Lindsay Renee Bauer
Helping Health Professionals Educate Parents About the Health Benefits of Reducing Trans Fat Intake
Advisor: Julee Waldrop, MS, FNP, PNP
I believe in promoting health, preventing illness and providing people with the knowledge and support they need to lead a healthier lifestyle.
The nurse is in a unique position to provide people with both education and reinforcement to reach their health and lifestyle goals.
Partially hydrogenated oils, also known as trans fat, are in many baked goods, snack foods, fast foods, margarines, and shortening. Partially hydrogenated oil is a form of vegetable oil that has been modified to be solid at room temperature and to lengthen the shelf life of products in which it is found. Consumption of trans fat has been linked to negative changes in cholesterol levels and molecular composition, systemic
inflammation, coronary heart disease, and diabetes. Evidence of processes leading to these conditions has been found in children. Dietary habits and preferences are established in early childhood; therefore, it is important to intervene early with parents to make healthier food choices, thereby encouraging their children to adopt healthier dietary habits and preferences. An educational intervention for parents is proposed, based on currently successful models of dietary education about reducing consumption of saturated fat. Programs reviewed for this paper consist of teaching, dialogue, informational handouts, review of current dietary practices and follow-up contact to evaluate changes in dietary habits. Content specific to this intervention would include the potential negative health effects of consuming trans fat, where trans fat may be found, how to identify the presence of trans fat in an item, and the importance of choosing a diet that includes the least possible amount of trans fat.
Teaching will be offered and reinforced by nurses during well-baby/well-child visits, school health events, and any additional opportunities for contact with the target population. As part of the initial intervention and future interactions, parents will receive an educational brochure to assist in making healthier choices at grocery stores and fast food restaurants. This brochure includes basic information regarding trans fat, where it is found, potential health consequences, and a sample list of healthier alternatives for common foods available in grocery stores and fast food
Kathryn Marie Bauk
Barriers to Cardiovascular Health Promotion in Latina Women
Advisor: Valerie Lunsford, PhD, RN, clinical assistant professor
I chose to pursue nursing because it is an ever-changing field in which professional opportunities are virtually limitless. I find nursing challenging, rewarding, exciting and perfect for my personality. I can’t see myself doing anything else!
Cardiovascular disease (CVD) is the leading cause of death in Americans of both genders and in all racial and ethnic groups. Disparities exist in the risk factors and outcomes of CVD in minorities, particularly Latino immigrants. The purpose of this study was to describe the barriers identified by Latina women and men in a faithbased setting in North Carolina and to eventually use this information in the creation of relevant interventions to lower the risk of CVD in Latina women. The nonrandom sample was recruited from a United Methodist Church in Durham, NC. The sample was comprised of two men and eleven women from Mexico (n=9), Guatemala (n=3), and Honduras (n=1). The majority of participants were between the ages of 18 and 34 (n=11) with primary or secondary school as the highest level of education attained. The participants had lived in the United States between 1 and 10 years, with 6 participants having lived in the US for at least 5 years. Two focus groups were
conducted with most of the original sample returning for the second group. The focus groups concentrated on the barriers to cardiovascular health promotion experienced by the women. The responses of the men were not detailed separately in the transcripts, and therefore, the men’s responses could not be excluded from the analysis and results. Qualitative data analysis was employed to identify 3 major themes: stress, cultural dissonance, and invisibility as interrelated barriers to cardiovascular health promotion in Latina women. The identified theme of stress
supported findings in the current literature. Cultural differences were also noted in the literature; however, the dissonance reported by the participants as a result of these cultural differences was not reported. Additionally, the central finding of invisibility was related to all the barriers identified but was not described in the current literature. The results of this study indicate the need for further research in this area and will contribute to the creation of culturally relevant interventions to improve cardiovascular health promotion behaviors in Latina women.
Brittany Lynne Berger
Perinatal HIV Testing in the United States: Education, Policies and Practices
Advisor: Janna L. Dieckmann, PhD, RN, assistant professor
I chose to go into nursing because it is such a diverse field that will allow me to work with a variety of populations. One of my biggest passions is preventive health, and nurses have always been big components of the preventive health and health promotion field.
