Nursing, 2013
  • Cultivating the Seeds of Hope
    Rachel Breuning
    Mentor: Renda Ross, Sharon Stout-Shaffer, Michaele Barsnack, Dina Lentsner, Janette McDonald, Amy Oehlschlaeger, Deborah Shields, Andrea Thomas

    Hope manifests itself in innately personal, individual expressions with unique capacities for sustaining the human spirit (Bauman, 2004; Duggleby, 2010; Webb, 2007; Snyder, 2002). Focusing awareness on the highly contextual images, practices, and situations embodying hope for an individual can preserve and cultivate even greater hope (Yohani, 2008). This project’s purpose is to explore and synthesize personal symbols into a sculpture whose visual dynamics articulate my understanding of hope’s diverse elements identified in class literature. In creating the piece I discovered specific characteristics of hope I had not previously realized. This piece may catalyze internal dialogue for observers, illuminating their own reflections. Articulating what uniquely speaks of hope in their own lives may cultivate broadened awareness of hope’s multifaceted manifestations.

    The Effect of Unsaponifiables on Osteoarthritis
    William Burton, Jodi Finney, Amalie Rowland
    Mentor: Barbara Duane

    Osteoarthritis (OA) is a noninflammatory chronic joint disease most prevalent in middle-aged and elderly populations (Daly, 2012). A Cumulative Index to Nursing and Allied Health Literature (CINAHL) literature review was carried out to gain a better understanding of the benefits of avocado and soybean unsaponifiables (ASU) supplements in the management of osteoarthritis. A review of three major studies conducted regarding the use of ASU for the treatment of OA affecting hip and knee joints was carried out (Melbard, 2003). These studies determined that a 300mg daily dose of ASU reduced the requirements of non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil. An additional finding of these studies demonstrated that the use of ASU did not yield any additional side effects when compared to the placebo group (Ameye & Chee, 2006). The significance of these findings highlights the effectiveness of complementary alternative medicine for patients suffering from OA.

    The Effects of Exercise on Cancer Related Fatigue in Adult Patients
    Emily Clark, Kristen Duncan, Ashley Graves, Kristie Swisher
    Mentor: Deborah Janssen

    Fatigue is a significant problem for adult cancer patients. Not only does it decrease their quality of life, it decreases the number of positive treatment outcomes as well. The purpose of the integrated review was to determine if physical activity causes adult cancer patients to experience more or less fatigue. A literature review evaluating twelve research articles was used to develop matrices for data analysis. The results showed that a routine exercise program was beneficial in lessening fatigue, thus improving overall quality of life. Implications for nursing practice include exercise and ambulation to prevent muscle atrophy and increase the patients’ ability to perform activities for daily living. In addition, assessing range of motion during hospitalization allows nurses to develop and educate patients on safe and effective exercise programs. The nursing interventions should include motivation, support, and resources that individually match each patient’s needs and schedule.

    Music: A Beneficial Nursing Intervention for Pain Management
    Kristin Cobb, Holly Hunt, Rebekah Pickrell, Ann Northrup
    Mentor: Barbara Duane

    Pain can cause many negative consequences to a person’s psychological and physiological well-being. To provide holistic care concerning pain management, nurses need to be educated on the many effective means of pain control. The purpose of this poster is to explore the potential benefits of music therapy in regards to pain management in a variety of circumstances. Through a Cumulative Index to Nursing and Allied Health Literature (CINAHL) literature review, it is evident that music therapy aids in both acute and chronic pain reduction on a psychological and physiological level (Bauer et al., 2011; McCaffrey & Freeman, 2003). However, the effect of music on more severe pain is not as conclusive. While music therapy provides effective pain relief, its effectiveness declines at a certain pain level (Liu et al., 2010). Overall, music therapy is a viable intervention for pain control, and should be considered in nursing practice.

    A Blooming Infection
    Kara Conard, Laura Kashian, Kayla Kochensparger
    Mentor: Barbara T. Duane

    Invasive Aspergillosis (IA) is the most common invasive fungal infection in hospitals and it remains a significant complication for immunocompromised patients. A Cumulative Index to Nursing and Allied Health Literature (CINAHL) literature review was done to determine the risk posed by the incidence of IA in nosocomial (health care facility acquired) infections in this group of patients. Research showed potted plants and fresh flowers in a patient’s rooms will increase the patient’s risk of contracting the IA fungus and inhibit or complicate their healing process. Treatment of an invasive fungal infection requires powerful and expensive anti-fungal medications, which poses adverse complications of their own. Although research shows a low incidence of IA in patients, it is critical in risk management to decrease nosocomial factors within health care facilities. Appropriate reduction of risk factors increases quality of care and improves patient outcomes, the ultimate goal in nursing care.

