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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: Wealth Over Health? An Analysis of Macro-Level Factors That Influence Public Opinion on Health Care Policy.
Creator: Reiss, Jacquelyn, Hinojosa, Ramon, Hinojosa, Melanie, Huff-Corzine, Lin, University of Central Florida
Abstract / Description: Currently, the U.S. reports some of the worst health outcomes while spending the most money on health care when compared to other developed countries in the Organization for Economic Co-operation and Development (OECD). In 2018, Americans took out $88 billion in debt to cover the cost of medical care and approximately 28.5 million individuals remained uninsured. Despite poor health outcomes across the country, health care reform is a highly controversial issue and has been for the last...
Show moreCurrently, the U.S. reports some of the worst health outcomes while spending the most money on health care when compared to other developed countries in the Organization for Economic Co-operation and Development (OECD). In 2018, Americans took out $88 billion in debt to cover the cost of medical care and approximately 28.5 million individuals remained uninsured. Despite poor health outcomes across the country, health care reform is a highly controversial issue and has been for the last century. Historically, elites in the Republican party have aligned themselves with New Right political philosophies, which stand for a privatized health care system with minimal government involvement. Elites in the Democratic party have aligned with Pluralist political philosophies, which is an orientation that encourages government oversight to protect the health of its citizens. Recently there has been a rise in political polarization that has stemmed from the asymmetric movement of the Republican Party further to the right escalating the controversy around health care reform. In addition to growing polarization, recent studies have found that politicians are more responsive to the affluent classes while concurrently accumulating an influx of wealth. When neglecting to vote with the majority of their constituents, politicians have tried to change public opinion rather than address it. These short-term manipulation strategies have been found to confuse constituents more than mobilize them, contributing to the controversy around health care reform today. This project aims to understand how macro level structures affect public opinion on government funding of health care utilizing the thermostatic model and the works of Nicos Poulantzas and Michel Foucault as theoretical frameworks to understand how political structures influence public opinion and how political structures are shaped within Capitalistic societies. Specifically, the current study examines how the political leaning of Congress and the Presidency, total lobbying dollars contributed by the top five medical industries, and the number of health care bills passed per year affects public opinion on government funding of health care between 1986 and 2018. The data were accumulated from multiple sources including the General Social Survey, OpenSecrets.org, GovTrack.us, and the Senate, House, and White House websites. After completing bi-variate and multi-variate autoregressive integrated moving average (ARIMA) models the only variable that was found to impact public opinion was the political party of the Presidency.
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Date Issued: 2019
Identifier: CFE0007713, ucf:52453
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007713

Title: LGBT AFFIRMING ENVIRONMENTS IN HOSPICE CARE SETTINGS.
Creator: Gore, Maria, Gammonley , Denise, University of Central Florida
Abstract / Description: Abstract The documented experiences and perceptions of lesbian, gay, bisexual, and transgender (LGBT) patients receiving hospice or palliative care gives merit to the need for the implementation of LGBT affirming environments in hospice care settings. The guidelines for creating these affirming environments are described in this paper. Applying the Donabedian (1988) model of structure, process, and outcome this thesis project analyzes identified interventions relevant to the implementation of...
Show moreAbstract The documented experiences and perceptions of lesbian, gay, bisexual, and transgender (LGBT) patients receiving hospice or palliative care gives merit to the need for the implementation of LGBT affirming environments in hospice care settings. The guidelines for creating these affirming environments are described in this paper. Applying the Donabedian (1988) model of structure, process, and outcome this thesis project analyzes identified interventions relevant to the implementation of LGBT affirming environments in hospice care settings. Utilizing a formal PICO questioning method, a search strategy was devised and studies were identified based on established criteria. The results suggest that there is a paucity of data in relation to the implementation of LGBT affirming environments in hospice care settings. In an effort to assist in identifying existing interventions that have not been studied this project also includes a recommended survey tool to measure the active efforts of hospice organizations to implement LGBT affirming environments.
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Date Issued: 2013
Identifier: CFH0004353, ucf:44986
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004353

