Lindsey Megan Carpenter
Profound Influences in Substance Abuse Treatment: A Three-Pronged Intervention for Improving Quality Care
Advisor: Theresa Rafael-Grimm, PhD, CNS
I have always had an interest in the healthcare field and have a desire to help and care for others. My mother, who exemplifies every quality of an outstanding nurse, inspired me to enter into the nursing field. After graduation, I would like to specialize in mental health and work in the hospital setting.
This paper is a summary of the development, implementation and evaluation of a multi-media educational project aimed at mitigating the negative and stigmatized attitudes of nursing personnel working with substance abusing patients on a rural, hospital based, psychiatric unit. Because of the complex nature of attitude formation and subtle factors and faulty assumptions that can contribute to negative judgments, both the literature review and the educational intervention reflect a synthesis of concepts from diverse bodies of knowledge to address the problem in a multifaceted manner. Information alone does not change behavior but education that provides a safe learning environment in which participants can examine biases, identify stereotypes, and explore expanded notions of the substance abuse experience promotes increased understanding as well as subject mastery. This intervention, while providing basic information about substance abuse, provided a virtual experience with an actual patient and an interactive component on stigma, judgmental attitudes and their negative impact on nursing care. The mechanics of partnering with an institution, engaging key institutional leaders, and executing the actual program are also described.
Samantha M. Caviness
The Development of a Standardized Daily Sedation Withdrawal Assessment Tool for Mechanically Ventilated and Sedated Patients in the Critical Care Unit
Advisor: Joan Williams, MSN, RN, ARNP
I honestly feel that nursing is my true calling in life and is what I am meant to do. I love helping people who are ill and, therefore, unable to care for themselves. I feel that nursing is the perfect fit for me in every way. It is also my desire that my tool will change the ways in which nurses assess their patients, resulting in better patient outcomes.
Critically ill patients often receive mechanical ventilation and continuous sedation infusions to lessen physiologic instability and to facilitate their care. Thus, accurate assessment of the level of sedation is crucial to appropriately tailoring treatment and nursing care. Research has shown an association between prolonged continuous sedation and an extended duration of mechanical ventilation, resulting in increased length of stay within the intensive care unit and the hospital. This effect heavily impacts patient prognosis, morbidity, and mortality, not to mention increased healthcare costs. For this reason, a relatively new practice of daily withdrawing sedation to obtain a more reliable and accurate neurological assessment has been developed. While many protocols exist on this practice, a comprehensive assessment scale for evaluating neurological status and degree of wakefulness is nonexistent. The primary objective of this project is to create a standardized sedation withdrawal assessment tool for use by critical care nurses to prevent individual bias and reduce variability of documented patient responses. This revolutionary tool consists of a basic patient information sheet, an assessment focused on evaluating consciousness and degree of wakefulness, a standardized assessment scale, and an algorithm-based web chart. Enclosed in a four sided easy-to-use booklet, the tool helps nurses reveal problems surrounding sedation withdrawal more promptly, consequently expediting treatment to lessen the risk of negative complications and improve patient health outcomes. Use of this tool will increase nurse awareness of patient performance and heighten identification of problems in response to sedation withdrawal, thereby enhancing the quality of nursing care.
Heather Love Lowry
Kangaroo Care and Pain Reduction: The Development of a Caregiver Educational Brochure to Increase Awareness and Influence Change
Advisor: Megan Williams, RN, MSN, FNP
I chose to go into nursing because I was immersed in the medical/nursing field as a young child. My father was paralyzed when I was 4-months-old, so he was always dealing with health issues, whether at home or in the hospital. I was always around nurses, as well as watching the care my mother gave my father. I want to care for others and give back since so many people gave their care to my family.
