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  • The Nurses’ Thought on Physical Restraints in the Healthcare Setting

    Gawrys, Carol; Parada, Jennifer (2023-05-01)
    Background: In healthcare, patient safety is highly prioritized. Health care providers may care for patients who are mentally altered due to a medical condition. When a situation escalates and the safety of the patient or staff is at risk, it's up to the judgment of the nurse if physical restraints are needed. The purpose of this paper is to explore how the nurse thinks when physical restraints are indicated. Method: A systematic review of literature took place for the research of this paper. The databases used were PubMed and CINAHL. The time frame is 2017 to 2023 in order to stay up to date with the views on the subject. Keywords would be "United States of America," "Nursing Practice/Care," "Adult," "Physical Restraints," and "cognitive impaired." The adult population found in the non-psychiatric setting is the focus of this paper. Analysis: Articles mentioned how physical restraints should not be the first option. Nurses are trained to use other techniques in order to diffuse a situation. In emergency situations, the physical restraints can be placed without a medical doctor order, but must get order within the hour. When the patient is in restraints, they should still have access to care like drinking, toileting, and comfort. Conclusion: Physical restraints should be the last resort when it comes to keeping the patient/staff safe. When physical restraints are in effect, the nurse should follow hospital guidelines on physical restraints. The restraints should be immediately removed when it is no longer needed.
  • Early Detection And Preventative Methods Of Deep Vein Thrombosis In Postoperative Patients From A Total Joint Arthroplasty: A Review Of Nursing Literature

    Gawrys, Carol; Maggiacomo, Emily (2023-05-01)
    Deep Vein Thrombosis is a serious complication following any extensive surgery such as a total joint arthroplasty (TJA) where the entire joint is replaced. An analysis of existing literature was evaluated to identify the most effective course of action in regard to medication, intervention, patient assessment, and effective education of both the patient and the care team. Through this review, it was determined that to provide the most comprehensive care aimed toward preventing DVT occurrence, it would be beneficial to determine which medication not only works the best but makes the most sense for the patient in regard to finances and side effects. Furthermore, ensuring that there are clear guidelines or policies provided by the institution for assessments of the patient both preoperative and postoperative to determine risk and or occurrence of signs and symptoms indicative of a developing thrombus. Such assessment would entail a comprehensive head-to-toe assessment, imaging, and blood tests to identify a baseline prior to surgery that can be compared to any results following. Finally, it was ascertained that providing the client with education and evaluating their understanding of their risk and concerning signs is crucial to the early detection of such a disorder. Equipping the care team with this knowledge and tools, it should help in the decrease of occurrence and or severity of DVT following a TJA due to early action and identification.
  • Treatments for Adolescents Affected by Eating Disorders: A Systematic Review of Literature

    Frost, Marion; Lessieur, Kaleigh (2023-05-01)
    A systematic literature review (analysis) for treatment options for patients diagnosed with eating disorders or predisposed to risk behaviors. Eating disorders are a mental health concern that affects many adolescents, who are more at risk due to certain behaviors such as body dissatisfaction or distortion, circadian rhythm disorders, or other diagnoses of mental/physical health such as obesity, poor nutrition, anxiety, depression, for example. This review is for the purpose of awareness of evidence-based practice in treatment and how care of patients in treatment plans can be improved in order to provide the best quality.
  • The Comprehensive Care of Pregnant Women with Opioid Use Disorder (OUD): The Application of Evidence to Nursing Practice

    Frost, Marion; Gray, Rachel (2023-05-01)
    The incidence of opioid misuse rates in pregnancy has been rising at alarming rates in recent years, paralleling the opioid epidemic seen in the general population since the 1990s. This public health crises poses a significant risk for complex medical needs in pregnant women and their fetuses and is one reason why many pregnant women do not seek prenatal care. Nurses must use pregnancy's unique opportunity to address the complex health needs of women with opioid use disorder (OUD) to promote optimal maternal and fetal outcomes. The Cumulated Index to Nursing and Allied Health Literal (CINAHL) was used to complete a systematic review of literature to identify common issues and areas for improvement in obstetric nursing practice related to the care of pregnant women with OUD. Common themes identified in the literature are the need for early screening and prenatal care and lack thereof in women with OUD; the use of medication-assisted treatment to manage and lessen the harmful effects of OUD and why it is a safer option than detox; and the significance of forming a trusting, non-judgmental relationship between the care team and mother to remove the stigma surrounding opioid use. Implementing these measures will provide nurses with the necessary information to support the mother's and her fetus's personalized needs and improve obstetric nursing care. The ultimate goal for these women is to reach a safe and successful delivery and further optimize health outcomes.
  • Advancements of Nursing Care in Interventions to Reduce Overprescribing and Adverse Effects of Opioids Postoperative Pain Management