    Focus Group on the Lived Experience of College Students of Siblings with Genetic Diseases
    Melanie DeArdo
    Mentor: Jill Kilanowski

    The purpose of this qualitative study is to gain a deeper understanding of the lived experience and needs among college students of siblings who have a genetic disease. A review of the literature showed limited research has been done examining siblings of children with genetic diseases, especially college-aged siblings. The growth and development of the college-aged student represents the theoretical framework. This is a cross-sectional pilot study with a phenomenological perspective. After a focus group was conducted in the library, ten Capital students who have living siblings with genetic diseases such as Cerebral Palsy, Muscular Dystrophy, Sickle Cell Anemia, Cystic Fibrosis, Down Syndrome, Trisomy 13, schizophrenia and bipolar disorder that requires multiple hospitalization were recruited. The focus group data were transcribed using the “long table approach,” following the methodology of Morgan and Krueger. Themes were identified. Findings will be used develop on-campus support programming, increase campus awareness, and identify ideas for helpful nursing interventions that would benefit siblings at all ages.

    Hopeful Thinking
    Andrea Green
    Mentor: Sharon Stout-Shaffer, Michaele Barsnack, Renda Ross, Deborah Shields

    The concept of hope, while extremely complex, can be portrayed in a multitude of different ways depending on one’s point of view; but at the same time, can bring people together as it creates a similar connection to people all over the world (Bauman). This art piece represents my discovery of hope through the study of different methods that involved interdisciplinary explanations of literature, art, music, interviews and more, relating to hope. The purpose of this project was to explore the essence of hope, and develop a personal definition of hope that can be useful to my nursing practice, and express this definition in an art form that can be appreciated by others. Now that I have developed an understanding, I think of hope as a way that brings people together in order to reach a goal in which a certain outcome can be fulfilled. I choose to use art as a way to show a different perspective that cannot always be expressed through words; rather, the words can only add an increased effect to the meaning of hope in which the art is displaying. This piece may be useful in the future to help me remain aware and reflect upon the meaning of hope in my future career as a nurse and to create a better relationship with those I care for.

    Aspiration Before Intramuscular Injection
    Sheila Green, Julia Capetillo, Nikki Jonard, Kelly Stark
    Mentor: Barbara Duane

    In 2006, the CDC advised that aspiration before intramuscular (IM) injection is not necessary because large blood vessels are not located in the two recommended areas on the body – the anterolateral area of the thigh and the deltoid muscle on the upper arm (CDC, 2006). The purpose of this study is to determine whether aspiration before an IM injection is considered best practice for nursing care. A literature review was conducted using the CINHAL and PubMed databases to examine journal articles and the 2006 CDC report. The findings suggest that original support for aspiration is outdated, and that current evidence does not warrant continuation of aspiration prior to IM injection. Aspiration is shown to prolong the procedure and cause unnecessary pain. In addition, evidence fails to show a relationship between failure to aspirate and compromised patient safety. This study examines when aspiration is appropriate and presents findings to help nurses determine whether or not it is considered best practice.

    Is Hand Sanitizing More Effective and Easier to Comply with than Hand Washing in the Clinical Setting?
    Zoe Kappelman, Emily McGonagle, Kimberly Hyatt Drew, Abilgail Heffalt
    Mentor: Barbara Duane

    In order to decrease transmission of nosocomial pathogens, attention is increasingly being focused on the hand hygiene of nurses and their compliance with hand cleansing routines. This literature review compares the compliance of hand washing versus hand sanitizing with an alcohol based disinfectant, to find which is more effective at reducing pathogens and which has a greater compliance rate. Data were sourced through computerized bibliographic databases such as CINAHL (Cumulative Index of Nursing and Allied Health Literature). Literature suggests that measuring compliance is difficult, but results in fewer health care associated infections. (“Hand washing: you must measure compliance,” 2007). It also shows that hand washing is more popular with nurses due to the misguided belief that it is less irritating to the skin, yet is actually much less effective than hand disinfection (Kampf et al., 2009). Compliance with hand sanitizing is more time efficient as it relates to the nurse’s overall workload, being that it is faster and dispensers are more readily available than sink basins. This information is significant and suggests further education is necessary to inform nurses about hand sanitizing compliance to reduce and prevent the spread of infection.

