Barbara Krainovich Miller

Abstract

Background. Quality patient care requires collaboration among health professionals. In 2016, 250,000 U.S. citizens died from preventable medical errors. One individual does not cause such errors. Researchers cite a lack of nurse–physician collaboration (NPC) as a contributing factor. Method. Streubert’s phenomeno-logical design guided this study. A rigorous analysis of eight nurse interviews was conducted and reached data saturation. Results. A developed formalized “ex-haustive description” of nurses’ lived experiences with NPC was validated by all nurse participants. One new finding was that nurses had difficulty initiating NPC for their patients early in their career and this remained an issue at times. Conclusion. This is the first U.S. qualitative study in which nurses described their positive and negative experiences with NPC and their desire to improve NPC for enhanced patient outcomes. Implications for nurse educator specialists, hospital adminis-trators, and researchers were derived.

Abstract

Background: Between 45% and 94% of registered nurses (RNs) experience verbal abuse, which is associated with physical and psychological harm. Although several studies examined predictors of RNs’ verbal abuse, none examined predictors of RNs’ experiences of verbal abuse by RN colleagues. Purpose: To examine individual, workplace, dispositional, contextual, and interpersonal predictors of RNs’ reported experiences of verbal abuse from RN colleagues. Methods: In this secondary analysis, a cross-sectional design with multiple linear regression analysis was used to examine the effect of 23 predictors on verbal abuse by RN colleagues in a sample of 1,208 early career RNs. Finding: Selected variables in the empirical intragroup conflict model explained 23.8% of variance in RNs’ experiences of verbal abuse by RN colleagues. Conclusion: A number of previously unstudied factors were identified that organizational leaders can monitor and develop or modify policies to prevent early career RNs’ experiences of verbal abuse by RN colleagues.

Abstract

BACKGROUND: Early childhood dental caries (dental cavities) is an infectious process. The development of oral problems during cancer care results in pain, fever, and delay in treatment. OBJECTIVES:The objective of this project was to integrate preventive oral care into pediatric oncology care. METHODS: This project consisted of an educational program for pediatric oncology providers who completed pre- and postprogram surveys assessing oral health knowledge, attitudes, and practice; attended an oral health education session; and performed oral assessment and fluoride varnish application on children during cancer treatment. FINDINGS: Three major outcomes resulted from this project: (a) 15 nondental healthcare providers attended the education session and 11 became certified by the American Academy of Pediatrics, (b) 53 pediatric patients with cancer received an oral assessment and fluoride varnish during the two-month project, and (c) oral health assessment and fluoride varnish was instituted as a standard of care.

Abstract

Oral health is crucial to overall health. Because of normal physiologic changes, pregnancy is a time of particular vulnerability in terms of oral health. Pregnant women and their providers need more knowledge about the many changes that occur in the oral cavity during pregnancy. In this article we describe the importance of the recognition, prevention, and treatment of oral health problems in pregnant women. We offer educational strategies that integrate interprofessional oral health competencies.

Abstract

Background. Overweight and obesity have become a global epidemic. The prevalence of overweight and obesity among U.S. adolescents has almost tripled in the last 30 years. Results from recent systematic reviews demonstrate that no single, particular intervention or strategy successfully assists overweight or obese adolescents in losing weight. An understanding of factors that influence healthy weight-loss behaviors among overweight and obese female adolescents promotes effective, multi-component weight-loss interventions. There is limited evidence demonstrating associations between demographic variables, body-mass index, and weight perception among female adolescents trying to lose weight. There is also a lack of previous studies examining the association of the accuracy of female adolescents' weight perception with their efforts to lose weight. This study, therefore, examined the associations of body-mass index, weight perception, and weight-perception accuracy with trying to lose weight and engaging in exercise as a weight-loss method among a representative sample of U.S. female adolescents. Methods. A nonexperimental, descriptive, comparative secondary analysis design was conducted using data from Wave II (1996) of the National Longitudinal Study of Adolescent Health (Add Health). Data representative of U.S. female adolescents (N = 2216) were analyzed using STATA statistical software. Descriptive statistics and survey weight logistic regression were performed to determine if demographic and independent (body-mass index, weight perception, and weight perception accuracy) variables were associated with trying to lose weight and engaging in exercise as a weight-loss method. Results. Age, Black or African American race, body-mass index, weight perception, and weight perceptions accuracy were consistently associated with the likeliness of trying to lose weight among U.S. female adolescents. Age, body-mass index, weight perception, and weight-perception accuracy were positively associated (p < 0.05) with trying to lose weight. Black/African American subjects were significantly less likely than their White counterparts to be trying to lose weight. There was no association between demographic or independent variables and engaging in exercise as a weight-loss method. Conclusions. Findings suggest that factors influencing weight-loss efforts, including age, race, body-mass index, weight perception, and weight-perception accuracy, should be incorporated into existing or new multi-component weight-loss interventions for U.S. adolescent females in order to help reduce the national epidemic of overweight and obesity among U.S. female adolescents.

Abstract

The TREAD

Abstract

This pilot study was designed to measure nursing students’ level of cultural awareness. It replicated phase II of Rew, Becker, Cookston, Khosropour, & Martinez's (2003) methodological study that developed and tested a Cultural Awareness Scale (CAS). Using a cross-sectional design, the CAS was distributed to nursing students in three nursing programs’ (bachelor's, master's, doctoral) beginning and end courses. Cronbach's alpha for the CAS Total instrument was 0.869, with subscale scores ranging from 0.687 to 0.902, comparable to the findings of Rew et al. Given the limitations of this study, results must be viewed with a degree of caution. Recommendations include further educational research in the form of psychometric testing of the CAS among nursing students, including refinement of both the CAS instrument and the demographic tool. The authors also recommend that studies be conducted to determine the validity and reliability of the CAS with nurses in the health care arena.

Abstract

PURPOSE: To propose an evidence-based model (EBM) to improve diagnostic accuracy in nursing. DATA SOURCES: Published literature, experience, and expertise of authors. DATA SYNTHESIS: Using an EBM directs clinicians on how to use the best available evidence from the literature to determine the best fit between cues and diagnoses, integrate this evidence with clinician expertise and patient preferences, and conduct a self-evaluation of the process. CONCLUSIONS: Use of an EBM to teach nurses how to ask relevant diagnostic questions and provide a framework for nurse educators to teach evidenced-based practice may lead to developing more competent diagnosticians and improving diagnostic accuracy in nursing.

Abstract

As advanced practice psychiatric-mental health nursing has transitioned from earlier models of practice, elements of clinical specialist and psychiatric nurse practitioner roles are being blended to produce a new type of practitioner. The challenge of preserving mental health expertise while expanding advanced practice primary and primary mental health care competencies is addressed in several nursing education models. At New York University's Division of Nursing, faculty have designed a program around elements identified as essential to the autonomy demanded of the evolving role, knowledge, and skills basic to broad based health care and mental health care delivery with quality patient care outcomes and the competencies necessary for accountability as care providers in a changing health care delivery system. Essential elements, resources to identify them, and strategies to attain them are discussed. Approaches that promote student, clinician, and faculty development and maximize education affirm the specialty's capacity for innovation and the profession's capacity for new direction and futuristic change.