<p> Catheter-associated urinary tract infections (CAUTIs) contribute to increased patient length of stay and health care costs. The literature has shown that one plausible cause of CAUTIs is improper Foley catheter insertion techniques among nurses. The purpose of this project was to answer the project-focused question that asked if there was a difference in nurses&rsquo; practice skills following an educational intervention involving aseptic Foley insertion. Benner&rsquo;s novice-to-expert theory was the conceptual model for the study. Nurses from a college nursing program were asked to demonstrate Foley catheter insertion on a simulation model, and their technique was evaluated using a standardized checklist. Following the simulation demonstration, an educational intervention was conducted with ample opportunity for the nurses (n = 16) to practice catheter insertion. Following the practice opportunity, the nurses completed a 2nd return demonstration. Percentages of correct skills from the preintervention observation were compared with percentages of correct skills from the postintervention observation to determine the effectiveness of the education intervention in enhancing Foley catheter skills in an acute care setting. Results of a paired t test revealed a significant increase (p &lt; .01) in performance scores on the demonstrations after the intervention and catheter insertion techniques were taught. Hospitals and nursing education programs could implement simulation interventions to improve nurses&rsquo; Foley catheter insertion skills. This study has the potential to contribute to social change by providing evidence that simulation training can lead to improved competence and confidence with nursing skills.</p><p>

<p> The purpose of this study was to examine new graduate nurses (NGN) perceived comfort/confidence over time using the Casey-Fink Graduate Nurse Experience Survey (2006). This information may help reduce barriers to improving their comfort/confidence level and transition to professional practice. The purposive convenience sample consisted of 53 NGNs enrolled into a Dedicated Education Unit (DEU) in a large academic medical center from May 2015 through June 2016 with the last data collection in June 2017. </p><p> Data analysis revealed the perceived confidence level was the lowest at the start of employment and highest when leaving the DEU. The confidence level declined at the six-month data point and trended upward at twelve months. The NGN&rsquo;s confidence at the 12 month data point remained somewhat lower than at the three month data point when they completed the DEU. The most vulnerable time for NGNs is between six and twelve months. The findings are consistent with other studies predicting that NGNs require at least one year to become comfortable/confident in their professional role. In this study the demographics had no bearing on the comfort/confidence of the participants.</p><p>

<p> In the U. S. approximately 795,000 people experience a new or recurrent stroke yearly. Stroke survival has increased with advances in medical technology. The impact of stroke on a patient&rsquo;s neurological status poses critical challenges for nurses. Communication is one area impacted by stroke. Strokes affecting the brain&rsquo;s right hemisphere (RHS) have been described in the literature as negatively impacting communication behaviors of patients, often in a subtle manner. The purpose of this exploratory descriptive study was to examine the knowledge that RNs in North Carolina possess about communication impairments associated with RHS and how these nurses anticipate using knowledge gained about these impairments in the care of these patients. The study also explored perceived barriers and facilitators to participating in continuing education about RHS associated communication impairments. </p><p> The RHS Communication Impairment Knowledge Assessment tool assessed demographic variables, knowledge of RHS associated communication impairments, perceived barriers and facilitators to participating in continuing education about communication clusters associated with RHS, as well as how nurses anticipate using education about these impairments in caring for patients following RHS. The study setting was North Carolina. A purposive sample of North Carolina RNs was contacted through email; and a sample size of 2495 was recruited. The study was guided conceptually by Ajzen&rsquo;s theory of planned behavior. </p><p> Results indicated that a large percentage (78.2%) had received education about RHS associated communication impairments in their undergraduate nursing programs. The mean score on the 12-item knowledge assessment was 6.15 with less than 50% answering 3 specific application of knowledge questions correctly. The KR-20 for these 12 items was 0.532 which is an acceptable KR-20 for short tests (10&ndash;15 items). Cost of continuing education courses (23.5%), work responsibilities (32.9%), and family responsibilities (23.7%) were infrequently reported as barriers to participating in continuing education about these communication impairments while identified education need (87.1%), interest in learning (72.2%), providing better patient care (89.3%), improved decision making (87%), and increased competency (71.4%) were all frequently reported as facilitators to participating in RHS communication cluster continuing education. Three themes emerged regarding how RNs would use knowledge gained to change their patient care. These themes were: awareness of the need for education, improved nursing management of patients, including patient teaching and critical thinking, and better communication with survivors of RHS. The research contributed to the current body of nursing science by identifying knowledge gaps of NC RNs on RHS associated communication impairments, barriers and facilitators to participation in RHS continuing education, and intended changes in care based on continuing education.</p><p>