Title: THE LASTING EFFECTS AND ANALYSIS OF THE SUPREME COURT'S DECISION IN: THE NATIONAL FEDERATION OF INDEPENDENT BUSINESS V. SEBELIUS.
Creator: Esposito, Devin, Wood, Robert, University of Central Florida
Abstract / Description: The purpose of this thesis is to examine the Affordable Care Act through an analysis of the United States Supreme Court's holding in The National Federation of Independent Business v. Sebelius. In order to better understand the Supreme Court's reasoning in that case, this paper will first examine the history and the function of the Supreme Court, which will demonstrate the Court's power to either augment or diminish the power of the states in relation to the federal government. This paper...
Show moreThe purpose of this thesis is to examine the Affordable Care Act through an analysis of the United States Supreme Court's holding in The National Federation of Independent Business v. Sebelius. In order to better understand the Supreme Court's reasoning in that case, this paper will first examine the history and the function of the Supreme Court, which will demonstrate the Court's power to either augment or diminish the power of the states in relation to the federal government. This paper will then discuss the background of the Affordable Care Act, the procedural history of the case, and the majority's analysis supporting its decision. The concurring and dissenting opinions of the other justices will be discussed to present the various viewpoints regarding the proper role of the federal government and the implications this case may have on federal/state conflict. The Supreme Court ruled in favor of the Department of Health and Human Services. The 5-4 decision was extremely close and the opinions given by each Justice highlighted the various flaws and benefits of the Act it was looking to uphold. Further research of Supreme Court cases in our country's history reveal the trend of augmenting and diminishing state's rights. This thesis will examine the constitutionality of the aforementioned decision, the effects it will have on each of the states within the United States, and the impact the citizens will experience.
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Date Issued: 2013
Identifier: CFH0004372, ucf:45012
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004372

Title: A Longitudinal Study of the Effects of Three Specific Communication Techniques in Vocal Rehabilitation.
Creator: Graham, Minnie S., Ingram, David, Social Sciences
Abstract / Description: Florida Technological University College of Social Sciences Thesis
Date Issued: 1978
Identifier: CFR0008166, ucf:53076
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFR0008166

Title: ASSESSMENT OF TRACHEOSTOMY CARE PRACTICES IN A SIMULATED SETTING.
Creator: Bolsega, Thomas, Sole, Mary Lou, University of Central Florida
Abstract / Description: Background: Although a tracheostomy is a common procedure for patients who require prolonged mechanical ventilation, little evidence exists as to the best practices for performing tracheostomy care to maintain the airway and promote skin integrity. Therefore, variability is likely, which may negatively impact patient outcomes. This study described tracheostomy care practices of registered nurses (RNs) and respiratory therapists (RTs) who regularly perform tracheostomy care in critical care...
Show moreBackground: Although a tracheostomy is a common procedure for patients who require prolonged mechanical ventilation, little evidence exists as to the best practices for performing tracheostomy care to maintain the airway and promote skin integrity. Therefore, variability is likely, which may negatively impact patient outcomes. This study described tracheostomy care practices of registered nurses (RNs) and respiratory therapists (RTs) who regularly perform tracheostomy care in critical care settings. Methodology: The descriptive study was conducted following informed consent. RNs (n=15) and RTs (n=5) were asked to perform tracheostomy care on a simulated mannequin patient. An array of supplies (both required and not necessary) was available to perform tracheostomy care. The procedure was video-recorded and the researchers also used an observation checklist. Equipment used and steps performed were compared to hospital policy and the American Association of Critical-Care Nurses (AACN) Procedure Manual. Data were analyzed with descriptive statistics. Results: The majority (80%) of participants were female and held a baccalaureate degree; median experience was 5 years. Equipment selection varied widely; supplies used by 50% or more of participants included non-sterile gloves, hydrogen peroxide, cotton swabs, disposable cannula, foam ties, and gauze dressings. The order of steps was variable with unique differences noted among all participants. The most common sequence was hand hygiene, clean flange, clean stoma, change inner cannula, change ties, and apply dressing. No one performed in the order recommended in the AACN Procedure Manual. Wide variability in practices emphasizes the need for establishing an evidence-based approach for performing tracheostomy care. Discussion: Research supported the belief that variation to technique and supplies does exist when performing tracheostomy care. Tracheostomy varied from provider to provider within one hospital unit, demonstrating the need for further research and protocols for tracheostomy care. Education on existing protocols and evidence-based practice should be conducted to ensure that providers are following unit protocols.
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Date Issued: 2015
Identifier: CFH0004746, ucf:45359
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004746