    Frost, Marion; Donoso, Alicia (2023-05-01)
    Opioids are a class of medications that block receptors in the brain that signal pain. The use of this medication can result in substance abuse disorder which poses a risk of overdose and death. The rise in opioid prescriptions highlights the demand for new interventions to be implemented when assessing the need for opioids in treatment plans. A licensed prescribing healthcare provider uses diagnostic tools to evaluate the requirement of a medication. By encouraging the use of effective interventions in healthcare facilities, there will be a reduction in overprescribing; decreasing the risk of poorly managed treatment, opioid abuse disorder, overdose, and death. Opioids can be taken responsibly and are effective in managing pain. However, there are measures that can be implemented to ensure medication is not being abused and is the right match. A systematic literature review was performed using the CINAHL Plus database to investigate interventions that healthcare providers have implemented to prevent overprescribing of opioids. Major themes are (a) presentation of prescribing behaviors to surgeons reduced overprescribing, (b) standardization of number of pills distributed based on surgeries decreases number of opioids prescribed, (c) screening tools to properly assess client qualifications for opioids, (d) non-narcotic methods: use of Transversus Abdominis Plane (TAP) block. The opioid crisis, management of opioids, prescribing behaviors amongst healthcare providers, and interventions targeting opioid abuse, are topics of focus for this literature review. In order to prevent complications in clients taking opioids, interventions must be implemented.
  • Myths, Implicit Bias, and Pain Medication Disparities in Emergency Department Settings: A Systematic Review of the Literature

    Frost, Marion; Cameron, Kacy (2023-05-01)
    A disparity in healthcare is any preventable difference that impacts a patient's health outcomes. Disparities arise from health inequities which false beliefs, lack of education, and implicit bias can impact. Implicit bias is defined as holding attitudes toward others or associating certain stereotypes with groups of people without our conscious knowledge. Marginalized communities across the United States face a myriad of health inequities due to implicit biases of healthcare providers; one example being pain medication administration rate among patients of color. The registered nurse is vital in protecting patients of color from health disparities perpetuated by the hands of our profession. The CINAHL database was used to conduct a systematic review of the literature to identify reasons that pain medication disparities might occur in Emergency Department settings. It was also utilized to identify evidence-based practices that could be implemented to decrease incidents of implicit bias in the healthcare system. Significant themes are a) Myth perpetuation regarding race and pain, b) Implicit biases of healthcare providers impact pain medication administration rates for patients of color, and c) Educational and nursing leadership-driven protocols regarding implicit biases. The nursing community is in a pivotal position to help mitigate the risk of poor health outcomes associated with pain medication disparities due to healthcare provider-held implicit biases. Nursing educators and hospital leadership must create an environment that recognizes the culture of implicit biases and supports the necessary work to mitigate the negative impact on patient outcomes. Additionally, introducing a comprehensive nursing education curriculum focused on delivering equitable care while promoting a culture of change would allow future nurses to help break down barriers that impede upon patient care.
  • The Impact of Childhood Cancer Beyond the Afflicted: A Literature Review

