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  • 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 (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 (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.
  • The Benefits of Cardiac Rehabilitation for Post-Myocardial Infarction Patients

    Fraley, Hannah (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.
  • Student Nurses' Knowledge of End-of-Life Treatment Options in Dementia Patients

    Fraley, Hannah (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.
  • Factors Affecting the Quality of Life of Residents in Nursing Homes: Knowledge and Strategies for the Novice Nurse

    Leger, Robin (2016-05-01)
    Background and Significance: Quality of Life (QOL) is a major focus of practice in all areas of nursing, including promoting QOL for the elderly. New graduate Registered Nurses (RNs) have the option of working in a nursing home for their first career opportunity. The significant increase in the Baby Boomer population (nearly tripling between 1980-2030) will cause an influx of nursing home residents as they require nursing home services. Review of the Literature: Quality of Life (QOL) is important to providing quality, holistic care. Many factors encompass QOL. It is necessary for the new graduate RN to learn about interventions that positively impact nursing home residents' QOL. The literature review speaks only about first-hand studies focusing on nursing home residents' own interpretations of QOL factors. Several QOL domains were identified including promoting comfort, meaningful relationships, and maintaining autonomy and dignity. Undergraduate nursing education and new graduate orientation programs offer little information on the nurse's role in promoting QOL in the elderly. Implications for Novice Nurse Education: A table was adapted to show the QOL domains for the Elderly and possible RN Interventions to positively impact nursing home residents QOL. Provided with education focused on competencies for promoting QOL in the elderly, the new graduate RN will be able to use the interventions presented in the table to realize ways to positively impact QOL of nursing home residents during their first nursing experience as a novice nurse.
  • Information Available to Patients Diagnosed with Dementia: Interviews With Caregivers and Their Experiences

    Fraley, Hannah (2015-05-01)
    Purpose: Dementia is a prevalent problem for older adults and their families. Early intervention and a multidisciplinary approach for treatment have been linked to better quality of life. The primary objective of this study was to discover what information is available to patients with dementia upon diagnosis and how beneficial the information given is perceived by the primary caregivers. Secondary objectives included types of resources most utilized by the caregiver and how caregivers found out about such resources. Methods: A qualitative study design was employed using snowball sampling methods and semi-structured interviews among primary caregivers (n= 5) of patients with Alzheimer’s Disease (n= 3), Lewy Body Dementia (n= 1), and Dementia Unspecified (n= 1) respectively. Thematic coding methods were used to identify potential barriers to accessing timely information regarding disease prognosis and optimal resources. Results: Several themes emerged from caregiver interviews. Central themes found among the caregivers include: 1.) chronic grief 2.) chronic frustrations 3.) chronic guilt 4.) total responsibility of care. Several subthemes emerged that compound upon these caregiver experiences including provider related parries such as lack of quality information, and access barriers including difficulty finding community resources. Conclusion: Caregivers interviewed in this study perceive support from their health care team in general, yet have limited perceived support in navigating how to access community resources. Patients and their families need guidance and support from the health care team upon diagnosis, yet also need ongoing support and education while caring for a loved one with Dementia.
  • Depression and Mental Health Awareness Regarding Adololescents Within the Primary Health Care Setting: Study Protocol

    Fraley, Hannah (2015-05-01)
    Background: Depression is a serious illness, warranting adequate access to care and treatment among adolescents. The aim of this study was to further understand college students’ perception of mental illness and perceived parental views regarding mental health disorders. Methods: Ethnicity and fields of study were analyzed to note any significance amongst the groups. Convenience sampling was used, targeting participants’ ages 18-25 years at Salem State University. Using mixed methods methodology, participants was asked to conduct a survey questionnaire. Survey questions were geared towards participant perception of depression, and perceptions of parental views on mental illness. Results: A total of 266 anonymous surveys were collected and analyzed to find that the majority of participants’ parental views on education and depression were correct. On the other hand, 25% of surveyors believed that their parents would believe that depression is caused by bad or weak character. As for ethnicity, Asian or Pacific Islander (50%), Hispanic or Latinos (35%), and Black or African American (36%) were more likely to think that their parents would believe that depression is caused by bad or weak character. As for fields of study, non-science majors were more likely to have stigmatizing beliefs in regards to depression. Conclusion: Further education on depression knowledge should be acknowledged in the school system, media, and more importantly; our health care system. Increased and more in-depth screenings for adolescent depression should be seen by the primary health care provider in order to decrease the number of untreated depression cases. For future studies, a more in-depth survey should be distributed with a larger sample size to increase the numbers in diversity.
  • Systematic Literature Review: A Family Approach to Postnatal Depression