Title: A COMPARISON OF COMPUTER AND TRADITIONAL FACE-TO-FACE CLASSROOM ORIENTATION FOR BEGINNING CRITICAL CARE NURSES.
Creator: Anzalone, Patricia, Sole, Mary Lou, University of Central Florida
Abstract / Description: 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.
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Date Issued: 2008
Identifier: CFE0002192, ucf:47888
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002192

Title: Barriers to timely administration of thrombolytics in acute ischemic stroke patients.
Creator: Joseph, Elizabeth, Talbert, Steven, Chase, Susan, Ullah, Saif, University of Central Florida
Abstract / Description: Stroke is a leading cause of long term disability in the United States. The therapeutic benefits of intravenous thrombolytics is time dependent in an acute ischemic stroke patient and is an important determinant of 90 day and one year functional outcomes. This study investigated areas in the stroke alert process of a community based primary stroke care center that resulted in the delay of administration of thrombolytics within 60 minutes of an acute ischemic stroke patient's arrival to the...
Show moreStroke is a leading cause of long term disability in the United States. The therapeutic benefits of intravenous thrombolytics is time dependent in an acute ischemic stroke patient and is an important determinant of 90 day and one year functional outcomes. This study investigated areas in the stroke alert process of a community based primary stroke care center that resulted in the delay of administration of thrombolytics within 60 minutes of an acute ischemic stroke patient's arrival to the emergency room. A retrospective descriptive design was utilized and chart reviews were done on 40 patients that received thrombolytics in the emergency room. Patient characteristics and time variables associated with the various steps in the stroke alert process were extracted. Findings showed that only 7.5% of the patients received thrombolytics within the recommended 60 minutes, with the longest time interval associated with time from arrival to the emergency room to time of evaluation by teleneurologist. There were no significant differences in the characteristics of patients who received thrombolytics within 60 minutes and those patients that received thrombolytics after 60 minutes. Recommendations were made for changes in organizational and practice strategies to improve timely administration, and for future research involving the effects of quality improvement initiatives.
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Date Issued: 2012
Identifier: CFE0004390, ucf:49406
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004390

Title: CONSUMER PERSPECTIVESOF HEALTH DURING PRENATAL CAREIN THE USA AND ICELAND: AN EXPLORATORY STUDY.
Creator: Wiseman, Claudia, Bushy, Angeline, University of Central Florida
Abstract / Description: ABSTRACT Purpose: Prenatal care (PNC) is the healthcare service most often provided to women of childbearing age throughout the world. Poorly understood and defined, based on culture, and expensive for any healthcare system, PNC remains a target for change and improvement. The purpose of this cross-national qualitative research study using narrative inquiry methods was to explore consumer perspectives of individual health and routine PNC in the USA and Iceland. Methods: A purposive sampling...
Show moreABSTRACT Purpose: Prenatal care (PNC) is the healthcare service most often provided to women of childbearing age throughout the world. Poorly understood and defined, based on culture, and expensive for any healthcare system, PNC remains a target for change and improvement. The purpose of this cross-national qualitative research study using narrative inquiry methods was to explore consumer perspectives of individual health and routine PNC in the USA and Iceland. Methods: A purposive sampling technique was used to identify study participants (n = 32) from the United States (n = 16) and Iceland (n = 16). Data were collected via a semi structured interview which included demographic questions. Results: Content analysis processes were used to analyze the transcribed narratives to identify common conceptual themes. Subsequently, the narratives of the women from the two nations were compared to identify cultural variations about PNC. In respect to the findings, demographically the two groups were similar. Respondents from both nations preferred a more supportive role from PNC providers with adequate time to explore important personal concerns and less emphasis on monitoring weight gain during the pregnancy. Variations between the two groups related to the health care delivery system of the nation in which respondents resided. These findings have the potential for expanding the definition of PNC to include consumer perspectives. Discussion/Implication: Additional research is needed with other groups of women to validate, clarify and expand identified themes, as they may improve PNC, and ultimately, perinatal outcomes. Improving PNC holds the promise of improving infant mortality while at the same time reducing healthcare expenditures for countries around the world.
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Date Issued: 2009
Identifier: CFE0002720, ucf:48180
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002720