    Ebersole, Nancy; Gawrys, Carol; Basile, Alessandra (2022-12-01)
    The sudden diagnosis of childhood cancer can be life-threatening and pose a substantial challenge to families. When a child is diagnosed, the family is expected to take on new responsibilities and learn new skills. The family's functioning may alter for long periods of time, which is not always simple, and for many families, it can result in severe emotional stress that lasts for a very long time. In this literature review, seven articles in the PubMed database met the common themes identified (a) the needs and impacts of the family experiencing childhood cancer, (b) social support and siblings of children with cancer, and (c) parental distress related to the diagnosis of childhood cancer. These themes underline the need to increase awareness of the potential emotional harm that these patients and their families might experience. Families are often forced to rearrange their current lifestyles by altering routines and family responsibilities. The importance of illness management regimens combined with physical symptoms like pain and exhaustion are likely to interfere with many aspects of everyday life for not only the children but also for their parents and siblings. It is important to properly assess the family involved to provide sufficient care, as they are also affected. Without proper interventions, family members and children can experience a sufficient amount of emotional, psychosocial, and physical distress that can last for many years.
  • Patients, Providers, And Perceptions: Achieving Quality Of Care When Goals Are Not Aligned

    Ebersole, Nancy; Smith, Catherine (2022-05-01)
    Despite asthma remaining one of the most common chronic pediatric conditions, patients are still constantly hospitalized due to poor adherence to the treatment plan. Patient-centered care requires professionals to understand what barriers affect controlled asthma during healthy childhood/adolescent development. This literature review consists of seven key articles from the CINAHL and PubMed databases with common themes identified (a) providers and patients have different goals of effective care; (b) nurses can help identify family roles to manage asthma care while building patient resilience and (c) identifying factors that decrease treatment compliance. These themes highlight the need for nurses to expand their role as medical caregivers and educators into a mediator between pediatric patients, their family members, and their providers. At the same time, natural family roles need to be respected and patients can care for themselves with little distractions from having a healthy childhood. This helps to improve the quality of self-care and decrease hospital readmissions in pediatric patients with asthma.
  • The Impact Of Disparate Treatment On Pregnancy Outcomes In Minority Women

    Ebersole, Nancy; Pueyo-Garcia, Claudia (2022-05-01)
    Pregnancy is one of the most vulnerable and important events in a woman’s life, however this experience can differ for minority women from disadvantaged backgrounds. The Center for Disease Control and Prevention reports that 700 women die each year in the US because of pregnancy or delivery complications while also reporting that Black women are three times more likely to die from pregnancy than white women. More than half of these deaths and near-deaths are the result of preventable causes, and a disproportionate number of the women suffering are Black women. A review of the literature was done using the CINAHL database, and the articles that were collected will be used to find common themes across multiple author’s findings that link directly to causative factors and their outcomes. The themes are (a) minority women experiencing lower-quality care; (b) minority women experiencing biases in communities; (c) minority women experiencing implicit bias within the health care delivery system; (d) minority women experiencing the effects of systemic oppression. Each of these elements have contributed to the rising prevalence of pregnancy-related morbidities and deaths. Nurses must advocate for high-quality, safe treatment and care for every patient to dismantle racial health disparities and decrease maternal morbidity and mortality rates. The desire to learn and to be aware of the variables influencing racial inequalities in pregnant minority women is the first step to improve health care standards and work to dismantle this growing racial health disparity.
  • Treating Patients With Ventilator-Associated Pneumonia (VAP): The Challenges Of Implementing Nursing Bundles Of Care

    Ebersole, Nancy; Guzman, Emilee (2022-05-01)
    A ventilator is any device used to support, assist, or control respiration. Ventilator Associated Pneumonia (VAP) can result from long term mechanical ventilation and causes a major life-threatening infection that has a high prevalence in patients in the Intensive Care Unit (ICU) within our hospitals today. Despite having life-saving benefits, mechanical ventilation puts patients at a high risk of developing VAP; this increases the length of hospital stay, increases the cost of treatment, and decreases patient quality of life. Therefore, hospitals have implemented standardized preventative care interventions or “bundles” for mechanically ventilated patients in attempts to reduce the overall VAP prevalence, and infection rate. A systemic literature review was performed using the CINAHL Plus database to investigate the challenges posed to nurses when implementing VAP care bundle interventions in ICU patients. Major themes are (a) VAP bundles significantly reduce days on a ventilator and days in the ICU, (b) What is in the care bundle matters, (c) Nursing compliance is related to education and years of experience, (d) Barriers to nursing adherence is related to the use of bundles, (e) Institutional barriers that affect nursing adherence to the use of bundles. The registered nurse is in a key position to mitigate the risk of VAP. Hospitals must provide standardized nursing policies that emerge from interpersonal communication with bedside nurses to enforce Evidence Based Practices. In the future, to provide optimal care for mechanically ventilated patients, hospitals must take action to create changes to overcome institutional barriers which impact patient care.
  • Period Poverty: How Access To Feminine Hygiene Products Affects The Psychosocial Development Of Young Women?