Some of the biggest strides in detection and treatment of human immunodeficiency virus (HIV) have been made in the area of perinatal transmission, which is the transmission from an infected mother to her infant in utero, during delivery, or after birth through breastfeeding. In 2001, the Centers for Disease Control published recommendations that every pregnant woman in the United States be tested for HIV during pregnancy. Regardless of this recommendation, many pregnant women still are not screened during pregnancy, either because they are not offered the test or because they refuse it. This project is an analysis of the various methods that agencies, health departments, and hospitals employ to reach the goal of universal HIV screening for pregnant women. Some agencies chose to focus on education and others chose to implement policies that required healthcare providers to offer HIV screening to all pregnant women. The agencies that had the most success with
increasing not only screening rates among pregnant women, but also improving coordination of care for HIV positive women and their infants were the ones that utilized the expertise and cooperation of various disciplines and agencies One change alone cannot achieve the goal of universal HIV screening. The analysis further showed that the work is not done once women are screened for HIV during pregnancy. Further collaboration with agencies that help HIV positive individuals is needed to provide comprehensive care to any HIV positive woman and her infant.
Korey Bishop Christian
A Reflection on the Development of Cultural Competency: HIV/AIDS Education in Malawi
Advisor: Christina Harlan, BSN, MA, clinical assistant professor
I have always known that I wanted to work in the health care industry, but it was not until I lost my father to cancer in 2004 that I realized that my true calling was nursing. I feel that giving others the care, attention, time and respect they deserve during the most critical times in their lives is the most incredible gift you can offer.
Nursing, as a profession of service, is constantly affected by societal, political, and cultural changes (Law and Muir, 2005). Moreover, health care delivery in the 21st century requires treatment for an increasingly multicultural society (Marcinkiw, 2003). Consequently, it is important for nurses to have an understanding of and willingness to strive for cultural competence in order to provide the best practice in settings with highly diverse patient populations. Cultural competence is “a process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of an individual or community from a diverse cultural or ethnic background” (Campinha-Bacote, 1994, pp. 1-2). This paper explores the complexities of the development of cultural competency, both within the role of the nursing student and beyond. It discusses current literature on cultural competence, including its importance to health care providers and to nursing education. This paper applies the use of Camphina-Bacote’s well-known model to investigate the development of cultural competency, in relation to my personal experience as a volunteer HIV/AIDS educator in Malawi. It chronicles my personal reflections on being immersed into the Malawian culture and identifies specific
cultural themes that were integral to my progression towards becoming more culturally competent. Finally, this paper serves to explore the question: How can cross-cultural experiences aid in nursing students and other health care providers’ development of cultural competency, both abroad and here at home? It gives recommendations, based on current literature and personal experience, as to how faculty can implement cultural competence into the nursing curriculum and how health care providers can provide more culturally appropriate care in their practice.
Renatta Diane Craven
HIV/AIDS Risk in the Incarcerated Male Population: An Analysis of Policy and Research and a Proposed Plan for Prevention
Advisor: Cathie Fogel, PhD, professor
I chose to go into nursing for reasons both personal and academic. My mother died of Acute Myelogenous Leukemia when I was a young child and throughout my youth my fear and fascination with blood cancers spurred my interest in science. Nursing’s concentration on palliation and holistic care attracted me to the profession and has further exposed me to the health disparities present in today’s society and the innovation and collaboration necessary to create change.
Public health experts acknowledge male correctional facilities as reservoirs for HIV/AIDS infection. As a high percentage of HIV-positive American males passes through correctional facilities each year, the magnitude of the HIV/AIDS prison crisis could compromise the health of outside communities. While much research has focused on community HIV prevention, research regarding prison HIV/AIDS prevention efforts has been limited. This state of the science study examines prison HIV/AIDS data and conducts an analysis of past and current prison HIV/AIDS prevention programs. The knowledge gained from these activities is used to formulate suggestions for a male prison HIV/AIDS intervention. The program utilizes Ajzen’s Theory of Planned Behavior as the framework for the development of a potential prison HIV risk reduction curriculum. This theoretical model was selected because of its ability to foster cognitive selfregulation. After completing this project, I have learned that tackling such a controversial and complicated issue must begin with interdisciplinary collaboration and societal acknowledgement. Before such interventions and subsequent progress in HIV/AIDS risk reduction can be realized, health professionals must work together to disseminate to the public knowledge and concern for the HIV epidemic and the health disparities experienced by male inmates and their communities of origin. Only then can the long-term goal of this project, to increase public awareness of the HIV/AIDS prison crisis and reduce further transmission, be accomplished.