    The Use of Complementary Alternative Therapies in Pediatric Sickle Cell Disease
    Erin Keeth, Allison Neal, Brittany Straffen, Chelsie Ruby
    Mentor: David Shields

    Sickle cell disease is one of the most common genetically inherited, hematological disorders, especially among African Americans with one in three hundred and seventy-five affected. The need for interventions targeting disease management and increasing psychological functioning and coping is high (Oshikoya et al., 2008). The hallmark signs of sickle cell disease are pain crises that affect sleep and activities of daily living including academic performance and attendance (Lemanek et al., 2009). The purpose of the integrative review is to describe the effectiveness of complementary alternative therapies in pain management of pediatric patients with sickle cell disease, as well as to describe the usage rates of types of complementary alternative therapies in pain management of pediatric sickle cell disease. Findings suggest that complementary therapies would be effective in the pediatric population for pain management of sickle cell disease when coupled with pharmacological treatments.

    Views of Hope: Interviews Regarding Life Experiences
    Amelia MacKinnon
    Mentor: Sharon Stout-Shaffer, Deborah Shields, Renda Ross, Michaele Barsnack

    The human experience of hope is important to social workers and those they serve, and thus for the profession. However, literature definitions of hope can be confusing and there are many variations in how hope is used. This project determines the connection of hope to the idea of quality of life. The researcher is interviewing people of a variety of ages, and looking at their personal hope experiences to see if there is a connection of aging and quality of life to hope. The participants include a variety of ages ranging from single digits to elderly, with most participants being on the later end of the spectrum; both males and females respond. The interviews are conducted in person or over the phone, at the participant’s convenience. Data of personal hope experiences are analyzed using content analysis; the researcher maintains objectivity during both interview and analysis. Findings are compared to the current literature. This project contributes to the understanding of the experience of hope among people of different age groups. It also contributes to the researcher’s confidence and ability to talk about hope with people of different stages of life.

    Is Your Doctor Wrong about Coronary Artery Disease? A Second Look at Cholesterol, Carbohydrates and CAD Treatment
    Greg Maney, Maria Boyden, Brad Klamet
    Mentor: Barbara Duane

    Coronary Artery Disease (CAD) affects about 13 million people in the United States alone. The causes of CAD are well known and widely understood along with its treatments. This CINAHL and Academic Search Complete literature review was undertaken to reassess the accepted knowledge regarding this disease process and its most common treatments. Carbohydrate has been implicated in the development of CAD for its atherogenic potential and tendency to cause inflammation in vessel walls when consumed as a major component of diet. This literature review has found significant evidence to suggest that carbohydrates are the primary cause of atherosclerosis and that cholesterol is merely an inflammatory response. Statins, the most common pharmacologic treatment of CAD, have also come under scrutiny for both their effectiveness (Pillarisetti et al., 2004) and potential to have negative effects on nervous tissue (Hoyer, & Riederer, 2007). This research will be important for future development of treatment for patients with CAD and promote greater awareness and interest in preventative care, especially in the areas of diet and lifestyle management.

    Prevention of Medical Line Entanglements in Pediatric Homecare
    Alexandra Marinelli
    Mentor: Heather Janiszewski Goodin

    Unintentional injuries from medical line entanglements occur when lines become tangled, compressed, or looped around children’s body parts. The Medical Line (ML) Wrap can be placed on medical lines to prevent patient harm such as strangulation, impaired circulation, and tubing dislodgment. By implementing the ML Wrap, the researcher gained feedback regarding the effectiveness of this device and its ability to decrease the risk for injury in children. To describe parents’ experiences using a new device, the ML Wrap, to prevent medical line entanglements in children who receive homecare. Families identified with high risk patients (n = 7) participated in the study. During this time, they kept a journal and were interviewed for parental feedback. The data collected was descriptive and analyzed for common themes. Feedback obtained about the ML Wrap was positive. Parents said the ML Wrap helped with entanglement and one labeled it as a life saver. The implementation of the ML Wrap into homecare may decrease the risk of injury to children due to entanglement. This is relevant to nursing practice because many children receive health care in their homes and ensuring the safety of these patients is essential to nursing practice.