Title: Impact of Cancer-Specific Advance Care Planning on Anxiety, Decisional Conflict, and Surrogate Understanding of Patient Treatment Preferences.
Creator: Waser, Lynn, Aroian, Karen, Chase, Susan, Norris, Anne, Loerzel, Victoria, Buckey, Julia, University of Central Florida
Abstract / Description: ABSTRACTPatients with life-limiting cancer and their families face unique challenges that interfere with their ability to make decisions or adequately express their health care preferences about end of life (EOL) treatment. As a result, patients at EOL often receive aggressive unwanted treatment that nationally costs billions of dollars and results in surrogate distress about not honoring patient wishes. Respecting Choices(&)#174; DS-ACP is a disease-specific Advance Care Planning (ACP)...
Show moreABSTRACTPatients with life-limiting cancer and their families face unique challenges that interfere with their ability to make decisions or adequately express their health care preferences about end of life (EOL) treatment. As a result, patients at EOL often receive aggressive unwanted treatment that nationally costs billions of dollars and results in surrogate distress about not honoring patient wishes. Respecting Choices(&)#174; DS-ACP is a disease-specific Advance Care Planning (ACP) intervention that is designed to overcome barriers associated with ACP and potentially decrease the incidence of unwanted, overly aggressive treatments at EOL. The intervention is delivered to patient-surrogate dyads by a trained facilitator who provides an opportunity for patients to identify values and goals that support their EOL choices and communicate these values and goals to their surrogates before they are in a medical crisis. Although Respecting Choices(&)#174; DS-ACP has been effective with other populations, it has not been evaluated for patients with life-limiting cancer. Thus, the purpose of this study was to evaluate the Respecting Choices(&)#174; DS-ACP intervention with patients with life-limiting cancer to determine if the intervention increases patient-surrogate congruence about the patient's EOL wishes and reduces decisional conflict without causing anxiety.Study design was a Phase I clinical trial. A volunteer sample of 15 patients with a diagnosis of life limiting cancer and their matched surrogates participated in the study. The Statement of Treatment Preferences for Life-Limiting Cancer Form, the Spielberger State-anxiety Scale Form Y-1 (STAI) and the Decisional Conflict Scale (DCS) were administered pre- and post-intervention. The Quality of Communication about End of Life Care Form was administered at post test. Descriptive statistics were used to describe the sample. McNemar Chi-square and Binomial tests were conducted to investigate whether the intervention increased congruence for five different situations on the Statement of Treatment Preferences for Life-Limiting Cancer Form. The Zar's Multiple Comparison Test of Differences was conducted to investigate the proportion of congruence observed across the five situations. A paired-sample t test was conducted to evaluate post-intervention changes in anxiety (STAI) and decisional conflict (DCS). Frequencies and percentages were conducted for the five items on the Quality of Communication about End of Life Care Form to evaluate patients' and surrogates' satisfaction with the intervention. Anecdotal comments about timing were content analyzed and summarized.Congruence between patients and surrogates improved significantly in all five situations (range of p =.001 to .031), decisional conflict lessened significantly (t (14) =4.49, p (<) .001), and anxiety did not change (t (14) = 1.75, p = .102) pre- and post-intervention. Participants reported satisfaction with the intervention, including its delivery and timing.Findings from this study provide guidance on how to assist patients with life limiting cancer and their surrogates with EOL decision making. Study findings also support making the Respecting Choices ACP intervention part of usual care for patients with life limiting cancer and timing the intervention so that it is delivered before a medical crisis occurs. The lack of change in post-intervention anxiety scores suggests that ACP does not add to patient distress when ACP is conducted by a trained facilitator. This finding can be used to persuade health professionals to refer their patients for ACP. Additional research is needed to determine if increased patient-surrogate congruence leads to patients' wishes being followed and reduces surrogate decisional conflict and distress at EOL. Future research is also needed to determine if the Respecting Choices DS-ACP intervention is equally effective with racial and ethnic groups whose reluctance to engage in EOL discussion has been documented in the literature or if the intervention needs to be culturally adapted.
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Date Issued: 2012
Identifier: CFE0004615, ucf:49944
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004615