    Ebersole, Nancy; Duvivier, Cephora (2022-05-01)
    The purpose of this study was to assess the menstrual hygiene needs of adolescent girls and explore factors influencing poor access to products and related school absences amongst adolescent girls. Many young women cannot afford menstrual health products to meet their monthly needs, and this may impact their well-being and school performance. Period poverty is a subset of the broader issue of hygiene insecurity. As a result of hygiene insecurity, women often lack health, self-esteem, and dignity due to limited access to hygiene products such as sanitary towels or pads, tampons, soap, and clean underwear. A systematic review of the literature was done in the CINAHL Plus database, PubMed, and Google Scholar databases. The themes identified across the studies are (a) poor access to menstrual products, (b) school environment does not provide for the needs of young women and (c) inadequate education on menstrual health in schools. The results indicate there is an unmet need for affordable products and teaching that targets both the knowledge and management of menstruation. Inadequate menstruation hygiene has been shown to be linked to school absenteeism. In schools, there is a significant need for menstrual hygiene products, as well as regular use of school resources to get them. With additional research to help inform how period poverty impacts adolescent girls and young women, there is tremendous opportunity to help address this critical, yet under-addressed issue. Menstruation is an ongoing biological process that affects women and adolescent girls. Menstruating women, on average, use over 9,000 sanitary items throughout their lifetime, which adds up rapidly. Adolescent girls face struggles to manage their menstrual cycles and those in lower socioeconomic classes often lack access to the products they need. Despite how essential menstrual products are, there are vast number of adolescent girls who are unable to afford or acquire these necessities. This lack of access to period products is often referred to as, ‘period poverty’. This can result in delayed challenges in achieving psychosocial growth in adolescent girls, as evidenced by not attending school Lack of access to products amongst adolescent girls causes inhibitions in psychosocial settings and causes girls to not interact with others freely. Ultimately this can limit a girl’s potential and opportunities later in life. 1 in 5 girls in the United States reported having missed school because they did not have access to menstrual products. Without proper menstrual hygiene management (MHM), a girl’s attendance at school is reported to decline or cease altogether. Providing adequate resources to meet women's and girls' menstrual hygiene needs may have an impact on female school attendance rates and expanding women's education is critical in achieving one’s life goals.
  • Living With Cardiovascular Disease: The Connection Between Mental Health And Quality Of Life

    Ebersole, Nancy; Desir, Pascale (2022-05-01)
    Cardiovascular disease is the leading cause of death worldwide. Depression and anxiety have been identified as common factors occurring with advanced heart disease. An unhealthy lifestyle, such as poor dietary habits or improper coping mechanisms is correlated with the onset of anxiety and depression. Patients with cardiovascular disease that are faced with various stressors as well as depression and anxiety are at risk for poor prognosis of their disease and an overall decreased quality of life. A systematic review was conducted using the CINAHL PLUS database to determine what mental health factors affect the outcome for individuals with cardiovascular disease. The results of this systematic review of seven academic articles outlined five themes that influence the quality of life for individuals with cardiovascular disease. The themes are (a) life satisfaction; (b) socioeconomic status and emotional state; (c) anxiety and fear; (d) stress and distress; and (e) depressive disorders. These results help to identify specific interventions that health care providers should implement when caring for patients with cardiovascular disease. Healthcare professionals should continuously monitor the mental status of their patients with cardiovascular disease, in order to treat their patients. By doing so this has the potential to reduce the progression of heart disease and improve their overall quality of life.
  • Adolescents With Migraine Headaches: Managing Triggers To Support A High Quality Of Life

