December 2009 Honors Graduates

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Ashley Marie Morelen

Education for Nursing Staff on Assessment and Care of the Late Preterm Infant: A Service Learning Project

Advisor: Kathryn R. Alden, EdD, MSN, RN, IBCLC

Highest Honors

Statement

During my time as a hospital volunteer, I saw that nurses spend more time with patients than any other healthcare professional. This time makes a huge difference to the patient and is a means through which I can serve others. I think that nursing is unique in that it focuses on social and physiological aspects of caring for individuals during some of their most vulnerable moments in life. Having this care responsibility is a distinct honor.

Abstract

Data from the March of Dimes (2009) indicates that, in 2006, late preterm births constituted 9.1% of all live U.S. births. Late preterm infants are born between 34 0/7 and 36 6/7 weeks gestation and are often cared for as full term infants in a well-baby setting. Despite this practice, late preterm infants are physiologically different from full term infants and deserve special attention. Compared to full term infants, late preterm infants are at a greater risk of developing respiratory distress, hypothermia, hypoglycemia, and hyperbilirubinemia. Late preterm infants are also more likely to have impaired neurodevelopment and poor long-term neurological outcomes than full term infants. In this project, there is an emphasis on feeding as late preterm infants often experience feeding difficulties related to prematurity. This project consists of two parts: a nursing literature review component and a service-learning component with educational materials for staff nurses working in a birthing center. The literature review and educational materials summarize current information on physiological differences between late preterm infants and full term infants. In addition, information on nursing management and parent education is included. The purpose of this project is to provide staff nurses with information about late preterm infants and population-specific care suggestions to optimize care and promote positive outcomes.

Jennifer Marie Fernandez

North Carolina’s Latino Patients in the Emergency Department – An Investigation of Culturally Competent Care

Advisor: Diana McCarty, RNC, MSN and Megan Williams, MSN, RN, FNP

Highest Honors

Statement

Through exposure in shadowing experiences, internships and jobs, I grew fascinated with the nurse’s role in patient care. I had never been aware of how much more time nurses spent with their patients in relation to the physicians themselves. The idea of following, taking care of and responsibly treating a patient from the time they walked through the doors of the hospital through discharge really appealed to me. It was the establishment of close interpersonal relationships with both the patient and their families that motivated me to enter the field of nursing.

Abstract

The Latino population in North Carolina is rising at an unprecedented rate most notably amongst children and women in their childbearing years. Due to lack of access to adequate health care, many Latinos use their local emergency department (ED) for primary care. With both language and access barriers in place, it is more difficult for nurses to provide culturally competent care. The aims of this descriptive qualitative study are to investigate nurse experiences and perceptions in the care of Latino patients in the Emergency Department (ED). It is anticipated that the information gained from this study will increase awareness of this experience among health care professionals and therefore help in the development of a cultural assessment tool that will assist with assessment and care of Latino patient needs when they present to the ED. The convenience sample was recruited from a large university hospital ED in North Carolina. The sample was comprised of six nurses with experience ranging from 4 months to 25 years. Interviews consisting of 10 preset written questions took place in the ED. Qualitative data analysis was employed to identify 3 major themes: inconsistency between translators, waiting time for interpreters, and the challenge of the fast pace ED environment as interrelated barriers to the care of Latino patients in the ED. The results of this study indicate the need for further research in this area and will contribute to the creation of an assessment tool to improve quality patient care for the Latino population.

Brittany Miller

Parental Stress and Role Disturbance during a Child’s Short Term PICU Admission: Sitting, Waiting, Thinking

Advisor: Diane Yorke, MBA, MSN, PhD, RN, CPNP

Statement

I have always known that I wanted to go into healthcare, but it was not until volunteering at UNC Children’s Hospital as a freshman in college that I realized nursing was the career I would pursue. I love that nursing gives me the opportunity to reach out and impact the lives of others around me, and I find the profession exciting, rewarding and full of opportunities. At some point in my career I hope to be able to travel abroad and practice nursing in less-developed countries.

Abstract

The purpose of this study is to assess and compare the impact of stress level and role performance on fathers and mothers who have a child requiring acute critical care in the hospital. Three mothers and two fathers of children in a pediatric intensive care unit (PICU) participated. Their children had been in the hospital between 2 and 21 days for an acute illness or injury. Each parent completed the Day 1 portion of the Iowa ICU Family Scale (a measure of family role, behavioral, and stress changes) and participated in a semi-structured interview about their experience in the PICU. Participants reported experiencing changes in sleep patterns, family roles and responsibilities, emotional support, and feelings. In the interviews parents revealed difficult experiences related to changes in routines and time management, self-care activities, and the appearance and behavior of their child, deviations from expectations in life, and feelings of uncertainty. Family and friends, relying on a spouse and/or others, and prayer and faith in God were helpful for parents. Admission of their child to the PICU imposes stressors and roles changes on parents which are all embedded in the activities of sitting, waiting, and thinking. Further study is needed to develop interventions to assist parents in coping with the multiple stresses of sitting, waiting, and thinking when their child is in the pediatric intensive care unit.