Megan Renae Allison
Communication with Orally Intubated Pediatric Patients
Advisor: Diane Yorke, RN, MSN, MBA, PhD
Highest Honors
Statement
Ever since I have known what nurses are, I have wanted to be one. I like the hospital environment, but most importantly, I love caring for others, especially children. I enjoy being able to ease someone’s discomfort with the simplest task and I love knowing I am in a position to improve someone’s life.
Abstract
Communication is an essential life process that can be impaired by oral intubation in an intensive care unit because the endotracheal tube inhibits the ability to speak. The research on the topic of communication with conscious, orally intubated pediatric patients is limited. Most of the research available on how to maintain and improve communication with intubated patients focuses on adults. The emotional responses to being orally intubated and unable to speak are typically negative for both the patient and the healthcare staff. The primary aim of this report was to identify the communication needs of conscious, orally intubated pediatric patients and explore different nonverbal communication options for these patients and to translate these findings into a communication tool that will aid communication among this population and their caregivers. A secondary effect of creating and using this tool will be to decrease the negative emotional responses felt by patients and healthcare staff by enhancing their ability to communicate. In a review of the literature, 21 basic communication needs were identified for inclusion in the communication tool, and a communication board was decided as the best tool for use with pediatric patients. The methods for creating this tool involved drawing from the literature and my experiences to determine which basic communication needs should be included, what images to use to depict them, how to display them on the board, and how the PICU nursing staff should evaluate the preliminary board. After this evaluation and alterations, the final board will be presented to the PICU staff prior to implementation. The final board will be printed and laminated and placed in all 16 PICU rooms to aid communication with conscious orally intubated pediatric patients. The board may also be adapted to fit other patient populations, but my communication board has been specifically designed for a pediatric population.</p>]]></abst>
Lisa M. Biltz
Professional Nursing Associations and Their Impact on Policy: The Image of Nursing
Advisor: Lindsay Allen Gainer, RN, MSN
Highest Honors
Statement
I went into nursing for a multitude of reasons, but mainly because this career provides flexibility and endless opportunities for advancement. Nursing is a career requiring a perfect balance of scientific knowledge, autonomous thinking, compassion and human interaction. It was this unique balance that drew me to the profession and ultimately the reason why I love it.
Abstract
The professional image of nursing remains full of negative stereotypes, despite many attempts to improve it. An integrative review of the literature including research studies, websites, and journal publications was conducted in order to gain a better understanding of the causes of the current nursing image and its effect on the profession. The image of nursing, both generally and professionally, is derived from a dynamic combination of media portrayals, gender stereotypes, and intra-professional pitfalls. The product created by the combination of these negative image catalysts restrains the profession from achieving further growth, recruitment, respect, and power. In order to address the current image crisis, it is imperative that nurses use their professional associations as a means to gain political power and support for an improved and accurate image. To this end, the information collected in the review of literature was used in writing a resolution that was submitted to the National Student Nurses Association and will be presented before the House of Delegates in Anaheim, California, on April 13, 2007.
Katherine Nicole Bumgarner
Influencing Political Activism in the New Graduate Nurse: Interventions With Nursing Students to Address the Current Deficit of Politically Involved Nurses
Advisor: Lindsay Allen Gainer, RN, MSN
Highest Honors
Statement
I have always been interested in health care and initially though that I would pursue medical school after graduating from college. However, for a high school career project, I had the opportunity to shadow a nurse and immediately fell in love with the profession. I love the fact that nurses get to be care providers, teachers, advocates and role models all rolled into one. Nurses are uniquely positioned to care for patients as well as be voices for the public.
Abstract
The value of political participation for nurses is immense as government legislation controls almost every aspect of their practice. However, the majority of the nursing profession remain politically inactive. To influence the public policy that governs both their livelihood as professionals, and the care they provide to their patients, nurses must develop relationships within their own community as well as with legislators and key officials. Professional nursing organizations provide an opportunity for nurses to practice political activism without needing expertise of legislative protocol. This study investigates the social and educational factors that may influence a new graduate nurses’ decision to join their state nursing association as an avenue for political activism, and which interventions nursing associations, educators, and employers can implement to promote a new generation of politically involved nurses.
