1,720,975 research outputs found
Assessing the Perceived Barriers to the Administration of Adjunctive Aromatherapy in Nurses Caring for Pediatric Patients with Postoperative Nausea and Vomiting: An Evidence-Based Practice Project
Get PDFPurposeThis project examines perioperative nurses' perceived barriers to using adjunctive aromatherapy for postoperative nausea and vomiting (PONV) treatment in pediatric patients.
Background
PONV is more prevalent in children than adults. Aromatherapy, a holistic approach using natural oils, has shown promise in treating PONV but faces barriers in clinical practice.
Methods
A mixed-methods evidence-based practice project was conducted at a large urban pediatric hospital in the United States. Pre and post-surveys were administered to evaluate nurses' knowledge and perceived barriers to using adjunctive aromatherapy before and after an educational in-service.
Results
Among 27 perioperative nurses surveyed, antiemetic medications were the primary treatment for PONV. Identified barriers included product availability, caregiver refusal, and patient-specific factors. After the in-service, perceived barriers decreased, and nurses reported greater familiarity with adjunctive aromatherapy and increased likelihood of use.
Conclusion
Increased education promotes the incorporation of adjunctive aromatherapy into clinical practice. To successfully integrate aromatherapy, healthcare organizations should establish oversight teams, staff training, and intervention monitoring. Institutional policies should address product and patient selection, monitoring, and documentation. Implementing these measures ensures consistency, potentially eliminating perceived barriers and promoting aromatherapy use for PONV treatment among nurses.Doctor of Nursing Practice (DNP)Nursin
Applying the Self-Determination Theory to Adolescents with Congenital Heart Disease
Get PDFProblem: Congenital heart defects are structural abnormalities that exist at birth and often require surgery and medical management from infancy through adulthood. There has been a substantial increase in life expectancy over recent decades with approximately 85-90% of children born with congenital heart disease (CHD) surviving into adulthood. However, despite improvements in life expectancy, many surgeries for moderate to complex CHD include palliative procedures, and these individuals face lifelong cardiac monitoring, self-management of care, and adherence to treatment regimens than may affect their health-related quality of life (HRQOL). There is empirical support that the three innate needs of the Self-Determination Theory (SDT), autonomy, relatedness, and competence, are related to self-management of care and adherence to treatment for adolescents with chronic illnesses. Also, self-management of care and adherence to treatment is necessary for a successful transition into adulthood and improved HRQOL for adolescents with CHD because of the complexity of care. Therefore, the purpose of this study is to examine the relationship among the three innate needs of SDT, self-management of care and adherence to treatment, and its relationship to HRQOL for adolescents with CHD.
Methods: A non-experimental, cross-sectional, correlational design was conducted in a sample of 92 participants, ages 13 to 18 years. Five instruments were used to measure each of the following major variables: Autonomy (Autonomy subscale of the Basic Psychological Needs Scale), Relatedness (Relatedness subscale of the Basic Psychological Needs Scale and the Child and Adolescent Social Support Scale), Competence (Competence subscale of the Basic Psychological Needs Scale and the Generalized Self-Efficacy Scale), Self-Management and Treatment Adherence (UNC TRxANSITION Scale), and HRQOL (Pediatric Quality of Life 4.0 Generic Core Scale). For data analysis, Pearson’s correlations were used to explore associations between variables, and the hypotheses were tested using multiple linear regression. An exploratory analysis was conducted to test for a mediating relationship among variables using the bootstrap method.
Results: Demographic and clinical data were collected. Participants were an average of 15 years of age (SD=1.6), with 59% male. Participants self-reported race-ethnicity as follows: White, non-Hispanic, 65.2%; Black or African-American, 15.2%; Hispanic, 12%; multi-racial, 4.3%; Asian, 2.2%; and American Indian or Alaska Native, 1.1%. For CHD severity, 43.5% had mild CHD, 31.5% had moderate CHD, and 25% had severe CHD. After controlling for covariates, regression analyses revealed relatedness (β=.64) and competence (β=.79) contributed significant variance to HRQOL, R²=.56, p
Conclusion: This study found that relatedness and competence were significantly associated with HRQOL in adolescents with CHD. Autonomy and self-management of care and adherence to treatment did not significantly influence HRQOL. These findings demonstrate the importance of further examining relatedness and competence in adolescents with CHD
Over 12 months, an immunisation navigator programme for urban adolescents increased immunisation rates by approximately 13% compared with control
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Implementation of the Provider Bull\u27s-eye: A Tool to Guide Clinical Reasoning and Communication for Nurse Practitioners
Get PDFProblem
In a large urban pediatric hospital in the southeastern region of the United States, Pediatric Intensive Care Unit nurse practitioners (NPs) had difficulty transitioning to practice. Identified NP transition to practice barriers were arduous clinical reasoning and ineffective communication. Transition to practice barriers impact patient outcomes and healthcare cost due to patient care errors, delays in care, and NP turnover from poor practice perceptions. The goal of the Doctor of Nursing Practice project was to examine whether the Provider Bull’s-Eye Tool (PBT), a tool to guide clinical reasoning and communication for NPs, would decrease time to diagnosis and intervention selection, while simultaneously improving communication and perceptions of practice confidence in new NPs.