Andrew L. Disser
Improving Gender Diversity in Nursing Programs:An Evidence-Based Approach
Advisor: Edward J. Halloran, PhD, RN, FAAN, associate professor
My view of nursing is that it is very meaningful work, as the profession is based upon the ideal of improving the lives of others. Additionally, nursing provides an almost unparalleled number of career options and opportunities for professional advancement. I come from a family of many outstanding nurses who have influenced me greatly, so my decision to pursue nursing came naturally.
Gender diversity in nursing is an important issue, yet nursing research has not frequently addressed it. The number of men in nursing programs has steadily risen in recent years, and some schools have undertaken a proactive approach to recruiting more men. This study investigated the perceived effectiveness of recruitment efforts made by the University of North Carolina at Chapel Hill School of Nursing according to the male
student cohort. Further, this study examined male student cohort attitudes toward what would encompass effective recruitment strategies in the future. It is intended that the information resulting from this investigation will be utilized to optimize future recruitment activities targeted at prospective male applicants to nursing programs at UNC. After collecting 51 (n=51) responses to a 16 item survey entitled Men in Nursing, a
descriptive analysis of the responses was conducted. It was found that men in this study rarely participate in the recruitment of other men into nursing, suggesting a culture of ambivalence regarding gender diversity. Study participants indicated that presenting nursing as a career appropriate for both male and females to students in elementary school, middle school, and high school would be an effective strategy to improve gender diversity in nursing. Hiring more male nursing instructors, and educating school counselors on the benefits of a career in nursing were other recruitment activities that would be effective according to participants in this investigation.
Shalia S. Gregory
Self-Actualization and Purposefulness: An Empowering Approach to Health Promotion and Health Disparity Interventions for African-American Women
Advisor: Cheryl L. Woods-Giscombe, PhD, RN, postdoctoral fellow
As one of seven children, taking care of the ill and promoting healthy living was always my role. As a nurse, I will mesh my love for science with my desire to enhance the quality of life of others. I chose nursing because I could not fathom any other career path with so many twists and turns, beauty, longevity and uncharted terrain that would lead to true inner fulfillment.
According to the U.S. Department of Health and Human Services, African American women experience disparate morbidity and mortality rates related to conditions such as heart disease, diabetes, and adverse birth outcomes. The improvement of the health of black women is aligned with the two primary goals of Healthy People 2010: increasing the length and quality of health in life and eliminating health disparities. This federal
initiative challenges health professionals to ensure good health for all. A potentially empowering approach to the elimination of health disparities among this population is the facilitation of health-promoting behaviors and attitudes. However, environmental, economic, and social barriers negatively influence the initiation and maintenance of these behaviors; and these barriers are significantly associated with pervasive health disparities. The purpose of this project is to examine the potentiality of self-actualization as a facilitator to the practice of health-promoting behaviors and attitudes among African American women despite these barriers and, moreover, to explore the potential contribution of self-actualization to the elimination of health disparities. The efficacy of self-actualization in increasing health-promoting behaviors and attitudes
and decreasing health disparities in African American women was investigated by conducting (1) a literature review of the development and operationalization of selfactualization, its cultural relevance to African American women, and its association with health promotion in this population; (2) a secondary analysis of qualitative focus group data on stress and coping in African American women between the ages of 18 and 72; and (3) a follow-up case interview with an exemplary focus group participant. This project found self-actualization, defined as “an ongoing actualization of potentials, capacities and talents, as fulfillment of mission” (Maslow, 1968, p. 25), to be of cultural relevance to African American women; furthermore, the definition of self-actualization for this population includes concepts of self-identity, racial-identity, and spirituality. The
pursuit of self-actualization appears to be an effective facilitator to health-promoting behaviors and attitudes despite the existence of multiple barriers. Health interventions that incorporate critical components to support the pursuit of purposefulness and selfactualization may enhance health outcomes and decrease disparate morbidity and mortality rates in African American women.