<p> Proper nutrition during early life is imperative for growth and development. Furthermore, infant growth is measured with CDC or WHO standards, as a static or change (longitudinal) outcome. There is a need to define optimal growth in relation to feeding practices, especially in diverse samples. The purpose of this study is to determine the association between infant feeding practices (breastfeeding, formula, mixed feeding (both formula and breastmilk) and complementary foods) in infants aged six months or less using the modified Infant Feeding Practices Study II (mIFPS II) questionnaire and indicators of growth (i.e. weight-for-age, weight-for-length and head circumference zscores/percentiles) in the same infants up to 12 months of age using WHO growth charts.</p><p> The validated mIFPS II questionnaire was administered to 247 caretakers of infants between 28 days and six months of age in a pediatric outpatient clinic located in Chicago, IL. At least two time points for growth data were collected for 149 of the 247 infants surveyed. We examined demographic correlates of infant feeding practices in relation to WHO growth indicators using chi-square and Kruskal Wallis tests with SPSS, version 23 (IBM, Chicago, IL). Weight status was categorized according to WHO growth chart standards using weight-for-length z-scores. Additionally, rapid weight gain was defined as a change in weight-for-age z-score of &ge;0.67 between birth and six months of age. Logistic regression using rapid weight gain was conducted with feeding practice as the predictor and additional demographic covariates.</p><p> The largest proportion of our 149 caretakers was African American (37%), with 46% having a college degree of above and 48% being enrolled in WIC. Of the infants, 32% were formula fed, 18% were breastfed, 25% were mixed fed and 25% were complementary fed. Feeding practices were associated with caretaker race-ethnicity, caretaker education level and WIC enrollment. Nearly 40% of infants demonstrated rapid weight gain by 6 months with weight gain being significantly less among exclusively breastfed infants as compared to mixed fed infants. Those who were complementary fed were almost five times more likely to have rapid weight gain than those breastfed exclusively.</p><p> Our findings suggest that various demographic correlates are associated with feeding practices. Exclusive breastfeeding may have a protective effect on obesity. However, more growth data are needed to adequately characterize correlates of infant growth perfoililance in this diverse sample. Accrual of caretaker/infant dyads are ongoing.</p><p>

<p> Although gout is the most prevalent form of inflammatory arthritis, its diagnosis can be complex. To meet the gold standard for diagnosis, providers need to perform a joint aspiration and identify the presence of monosodium urate crystals (MSU) in the synovial fluid or from tophi, a challenging skill in the primary care setting. In its absence, patients have to meet several criteria before a diagnosis can be made. Not surprisingly, gout has been inconsistently diagnosed by Primary Care Providers (PCPs). Thus in 2015, the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) worked collaboratively to develop a new set of clinical criteria for the diagnosis of gout. </p><p> For this Doctor of Nursing Practice (DNP) Capstone Project, a review of the literature was conducted using the Chronic Care Model (CCM) as a guide to examine the evidence regarding the use of clinical guidelines for the diagnosis of gout in the primary care setting. Using a pretest-posttest reflexive control design, chart abstraction was performed and, subsequently, an educational session was conducted to see if a short learning lunch would increase PCP knowledge and documentation in the medical record related to use of the 2015 ACR/EULAR diagnostic criteria. </p><p> A total of 36 PCPs from six different primary care settings participated. Chart abstraction revealed that only 31 out of the 54 charts (57%) had adequate documentation to support a diagnosis of gout. A statistically significant improvement in knowledge was demonstrated for several domains of the diagnostic criteria at the posttest. Results from this project indicated that a short learning lunch was effective for increasing PCP knowledge of the 2015 ACR/EULAR gout classification criteria. Through clinical support, easier access to updated evidence based clinical guidelines, and continuing education, PCPs acquired new knowledge and skills essential for providing evidence-based, quality care to their patients.</p><p>