Matthew S. Fields
A Comparison of Coping Mechanisms Most Frequently Utilized Among Intensive Care Unit Registered Nurses
Advisor: Makeba Felton, MSN, RN, FNPC, WHNP
Statement
I chose nursing because, like most nurses, I care a great deal about others and I wanted a career that would provide me with the opportunity to help. In addition, I knew nursing would be an extremely gratifying profession that would give me a sense of purpose and pride. Nursing provides the ultimate opportunity to connect with, learn from and share with others.
Abstract
Work related stress significantly contributes to job burnout. Characteristics of the intensive care unit setting create a high stress environment for registered nurses. Nurses must identify and utilize effective coping mechanisms to manage work related stress; however, little research has identified the coping mechanisms utilized by nurses in the intensive care unit setting. Specifically, future research should compare the coping mechanisms of experienced nurses with those of new graduate nurses to assess for differences in coping mechanisms used. Fourteen nurses from the surgical/trauma intensive care unit at UNC Hospitals completed questionnaires that measured the frequency with which coping behaviors, adapted from previous research, were used to cope with work related stress in the ICU. Six nurses had more than three years experience in the intensive care unit, and eight nurses had less than one year experience. Analysis found that problem-oriented coping mechanisms were used more frequently than emotion-oriented mechanisms. When nurses with more than three years experience were compared with nurses with less than one year experience, the nurses with more experience more frequently attended staff meetings, rationalized the situation, avoided other staff members, and expressed their feelings to others.With the identification of coping mechanisms utilized by more experienced nurses, steps can be taken to educate new graduate nurses on effective coping mechanisms, with the goal of increasing the new graduate nurse’s longevity in the profession and preventing work related burnout.
Catherine T. Hill
Effective Heart Failure Management: An Accompanying Nurses’ Teaching Guide to a Low Literacy Heart Failure Educational Tool
Advisor: Beverly Foster, PhD, RN
Statement
The day that I knew I was going to be a nurse was the day I fell off my bike in third grade and had to get stitches. I carried around a first aid kit for days and changed the bandage on my leg. I have volunteered in nursing homes and hospitals for most of my life and have found those experiences to be personally fulfilling. There is something so rewarding about helping others feel better and it is that feeling that lured me to nursing.
Abstract
Heart failure (HF) is a condition that affects 5 million Americans and accounts for the greatest number of hospitalizations among Medicare patients (Martinen & Freundl, 2004). A high rate of recidivism among HF patients is an issue of great concern. Nearly one third of hospitalized HF patients are readmitted within 3 to 6 months of discharge. Many of these HF related hospitalizations are easily preventable with early symptom identification and appropriate management. To further investigate reasons attributing to such high rates of recidivism among HF patients, an integrated literature review was conducted. This review revealed a holistic view of HF with a focus on current nursing efforts to improve disease management and patient outcomes.</p><p>A primary concern among nurses and other healthcare providers who care for HF patients is the effectiveness of patient education in the identification of worsening signs and symptoms of HF. Many individuals with HF have low literacy levels or are functionally illiterate. In healthcare institutes where time is limited, this disability is often overlooked. In order to improve patient outcomes, educational materials must be tailored to patients’ abilities. Little research related to low literacy and HF has been conducted. However, a study first conducted at UNC Hospitals in 2003 explores this issue through the development of a low literacy HF symptom management guide. Dr. Darren DeWalt is the first author of this study and was collaborated with in identifying a contribution I could provide. I created a nurses’ teaching guide for the low literacy HF educational tool currently being utilized by Dr. DeWalt and his colleagues. The guide is targeted towards LPNs and RNs working in primary care clinics, a setting in which most HF management and teaching occurs.
Anna Ashley Kairalla
Minority Health in a Faith Based Setting
Advisor: Valerie Lunsford, PhD, RN
Highest Honors
Statement
I want to make a difference in the lives of other people and feel that nursing will give me that opportunity. Pursing Honors has helped me extend myself academically, giving me the opportunity to work closely with a faculty member and to appreciate the process of research.