Title: ORAL HYGIENE PRACTICES IN NON-VENTILATED INTENSIVE CARE UNIT PATIENTS.
Creator: Emery, Kimberly P, Guido-Sanz, Francisco, University of Central Florida
Abstract / Description: 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.
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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: John, Surya, Loerzel, Victoria, University of Central Florida
Abstract / Description: 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.
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Date Issued: 2016
Identifier: CFH2000093, ucf:45522
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000093

Title: PERFORMANCE BASED DECISION SYSTEM IN DETERMINING POST CLOSURE CARE (PCC) DURATION IN FLORIDA LANDFILLS.
Creator: kulkarni, Asawari, Reinhart, Debra, University of Central Florida
Abstract / Description: This study is an evaluation of Post Closure Care (PCC) duration of landfills using performance based methodology. The post closure care phase begins once the landfill is closed. As required by the Resource Conservation Recovery Act (RCRA) Subtitle D, PCC duration for municipal solid waste landfills is 30 years. During the PCC period, the landfill operator/owner is required to conduct monitoring for leachate, landfill gas, and ground-water and maintain the integrity of the cap so that the...
Show moreThis study is an evaluation of Post Closure Care (PCC) duration of landfills using performance based methodology. The post closure care phase begins once the landfill is closed. As required by the Resource Conservation Recovery Act (RCRA) Subtitle D, PCC duration for municipal solid waste landfills is 30 years. During the PCC period, the landfill operator/owner is required to conduct monitoring for leachate, landfill gas, and ground-water and maintain the integrity of the cap so that the landfill does not impose a threat to surrounding human health and environment (HH&E). The duration of PCC can be reduced by the director of an approved State if an owner/operator of a landfill demonstrates that the landfill exhibits no threat to the surrounding HH&E or can be increased if the director of the approved State determines that an increased PCC period is required for the protection of HH&E. RCRA provides flexibility in optimizing PCC duration of landfills, although it does not identify the criteria/methodology which can be used in demonstrating the status of a landfill from the point of PCC. Researchers worldwide recognize that the threat imposed by a landfill after closure depends on the extent of degradation occurring inside the landfill. The increased functional stability of landfills reduces its risk to the surrounding HH&E. However, there is a wide range of opinions in defining functional stability of a landfill. The present thesis applies performance based methodology, developed by Environmental Research and Education Foundation (EREF), to making a decision on the PCC of landfills. Performance based methodology is a modular approach encompassing all four PCC components of landfills (Leachate, gas, groundwater and cap maintenance). This methodology was applied to Alachua County Southwest Landfill (ACSWLF) in Alachua County, Florida. Each module was analyzed individually and recommendations on the PCC monitoring at the landfill site were provided.
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Date Issued: 2008
Identifier: CFE0002471, ucf:47700
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002471

Title: EXPERIENCES OF HOSPITALIZED PATIENTS WITH DEMENTIA.
Creator: Bainbridge, Samantha, LaManna, Jacqueline, University of Central Florida
Abstract / Description: People with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff....
Show morePeople with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff. Results showed a limited body of literature that addressed hospital experiences of people with dementia and those of family and professional caregivers. Additionally, few studies addressing this topic have been conducted in the United States. The primary finding from this study is that better communication is needed between nursing staff, patients, and their family caregivers. Nurses should carry out detailed assessments of cognition and pain in all elderly patients, and strive to provide appropriate palliative and end-of-life care. Dementia- specific training for all staff members may help to promote a better understanding of patients with dementia. Lastly, further research into the experiences of hospitalized dementia patients is needed, with a focus on acute care settings within the United States.
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Date Issued: 2012
Identifier: CFH0004146, ucf:44855
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004146

