Provision of complete and responsive solution to healthcare services requires a multi-tired health delivery system. One of the aspects of healthcare hierarchy is the need for nursing care of the patient. Nursing care and observation provide basis for nurses to communicate with other aspects of healthcare system. The ability of capturing and managing nursing practice is essential to the quality of human care. The thesis proposes knowledge based decision making and analyzing system for the nurses to capture and manage the nursing practice. Moreover it allows them to monitor nursing care quality, as well as to test an aspect of an electronic healthcare record for recording and reporting nursing practice. The framework used for this system is based on nursing theory and is coupled with the quantitative analysis of qualitative data. It allows us to quantify the qualitative raw natural nursing language data. The results are summarized in the graph that shows the relative importance of those attributes with respect to each other at different instances of nurse-patient encounter. Research has been conducted by the Department of Computer and Electrical Engineering and Computer Science for the College of Nursing. / by Shubhang Tripathi. / Thesis (M.S.C.S.)--Florida Atlantic University, 2010. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2010. Mode of access: World Wide Web.

Patients who are hospitalized and are without voice would like to participate in their care. This requires clear communication. Speak for Myself™ (SFM) was developed for use at the bedside so that communication may be facilitated between patient and nurse when the patient is voiceless. The objective of this study was to evaluate Speak for Myself™ at the bedside and to measure the outcomes. This was a mixed methods, one group pre-test-post-test, quasi-experimental study. Twenty adult patients in three hospitals in South Florida agreed to use Speak for Myself™ during their acute care hospital stay (M = 8.86 hours). This group of participants (n = 20) ranged from 45 to 91 years old (males = 14; females = 6). Of the participants, 15 (75%) self-identified as European American, 2 (10%) self-identified as Hispanic, 2 (10%) self-identified as African American, and 1 (5%) self-identified as Asian. Ten of the participants (50%) were in respiratory failure. Two (10%) were receiving oxygenation measures related to unspecified complications of their illnesses. Of the remaining eight participants (40%), one each was receiving oxygenation measures due to atrial fibrillation, arteriosclerotic heart disease, cardiogenic shock, endocarditis, neck abscess, renal failure, status post seizure activity, and tongue metastasis. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

Indiana University-Purdue University Indianapolis (IUPUI) / Parents have increasingly participated in their children’s bedside care. Parental participation has led to more provider-parent interactions and communication during such stressful events. Helping parents through such stressful events requires nurses to be skilled communicators. Brief methods of training emotion-focused communication with newly licensed nurses are needed, but as yet are rare. The purpose of this study was to evaluate the impact of a validated brief communication (Four Habits Model) training program for newly licensed pediatric nurses. The intervention focused on ways to improve nurses’ emotion-focused conversations with parents. Information processing and Benner’s novice to expert informed this study. The intervention is based on the four habits model, with “habits” providing a structure for nurses to organize their thinking and behavior during emotion-focused conversations with parents. Thirty-five pediatric nurses with 0–24 months of nursing experience at a large mid-western children’s hospital participated in the study. Mixed methods provided data for this experimental study, using a group-by-trials repeated measures ANOVA design. Participants randomized to the intervention group participated in a one-hour three-part training: adapted four habits model content, simulated nurse-parent communication activity, and debrief. Participants randomized to the control group observed a one-hour travel video. Key outcome variables were Preparation, Communication Skills, Relationships, Confidence, Anxiety, and Total Preparation. Compared with the controls, the intervention group improved significantly in the following areas: Preparation, F(1,33) = 28.833, p < .001; Communication Skills, F(1,33) = 9.726, p = .004; Relationships, F(1,33) = 8.337, p = .007; Confidence, F(1,33) = 36.097, p < .001; and Total Preparation, F(1,33) = 47.610, p < .001. Nurses’ experience level had no effect, with the exception of Anxiety. Nurses with more experience (≥ 12 m) showed a greater reduction in Anxiety, when compared to nurses with less experience (< 12 m), F(1,31) = 5.733, p = .023. Fifty-two percent of the nurses involved in the intervention later reported specific examples of implementing the four habits when working with parents in clinical settings. A one-hour four habits communication-training program is effective in improving newly licensed nurses’ preparation for emotion-focused conversations with parents.

Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

Indiana University-Purdue University Indianapolis (IUPUI) / Evidence based practice (EBP) is essential to the practice of nursing for purposes of promoting optimal patient outcomes. Research suggests that the implementation of EBP by staff nurses is problematic and influenced by beliefs, nursing leadership and the work environment. The purpose of this descriptive study was to examine variables that describe the relationship among beliefs about EBP, the work environment and nursing leadership on the EBP implementation activities of the staff nurse. The variables of interest were 1) individual staff nurse characteristics, 2) beliefs about EBP, 3) the EBP work environment and 4) nursing leadership for EBP. A descriptive, quantitative method was used. A sample of 422 Registered Nurses from two urban hospitals (one Magnet and one non-Magnet) completed an online 58 item survey that included questions related to individual belief’s about EBP, the EBP work environment and nursing leadership for EBP as well as EBP implementation activities. Education, tenure and Magnet status were not significantly related to EBP implementation activities in either the univariate or multivariate analysis. EBP beliefs had a significantly positive relationship with EBP implementation activities in both the univariate and multivariate analyses. Work environment and nursing leadership support for EBP had significant positive relationships with self-reported implementation activities in only the univariate analysis. The most surprising finding was that there were no differences between Magnet and non-Magnet work environments for EBP implementation scores, yet the Magnet hospitals reported higher means on the EBP Beliefs Scale than the non-Magnet hospital. The results of this have implications for identifying and testing strategies to influence EBP implementation activities through development of nursing leadership skills for EBP and creating a more EBP friendly work environment.

Indiana University-Purdue University Indianapolis (IUPUI) / Factor H is a newly identified phenomenon which describes a constellation of attributes of the new graduate nurse reflecting personality traits, intellectual abilities, and clinical judgment. In a previous pilot study conducted by this researcher nurse managers and experienced Registered Nurse (RN) preceptors described characteristics demonstrated by new graduate nurses demonstrating Factor H and the new graduate nurse’s ability to transition quickly and successfully into the RN role in the acute care environment. There is currently no instrument available to measure this phenomenon. The specific aim of this research was to develop and psychometrically test a scale designed to identify the presence of attributes of Factor H in the new graduate nurse. The Sims Factor H Assessment Scale (SFHAS) was developed and piloted with a sample of one hundred one new graduate nurses within three months of completing the their nursing program at one of three nursing schools in central and south central Indiana. Evidence of content validity was demonstrated through the use of the Content Validity Index conducted with a panel of four experts. Evidence of face validity was demonstrated through interviews with a group of new graduate nurses, nurse managers, and experienced RN preceptors. Principle Axis Factoring with Varimax rotation was used to demonstrate evidence of construct validity and the scale was found to have a single component which was identified as nursing personality. Evidence of criterion-related validity was demonstrated utilizing analysis of the SFHAS and the criterion scale for personality traits (NEO-FFI). Evidence of internal consistency reliability was demonstrated through analysis of inter-item correlations, Cronbach’s coefficient correlations, and item-total correlations. Test re-test reliability using interclass correlation was also conducted to demonstrate stability of the scale. The SFHAS was found to be reflective of nursing personality and not general mental ability or clinical judgment. Use of the SFHAS will allow organizations to evaluate the nursing personality of the new graduate nurse for fit into the work environment. Further study is recommended to gain clarity around the attributes which support successful transition of the new graduate nurse into practice in the acute care environment, also known as Factor H.