    Campbell, Charlene (2015-05-01)
    Through a systematic review of literature, this research project explores a family approach to postnatal depression (PND). Within the first year of giving birth, seven to 15 percent of woman experience postnatal depression. Postnatal depression does not solely affect new mothers, but also fathers and babies. In conducting a systematic review of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Boston Public Library Electronic Resources, and Education Resources Information Centre Database (ERIC), along with Google and Google Scholar, nine peer-reviewed studies were ultimately selected for inclusion in this review. The systematic literature review revealed the benefits of a family approach to postnatal depression. Three main themes emerged from the research: 1) social and relationship support; 2) paternal PND; and 3) PND stigma. According to the results found in this review, teaching about PND should be focused on the all-new families in addition to the new mother. These results demonstrate teaching interventions should occur during the prenatal and postnatal time to reduce PND instances in both women and men.
  • Advancements of Nursing Roles in Pediatric Burn Care

    Leger, Robin (2015-05-01)
    Burns are a common injury for children, especially in toddlers and adolescents. Nurses are in the front line of care and possess many roles within the care of pediatric burn patients. Nursing roles in pediatric burn care can be organized into three major areas of care, including acute, rehabilitative and psychological. it is the roles that nurses carry out that make a difference in the long term quality of life in the pediatric burn patient. Goals and objectives: To address nursing roles in all three major areas of nursing care in pediatric burn care, acute care, rehabilitation care, psychosocial care, long term care and follow-up care.
  • How Stigma and Negative Attitudes Towards the Mentally Ill Affect Patients' Quality of Care: Moving Towards a Better Understanding for Change

    Fraley, Hannah (2015-05-01)
    Background: 1 out of every 4 American adults currently have a form of mental illness, while 50% of others will develop a mental disorder at some point in time. Mental illness not only emotionally deteriorates a person; it impairs one’s ability to function daily. Mental illness is highly correlated with other chronic diseases, such as diabetes, cardiac conditions and obesity, as well as homelessness and drug and alcohol dependency. The mentally ill are less likely to access healthcare for treatment due to experienced stigmatization, negative attitudes and stereotypes due to their diagnosis. The aim of this study is to detect and understand the negative attitudes towards the mentally ill, and to recognize how to work towards facilitating change in health care. Methods: CINAHL databases were searched to identify studies performed relating to the stigmatization of mental illnesses and how negative stereotypes affected patients’ quality of care. Results included data from qualitative and quantitative studies. Out of 171 reviewed papers, 11 met the criteria to perform this literature analysis. Results: Stigma towards the mentally ill is a prominent theme identified within the literature. Evidence based changes to eliminate stigma and negative attitudes towards mental disorders must be taken to improve quality of care. Understanding experienced stigma among the mentally ill is a first step to promote much-needed changes to health care delivery.
  • Knowledge of HIV screening in Women of Childbearing Age: 18-50

    Leger, Robin (2015-05-01)
    Background and Significance: Today across the globe, children are still being born with Human Immunodeficiency Virus (HIV) contracted from their mothers. Although the Center for Disease Control and Prevention (CDC) recommends that all women be screened for HIV during each pregnancy, women are still failing to meet this goal. Research shows that women who understand the benefits of HIV screening for their developing child in utero are more likely to receive an HIV screen during pregnancy. Furthermore, research has shown that women who perceive themselves as “low-risk” are less likely to receive and HIV screen prenatally. Methodology: The nursing student and faculty advisor composed a survey with questions on demographics, HIV transmission knowledge and a self-evaluation tool to assess women’s perception on their own knowledge of HIV transmission, screening, and benefits of screening. Results: Nearly 70% of women indicated of how much they themselves believed to known about HIV transmission with a range of scores from 27 to 100. Women’s responses to the VAS for knowledge of benefits of prenatal treatment for the developing fetus were much more discouraging than the previous VAS scale results. For this scale, there was a mean of only 34.1 with a range of 0-93. The standard deviation among responses was 27.1, meaning there was high variability among samples. Finally, the last VAS scale asked women to rate their knowledge of the fact that HIV transmission from mother to child can be prevented over 98% with the proper treatment. Women’s mean for this scale was only 44.7 with a range of 0-96 and the standard deviation among responses was 30.8, meaning there was also high variability among responses. Education level had absolutely no correlation to women’s knowledge of HIV transmission, screening, or treatment benefits during pregnancy. Of equal importance, results show that the majority of HIV transmission questions that were answered incorrectly were related to oral transmission. Implications: Education about HIV transmission and screening during pregnancy needs to be spread to women of all educational levels. Further research can focus on how best to educate women and how to promote prenatal HIV screening for all women during every pregnancy.
  • Todos Estamos Satisfechos? Are We All Satisfied? A Review of the Literature