Title: Factors Influencing Nurse Practitioners' Weight Management Practices in Primary Care.
Creator: Hyer, Suzanne, Edwards, Joellen, Quelly, Susan, Upvall, Michele, Pasarica, Magdalena, University of Central Florida
Abstract / Description: More American adults are overweight or obese than ever before. Nurse practitioners (NPs) play a critical and expanding role in primary care, which is an ideal setting for the assessment and management of weight loss. NPs can make a significant contribution to tackling the obesity crisis. The study presented here seeks to close the gap in data related to how NPs approach weight management with their primary care patients. This study focused on a comprehensive examination of the current...
Show moreMore American adults are overweight or obese than ever before. Nurse practitioners (NPs) play a critical and expanding role in primary care, which is an ideal setting for the assessment and management of weight loss. NPs can make a significant contribution to tackling the obesity crisis. The study presented here seeks to close the gap in data related to how NPs approach weight management with their primary care patients. This study focused on a comprehensive examination of the current practice patterns of NPs related to weight management, a theoretical concept analysis of weight bias among healthcare providers, along with the results of a cross-sectional survey that investigated primary care NPs' weight management practice patterns and the relationship among attitudes, perceived barriers, self-efficacy, perceived skill, and demographic characteristics. The results from this study may be applied to provider training and education for obesity and weight management that ultimately improves patients' health outcomes.
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Date Issued: 2019
Identifier: CFE0007658, ucf:52498
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007658

Title: An Exploratory Study of Physiologic Responses to a Passive Exercise Intervention in Mechanically-ventilated Critically Ill Adults.
Creator: Amidei, Christina, Sole, Mary, Byers, Jacqueline, Covelli, Maureen, Smith, Gerald, University of Central Florida
Abstract / Description: 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.
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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: Knapp, Sandra, Sole, Mary Lou, University of Central Florida
Abstract / Description: 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
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Date Issued: 2009
Identifier: CFE0002774, ucf:48134
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002774

Title: Subjective-Objective Discrepancies Among Patients with Sleep Complaints in the Patient-Centered Medical Home.
Creator: Dotson, Keri, Dunn, Michael, Cassisi, Jeffrey, Bowers, Clint, University of Central Florida
Abstract / Description: Sleep misperception (-) the discrepancy between objective and subjective measures of sleep (-) has been shown to be prevalent among patients with insomnia and may be a promising target for sleep intervention. This study examined sleep misperception in a diverse outpatient medical sample using consumer-grade wearable actigraphs (i.e., Fitbit Charge HR(TM)). Forty-four self-identified problem sleepers aged 20 to 79 participated in the study. Participants completed sleep diaries for one week...
Show moreSleep misperception (-) the discrepancy between objective and subjective measures of sleep (-) has been shown to be prevalent among patients with insomnia and may be a promising target for sleep intervention. This study examined sleep misperception in a diverse outpatient medical sample using consumer-grade wearable actigraphs (i.e., Fitbit Charge HR(TM)). Forty-four self-identified problem sleepers aged 20 to 79 participated in the study. Participants completed sleep diaries for one week while also tracking their sleep using the Fitbit Charge HR(TM). After receiving a personalized sleep report based on these data, participants repeated another week of sleep assessment. Sleep misperception was observed for both total sleep time and sleep onset latency during the first week, such that participants underestimated their total amount of sleep per night and overestimated the amount of time it took them to fall asleep. Pre-post changes in self-reported sleep, mood, and health were examined as a secondary aim in this study. Objectively measured sleep remained relatively unchanged from baseline to follow-up. Despite this lack of change in actual sleep, participants perceived themselves to be sleeping more hours per night, falling asleep more quickly, and sleeping better overall at one-week follow-up. Statistically significant improvements in depression, anxiety, mental health functioning, and insomnia symptom severity were also observed at follow-up. Overall, findings showed that sleep misperception is prevalent among problem sleepers and that sleep discrepancy can be reduced through the use of corrective sleep feedback.
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Date Issued: 2018
Identifier: CFE0006976, ucf:51645
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006976