<p> The purpose of this quantitative study was to evaluate the self-efficacy of novice nursing and allied health educators as it pertains to their overall desire to enhance their knowledge of educational instruction. Many nursing and allied health faculty transition from clinical practice to teaching with little to no formalized knowledge in education (Cangelosi, 2014; Gresham-Anderson, 2015). Bandura&rsquo;s (1977a) theory of social learning and self-efficacy was utilized as the theoretical framework for the study. This study was guided by four research questions used to investigate how the self-efficacy of nursing and allied health professionals changed as participants became more experienced educators, the types of learning opportunities the contributors participated in, and the supports and barriers novice educators faced when making the transition from being a practitioner to becoming a teacher. A survey was utilized to gain the data needed. A total of 202 surveys were sent to allied health personnel in higher education institutions in a Midwest state. The results were analyzed using descriptive statistics. In the findings, most of the survey respondents noted their self-efficacy was lower when entering the teaching field as compared to working in their designated allied health field. However, by participating in self-directed learning, professional development, and mentoring, the survey respondents noted self-efficacy increased as they became more skilled as instructors. Implications for practice included providing a formalized orientation process, investment in faculty development, as well as mentoring for novice teachers. Future research studies could gain a more comprehensive understanding of the barriers novice educators face when transitioning from clinical practice to academia and the steps taken to improve self-efficacy. </p><p>

<p> The purpose of this study was to analyze factors that predict marijuana use and grade point average among undergraduate college students using the Core Institute national database. The Core Alcohol and Drug Survey was used to collect data on students&rsquo; attitudes, beliefs, and experiences related to substance use in college. The sample used in this study was delimited to include only full-time undergraduate students (N =111,664) and data were collected from 2011 to 2015. Six research questions provided the foundation of the study, which was operationalized by Astin&rsquo;s (1993) input environment outcome model (IEO).</p><p> Descriptive analysis was conducted to describe the sample in terms of individual and institutional characteristics, campus experiences, and substance use. Comparative analyses including one-way analysis of variance and two-way analysis of variance were conducted to determine statistical significance of differences between groups for gender, ethnic origin, marijuana use, and grade point average. Effect sizes were calculated for each ANOVA to determine the magnitude of the effect and practical significance for the population. Finally, inferential analyses using hierarchical, multiple regression were conducted to predict marijuana use. The regression model was also used to explore factors predicting medical marijuana and recreational marijuana use among students in the 2015 cohort. Statistically significant results were reported for each regression model. Statistically significant at p &lt; .001, the factors that explained 42.2% of the variance in the final model included: gender, ethnic origin, age, institutional control, campus locale, intercollegiate athletics, social fraternities and sororities, music and performing arts, alcohol use, illegal drug use change, perceived risk of harm from trying marijuana once or twice, and perceived risk of harm from smoking marijuana regularly. Implications for policy, practice, and future research regarding marijuana use and academic performance are included.</p><p>