Abstract
Hispanic individuals are at increased risk for cardiovascular disease (CVD) development because they are significantly less likely to be physically active or to consume diets high in fruits and vegetables and low in fat compared with other ethnic groups within the United States. Few researchers have conducted CVD risk reduction interventions with Hispanic groups in a faith-based setting. Therefore, this literature review was expanded to include all community-based interventions with components to facilitate increasing physical activity and/or making dietary modifications conducted with minority groups within the last 10 years. This review also explores commonly reported barriers to physical activity reported by Hispanic individuals and factors important for faith-based research. Based on the finding of this integrated review, four recommendations for future research are proposed: increasing the focus on CVD research of Hispanic persons in faith-based settings with particular attention to Hispanic males, the inclusion of community input in study design and relevance, the collection of objective and subjective data, and the use of theory for study design and implementation
Macallagh J. McEvoy
Having a Child with Hypoplastic Left Heart Syndrome: A Case Study of a Family’s Experience
Advisor: Marcia Van Riper, PhD, RN
Statement
I chose to go into nursing because it was a discipline that combined my love of teaching, caring for children, and interest in science and disease processes. The profession presents unlimited opportunities and career directions. I want to be part of a group of professionals that places people, their health and their well being above all else.
Abstract
Families raising children with Hypoplastic left heart syndrome (HLHS) must cope with extensive medical and surgical treatments used to correct the congenital defect, the risks of multiple open-heart surgeries in infancy and the emotional strain of having an ill infant, all while their child’s long term prognosis is very uncertain. The difficulty of adapting to this experience is a relatively new phenomenon as better medical care is allowing more children with HLHS to survive past infancy. Although the condition had received significant medical and scientific attention, little nursing research has been done on the topic. Few case studies exist that give a family’s perspective on how they adjusted to having a child diagnosed with this congenital defect. This research project serves to explore the family experience of having a child with HLHS. An interview with a two parents affected by this disorder was conducted to gain their perspective. This family’s experience was described within the context of the main principles of the Resiliency Model of Family Stress, Adjustment and Adaptation. By integrating this information with current research on HLHS, this case study provides additional insight to nurses and care givers about the issues families face when dealing with this diagnosis and course of treatment.
Rachael W. Menius
Anticipatory Guidance for Parents as a Child Maltreatment Prevention Method for Children Ages Zero to Three Years Old
Advisor: Laura Nasir, RN, MSN, FNP
Highest Honors
Statement
I chose nursing as a career because I wanted to work with children and their families by giving them care and support during times of stress and vulnerability. I look forward to using the communication, patient education and technical skills I have learned in nursing school to provide holistic, curative and preventative care in both hospital and community settings. A nursing career will provide me with opportunities to play many different roles in my patients’ lives.
Abstract
The purpose of this honors project was to implement the use of anticipatory guidance and parenting education as a secondary prevention method for child maltreatment by families who are at-risk for child maltreatment. Child maltreatment is an issue that affects many children and families in North Carolina as well as the United States. While there are identifiable risk factors for child maltreatment and prevention methods that can target children and families who may be at risk, a disproportionate number of children do not receive preventative services. At this time in North Carolina, where the rates of child maltreatment are higher than the national average, no standard child maltreatment prevention program is in place. Therefore, health care providers can and should be integral in creating evidence-based maltreatment prevention programs in their own communities. In this project, a review of current literature on child maltreatment issues was conducted. An evidence-based parent education notebook, Information for Parents of Children Ages 0-3, was created for use at the Student Health Action Coalition (SHAC) clinic, a free health clinic run by the health affairs students at the University of North Carolina at Chapel Hill. In order to reach a large population, a copy of the notebook in both English and Spanish will be placed in all 13 exam rooms at the Carrboro Community Health Center (CCHC), where the SHAC clinic is held every week. A second and equally important goal of the project was to educate the future health care providers who volunteer at SHAC on the role they can play in the future in child maltreatment prevention. A CAPTIVATE presentation was created and implemented as an educational tool for SHAC volunteers about child maltreatment issues. The notebook and presentation create an opportunity for interdisciplinary learning among these student volunteers so they can then reach a greater number of community members.
Adrienne Marie Rose
Through Her Eyes: Living with Cystic Fibrosis
Advisor: Ann O’Hale, MSN, RN, NNP
Statement
As a little girl, I knew that I wanted to work in a hospital. Everything about it interested me–the science, the medicine, the people. My dad is a CRNA and I never met anyone who loved their job so much. When I was sixteen, I asked to shadow him at work. As I watched him interact with his patients, I saw what an impact he had on each and every one of them. From that moment on I realized that nursing is more than biology and scrubs; it’s a relationship. As a nurse, not only will I be helping someone physically, but I will get to relate with them on a personal level. That relationship is why I chose to go into nursing.