The Development of an Inflammatory Bowel Disease Resource Notebook for Adolescent Transition into Adulthood
Advisor: Maureen Kelly, MS, RN, CPNP, clinical assistant professor
Once I discovered nursing as a career option, I knew it was the one for me. I love being in a profession that provides holistic care through compassion, patient education, advocacy, autonomous thinking and thorough scientific knowledge. I find nursing to be an extremely rewarding career and am excited to have the opportunity to impact the lives of so many people as they make their recoveries.
The transition of adolescents into adulthood is an important aspect of development for all people, especially those with chronic illnesses such as inflammatory bowel disease (IBD). Adolescent transition into adulthood is an area that is gaining attention in terms of research but is still frequently overlooked by providers. Negative outcomes for adolescents and young adults often result when transition is not addressed. The primary aim of this project was to develop a resource notebook following the UNC TRANSITION assessment in order to provide adolescents with IBD with specific information about their illness as well as general transition information. Providers will use the notebook to enhance the self-management, understanding, and transition of adolescents with IBD seen at the UNC Pediatric Gastroenterology Clinic. The methods
for creating this notebook included drawing from a review of literature and assessing websites and other educational sources to determine what needed to be included in each section, how to present it, and how to utilize the notebook. The Adolescent Transition Coordinator and pediatric gastroenterology providers evaluated and altered it to ensure its appropriateness. The final notebook is available for use in the UNC Pediatric
Gastroenterology Clinic. It is currently awaiting pilot testing and further evaluation by the gastroenterology team before being fully applied within the IBD adolescent population. The resource notebook may also be adapted to fit other patient populations, but it has been specifically designed for adolescents with IBD.
Heather Elizabeth Johnston
Family Needs in the Pediatric Intensive Care Unit as Identified by Families and Nurses: How Do Nurses Meet These Needs?
Advisor: Diane Yorke, MSN, MBA, PhD, RN, CPNP, clinical assistant professor
I went into nursing because I enjoy caring for others and doing for them what they cannot do for themselves. I love to interact and
communicate with people and especially enjoy working with children. I feel that nursing is a career that will provide me with excellent job
satisfaction and many opportunities for career advancement.
The needs of families of patients in intensive care, especially for proximity and information, are well documented (Aldridge, 2005; Kirschbaum, 1990; Leske, 2002; Molter, 1979; Tomlinson, Thomlinson, Peden-McAlpine, and Kirschbaum, 2002). Yet families still report that their needs are unmet. Meeting family needs increases the family’s ability to focus on and attend to their child’s condition. The purpose of conducting this nursing literature review was to determine the needs that families of critically ill children rate as high priority, to identify any discrepancies
between how families and nurses perceive these needs, and to discover how families would like for their needs to be met during their child’s intensive care hospitalization. The nursing literature review was conducted using the CINAHL nursing database. Search terms used were: family needs, PICU, pediatrics, critical care, and intensive care. Discrepancies were found between how families and nurses rank and identify priority
family needs and to what extent families perceive these needs are met. This review also revealed what interventions families regard as helpful or not helpful in meeting the needs they identified as having high priority and families’ suggestions for how they would like for their needs to be met more effectively. Nurses can use the information reported as helpful to design interventions to effectively meet the needs of families who have a child in the pediatric intensive care unit.
Darci D. McClary
A Quantitative Analysis of the Breastfeeding Attitudes and Knowledge of BSN Nursing Students Before and After Completing a Maternal-Newborn Nursing Course
Advisor: Kathryn Alden, MSN, RN, IBCLC, clinical associate professor
My interest in science and caring for people led me to nursing. It’s a great way to positively impact people’s lives, and there are a multitude of career trajectories in nursing.