    Fraley, Hannah (2015-05-01)
    United States healthcare is experiencing a growing need for medical interpretation among diverse populations. Of note, the Hispanic population is steadily growing reaching upwards of 17% of the US population. The Hispanic patient experience and perception of care is poorly understood in the context of patient to provider communication in the US, despite 62% of Hispanics primarily speaking Spanish and limited English. A review of the literature was conducted, the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database was exhaustively searched for English language research published between 2000 and October 2014 that identified disparities between Spanish-speakers and English-speakers regarding their healthcare experiences. Keyword searches included the following: Spanish speaking patients, patient satisfaction, and health disparity. Of twenty-five articles initially yielded by the search strategy, seventeen articles were selected that met inclusion criteria for further analysis and review. Within these articles, it appeared that patients generally did experience a lower rate of satisfaction as compared to English-speaking patients regarding their healthcare providers and the language utilized. Contrastingly, an article described a population of Spanish-speaking patients whose language barrier was not reported as an issue when being assessed for domestic violence. Limited research exists which targets the Hispanic patient population and language barriers faced when communicating with their health care providers. This presents an important gap in the literature to consider for this patient population specifically their experiences and perceptions of how care is delivered in the US. Culturally relevant research is needed in order to appropriately change the way in which health care is delivered to this population, which will ultimately improve patient to provider communication and health literacy.
  • A Literature Review of the Onset of Social Media and its Effect on HIPPA Violations

    Magazzu, Tammi (2014-05-17)
    Social media has become increasingly popular in the United States and is accessed daily. It consists of different websites such as Facebook and Twitter. Access to these websites is easy and fast, allowing users to frequently network. In many situations, social media can be utilized in a positive manner. However, in fields such as nursing, social media can be detrimental. The Health Insurance Portability and Accountability Act, HIPAA, provides specific and strict regulations regarding the use of social media in the medical field. Breaching patient confidentiality can jeopardize a nurse’s job and future career. With the onset of social media, HIPAA violations have increased. This thesis will provide a literature review of social media and its onset, and how it affected HIPAA. I will show how these websites have caused more violations of HIPAA, and provide interventions and suggestions to decrease the violations. Specific methods will be included to show how the problem can be fixed. In addition, a brief history of social media will be provided to illustrate how it is extremely prevalent.
  • Sexually Transmitted Infections in the Elderly: Nursing Implications for Prevention and Education

    Leger, Robin (2014-05-17)
    This study will examine why the elderly population in the United States is at high risk for contracting and spreading sexually transmitted diseases. Through a review of literature, many different risk factors will be identified and discussed. The study will also include methods of prevention to protect this population. Education strategies will also be discussed, not only for the members of the elderly population, but for the health care professionals who treat them. By identifying risk factors, providing education, and learning about prevention, the rate sexually transmitted diseases are being spread will decrease among the elderly population.
  • Using the Ketogenic Diet to Reduce the Incidence of Pediatric Seizures: Helping Children and Families to Find a Better Quality of Life

    Ebersole, Nancy; Nowka, Scott; Gonsalves, Joanna (2021-05-01)
    Seizure disorders have both medical as well as quality of life implications for anyone experiencing them. The use of medications to control and manage this disorder is not always effective and may cause side effects that discourage compliance with the prescribed drugs. All of these concerns are especially problematic for children with seizures and their families. The use of diet modifications to control seizures is showing promise as an alternative to medications. The high fat, ketogenic diet as well as the low glycemic index diet are being investigated to control seizures in children. A systematic review of the literature was done in the CINAHL Plus database. The themes identified across the studies are (a) the ketogenic diet was effective in reducing seizures whereas the low glycemic index diet was not; (b) compliance with diet changes is a significant concern in this patient population; (c) parents view quality of life differently than the children with seizure disorders and this can impact diet adherence; and (d) how this diet interacts with medications and alters other body functions must be considered when using the ketogenic diet for seizure management. These results indicate an opportunity for nurses to work with families and the health care team to reduce the incidence of seizures, improve treatment compliance, and enhance the quality of life. A treatment option which provides for the needs and desires of both the individual and the parents can strengthen the family unit and promote healthy outcomes for all.
  • The Significance Of The Microbiome: It's Role In Infant Development And Long-Term Health