    Ebersole, Nancy; Darden, Mikayla (2022-05-01)
    Migraine headaches are common amongst adolescents, beginning in early childhood and following them into adulthood. Migraines are typically described as intense pain located on one side of their head, accompanied by other symptoms, such as nausea, vomiting, and sensitivity to stimuli. Migraines have a negative impact on the daily lives of those who suffer from them. Successfully navigating life is hard enough for people of this age group and healthcare professionals should strive to increase the quality of life for both the patient and the family. A systemic review of literature was conducted. A CINHAL Plus search was used with the keywords: migraines, quality of life, and adolescents. The search was refined to only show peer reviewed sources and journal articles. The publication date was set between the years 2017 to 2022. Six articles met the criteria for inclusion in this systemic review of literature. The criteria being article on headaches that did not have a co-morbidity. Three themes were identified and included in the review: who is at highest risk for migraines, the effect migraines have on health and school performance, and the poor quality of life of both the adolescent and their families. Further awareness of migraines and their triggers is needed. This will allow patients and their families to take a proactive approach and understand acute treatments that will help the adolescents improve their quality of life. In addition to positive outcomes and proper growth & development. Controlling the triggers and symptoms of migraine headaches will allow the adolescents to live better lives and lessen the burden on families.
  • Adolescents And E-Cigarette Use: The Hidden Danger Of Developing E-Cigarette And Vaping Associated Lung Injury

    Ebersole, Nancy; Aniagu, Anastasia (2022-05-01)
    Newer generations have opted out of the traditional cigarettes but instead smoking electronic cigarettes. Electronic Cigarettes (EC), produce an aerosol by heating a liquid that usually contains nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products—flavorings, and other chemicals. EC can come in various sizes, shapes and flavorings and typically is used as a recovery source for overcoming nicotine addiction and smoking cessation. Adolescents have become fascinated with EC causing a health crisis among the age group called EVALI (E-cigarettes or Vaping Lung Injury). This thesis will be addressing the EC substance abuse in adolescents and why it is important for healthcare workers, nurses, and providers to be updated on the health issues that can occur from chronic use of EC. The thesis will address the psychological and risk factors that may influence teenagers into smoking EC, THC involvement with EVALI, the health history of adolescents, and the initial signs and symptoms of EVALI. Various sources from accredited academic databases will be used to relay pertinent information when it comes to smoking EC and the health impact of EVALI. Healthcare providers, public health administrators and other personnel that work with adolescents should have some foundational information when it comes to adolescents smoking EC and how EVALI can have an everlasting impact on their health.
  • Managing Pain In Children: Barriers To Effective Care

    Ebersole, Nancy; Agno, Sandrei (2022-05-01)
    This thesis focuses upon pain management in a healthcare setting and at home, specifically within the population of children. The purpose of this research is to understand why assessment and pain management of children is difficult for healthcare providers and caregivers. This study covers the influencing factors that act as barriers in the direct care of healthcare providers to children. The aim is to understand why these barriers affect successful pain assessment and management. A systematic literature review was conducted to investigate the challenges that affect successful care for children. There were four themes that were identified in the eight articles that met the criteria for the barriers of pain assessment and management. The themes identified were the healthcare worker’s ability to collect subjective and objective data, communication within staff and family, forgotten priorities by healthcare providers and a child’s inability to rate their own pain. Recognizing these challenges and how they hinder optimal childcare will promote good patient outcomes and support child growth and development.
  • The Learning Needs of Newly Licensed Registered Nurses

    Fraley, Hannah; Goodwin, Paige Allison (2016-05-01)
    Nurses are on the frontline of healthcare delivery. The learning needs of newly licensed registered nurses are poorly understood. The aim of this study is to identify the specific learning needs of these newly licensed nurses so that they are able to confidently provide excellent care to culturally, ethnically, and racially diverse patients. A qualitative approach was used to complete this study. Convenience sampling was used to recruit ten newly licensed registered nurses who were interviewed by phone. The interviews were transcribed. Questions targeted working nurses experiences with nursing skills, interdisciplinary interactions, and documentation. Data was analyzed and coded for the identification of themes. Gaps in the literature exist regarding the specific learning needs of newly licensed registered nurses. Understanding their learning needs can provide insight into how to better transition student nurses to registered nurses so that they are able to adequately and safely take care of a diverse patient population and work successfully as new nurses.
  • Risks and Benefits of Self-Diagnosis Using the Internet

