Recent Submissions

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

    Leger, Robin; Angel, Katelin N (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; Williams, Leigh (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; Visconti, Andrew (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; Swain, 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.
  • How Stigma and Negative Attitudes Towards the Mentally Ill Affect Patients' Quality of Care: Moving Towards a Better Understanding for Change

    Fraley, Hannah; Shanahan, Molly (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.
  • Advancements of Nursing Roles in Pediatric Burn Care

    Leger, Robin; Scherrer, Stephanie (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.
  • Knowledge of HIV screening in Women of Childbearing Age: 18-50

    Leger, Robin; Najjar, Alexandra (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.

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