    Ebersole, Nancy (2021-05-01)
    Humans enjoy a beneficial symbiotic relationship with bacteria. Although commonly thought to be the cause of illness, bacteria aid in food digestion along with creating resistance to disease. The microbiome refers to the aggregate of bacteria that reside in our intestinal track. There has been an effort over the past decade to map the human microbiome in order to identify this relationship. Given this crucial role of microbiota in human health, it is important to know how the microbiome is formed in infancy as it may impact one’s future ability to obtain wellness. A review of the literature was done to examine what is known of the microbiome at the earliest stage of life and the relationship to issues later in life. The articles were identified using the databases CINAHL, PubMed, and MEDLINE. Five themes were identified across the articles studied. The microbiome: (a) of preterm infants differs from full-term infants; (b) at birth is found in both the lungs and intestines; (c) development is affected by an infant’s intake of formula vs. breastmilk; (d) present and its amount present during infancy may influence the risk of developing behavioral issues; (e) development is altered when antibiotics are administered to newborns/infants. The choices of how a child will be fed is decided during pregnancy and consideration of the microbiome and its effect on future health has serious implications. Knowledge of the microbiome’s role in healthy growth and development should be considered when working with expectant mothers, parents and families of newborns.
  • Minimizing The Risk Of Orthopedic Surgical Site Infections In The Pediatric Population: Using Evidence To Inform Practice

    Ebersole, Nancy (2021-05-01)
    Surgical site infections are some of the most common hospital-acquired infections and are associated with higher rates of morbidity and mortality for patients. Surgical site infections can also increase length of hospital stay for patients and elevate healthcare costs. There is extensive literature exploring risk factors associated with acquiring surgical site infections in adults undergoing orthopedic surgery, however, literature exploring this topic in the pediatric population is limited. Additionally, many interventions and assumed risks within the pediatric population are extrapolated from data collected from adults. A systematic review of the literature was done using the CINAHL database to identify risk factors associated with acquiring surgical site infections in the pediatric orthopedic patient population and interventions to help mitigate these risks. The result of these studies showed that both weight and nutritional status played a role in predicting the incidences of acquiring a surgical site infection. Additionally, prophylactic antibiotic selection and dosing needs to be specific to both the possible pathogen and the patient. A bundle approach to interventions can help to reduce the rate of surgical site infections, however, strict compliance amongst staff can be difficult to ensure. It is imperative as healthcare professionals that we work lo identify associated risk factors for developing surgical site infections within the pediatric population undergoing orthopedic surgery. The identification of these risk factors can guide evidence-based practice to establish interventions that can mitigate these risks and promote health and safety for the pediatric population.
  • Pediatric Traumatic Brain Injuries: Challenges in Providing Effective Patient Care and Importance of Proper Family Support

    Ebersole, Nancy (2021-05-01)
    The human brain is one of the most important, yet least understood, organs in the human body. This functional unit innervates every aspect of human life and is ever changing from conception until full maturity around age 25. Considering this, it makes sense that pediatric traumatic brain injuries are so misunderstood. Attempting to diagnose and monitor a traumatic injury to a complex organ that is still growing and developing is challenging for clinicians. Proper interaction with these children and their families is vital to physical health and psychosocial development. Identifying current knowledge and disseminating it is crucial for planning interventions and promoting healthy outcomes. A review of the literature was done using the CINAHL database, and articles collected identify themes that are important and unique to caring for these patients. The themes are (a) impact of age at time of injury on post injury behavior; (b) importance of proper identification of TBI related behaviors and appropriate interventions; (c) relationship between severity of injury and post injury behaviors; (d) patient challenges with internalizing and externalizing problems; and (e) role of home environment on post injury behaviors and recovery process. When caring for this patient population, it is important for health care providers to not use a "one size fits all" approach, as each patient will have a different presentation and different needs based on the factors listed above. The themes identified here provide a point of reference for clinicians when planning care for children who have experienced a traumatic brain injury.
  • Central Line-Associated Bloodstream Infection Reduction: Using Evidence to Inform Practice

    Ebersole, Nancy; Cohen, Christopher (2021-05-01)
    Central line-associated bloodstream infections or CLABSIs cause major life-threatening illnesses that have a high prevalence rate within our healthcare industry today. CLABSIs not only cause potentially fatal consequences for patients, but also cost hospitals a substantial amount of money to treat these infections. CLABSIs can result from not only the insertion of the central line from a healthcare provider, but also in the central line care by nursing staff. Therefore, hospitals have implemented standardized "bundles" for central lines to try to reduce the overall amount of CLABSIs. However, many hospitals are not seeing a significant decrease in the number of infections from the time that they adopted these practices. A systematic review of literature was conducted using the CINAHL Plus database to investigate the efforts of trying to reduce the overall occurrence of CLABSIs and the success rates of these practices. Major themes include the implementation of bundles for central lines are not being consistently applied by those working at the bedside. Inconsistency with the implementation of bundles of care for central lines can be attributed to incomplete knowledge of what needs to be done; while the presence of written policies do not ensure policy compliance. Nurses are at the frontline to ensure patient safety and reducing patient risk for acquiring CLABSIs. It is important that nurses identify the barriers to compliance and collaborate to create effective strategies to promote patient safety and lower the overall occurrence of these life-threatening infections.

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