs that help families function and adapt to the extremely stressful experience of having a loved one who is critically ill. The information can be used to develop future research on larger scales with a longer and more extensive plan for implementation of the intervention to assist in a unit culture change. Nurses can use the results to facilitate practice changes in caring for families of critically ill patients. Modifying the interventions to focus on an interdisciplinary approach to meet families' needs, reduce stress, and improve coping also warrants further development and testing. Funding acknowledgement: Florida Nurses Foundation and the American Association of Critical Care Nurses. College of Nursing, University of Central Florida
Show less - Date Issued
- 2009
- Identifier
- CFE0002774, ucf:48134
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0002774
- Title
- ORAL HYGIENE PRACTICES IN NON-VENTILATED INTENSIVE CARE UNIT PATIENTS.
- Creator
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Emery, Kimberly P, Guido-Sanz, Francisco, University of Central Florida
- Abstract / Description
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Introduction: Oral hygiene is a significant aspect of nursing care. Endocarditis, stroke, lung cancer, and hypertension have been associated with poor oral hygiene. Research exploring oral care practices for mechanically ventilated patients is well documented. In contrast, oral hygiene for the non-mechanically ventilated acute care population remains underestimated. The purpose of this study was to establish a baseline of the type, frequency, and consistency of oral hygiene being performed on...
Show moreIntroduction: Oral hygiene is a significant aspect of nursing care. Endocarditis, stroke, lung cancer, and hypertension have been associated with poor oral hygiene. Research exploring oral care practices for mechanically ventilated patients is well documented. In contrast, oral hygiene for the non-mechanically ventilated acute care population remains underestimated. The purpose of this study was to establish a baseline of the type, frequency, and consistency of oral hygiene being performed on non-mechanically ventilated ICU patients and explore how the oral care provided was documented. Methodology: A literature search was conducted and reported as a literature review. The databases CINAHL Plus with Full Text, MEDLINE, PsychINFO, Academic Search Premier, and Cochrane Database of Systematic Reviews were searched. Key terms used were "oral hygiene," "oral care," "oral intensity," "mouth rinse," "mouth care," chlorhexidine rinse and ICU, "intensive care unit," "critical care" and infection*, pneumonia*, NV, non-ventilat*, and nonventilat*. The articles' selection addressed type, frequency, consistency, and/or documentation of oral hygiene in ICU patients, particularly non-mechanically ventilated patients, if available. Inclusion criteria consisted of English language, and academic journal articles. No specified publication date was placed as a restriction. The results were limited to English language, academic journal articles, peer reviewed research articles, evidence-based articles or practices, and articles published within the last ten years (2006 to 2016). All articles on oral hygiene practices in the ICU or critical care population were included. Articles that did not relate to oral hygiene practices in acute care, ICU patients, or critically ill hospitalized patients were excluded. Articles focused solely on the mechanically ventilated or intubated population were also excluded. Results: The review yielded very few articles focusing solely on non-mechanically ventilated ICU patients. Nevertheless, resulting data showed four areas common to oral hygiene practices in non-mechanically ventilated patients in the ICU: type of documentation, type of products, frequency of care, and personnel providing care. Documentation was found to be lacking compared to personnel's self-reported frequency of oral care. Oral hygiene products were found to be consistent in non-mechanically ventilated patients, while there was no consistency of products used in the general acute care population. Oral hygiene was self-reported by staff members to have been performed an average of two to three times per day for non-mechanically ventilated patients. Oral hygiene self-reported frequency was found to be inconsistent among the general acute care population. Lastly, registered nurses (RNs) were the primary providers of oral hygiene to patients. Conclusions: Findings support the existing gap in the literature on oral hygiene practices in non-mechanically ventilated patients in the ICU. Despite evidence documenting the impact of oral hygiene on health, further research is guaranteed.
Show less - Date Issued
- 2017
- Identifier
- CFH2000156, ucf:46036
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000156
- Title
- INTENSIVE CARE IN ONCOLOGY: ADMISSION AND OUTCOMES IN ADULT PATIENTS WITH CANCER.
- Creator
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John, Surya, Loerzel, Victoria, University of Central Florida
- Abstract / Description
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Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer...