Abstract
Cystic fibrosis (CF) is the most fatal autosomal recessive disease among the Caucasian population. In the past, chances of survival were grim, but with the advent of new medical treatments and maintenance routines, the life expectancy is now 37 years (Yankaskas, 1999). While these statistics represent a medical achievement, the increased life span brings with it the highly complex health regimens and the continual battle to live a “normal” life.</p><p>This project is a biographical case study of a 20-year-old female college student, Julia Lucas, who was diagnosed with CF at birth. Julia was interviewed regarding stressors in her life as well as mechanisms that she uses to cope. This study takes the form of a narrative that depicts the life of a young woman with a serious chronic illness. The purpose is not to generate data that is entirely generalizeable to all CF patients but rather to add to the knowledge that already exists regarding CF and coping styles. Through analysis of the interview data, this study illustrates Julia’s key stressors, including her rigorous therapy and her inability to plan for the future because of the uncertainty of her disease. Her narrative reflects the physical, mental, and emotional obstacles that she has encountered while exemplifying her coping skills of humor and faith in God. As holistic caregivers, nurses must understand all aspects of a disease, and Julia’s story offers insight into what life is like for a patient with CF, showing everyone the person behind the disease.
Camille N. Scronce
Healthcare Professional’s Perceptions of Nursing Attire
Advisor: Shielda Rodgers, RN, PhD
Statement
I chose a career in nursing because I wanted to make a difference in the lives of others in a holistic manner while being intellectually and professionally challenged. Pursing Honors has been challenging, but I have learned how to organize and conduct research, which will assist me in my long-term goal of pursuing advanced nursing education.
Abstract
The attire nurses wear and the image conveyed by that attire have been an ongoing topic of debate since the days of Florence Nightingale. The purpose of this study was to explore the perceptions of members of the healthcare team about nursing attire. A convenience sample of pharmacists, physical therapists, physicians and respiratory therapists at a 600-bed regional health system were asked to look at photos of a nurse in three different uniforms. Using the modified Nurse Image Scale (Skorupski & Rea, 2006), participants selected the uniform that best reflected each of ten characteristics. The following research question was posed: What image of the nurse is conveyed by three different uniforms? The findings of this study provide insight into the first impressions the nurse uniform created in the minds of other members of the healthcare interdisciplinary team. This research adds to the literature and discussion of this controversial issue by suggesting that nurses may want to consider returning to the traditional all-white uniform.
Tneshia J. Sweat
Building Bridges of Communication: Application of Critical Success Factors to Effectively Promote Evidence-Based Practice in a Neonatal Intensive Care Unit
Advisor: Suzanne Thoyre, RN, PhD
Highest Honors
Statement
Healthcare has always fascinated me and I knew that I wanted to have the power to heal whether with touch, words or medicine. I chose to go into nursing because of the level of intimacy with patients that it offered. Pursing Honors has allowed me to see how the research process works first hand. This experience has confirmed for me my desire to do nursing research.
Abstract
Dissemination of research is vital to bridging evidence and practice. However, in bringing research results to the appropriate audience, both researchers and healthcare workers face considerable barriers, such as time constraints and lack of incentive. Three critical factors have been identified to successfully move evidence into practice: involvement of stakeholders such as researchers, nurses, and other clinicians who are dedicated to improving a specific area of clinical practice harnessing; momentum; and showing results to stakeholders. The purpose of this project was to apply the concept of the three critical success factors to an inpatient unit in a hospital and to evaluate the impact these factors have had on staff mentality pertaining to research presented. A research study was done on caregiver feeding practices in the preterm infant population. Currently, caregiver feeding strategies are often inconsistent, undefined, and undocumented and, moreover, are rarely evidence-based. It is not clear which feeding strategies, if any, are associated with infant distress or regulation during feeding. Identifying these feeding strategies could be one step toward developing effective interventions to minimize the physiologic consequences of feeding for the infant and to sustain positive practice for the infant throughout the period of learning to oral feed. The results of the study were used to develop an in-service that was presented to staff members of a neonatal intensive care unit during a staff meeting. The responses of the staff revealed areas of research that had not been sufficiently explored. Overall, the three critical success factors were successfully applied to the newborn critical care center. The barriers presented by traditional methods of dissemination and approaches for evidence-based practice were lessened by bringing researchers into the nursing units.