Deirdre Brett Shaver
Probiotic Supplementation in Elderly Hospitalized Patients
Advisor: Anna Song Beeber, PhD, RN
I chose to go into nursing because I believe that nursing is both a science and an art. Nurses must have an understanding of the science of medicine: pathophysiology, pharmacology, physical assessment, medical technology and diagnosis. In addition, nursing is not merely a profession, but a calling. Nurses must be altruists who believe in providing service in order to improve the lives of others.
Hospitalization of the elderly often leads to a downward spiral of declining health that can end in death. Hospitalized elderly are at high risk for infections and dysfunction of the gastrointestinal and urogenital tracts, malnutrition, and inflammatory conditions. This project is an analysis of the evidence showing that probiotic supplementation may be an effective adjunct to traditional treatment for these conditions. A search was conducted through PubMed and CINAHL for peer reviewed articles on health risks for elderly hospitalized patients, mechanisms of action of probiotics, and clinical trials of probiotics. This search revealed that a substantial body of recent research indicates that probiotic supplementation improves nutritional status, decreases incidence and duration of infections, decreases inflammation, and stimulates immune function. It also indicated that probiotics have been used clinically to prevent urinary tract and gastrointestinal infections, including opportunistic and antibiotic resistant infections such as VRE and C. difficile. This indicates that probiotics may be an important tool in reducing health risks for the hospitalized elderly. However, little research has been done specifically on the effects of probiotic supplementation in this patient population. This appears to be an opportunity for future inquiry. This paper will form the literature review for a future research project on use of probiotic supplementation in hospitalized elderly.
Janet M. Aiken
Adult of Older Adults on Type 2 Diabetes Mellitus via Computer
Advisor: Julie Page, MSN, RN
I love to work with people. Nursing gives me an opportunity to meet new people every day and to go home at night knowing that
I made a difference in their lives. I would like to learn as much as possible in a hospital setting so I can become a great nurse. Down
the road when I feel fully confident with my abilities, I would like to switch gears and work in a long-term nursing facility for
the elderly. I would also like to precept students so I can do my part in educating future nurses while remaining at the bedside.
As the morbidity and mortality in the United States has veered from infectious diseases to chronic diseases related to lifestyle, the need for health education has increased. A primary focus of the Healthy People 2010 initiative is on health promotion. Since most chronic diseases have very similar unhealthy lifestyle risks related to weight, activity, and diet, education on healthy behaviors for one chronic disease may help to reduce the risk of others as well. Targeting one disease also allowed the target audience to choose by survey the topic they felt was most relevant which in turn would serve to increase their motivation to learn and empower them to make healthy changes in their lives. The topic chosen most frequently was diabetes. For this project the senior population, who are often found to have three or more chronic diseases, was targeted and the Center for Senior Life in Durham was used as the testing ground. This location has a computer laboratory with twelve computers for use by the senior citizens of Durham County. Results of a survey taken at this senior center in addition to data gleaned from a review of literature confirmed that education via computer was indeed a viable option for the older population. A user friendly computer-based educational program was created that could be accessed via an icon on the computers? desktop to allow easy access to the material at any time. The program displays information gained through many reliable sources in fun, easy to read terms.
Erin Elise Freemyer
Development of Patient Education Materials for a Public Prenatal Clinic: A Service Learning Project
Advisor: Kathy Alden, EdD, RN, IBCLC
Ever since I was a little girl, I have had dreams of helping people. Traveling early in life exposed me to poverty and physical hurt in a unique way which gave me a vision for my future. I entered nursing with the desire to gain skills which would allow me to travel and make a difference in the lives of all people, whether here or abroad. The holistic foundation of nursing emboldened my heart to serve others and has challenged me to go beyond the physical hurts of people. Nursing incorporated culture, medicine, service and professionalism which matched my life’s ambition, and I could not imagine a better career.
The transition to pregnancy and motherhood is filled with many physiologic, psychologic, and behavioral changes. During this time, there are decisions to be made regarding health care practices. It is important that women are educated during the prenatal period so that they are able to make informed decisions affecting their own health and the health of their newborns. The purpose of this service learning project was to create evidence-based patient education materials for a prenatal clinic at the Durham County Health Department. Midwives working in the clinic identified the topic areas for which updated patient education resources were needed. These topics included: (1) circumcision: benefits, risks, and expense; (2) pain medications during labor and implications for mother and neonate; and (3) nausea and vomiting during pregnancy. A literature review was conducted to identify the most recent evidence-based information related to the identified topic areas. A web search was also performed to identify sites that provide current, correct information. The results of the literature review and web search were used to create patient education materials containing practical, evidence-based information including suggested websites, commonly asked questions, and costs of interventions, if applicable. The educational materials were designed to meet literacy needs of the patient population in the clinic in a format that they would find easy to read and understand. Materials were reviewed and approved by the midwives in the clinic. This project is a step towards providing women with educational materials to inform their decision making related to self-care and infant care. It also provides a model for further development of evidence-based educational resources.
Post-traumatic Stress Disorders Symptomatology Following PICU Hospitalization
Advisor: Diane Yorke, MSN, MBA, PhD, CPNP, RN
I have always known that I wanted to go into the health care field. I had never really considered going into nursing until I was hospitalized during high school and was cared for day and night by nurses. I realized that the nurses were the ones who really took the time to get to know me and do more hands-on care. Having that personal experience made me recognize that nursing was the career I wanted to pursue.
There are elements of the Pediatric Intensive Care Unit (PICU) setting that are very stressful for the hospitalized child, but very little research has investigated the psychological sequelae of a PICU admission on children themselves. This study examined the prevalence of post-traumatic stress disorder (PTSD) symptomatology in children following PICU transfer to general pediatric units. SETTING/SUBJECTS: Six children aged eleven to eighteen both male and female participated. The setting was one southeastern regional children’s hospital. METHODS: Each child was given a copy of the Impact of Events Scale-Revised (IES-R) questionnaire (Weiss and Marmar, 1997). They were then asked the question, “Please tell me the story about your PICU experience,” and their story tape-recorded if the child consented. The child was allowed to continue talking until they said they had no additional memories from their PICU experience. FINDINGS: The IES-R demonstrated that children ranged from being “not at all” to “moderately” distressed. The children who spent more time in the PICU and the two females in the study ranked the experience more stressful. The interview portion of the study correlated well with the questionnaire for each child. The most common memory mentioned by the children was the presence of “nice nurses.” CONCLUSION: These findings suggest it is likely for children with longer PICU hospitalizations to be at even greater risk for PTSD development. More research is necessary to increase the generalizability of these findings and to develop a program of nursing follow-up and intervention.