Kangaroo care is a skin-to-skin technique that research has demonstrated to be effective for growth and development of the premature neonate as well as to enhance the bond between parent and child. Kangaroo care has been discussed within educational preparation of health care providers but it is rarely used as a standard intervention. This project set out to develop a caregiver educational brochure describing the benefits of kangaroo care. I wanted to explore the most recently identified benefit of kangaroo care: pain reduction in the preterm neonate exposed to kangaroo care prior, during, or after a painful stimuli. Kangaroo care and pain reduction became an interest of mine because the birth of a premature neonate often leads to admission to the Neonatal Intensive Care Unit where the neonate undergoes several potentially painful procedures intended for diagnosis and treatment. Therefore, the purpose of this project was to first do a literature review of kangaroo care and pain reduction to develop a knowledge base on the subject in order to develop a caregiver educational brochure intended to highlight the pain reduction benefits that kangaroo care has to offer. The educational material for this project is comprised of background information about kangaroo care, general benefits of kangaroo care, and a focus on pain reduction and kangaroo care. All of this information was developed into an educational brochure for future use with parents and caregivers in a Neonatal Intensive Care Unit to offer awareness and influence change.
Audrey Francis McGraw
SPAN-IT: Spanish-speaking Audio-visual-tool for Nurses Improving Treatment
Advisor: Debra J. Barksdale, PhD, FNP-BC, CNE, FAANP
I chose nursing because I wanted to do something in life that would matter; something that was important and helpful to the world around me. I wasn’t sure what that would be until later when I discovered that human anatomy and physiology were the most fascinating topics I had ever encountered. Nursing is the perfect blend of the two.
The Hispanic population in the US has increased more than 50% in the past decade; the total number is now over 45 million people. Many Hispanic persons speak only Spanish or have limited English proficiency. Most health care organizations provide either inadequate interpreter services or none at all. Research shows that language barriers result in longer hospital stays, more medical errors, and lower patient satisfaction. Imagine yourself awakening from surgery. You are in pain. You have a breathing tube down your throat and multiple tubes and wires crisscross your body. You are incapable of uttering a sound — fear and confusion overwhelm you. A nurse approaches and speaks but you are unable to understand one word. This is exactly what happens, all too often, to Spanish speaking post-operative patients. An examination of available resources revealed very little to address this type of one-way communication with this specific patient population. Therefore, the purpose of this project was to assist in meeting the communication needs of post-operative, Spanish-speaking patients. I developed an easy to use, highly accessible, audio-visual tool (with input from a focus group of registered nurses) which provides simple audible instructions for directing Spanish speaking patients. With this tool, nurses do not need to understand or speak any Spanish. The tool will bridge the communication gap in situations where interpreters are limited or not readily available and when other communication methods are not feasible.
Improving Postpartum Care for the Teenage Mom: One Step at a Time
Advisor: Janna Dieckman, PhD, RN
I have had the dream of one day becoming a nurse since I was in elementary school, dressing up for career day. Many of my friends and family members are nurses, and they said I would change my mind many times before college, but I never did. So, here I am today. As I became older, I began to realize that I wanted to go into a profession where I could make a difference in the lives of others, and nursing was a perfect fit.
The high prevalence of adolescent pregnancy requires nurses to improve quality of care through increased understanding of the adolescent’s needs. The purpose of this study was to identify effective nursing interventions for the postpartum adolescent mother. Study participates were English speaking women 25-45 years of age who delivered their first child before the age of 20. Six women were asked to recall their postpartum experience through telephone interviews and oral questionnaires. Half of the women took parenting classes and found these beneficial; none reported that her school nurse helped during the postpartum period, and almost all reported having strong family support. Two-thirds were not referred to formal support services and most of these did not feel it would have been beneficial. Four out of six participants received education from nurses after childbirth. These women revealed many interventions which they felt were effective for teenage moms including: teaching the basics of childcare; teaching CPR and the Heimlich maneuver; explaining financial aspects of parenting; providing infant injury prevention education; and explaining to the mother the importance of self-care. Study findings can be used to enhance future nursing practice. Nurses should focus on individualizing education and referrals. When nurses provide education they should take special precautions to avoid belittling or demeaning adolescent mothers. The education should also assist teen moms in their search for self-efficacy. Although studies suggest that formal support networks are effective for teenage mothers, the mothers in this study preferred informal rather than formal networks.