Show moreBackground: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care. Methods: A total of 768 articles were found in a literature search including all literature from 2005 to 2016 from all countries using the databases CINAHL Plus, MEDLINE, PsycINFO, and Academic Search Premier. These were further narrowed down based on relevancy by topic or reading abstracts. A total of 13 articles utilizing the inclusion and exclusion criteria of the literature search were included in the final literature synthesis. Results: In addition to general ICU admission criteria several other criteria and scores can be helpful in admitting patients with cancer to the ICU including cancer specific criteria, mortality predictor tools, performance status, and ICU trials. Mortality predictors, in combination with other patient characteristics, demonstrated effectiveness to predict outcomes in patients with cancer. Survival rates in hematological and solid tumor cancers have improved from the past, and lower prognostic scores can predict who will have better outcomes. Conclusion: Cancer specific criteria, mortality predictor tools, performance status, and ICU trials in addition to general ICU criteria should be used for admission of cancer patients into ICU. Practitioners and nurses should become familiar with the newest outcomes in patients with cancer to make collaborative informed decisions about ICU admission.
Show less - Date Issued
- 2016
- Identifier
- CFH2000093, ucf:45522
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000093
- Title
- EVALUATING INTERVENTIONS TO MITIGATE COMPASSION FATIGUE AMONG AT-RISK NURSING POPULATIONS.
- Creator
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Derayunan, Emily R, Andrews, Diane, University of Central Florida
- Abstract / Description
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This thesis examined the experience of compassion fatigue in nurses through analysis of research studies conducted within the past ten years. A literature review was completed using CINAHL Plus with Full Text, MEDLINE, and PsycINFO databases. Efficacy of current management strategies and interventions was evaluated. Findings indicate that educating nurses working in high-risk units improves self-recognition and lowers compassion fatigue levels. Institutional factors such as a lack of...
Show moreThis thesis examined the experience of compassion fatigue in nurses through analysis of research studies conducted within the past ten years. A literature review was completed using CINAHL Plus with Full Text, MEDLINE, and PsycINFO databases. Efficacy of current management strategies and interventions was evaluated. Findings indicate that educating nurses working in high-risk units improves self-recognition and lowers compassion fatigue levels. Institutional factors such as a lack of managerial support and organizational commitment contribute to the experience of compassion fatigue. An organization's involvement in maximizing compassion satisfaction through meaningful recognition of nurses' contributions to care and implementation of organizational prevention programs minimizes the risk of developing compassion fatigue. Once self-recognition by nurses and organizations participation level in mitigating compassion fatigue is addressed, interventions can be implemented to attenuate the experience of compassion fatigue. Resiliency programs and mindfulness-based interventions were efficacious in mitigating compassion fatigue.
Show less - Date Issued
- 2019
- Identifier
- CFH2000469, ucf:45723
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000469
- Title
- THE EFFECTS OF AUDITORY STIMULI ON STRESS LEVELS OF ADULT PATIENTS IN THE CRITICAL CARE SETTING.
- Creator
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Ellermets, Jessica, Heglund, Stephen, University of Central Florida
- Abstract / Description
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The purpose of this review of literature is to explore the effects of interventional and environmental auditory stimuli on the adult critical care population. Current research has yet to compare and contrast the effectiveness of various interventional auditory stimuli on stress relief, an oversight this thesis aims to remedy. Modern day critical care settings demand the identification of the most therapeutic interventional auditory stimulus and the most stress-inducing environmental stimuli,...
Show moreThe purpose of this review of literature is to explore the effects of interventional and environmental auditory stimuli on the adult critical care population. Current research has yet to compare and contrast the effectiveness of various interventional auditory stimuli on stress relief, an oversight this thesis aims to remedy. Modern day critical care settings demand the identification of the most therapeutic interventional auditory stimulus and the most stress-inducing environmental stimuli, so that interventions can be made to optimize patient stress levels and improve outcomes. Suggestions will be made on how to simultaneously reduce harmful or stress inducing auditory stimuli in the critical care setting and implement the optimal stress-relieving interventional auditory stimuli.
Show less - Date Issued
- 2015
- Identifier
- CFH0004853, ucf:45482
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004853