    Fraley, Hannah; Gass, Meghan Alesia (2016-05-01)
    As technology use increases, self-diagnosis using a symptom checker on the World Wide Web has become a topic of discussion in the health field. Given that many in the United States continue without access to medical care, it is becoming common practice for patients to self-diagnose using information sought on the internet. Health literacy of internet health information is a concern, especially among vulnerable populations, such as immigrants and those without access to health insurance. The aim of this study is to understand the phenomenon of self-diagnosis using the internet as a source of health information among a convenience sample of Salem State University students (N= 150). A survey instrument was used to examine the following: perception of accurate health information sought throughout the internet; follow-up with primary physicians, how much trust is placed in internet self-diagnosis, and how often participants use the internet to self-diagnose. Data was analyzed using thematic coding methods. The internet provides us with access to information, yet among those seeking health-related information, there is a concern that critical health information can either be misinterpreted, unreliable or both. Self-diagnosis using the internet is a particular concern if patients are using the internet in the place of a physician. Results from this study can inform healthcare professionals about college faculty, staff and student perceptions regarding use of the internet to self-diagnose prior to seeing a primary physician, as well as inform future study of this phenomenon.
  • Assessing the Nutritional Health of College Students: An Ethnographic Approach

    Hills, Donna; Forina, Nicole Marie (2016-05-01)
    The culture of college students does not appear to give adequate attention to nutritional health. The purpose of this study seeks to explore whether college students are at risk for imbalanced nutrition. Among the studies reviewed, samples suggest that college students are at risk for imbalanced nutrition due to their financial instability, lack of nutritional knowledge, and inability to obtain healthy foods. The results of this systematic review of the literature suggest that implementations of nutritional education may reduce those risks.
  • Student Nurses' Knowledge of End-of-Life Treatment Options in Dementia Patients

    Fraley, Hannah; Coulter, Shelby Anne (2016-05-01)
    Dementia is a serious disease that affects 46.8 million elders globally with 9.9 million new cases each year. It is not often understood that dementia is considered a terminal illness, and it is thought that misconceptions about dementia may be a factor of poor quality of care for this vulnerable population at the end of their lives. Nurses are on the front lines of caring for dementia patients, however nurses may lack knowledge of how to best care for dementia patients and their families. A qualitative survey study will be conducted using a convenience sample of Salem State nursing students (N= 100). Specific study aims include: do nursing students know about dementia, advanced directives, and end of life care and treatment options specifically related to the dementia patient? Thematic coding methods will be used to analyze the data. Results from this study will help identify knowledge needs of nursing students related to end-of-life treatment for dementia patients. Understanding knowledge needs of nurses can further inform future educational programs for nursing students in order to increase the quality of care for this population.
  • The Benefits of Cardiac Rehabilitation for Post-Myocardial Infarction Patients

    Fraley, Hannah; Dahlberg, Jenny Kathryn (2016-05-01)
    Myocardial infarction is one of the most significant causes of death worldwide. Factors leading to a patient's risk of having a myocardial infarction are obesity, smoking, high cholesterol, hypertension, and a sedentary lifestyle. If patients knew of these risks, the likelihood of a myocardial infarction occurring could decrease. Because of a lack of information about the topic, many patients unfortunately experience a myocardial infarction before it is preventable. Lack of knowledge about how serious the disease is and treatment is also a reason for not going through with cardiac rehabilitation. People around the world need to be educated about myocardial infarction risks and the positive outcomes of attending cardiac rehabilitation. The aim of this study is to improve the quality of life of myocardial infarction patients by determining the long-term benefits of going through with cardiac rehabilitation. A review of the literature was conducted. CINAHL was used to search articles pertaining to the research topic. Results include the following: a lack of cardiac knowledge led to patients' unawareness of the need for attending cardiac rehabilitation; patients improved both physically and psychologically after attending rehabilitation; individualized education has been the most effective for myocardial infarction patients. Myocardial infarction can potentially be prevented through education of cardiac patients on the benefits and importance of cardiac rehabilitation. Results from this study have implications for helping to decrease morbidity and mortality among this high-risk population.

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