    Creative Expressions of Hope for Children in Bethlehem, Palestine
    Olivia McSpadden
    Mentor: Sharon Stout-Shaffer

    The human experience of hopelessness is common among children who are living with conflict and poverty regardless of demographics or culture. The hopelessness experienced by youth during devastating situations may be channeled into hope through creative activity. This project replicated an arts-based intervention methodology designed to work with refugee children (Yohani, 2008) to a population of children from Bethlehem, Palestine who is dealing with trauma associated with the current Israeli-Palestinian conflict. Literature and artistic activities were designed for use with students at Dar al-Kalima, a Lutheran-Muslim model school. Emphasis was given to activities that signify hope and gratitude and the development of community as children create connectedness among each other and with instructors. The material created will help children explore hope in their own perspective while encouraging them to ask people who they look up to for their definitions. The outcome of this intervention is that children are expected to expand their perspectives and open up channels for communication for stories and perspectives that go unheard in the current situation. The program serves as a first step in longer term curriculum development that will be implemented alongside The Kairos Palestine Document for a more consistent message of hope.

    The Benefits of Private Rooms in the Neonatal Intensive Care Unit
    Cassandra Mizer, Melanie DeArdo
    Mentor: Caitlin Beggs

    Many NICUs throughout the country are changing from the open baby design to a single family room design. By applying the information that has been acquired and the information that will be gathered on employees and parent satisfaction, feedback will be obtained as to which design is preferred, to distinguish the advantages and disadvantages between staff, neonatal, and parent experiences in an open bay NICU and a single family NICU design, it is important to provide the best care possible. To understand the differences in parent, staff, and neonatal experiences, we plan to perform a literature review of previous research and provide a survey for parents and staff. Feedback obtained suggested that the neonatal and parent experience was more positive in the single family NICU design. The reduction of light and sound, increased privacy, and one-on-one time with medical staff showed a better outcome. The results, however, were less significant in more critically ill neonates due to need for closer observation that can be provided in the open bay NICU. The contribution is to provide a unit that promotes family centered care.

    Treating Pressure Ulcers One Chicken Breast at a Time
    Shreya Patel, Doug Pelanda, Courtney Reuter, Rose Weston
    Mentor: Barbara Duane

    The National Pressure Ulcer Advisory Panel (NPUAP) endorses the application of nutritional assessment and treatment for clients at risk for and with pressure ulcers, despite the lack of support for this intervention by rigorous clinical trials (Ackley & Ludwig, 2011). A literature review was performed using the CINAHL Plus database to investigate whether current research demonstrates that nutritional interventions are beneficial in the treatment of pressure ulcers. New research shows that nutritional interventions (such as nutritional screening and increases in calorie and protein intake) do result in enhanced healing of pressure ulcers (Ohura et al., 2011). These clinical studies showed that nutrition screenings and interventions resulted in shorter hospital stays and decreased costs (Allen, 2010). More research needs to be conducted in this area to aid in the development of standardized guidelines for nutritional therapy in the treatment of pressure ulcers.

    Was Grandma Right About Chicken Soup?
    Kristen Powell, Kathryn McMillen, Lauren Tyler
    Mentor: Barbara Duane

    Every year, thousands of people suffer from the common cold. Although there is no known cure for a cold, there is no shortage of possible remedies; both pharmaceutical and homeopathic. As far back as the 12th century, physicians have been recommending chicken soup for cold symptoms (Rennard et al., 2000). In recent history, there has been a long standing practice of giving chicken soup to people who are ill. The purpose of this poster is to demonstrate the results of a CINAHL literature review carried out to determine whether chicken soup remedies cold symptoms or if it simply has a strong placebo effect. One historic study conducted at Nebraska Medical Center (Rennard et al., 2000) is compared to more recent investigations of the conclusions drawn by the original researchers. Overall, the literature demonstrates it is accepted that chicken soup is a comfort to people with colds, but it also has the ability to lessen the severity of symptoms from which they suffer.