The purpose of this study was to investigate the effectiveness of dental students and dental hygiene students in their teaching of prevention. Forty new periodontal patients were randomly chosen and assigned to twenty second year hygiene students and twenty third year dental students. Three variables were investigated: (1) patients' knowledge of oral hygiene; (2) patients' practices of oral hygiene as assessed by a questionnaire administered before and after initial preventive treatment and again at a six-month recall appointment; and (3) patients' plaque index as recorded by students performing a visual check on oral cleanliness. In addition, the student's attitude toward his role as an educator was assessed by a questionnaire administered prior to any patient contact. The patients' responses were evaluated to determine any changes in knowledge and improvement in preventive habits over the six-month period. The plaque index was used to correlate the patient's actual oral hygiene with his reported oral hygiene practices. The results demonstrated that dental students and dental hygiene students were equally effective in the teaching of correct oral hygiene procedures. The teaching program itself was effective in that all patients showed a significant improvement in their oral health by the end of the study. The results of the student questionnaire showed that the hygienists did feel that the task of teaching was more important than did the dental students although both groups responded favourably in their attitudes toward teaching prevention. The plaque index at follow-up was most influenced by pre-test knowledge score and by habits at the conclusion of the initial treatment period. Such socio-economic characteristics as age and educational level had little influence on the adoption of correct oral hygiene practices. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Until the mid 1960's British Columbia was dependent upon outside sources for its dental manpower. With a significant increase in population and a similar increase in demand for dental care it became apparent that British Columbia could no longer rely on the goodwill of other universities for the training of the province's dentists. As a result of two detailed studies authored by Dr. John B. Macdonald, a Faculty of Dentistry was established at the University of British Columbia in 1962 and the first undergraduate class admitted in September 1964. After ten years in operation it seemed appropriate to examine the question as to whether or not the implementation of a graduate studies program in the Faculty of Dentistry was justified. In order to provide an in-depth perspective as to the present status of graduate dental education programs a survey questionnaire was sent to all ten dental schools in Canada. The questionnaire dealt with three separate aspects of graduate dental education, namely: 1. the preparation for practice of a clinical dental specialty; 2. the preparation for a teaching and/or research career; and 3. the continued improvement of the existing professional dentist through continuing dental education. Undergraduate dental programs supply manpower to provide for the public's need for regular and routine dental care, while graduate dental education can provide qualified personnel for research, teachers for dental education, as well as dental specialists requiring the advanced skills to meet the public's need for special dental services. Consequently, the aim of both the undergraduate and graduate dental education programs is to provide the knowledge, skill and manpower to meet the dental health care demands of the community. With the advent of prepaid dental care plans, coupled with the public's growing awareness that it is their right to enjoy good dental health, it is clear that the increasing demand for service cannot be met by the undergraduate dental programs alone. Graduate dental education is the beginning of a partial solution to the problem. An analysis of the collected data, taking into consideration the dental care delivery system as it now exists in Canada, has shown that: 1. If undergraduate enrollment in dentistry is to be increased, not only in British Columbia but also in Canada as a whole, it is essential to provide the advanced training needed for personnel to staff the dental schools; 2. more research workers are needed if the answers to the major problems in the field of dentistry are to be found; 3. more clinical specialists are required if the public is to be afforded the treatment necessary in specialty areas; 4. many Canadian dentists pursue their graduate training at American institutions even though there are Canadian programs and positions available within these programs; 5. over the past five years dentists in Canada have demonstrated an increasing interest in continuing dental education programs. If the profession of dentistry is to achieve its ultimate goal of effective and economic treatment of dental disease, then it is of paramount importance for both undergraduate and graduate dental education programs to begin to deliver the professionally equipped personnel needed in Canada. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

The purpose of this study was to obtain information regarding how people are affected by a diagnosis of genital warts/HPV. The psychosocial affects studied included emotional health, social and sexual relationships, feeling's about one's sexuality, safer sex practices and sexual behavior. 147 students (96 females and 51 males) completed the Symptom Check List 90-R (SCL-90-R) and a sexual history and demographic questionnaire. Participants were divided into three groups: students diagnosed with genital warts/HPV (HPV group), students diagnosed with a curable STD (curable group), and students with no diagnosed STD (No STD group). Thirteen students who were diagnosed with genital warts/HPV agreed to be interviewed, and each expressed recurring concerns about fear of transmission, rejection, frustration with the medical establishment and telling future partners. The qualitative findings from this study found that subjects who were older (more than 20-years-old), had more than 2 to 4 sexual partners in their lifetimes, had their first sexual intercourse at an early age (13 to 15-years-old) and only practiced safer sex "sometimes" were more likely to have been diagnosed with either genital warts/HPV or a curable STD than the No STD group. Subjects with genital warts/HPV were more likely to change their sexual behavior after a diagnosis by practicing safer sex "consistently". Some subjects reported that they had stopped being sexually active as a result of their diagnosis with genital warts/HPV. Analysis of variance was used to compare the sample means of the SCL-90-R sub-scales for the three sample groups. The most significant findings were demonstrated when subjects were evaluated by gender. The sub-scales of the curable and genital warts/HPV groups for women were both elevated. This may indicate that "curability" is not a factor affecting the psychological symptomatology of these groups. Based on these findings, the diagnosis of genital warts/HPV and a curable STD requires certain psychological assistance and patient education. People at high risk (those with multiple partners, early age at first intercourse, a history of STDs and alcohol abuse) need to be informed about genital warts/HPV, its prevalence, its virulent nature, and its medical complications. The psychosocial impact of any STD, curable or incurable, is of great importance in treating the person "systemically" to fully address all aspects of the disease.