The purpose of the study was to explore and describe the existing relationship between traditional healers and nurse practitioners in Maseru Health Service Area in Lesotho and also to determine why people consult traditional healers. Qualitative and quantitative methods were used to investigate the relationship between traditional healers and nurse practitioners and also to determine why people utilize the services of traditional healers. The study was limited to Maseru Health Service Area in Lesotho. Data was collected from twenty-seven (27) nurses from nineteen (19) clinics and from thirty (30) traditional healers from the same health service area. Data from traditional healers was collected using semi-structured interviews while nurse practitioners were given a questionnaire to complete. The study revealed that there was no formal relationship between traditional healers and nurse practitioners. Support for traditional healers was revealed to be limited, for example, only four (14.8%) nurses had a programme for traditional healers while twenty ( 66.7%) traditional healers did not have any contact with nurse practitioners. Involvement of traditional healers in primary health care at grassroots level has therefore been very minimal. The reasons why people utilize traditional healers were found to be as follows: • When people think they have been bewitched. • Traditional healers can tell the actual cause of disease • Failure of modern practice • For social problems According to the study, both traditional healers and nurse practitioners felt that collaboration between traditional healers and nurse practitioners was essential because it would enable planned referral of patients from one group to another where necessary; it would also facilitate exchange of ideas and knowledge for the benefit of the people served. Recommendations on collaboration and on support systems are given in Chapter Six. / Health Studies / D. Litt. et Phil. (Nursing Science)

The purpose of the study was to explore and describe the existing relationship between traditional healers and nurse practitioners in Maseru Health Service Area in Lesotho and also to determine why people consult traditional healers. Qualitative and quantitative methods were used to investigate the relationship between traditional healers and nurse practitioners and also to determine why people utilize the services of traditional healers. The study was limited to Maseru Health Service Area in Lesotho. Data was collected from twenty-seven (27) nurses from nineteen (19) clinics and from thirty (30) traditional healers from the same health service area. Data from traditional healers was collected using semi-structured interviews while nurse practitioners were given a questionnaire to complete. The study revealed that there was no formal relationship between traditional healers and nurse practitioners. Support for traditional healers was revealed to be limited, for example, only four (14.8%) nurses had a programme for traditional healers while twenty ( 66.7%) traditional healers did not have any contact with nurse practitioners. Involvement of traditional healers in primary health care at grassroots level has therefore been very minimal. The reasons why people utilize traditional healers were found to be as follows: • When people think they have been bewitched. • Traditional healers can tell the actual cause of disease • Failure of modern practice • For social problems According to the study, both traditional healers and nurse practitioners felt that collaboration between traditional healers and nurse practitioners was essential because it would enable planned referral of patients from one group to another where necessary; it would also facilitate exchange of ideas and knowledge for the benefit of the people served. Recommendations on collaboration and on support systems are given in Chapter Six. / Health Studies / D. Litt. et Phil. (Nursing Science)

Indiana University-Purdue University Indianapolis (IUPUI) / Nurse-physician collaboration has received much attention over the past decade in the USA. The release of three reports from the Institute of Medicine implicated poor communication and collaboration among nurses and physicians as a major contributing factor to the incidence of sentinel events and medical errors. Despite the growing awareness of the imperative related to collaboration between nurses and physicians to ensure patient safety, the problem of poor nurse-physician collaboration remains endemic throughout the country. Indian nurses, along with many other internationally educated nurses, comprise 12-15.2% of the nursing workforce in the USA. Little is known about how Indian nurses culture potentially influences their ability to effectively collaborate with physicians to ensure patient safety. The purpose of this study is to understand Indian nurses’ attitudes and perceptions about nurse-physician collaboration. Hermeneutic interpretive phenomenology as influenced by the work of Martin Heidegger guided this study through the use of interviews via Skype. The overall experience of the Indian nurses was of one experiencing a dramatic positive change in nurse-physician collaboration in the USA as compared to India. Four themes emerged describing this phenomenon: Respect/feeling heard, Being Trusted, Assurance of Accountability, and Finding Freedom. Indian nurses practicing in the USA find a freedom that empowers them to collaborate with physicians for patient safety. They, as all nurses may, benefit from continuing educational opportunities that demonstrate ways to collaborate more fully.