    Reducing Mortality Rates for Premature Low-birth Weight Infants with Kangaroo Care
    Lisa Re
    Mentor: Jill Kilanowski

    Four million newborns die each year, 99% in developing countries with 28% deaths attributed to low birth weight (LBW) and prematurity. The adaption to extrauterine life presents physiologic challenges, especially for the premature LBW neonates. Some of these challenges include thermoregulation, quality sleep, and adequate breastfeeding. Many neonatal intensive care units (NICU) promote kangaroo care (KC) to support to neonates and promote maturation of these systems. KC is skin-to-skin contact between infant/parent. The purpose of the study was to conduct an integrated review of the literature to examine preterm LBW infants who do and do not receive KC in outcomes of breastfeeding status, thermoregulation, and sleep patterns. A computerized bibliography database search was conducted using keywords: KC, KC and thermoregulation, KC and temperature regulation, low-birth weight infants and KC, NICU, and sleeping patterns and KC in years 2002-2012. Twelve peer-review journals met this selection criterion. Findings show a positive correlation between KC and increased breastfeeding, temperature regulation, and increased quality sleep with ability to develop their body systems more efficiently. NICU nurses (with proper education) play an important role in educating and encouraging mothers to use KC, which can reduce the mortality rate substantially and increase neonate’s ability to thrive.

    Sweet Care for Chronic Wound Repair
    Amy Shaw, Jenn Reid, Yasmin Thurston
    Mentor: Barbara Duane

    Chronic wounds, which affect 6.5 million patients in the United States, are a burden that is growing rapidly due to increasing health care costs, an aging population, and a sharp rise in the incidence of diabetes and obesity (Gordillo et al., 2009). Honey is an ancient remedy that has been used in the treatment of chronic infected wounds and burns for centuries. The purpose of this Cinahl literature review was to determine if there was evidence that using honey is an effective treatment for chronic wounds. This remedy has recently been “rediscovered” by medical professionals because of its natural qualities and affordable price. There are now many published research reports describing the effectiveness of honey in clearing infection, minimizing scaring, and actively healing wounds (Fox, 2002). This literature review focuses on comparing honey with conventional treatments regarding the healing rates of chronic wounds. Seeking out effective and affordable treatments is an important part of providing exceptional care to a patient. Results support that there are clinical benefits from using honey in chronic wound care.

    CINAHL Literature Review of 3 Common Evidence Based Practices for Determining NG Tube Placement
    Vanessa Tran, Brittany Heunen, Lindsay Freedman
    Mentor: Barbara Duane

    Nasogastric intubation is a medical process that involves inserting a plastic tube (NG tube) through the nose, past the tongue, and through the esophagus to the stomach. The tube can be used for tube feeding, administering medications, and to suction contents out of the stomach. The main complication with tube placement is misplacement, especially if it diverts through the trachea into the upper lobe of a lung. Therefore, it is essential to use reliable methods to check correct tube placement. Proper placement can be ensured by: (1) injecting air through the tube while listening with a stethoscope for a gurgling sound as the air enters the stomach, (2) aspirating fluid with a large syringe and checking the contents with a pH strip as an acid result would indicate stomach contents, (3) and using an X-ray of the chest/abdomen to identify the placement of the tube by its radiopaque stripe on the side. A CINAHL literature review was carried out to evaluate the evidence based practice behind the 3 previously mentioned methods. This information will assist nurses utilize best evidence for their practice to avoid patient complications.

    The Importance of Parent-Nurse Interactions to Promote Pediatric Safety
    Jacinda Wright, Janet Jones, Kacee Boham, Caitlin Moore
    Mentor: Heather Janiszewski Goodin

    Safety is a high priority within the hospital; however, accidents continue to occur with nurses and guardians present. To describe the interactions and perceptions between parents and nurses with regards to pediatric patient safety. Eight research articles were analyzed from CINAHL and PubMed databases. Articles were selected from full text, scholarly peer reviewed journals published between 2007 and 2012. There was a direct correlation between pediatric patient falls and parental stress levels. Effective communication between parents and nurses, as well direct parental support, can decrease parental stress levels during their child’s hospitalization. Nurses are also more cognizant of patient safety when working separately from parents. To reduce accidental falls, there needs to be effective communication between parents and nurses along with education on fall reduction precautions. The use of patient and parent stress scales may be beneficial to help the nurse assess stress levels during hospitalization. Currently, adult-focused fall scales are being used but the use of appropriate pediatric patient fall scales are been investigated. Parent-nurse interactions regarding pediatric patient safety need further exploration in order to better understand parent and nurse expectations during hospitalization.