Current evidence indicates that breastfeeding is the ideal form of providing infant nutrition with significant benefits for infants, mothers, and families. It is recognized that health care professionals, especially nurses, influence breastfeeding initiation and duration rates; yet studies have shown that nurses may lack knowledge and may have negative attitudes about breastfeeding. Education is one way to improve nurses’
breastfeeding knowledge and attitudes so that they may positively influence infant feeding decisions and practices of their clients. Breastfeeding education ideally should begin in prelicensure nursing education programs in courses such as maternal-newborn nursing. Interestingly, minimal research has been done to examine the effectiveness of undergraduate nursing programs in educating students about breastfeeding. To address
the gap in knowledge, this study answered the following research question: What is the effect of a maternal-newborn course on baccalaureate nursing students’ (BSN) breastfeeding beliefs, attitudes, and knowledge? A questionnaire was administered to two groups of BSN students at the University of North Carolina. The first group consisted of 120 students who had completed a maternal-newborn course. The second group consisted of 86 students who had not yet taken the maternal-newborn course. A two-way ANOVA analysis of the data showed that students who had taken a maternalnewborn course had significantly higher breastfeeding knowledge and significantly more positive breastfeeding beliefs and attitudes than those students who had not taken the course.
Claire Louise Phelps
Development of a Pamphlet Addressing the Needs of Bereaved Parents
Advisor: Diane Yorke, MSN, MBA, PhD, RN, CPNP, clinical assistant professor
Nursing appealed to me as a profession because of the diversity of the field. However, nursing school developed my love for nursing and
passion for pediatrics. I am excited to become a nurse and have the opportunity to make an impact on families as well as my patients.
The loss of a child is a difficult experience for parents as indicated by research showing bereaved parents suffer emotional, physical, and psychological effects from their loss. The purpose of this project was two-fold. First, to review the literature to examine the effects of bereavement on parents and list the resources parents have identified as being useful in helping bereaved parents cope with the loss of their child, and second, to use these identified resources to develop an information pamphlet of resources available in Orange County, North Carolina for bereaved parents. Parents have identified five needs that should be addressed when coping with the loss of a child: addressing spiritual needs, maintaining connection with their child, maintaining connection with their child’s healthcare providers, discussing the loss of their child, and acknowledging gender differences in grief. Interviews with bereavement professionals identified four local organizations that offer services that meet the needs of bereaved parents. The pamphlet for this project is comprised of information describing each of these organizations,
contact information, and meeting times if applicable. Parental bereavement resources in Orange County were limited and difficult to find. Therefore, these resources would be difficult for bereaved parents to find on their own, especially if being sought when experiencing the recent
death of their child. The progress made by this project is a first step toward providing better care for grieving parents and can be used as a model for future development of bereavement resources and dissemination of bereavement information.
How Bar-Coding Changes Medication Administration
Advisor: Joan Williams, RN, MSN, ARNP-BC, clinical assistant professor
I chose nursing to satisfy my fascination with the human body, my love of learning and my desire for new experiences. I’ve always enjoyed helping others better their health, and a career in nursing will allow me to do this in a variety of ways.
Introduction: Medication administration can be a high risk activity for a nurse due to the possibility for error. Bar-coded medication administration (BCMA) systems have been developed as a double-check for the nurse at the bedside and have been shown to drastically reduce error rates. Literature on the subject mentions additional factors that are affected by implementation of a BCMA system, but very few articles report on measured data. Additionally, implementation of BCMA systems often changes the way in which medication errors are reported.
Methods: Electronic databases were searched for articles published between 2002 and 2007 that included pre-implementation and post-implementation data on BCMA systems. Articles that reported on changes in data were included. Articles that could not be accessed electronically were excluded.
Results: Nine articles were found, some of which reported on multiple outcomes. Seven of the studies looked at medication errors, with 5 of them reporting decreases. Two studies looked at staff time spent in medication tasks with conflicting results. One study looked at nurses’ perceptions of the system and one looked at nurse satisfaction with BCMA. A study that examined the percentage of patient’s whose ID was checked before medication administration showed an increase in the rate of patient identification checks.