Methods
The PBT was evaluated using a two-group comparison. All pilot participants were volunteers, actively enrolled in a NP program or had less than or equal to two years NP experience. Project participants, N=17, were randomly divided into those who completed simulation in medicine education (SIM) evaluation prior to PBT education, and those who completed SIM evaluation post PBT education. During SIM, project participant time to diagnosis and interventions were documented using a validated checklist. After SIM, each participant verbalized a recorded handoff report to a transferring facility. Recorded handoff reports of both groups were analyzed for communication enhancements from PBT training. Once both groups concluded all project components, a Likert survey evaluating perception of practice confidence after PBT training was completed.
Results
The PBT trained group was observed to be marginally slower during SIMS due to increased cognitive processing; however, they were more likely than the non-PBT group to diagnose and intervene appropriately in several areas. The PBT group also had more effective communication patterns during handoff reports than the non-PBT group. Further, PBT training increased perception of practice confidence in both groups.
Conclusion
Based on findings, the PBT is a promising tool that has the capacity to enhance NP clinical reasoning while simultaneously promoting effective handoff communication. Improving these skills increased perceptions of practice confidence. Combined, these improvements could result in decreased healthcare cost by reducing patient errors, delays, and NP turnover
Caregivers experiences in symptom management for their children who require medical technology at home
No full textA Strategic Planning Tool for Increasing African American Blood Donation
No full text Historically, African Americans (AAs) have been underrepresented as blood donors. Having a lack of racially diverse blood donors contributes to transfusion complications, particularly in patients with sickle cell disease, who are both disproportionately AA and the recipients of frequent transfusions. Increasing AA blood donation is a complex public health issue. This review article serves to fill a gap in translating research regarding known hindrances and facilitators of AA blood donation to improve real-world donation practice and ultimately, patient outcomes. We incorporate findings from a literature review to develop a tool that blood centers, provider organizations, and patient advocacy groups can use to aid strategic planning efforts aimed at increasing AA blood donation. </jats:p
Reducing Pregnancy Risk by Motivation Overweigth and Obese Women to Make Preconception Changes to Diet and Physical Activity Behavior: A Pilot Study
Get PDFOverweight and obese women who lose weight prior to pregnancy have fewer pregnancy complications than those who do not (Forsum, Brantsaeter, Olafsdottir, Olsen, & Thorsdottir, 2013; Schummers, Hutcheon, Bodnar, Lieverman, & Himes, 2015). Research findings suggest there are missed opportunities to provide diet and physical activity counseling during preventive care visits. Providers cite a lack of time and resources as barriers (Morgan et al., 2006; Yamamoto et al., 2014).
This was a two-group, randomized, pilot-study of 19 overweight or obese women in Central Georgia. Participants completed surveys related to their perception of risk for obesity-related pregnancy complications, readiness to change nutrition and physical activity behaviors, nutrition and physical activity self-efficacy, actual physical activity, and dietary history at baseline, after completion of the study, and at follow-up. Those in the intervention group participated in one face-to-face meeting, reviewed eight online education modules, and received weekly booster messages. The control group participated in a similar protocol; however, information was limited to general women’s health topics.
Nineteen women (intervention = 11, control = 8) completed all instruments related to primary outcomes—perception of risk, readiness to change, and self-efficacy. The average age of participants was 28.7 years (SD = 6.35). The average body mass index was 36.54 kg/m2 (SD = 5.52). Women were predominately Caucasian (68.4%) and married (52.6%) with children (57.9%). Most had a college degree (42.1%) or higher (15.8%), and a yearly income between 75,000 (42.1%). Evaluation of completion data, resources, and intervention management indicated that the intervention may be feasible during preventative care visits. Participant responses to exit interview questions demonstrated the intervention may be acceptable for women of childbearing age. Effect sizes ranged from small (ƞp2= .00, p = .88) to large (ƞp2= .27, p = .08) indicating the intervention may be effective in an adequately powered sample.
Future research should focus on the further development and implementation of programs that assist with pre-conception weight loss. Providing women with information regarding the complications associated with being overweight and obese, as well as the information or tools necessary to reduce weight prior to pregnancy, may be instrumental for improving short and long-term pregnancy outcomes for both mothers and their offspring
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