Title: THE EFFECTS OF KANGAROO CARE ON THE NEURODEVELOPMENT OF PRETERM INFANTS IN THE NEONATAL INTENSIVE CARE UNIT (NICU).
Creator: Sarg, Tiffany, Quelly, Susan, University of Central Florida
Abstract / Description: Preterm birth disrupts the development of the brain and other critical organs of the infant body. Since the brain is one of the last organs to finish developing during pregnancy, the risk for substantial neurological deficits increases as the gestational age decreases. One way to combat these deficits is to reconnect the preterm infant with the mother via skin-to-skin contact, also known as kangaroo care (KC). This intimate touch helps to replicate aspects of the environment that the preterm...
Show morePreterm birth disrupts the development of the brain and other critical organs of the infant body. Since the brain is one of the last organs to finish developing during pregnancy, the risk for substantial neurological deficits increases as the gestational age decreases. One way to combat these deficits is to reconnect the preterm infant with the mother via skin-to-skin contact, also known as kangaroo care (KC). This intimate touch helps to replicate aspects of the environment that the preterm infant experienced in utero. The purpose of this literature review was to analyze the current literature to better understand the effects that KC may have on facilitating neurodevelopment of preterm infants in Neonatal Intensive Care Units (NICUs). Emphasis was placed on neurophysiologic functioning, autonomic functioning, and neurobehavioral functioning. A database search of CINAHL Plus with Full Text, PsycINFO, MEDLINE, Cochrane Central Register of Controlled Trials, and Health Source: Nursing/Academic Edition was conducted, and a total of six articles were reviewed based on their relevance and application towards this thesis. KC is a low-cost, relatively easy intervention to initiate that can have positive impacts on many aspects of preterm infant growth and maturation. There is limited research regarding the use of KC as an intervention to support neurodevelopment, especially with regards to long-term effects. Existing research supports the use of KC as an intervention to facilitate neurodevelopment in preterm infants in the NICU.
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Date Issued: 2016
Identifier: CFH2000010, ucf:45577
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000010

Title: SPIRITUAL CARE INTERVENTIONS TO IMPROVE THE QUALITY OF LIFE IN PATIENTS WITH ADVANCED CANCER RECEIVING PALLIATIVE CARE.
Creator: Ballen-Sanchez, Maria, Conner, Norma, University of Central Florida
Abstract / Description: Title: Spiritual Care Interventions and Quality of Life in Cancer Patients Receiving Palliative Care Background: Despite the evidence supporting spiritual care in nursing and an increased quality of life among patients, patients feel that their spiritual needs are not being supported by medical professionals. Nurses agree that the role they play is significant in addressing the needs of cancer patients; however, they feel that they lack the knowledge for addressing spirituality concerns at...
Show moreTitle: Spiritual Care Interventions and Quality of Life in Cancer Patients Receiving Palliative Care Background: Despite the evidence supporting spiritual care in nursing and an increased quality of life among patients, patients feel that their spiritual needs are not being supported by medical professionals. Nurses agree that the role they play is significant in addressing the needs of cancer patients; however, they feel that they lack the knowledge for addressing spirituality concerns at the end of life. The purpose of this study is to identify spiritual care interventions that nurses can implement to improve quality of life (QOL) in patients with advanced cancer receiving palliative care. Method: This literature review consisted of articles retrieved from several databases, including CINAHL, PubMED, and PsychINFO , PsychARTICLES, ATLA Religion databases using the key words "cancer*" and "quality of life" "therapeutic communication", "spirit* therapy", "relaxation therapy", and "self-care". Inclusion criteria consisted of research conducted after the year 2000, peer reviewed work and research studies written in the English language. Results: Results from this literature review include recommended nursing interventions that provide spiritual care to patients with advanced cancer receiving palliative care for the purpose of improved quality of life. Spiritual care interventions identified in this study include Meaning Centered Group Psychotherapy (MCGP), Supportive Group Psychotherapy (SGP), mental relaxation, mental images, TM, art therapy, socializing, communicative acts, aromatherapy, massage, exercise, hatha yoga, meditation, and activities such as gardening, watching TV, resting/sleeping and socializing.
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Date Issued: 2012
Identifier: CFH0004245, ucf:44925
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004245

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