Conclusion: BCMA is an emerging technology and nurses need to be aware of how it can affect their practice and their patients’ safety. Implementation of a BCMA system can result in a reduction in medication errors and an increase in patient identity checks during medication
administration. Nurses say they are satisfied with the technology, but staff time commitments change when the systems are implemented. BCMA only works when used correctly and changes how medication errors are reported. Nurses and other staff need to be aware of the pros and cons
of using bar codes at the bedside to ensure patient safety.
Critical Incidents and the New Nurse: The Impact, the Experience, the Management
Advisor: Joan Williams, RN, MSN, ARNP-BC, clinical assistant professor
Having been exposed to the health care system at an early age, volunteering at hospitals and nursing homes, I knew nursing was a perfect chance to advance my curiosity and knowledge and foster my passion to care and help others. Nursing will not only provide me the opportunity to enhance my clinical skills, but also work closely with patients, families and co-workers to form lasting relationships.
First crisis, first trauma, first death…a number of first experiences occur through the journey of becoming a new nurse. Every nurse reaches a pivotal point in their professional career, in which they realize that they have implemented their skills and care to their best capability, yet a
particular patient's diagnosis, prognosis, or magnitude of care, alarms or disturbs them physically or emotionally. All individuals remember their “first” and the feelings and the emotions that parallel with that experience. Nursing students and novice nurses encounter numerous events
and patient circumstances throughout their beginning years that critically impact their understanding, learning, and emotional stability. Critical incidents have deep meaning that can be educationally and individually constructive. Through these experiences individuals can learn a variety of coping, supporting, and clinical skills. The idea of debriefing is a widely used method that can be implemented after a critical incident occurs in order to facilitate discussion of the event and encourage the review of details, feelings, impressions, and thoughts of group members. Debriefing promotes strong group dynamics and creates a supportive and understanding environment that provides empathy and opportunity for professional development. This integrative project illustrates the need to educate, provide opportunity to experience critical incidents, and reiterate the importance of positive coping mechanisms and support systems in nursing students and novice nurses. Through research, analysis, and literature review, I recognized the importance of these experiences and created an informational brochure for nursing students and new nurses. Critical events are inevitable and essential to appropriate learning and professional development in the new nurse. Every new and upcoming nurse has the potential to experience and recognize the impact of critical incidents, and ultimately has the capability to manage thoughts and feelings from proper guidance, teaching, and support.
Leslie C. Williams
Induced Hypothermia after Cardiac Arrest: A Literature Review with Implications for Patient and Family Teaching
Advisor: Beth Pack, RN, BSN, MPH, MALS, clinical instructor
I chose to go into nursing to satisfy both my passion for working with people, as well as my passion for medical science. The health care profession is always changing, always producing new research, new techniques and new information that improves health. The science behind nursing is alluring, but the satisfaction that comes from helping those in need is substantially great.
Induced hypothermia is a relatively new therapy used to treat comatose patients who have undergone cardiac arrest. The therapy has demonstrated an ability to preserve cognitive
function by decreasing possible neurological deficits caused by the body’s response to a ventricular fibrillation arrest. The American Heart Association and the International Liaison Committee of Resuscitation have endorsed the use of therapeutic induced hypothermia in comatose patients post cardiac arrest, but limitations exist in establishing a standard protocol for initiating the therapy. Understanding how induced hypothermia is implemented, why the therapy is implemented, what are typical outcomes for such implementation, and what is the nursing role in care will aid nurses in caring for both patients and families experiencing induced hypothermia as a therapy. This paper is a literature review of studies about induced hypothermia in comatose patients post cardiac arrest with a case study to demonstrate how nursing knowledge of
the therapy can be employed to adequately educate family members and patients about the implications and effectiveness of induced hypothermia. Further, minimal materials are available that provide information to give family members of patients experiencing this therapy. This paper addresses the need for specific brochures that would assist in answering questions about the therapy until the patient care team is adequately able to do such. Induced hypothermia continues to be a leading advancement in emergency and critical care, for which nurses ought to understand the mechanisms of the therapy and how to convey such understanding to patients and family members.